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Several explanations (or "models") have been presented to explain addiction:
The moral model of addictions
- The moral model states that addictions are the result of human weakness, and are defects of character. Those who advance this model do not accept that there is any biological basis for addiction. They often have scant sympathy for people with serious addictions, believing either that a person with greater moral strength could have the force of will to break an addiction, or that the addict demonstrated a great moral failure in the first place by starting the addiction. The moral model is widely applied to dependency on illegal substances, perhaps purely for social or political reasons, but is no longer widely considered to have any therapeutic value. Elements of the moral model, especially a focus on individual choices, have found enduring roles in other approaches to the treatment of dependencies.
The temperance model of addiction
- The temperance model has some relationship with moral approaches. This perspective began with the prohibition movement in the late 19th century. The movement emphasized that the idea of moderation could not be relied upon as the key to treatment. Abstinence was asserted as the only alternative. The core assumption of the temperance movement was that the addictive and destructive power of the drug is strong and that it is the drug itself that is the problem. This leads to an emphasis in institutional and political solutions to the problem.
The opponent-process model of addictions
- The opponent-process model generated by Richard Soloman states that for every psychological event A will be followed by its opposite psychological event B. For example, the pleasure one experiences from heroin is followed by an opponent process of withdrawal, or the terror of jumping out of an airplane is rewarded with intense pleasure when the parachute opens. This model is related to the opponent process color theory. If you look at the color red then quickly look at a gray area you will see green. There are many examples of opponent processes in the nervous system including taste, motor movement, touch, vision, and hearing. Opponent-processes occurring at the sensory level may translate "down-stream" into addictive or habit-forming behavior.
The disease model of addictions
- The disease model holds that addiction is an illness, and comes about as a result of the impairment of healthy neurochemical or behavioral processes. While there is some dispute among clinicians as to the reliability of this model, it is widely employed in therapeutic settings. Most treatment approaches involve recognition that dependencies are behavioral dysfunctions, and thus involve some element of physical or mental disease.
The genetic model of addictions
- The genetic model posits a genetic predisposition to certain behaviors. It is frequently noted that certain addictions "run in the family," and while researchers continue to explore the extent of genetic influence, there is strong evidence that genetic predisposition is often a factor in dependency. Researchers have had difficulty assessing differences, however, between social causes of dependency learned in family settings and genetic factors related to heredity.
The personality model of addiction
- This characterological approach to addiction views chemical dependency as rooted in abnormalities of personality. It is argued that an "addictive personality" exists in some individuals and their traits of poor impulse control; low self-esteem; inability to cope with stress; egocentricity; manipulative traits; and a need for control and power, while feeling impotent and powerless all contribute to their addiction. As a consequence successful therapy is thought to require a substantial restructuring of the their personality.
- The social education model represents an integrative approach that borrows principles from classical and operant conditioning, where addiction is seen as a learned behavior stemming from cognitive processes, modeling influences and behavioral as well as genetic influences.
Social Education theorists place an emphasis on human-environment interactions as key to shaping addiction behavior. They stress, in particular, socialization processes, imitation of observable behavior, as well as the influence of modeling (role models) in both the forming of an behavior, but also in successful treatment.
The cultural model of addictions
- The cultural model recognizes that the influence of culture is a strong determinant of whether or not individuals fall prey to certain addictions. For example, alcoholism is rare among Saudi Arabians, where obtaining alcohol is difficult and using alcohol is prohibited. In North America, on the other hand, the incidence of gambling addictions soared in the last two decades of the 20th century, mirroring the growth of the gaming industry. Half of all patients diagnosed as alcoholic are born into families where alcohol is used heavily, suggesting that familiar influence, genetic factors, or more likely both, play a role in the development of addiction.
The blended model of addictions
- The blended model attempts to consider elements of all other models in developing a therapeutic approach to dependency. It holds that the mechanism of dependency is different for different individuals, and that each case must be considered on its own merits.