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DSM 5 SUD Criterion 10 Tolerance
Published in Joan Ifland, Marianne T. Marcus, Harry G. Preuss, Processed Food Addiction: Foundations, Assessment, and Recovery, 2017
The timing of dopamine releases shifts from responding to drugs themselves to responding to cues for the drugs. This shift allows previously neutral cues to activate the addiction. Cue reactivity strengthens with repeated exposure to newly associated cues and creates strong motivation to use the drug (Volkow et al., 2016).
The principles of behaviourist psychology
Published in Devinder Rana, Dominic Upton, Psychology for Nurses, 2013
The principles of classical conditioning can also in part explain why patients may find it difficult to change their current health behaviours when advised to do so. A nurse who acknowledges possible triggering factors and then addresses these with the patient will increase the chances of a care plan being put together that is individualised and hence more effective in facilitating behaviour change. Studies have shown that nicotine craving tends to occur on presentation of smoking-related stimuli, e.g. drinking in a pub (Payne et al., 1990) which results in an increased desire for a cigarette. This has been referred to as cue reactivity.
Controlled and Automatic Learning Processes in Addiction
Published in Hanna Pickard, Serge H. Ahmed, The Routledge Handbook of Philosophy and Science of Addiction, 2019
Wikler’s early account of cue reactivity argued that drug cues elicit conditioned withdrawal, which automatically primes drug-seeking to ameliorate this state. To quote: ‘abstinence distress . . . may be reactivated long after cure . . . providing an unconscious motivation to relapse’ (Wikler 1984, p. 280). Key support for this claim is that drug cues elicit conditioned withdrawal (O’Brien et al. 1977), and compensatory responses (Siegel et al. 1982), but the assumption that these CRs exert unconscious motivational influences has not been supported (see the section below on p. 332 on incentive learning and self-medication). Another complication was added by positive reinforcement theorists who found that drug cues could elicit dopamine and locomotor activity akin to the drug effect. This positive state arguably energises drug-related cognitions driving behaviour, i.e., an S–S account (Stewart et al. 1984). To quote: ‘Conditioned stimuli associated with these drugs arouse neural states that mimic features of those produced by the drugs themselves and thereby serve to increase . . . the probability of drug-related thoughts and actions’ (p. 251). Later studies found that physiological CRs are not consistently drug-like or drug-opposite and so do not distinguish withdrawal and positive reinforcement accounts (Carter and Tiffany 1999). By contrast, studies that have taken subjective measures reliably suggest that drug cues elicit positive emotional states and craving (Niaura et al. 1988) and that cue-elicited craving is the best predictor of cue-elicited drug consumption (Hogarth et al. 2010), again supporting a controlled S–S positive reinforcement account of cue reactivity.
When triggers become tigers: taming the autonomic nervous system via sensory support system modulation
Published in Journal of Social Work Practice in the Addictions, 2021
Holly C. Matto, Padmanabhan Seshaiyer, Stephanie Carmack, Nathalia Peixoto, Matthew Scherbel
Several theories of addiction, including the incentive salience sensitization theory (Berridge & Robinson, 2016) and stress surfeit disorder (Koob et al., 2014), suggest that drug cues hold motivational power through the reinforcement learning process, which can lead to relapse when triggered by the cues. Exteroceptive cues, those experienced by stimuli outside the body such as the sensory characteristics of the drug itself (visual, smells, tastes) or rituals used to obtain and consume the substance, can activate autonomic (physiological changes), attention, and motor activity and are hypothesized to lead to substance use (Cofresi et al., 2019). Such cues increase Heart Rate (HR) even when mental imagery is used as the cue-elicited task (Oberlin et al., 2018). Behavior (i.e., drug-seeking) is affected when exposed to cues, even when the cue was not followed by substance ingestion in the past; this can be referred to as drug cue reactivity (Cofresi et al., 2019). While there are many drug treatment options that attempt to address the psychological factors and the surrounding social environment influences that may lead to relapse, they still leave those with SUD vulnerable because they fail to effectively address or limit drug cue reactivity (Cofresi et al., 2019).
Does sleep affect alcohol-related attention bias?
Published in Journal of Substance Use, 2020
C. E. Brown, T. D. W. Wilcockson, J. Lunn
Attentional bias is the preferential processing of stimuli which has developed increased saliency e.g., alcohol-related stimuli for heavy alcohol drinkers (e.g., M. Field & Cox, 2008). Substance use is often associated with cue reactivity to substance-related stimuli, usually with signs of physiological arousal and subjective craving (Carter & Tiffany, 1999). These biases have been demonstrated to predict relapse in users abstaining and in substance-use treatment (e.g., Cox et al., 2002). Attentional biases have also been demonstrated to be heavily involved in substance use maintenance i.e. increased attentional biases are thought to lead to further substance seeking behavior (M. Field & Cox, 2008). Furthermore, attentional biases, once developed, have been observed to be stable (T. D. W. Wilcockson et al., 2019), difficult to inhibit (T. D. W. Wilcockson & Pothos, 2015) and context has also been found not to affect the expression of attentional biases (T. D. Wilcockson et al., 2019). Thus potentially demonstrating the robust (i.e. stable, strong, and intransient) nature of attentional biases.
Virtual treatment for veteran social anxiety disorder: A comparison of 360° video and 3D virtual reality
Published in Journal of Technology in Human Services, 2020
Erica E. Nason, Mark Trahan, Scott Smith, Vangelis Metsis, Katherine Selber
Another related approach, cue exposure therapy, has been used for addressing phobic anxiety disorders and obsessive-compulsive disorders. It uses classical conditioning principles to loosen the associations between cues in the environment and habitual anxiety responses (Marissen, Franken, Blanken, Brink, & Hendriks, 2007). One potential mechanism for implementing cue exposure therapy is to create virtual environments purposefully developed for cue reactivity (e.g., Rizzo et al., 2015). In fact, research on using virtual reality in mental health treatment have primarily focused on anxiety disorders and provide good evidence that virtual cue-based exposures is effective in reducing anxiety symptoms (Freeman, Reeve, Robinson, Ehlers, Clark, Spanlang, & Slater, 2017). Once anxiety is stimulated through exposure to the virtual environment, habituation by continual exposure increases tolerance to cues (Meyerbröker, & Emmelkamp, 2010). Additionally, coping skills may be taught in the intervention during exposure (Maples-Keller, Bunnell, Kim, & Rothbaum, 2017).