Substance Use Psychological Theories

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Substance use can be experimental or a one-off experience, for example, but the risk factors and vulnerabilities of some individuals developing a dependency, resulting in Substance Use Disorder (SUD), over another individual has varying influences and is multifaceted.

The DSM-V criteria for substance use disorders cover several criteria, including: 1) taking the substance in large amounts or for longer than you’re meant to, 2) Wanting to stop but not managing to, 3) Cravings and urges to use the substance, 4) Spending time recovering after using the substance, 5) using the substance again and again, when it puts you in danger.

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The pathway of SUD generally moves from experimentation to regular use and then to abuse dependency. Substance ‘use’ is the use a substance despite the fact that it has negative consequences, whereas substance ‘dependency’ is the continued use despite problematic consequences. Addiction is when the substance is needed to feel ‘normal’ or the need for the often temporary ‘high’ that the substance provides. The psychological dependency is when the individual has changed their lives to ensure continued use of the substance.

Research in SUD considers various theories in considering if it is a choice or are some people more predisposed to the experimental stages. Additionally, what are the perceptual factors in developing the actual dependency.

A distinguishing feature of addiction and dependency is that individuals continue with the substance and abuse or activity despite physical or psychological harm or detrimental consequences.

Research on the psychological reasons for substance experimentation and dependence considers biological, developmental, environmental, cognitive and psychological factors. West (2007) believed that it is rare for any single event or element to be responsible for the addictive pattern in behaviour. There are several psychological approaches to the explanation of SUD.

Biological Factors

Genetic influences include parental addiction that increases the risk of a child developing a substance dependency. Numerous twin studies have evidenced the increased biological risk of addiction. Additionally, there are other contributory factors in the biological theory such as personality traits and temperaments including impulsivity, thrill seeking tendencies and compulsivity. Cloninger’s (1987) specifies personality risks for substance abuse as anxiety, sensitivity, introversion-hopelessness, sensation seeking and impulsivity. Sensation seeking and low harm avoidance predict early-onset alcoholism (Cloninger et al., 1988). Eysenck (1997) implied that certain personality dimensions (psychoticism, extraversion and neuroticism) are prone to SUD as it fulfils a certain purpose for the individual. In contrast, there has been considerable research that suggests people who are moodier and more irritable (Francis, 1996) are more prone.

Substance use stimulates dopamine, the brains reward system and this plays a key role in classical conditioning. Pavlov’s (1897) study helps to show how a particular environment or stimuli, could provide individuals with a positive feeling or an association with a place that triggers repeated substance abuse. However, evidence has also shown that not everyone who tries substances become addicted (Lewis, 2011)

Environmental Factors

Putting genetics to one side, there is a history of drug or alcohol abuse in the family, it is more likely that the observer, particularly a child, would be affected with an increased potential to experience substance abuse first-hand. Problematic family environments could also be a predisposing factor.

Social and environmental factors promote addition (West, 2007) especially where there is a culture where the activity is regarded as normal or it helps form the peer groups social identity. If there is a social environment with reduced opportunities, then the ‘reward’ is the temporary high from the substance.

Cognitive Factors

The model of automaticity (Tiffany, 1990) was based on theory of habit formation in that substance abuse, in the experimental phase, is non-automatic and voluntary but eventually becomes habitual.

Stacy & Weir (2010) argue that there is an imbalance between controlled and automatic responses, so that substance use could be driven from either. The experimental is more controlled as a process, but the strength of the automatic response overrides that.

Brain injury and resulting control deficits can result in not being able to control impulsivities making the individual more predisposed to substance abuse if exposed to them, particularly with peer pressure. Additionally, long-term substance abuse can result in cognitive deficits and impulsive disinhibited behaviour – which in turn impact on a person’s ability to control and manage addictions.

Psychological Factors

Neglect and negative childhood experiences and sudden or long ranging traumatic experiences lead to the experimental phases of substance abuse. Often there is another psychopathology such as depression and mood disorders that heavily influence self-esteem. Seligman (1968) suggested that depression develops due beliefs that environmental beliefs can’t be controlled. Alcoholism often stems from the attempt to ‘relax’ but afterwards alcohol acts as a depressant – and the cycle begins.

Experimentation with substance abuse at a young age show that substance abuse can have a detrimental affect the developing brain. This makes it more likely that the young person will develop a problem with SUD later on in life.

It has been suggested that depression may also be considered as risk factor (Harker, 1991) and Stewart (1996) suggested an overlap between alcoholism and anxiety disorders. SUDs are highly comorbid with several other psychopathologies such as OCD, depression and schizophrenia.

There are a strong number of factors across all of the factors and theories discussed. Clearly, there have been a number of approaches and studies to explain why some people become more dependent. Each explanation can be supported by research and evidence. Genetics, personality, environmental factors and a degree of resilience all play multifaceted role in substance use disorders. 


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