Addiction

In defining addiction, what does 'tolerance' specifically mean?

• ANeeding increasing amounts of a substance to achieve the same effect once obtained by a smaller dose✓
• BThe unpleasant physical and psychological symptoms felt when the substance is stopped
• CA strong desire or compulsion to take the substance
• DContinuing to use despite knowledge of harm

Answer: Tolerance is the reduced response to a drug with repeated use, so larger doses are needed for the original effect. The unpleasant symptoms on cessation describe withdrawal, the compulsion describes craving/dependence, and continued use despite harm is a separate diagnostic feature.

Which statement best distinguishes physical dependence from psychological dependence?

• APhysical dependence involves a compulsion to use for emotional reasons; psychological dependence produces bodily withdrawal symptoms
• BThey are identical terms with no real difference
• COnly illegal drugs can cause physical dependence
• DPhysical dependence is shown by a physiological withdrawal state when use stops; psychological dependence is a compulsive need to use for its perceived benefits✓

Answer: Physical dependence is indicated by a withdrawal syndrome (physiological symptoms) when the drug is removed, reflecting bodily adaptation. Psychological dependence is the compulsive desire to keep using because of the perceived emotional or psychological benefits. Option A reverses the two.

Twin and family studies are used to argue for a genetic vulnerability to addiction. Which finding would best support this claim?

• AConcordance for addiction is identical in monozygotic and dizygotic twins
• BConcordance for addiction is significantly higher in monozygotic than dizygotic twins✓
• CAdopted children always resemble their adoptive, not biological, parents in addiction risk
• DAddiction occurs only in people with no family history of it

Answer: If monozygotic (100% shared genes) twins show higher concordance than dizygotic (about 50% shared) twins reared in similar environments, this points to a genetic contribution. Equal concordance would suggest no genetic effect, and the other options contradict a heritability argument.

Which combination of risk factors for addiction is correctly identified by the AQA specification?

• ABlood type, eye colour, handedness, and height
• BGenetic vulnerability, stress, personality, and family/peer influences✓
• COnly genetic factors; environment plays no role
• DOnly peer pressure; biology plays no role

Answer: The specification lists genetic vulnerability, stress, personality (e.g. impulsivity/sensation-seeking), and family and peer influences as risk factors in the development of addiction. Addiction is multifactorial, so single-cause options and irrelevant physical traits are incorrect.

According to the neurochemical (dopamine) explanation, why is nicotine addictive?

• ANicotine blocks dopamine, reducing pleasure so users smoke more
• BNicotine destroys the nucleus accumbens, removing the ability to feel reward
• CNicotine acts only on serotonin, not dopamine
• DNicotine stimulates nicotinic acetylcholine receptors, increasing dopamine release in the mesolimbic reward pathway✓

Answer: Nicotine binds nicotinic acetylcholine receptors on dopaminergic neurons, boosting dopamine release in the mesolimbic reward pathway (e.g. ventral tegmental area to nucleus accumbens). This reinforcing surge of dopamine underlies the rewarding, addictive effect of smoking.

How does learning theory use operant conditioning to explain the maintenance of nicotine addiction?

• ASmoking is positively reinforced by pleasant effects and negatively reinforced by relief of withdrawal/craving✓
• BSmoking is punished by the body and therefore strengthened
• CSmoking becomes an unconditioned reflex present from birth
• DSmoking is maintained purely by genetic dopamine receptor density

Answer: Operant conditioning maintains smoking through both positive reinforcement (the pleasurable dopamine-driven effects) and negative reinforcement (smoking removes the aversive withdrawal symptoms and craving). This dual reinforcement strengthens the behaviour over time.

Which cognitive bias is central to the cognitive explanation of gambling addiction, in which gamblers overestimate their ability to influence chance outcomes?

• AThe 'just-world' belief
• BHostile attribution bias
• CThe fundamental attribution error
• DThe illusion of control✓

Answer: The illusion of control is a key cognitive distortion in gambling: players believe their skill, rituals or choices can influence outcomes that are actually random. Related distortions include the gambler's fallacy and near-miss effect. The other options are unrelated social-cognitive biases.

Why is a variable-ratio reinforcement schedule particularly important in explaining the persistence of gambling behaviour?

• AIt delivers a reward after every single bet, guaranteeing satisfaction
• BRewards arrive unpredictably after a varying number of responses, producing high, persistent response rates resistant to extinction✓
• CIt punishes the gambler at fixed intervals, increasing play
• DIt removes all reinforcement, which strengthens the habit

Answer: Gambling pays out on a variable-ratio schedule: wins occur after an unpredictable number of bets. Such schedules generate very high, steady rates of responding and are highly resistant to extinction, which helps explain why gambling persists despite frequent losses.

Aversion therapy as a behavioural intervention for addiction works by:

• AReinforcing the addictive behaviour with a pleasant stimulus
• BTeaching relaxation to replace cravings only
• CPairing the addictive behaviour with an unpleasant stimulus so it becomes associated with aversion (classical conditioning)✓
• DReplacing the drug with a chemically identical substitute

Answer: Aversion therapy uses classical conditioning to pair the addictive behaviour (e.g. drinking) with an unpleasant stimulus (such as a nausea-inducing drug like disulfiram, or imagined aversion in covert sensitisation), so the behaviour comes to elicit an aversive response. Drug substitution and relaxation are different approaches.

In Prochaska and DiClemente's six-stage (transtheoretical) model, a smoker who acknowledges they have a problem and intends to quit within the next six months, but has not yet committed to act, is in which stage?

• AContemplation✓
• BPrecontemplation
• CAction
• DMaintenance

Answer: In the transtheoretical model the six stages are precontemplation, contemplation, preparation, action, maintenance and termination. Contemplation is the stage where the person is aware of the problem and is thinking about changing within around six months but has not yet committed to a plan. Precontemplation involves no intention to change; action is active behaviour change.