Tuesday, January 1, 2013
Alcohol Addiction Theories
I appreciate the learning theory of conditioning, especially the operant type in alcohol addiction, although, without acknowledging the biological or genetic component that predisposes the individual to addiction I find the learning theory incomplete. In addition, I believe cultural, political, and environmental factors exist that are not explained fully by learning or the other theories. I do, however, believe that for individuals predisposed to alcoholism, operant conditioning explains the maintenance of alcoholism and the gradient response encourages the drinking behavior (Marks, Murray, Evans, & Estacio, 2011).
Although I support the theory of genetic predispositions, I agree with Marks et al., (2011) that environmental factors cause the predisposition to be expressed as alcoholism. These environmental factors can be any combination of cultural, psychological, and political influences that cause or contribute to alcoholism (Marks et al., 2011). Addiction takes place in layers or levels, so to speak, that are within and greater than the individual (Barber, 1994). Addiction may be more accurately perceived through a combination of theories, from a holistic perspective, acknowledging intrinsic and external or environmental contributors.
As an example of biological factors, Silveri, Rogowska, McCaffrey, and Yurgelun-Todd (2010) identified changes in the frontal lobe in adolescents at risk for alcohol abuse. Suissa (2003) discussed twins removed from biological parents and living with non-alcoholic adoptive parents still associated with the parents' alcoholism. Suggesting social factors influence alcohol addiction, Hemovich, Lac, and Crano (2011) found that adolescents from single-parent families had higher levels of alcohol abuse than their counterparts from two-parent households. In another example, parental monitoring and warmth were predictive for many of the choices adolescents made regarding alcohol abuse including the friendships they chose, their refusal strength, and their perceptions of normal drinking patterns (Hemovich, Lac, & Crano, 2011).
Barber (1994) claimed the scientific dissecting of alcoholism and dealing with one aspect at a time, such as the learned behavior aspect of addiction, does not help to understand the whole. Alcoholism and addiction may be better perceived by embracing its multiple factors as equally contributing. The social aspect of addiction is well known. As exampled by adolescents and young adults, peer pressure contributes to drug and alcohol abuse (Barber, 1994; Hawkins, Catalano, & Miller, 1992). Alcohol and drug abuse are serious culture-wide problems (Hawkins et al., 1992) that rarely take place in a socially devoid vacuum, wherein one individual, separate from a social context, becomes abusive of substances (Barber, 1994). Furthermore, individuals predisposed to alcoholism are more likely to maintain the behavior in chaotic or problematic circumstances, such as poverty, lack of resources, or abuse (Hawkins, Catalano, & Miller, 1992).
Although alcoholism and addiction may have definitive genetic and other biological components, these disordered states have psychological and social components as well (Barber, 1994). Rather than treating separate pieces of one problem, it may be effective to devise a theory that not only acknowledges individuals' genetic predisposition, but also their lifestyle, immediate environmental influences, community and social influences, and the cultural and political environment as well. Addiction is not accurately described by one paradigm, but must incorporate a more holistic approach. This is not to say that alcoholics' social, community, or other extrinsic environments are of greater consequence than their intrinsic problems, but that alcoholism may be more adequately perceived as one problem, but multi-factorial (Barber, 1994; Suissa, 2003). Ultimately, resolve for the issues of alcoholism are likely multiple and individual and one theory or treatment plan will not work for all alcoholics (Suissa, 2003).
Barber, J. G. (1994). Alcohol Addiction: Private Trouble or Social Issue? Social Service Review, 68(4), 521-535. doi: 10.1086/604082
Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64-105. doi: 10.1037/0033-2909.112.1.64
Hemovich, V., Lac, A., & Crano, W. D. (2011). Understanding early-onset drug and alcohol outcomes among youth: The role of family structure, social factors, and interpersonal perceptions of use. Psychology, Health & Medicine, 16(3), 249-267. doi:10.1080/13548506.2010.532560
Marks, D. F., Murray, M., Evans, B., & Estacio, E. V. (2011). Health Psychology: Theory, Research, and Practice (3rd ed.). London: Sage.
Silveri, M. M., Rogowska, J., McCaffrey, A., & Yurgelun-Todd, D. A. (2010). Adolescents At Risk for Alcohol Abuse Demonstrate Altered Frontal Lobe Activation During Stroop Performance. Alcoholism: Clinical and Experimental Research, No-No. doi: 10.1111/j.1530-0277.2010.01337.x
Suissa, A. J. (2003). Alcoholism as a Disease in North America: A Critical Social Analysis. Journal of Addictions Nursing, 14(4), 201-208. doi: 10.1080/jan.18.104.22.168