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Changing addictive behaviours is an arduous process for someone to go through. With how complicated human behaviour is, are there ways of reducing Addiction? According to aversion therapy, we can potentially tackle addictive behaviours through Behavioural Interventions, but how do we do this? And what are the merits of using aversion therapies over other treatment plans?
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Jetzt kostenlos anmeldenChanging addictive behaviours is an arduous process for someone to go through. With how complicated human behaviour is, are there ways of reducing Addiction? According to aversion therapy, we can potentially tackle addictive behaviours through Behavioural Interventions, but how do we do this? And what are the merits of using aversion therapies over other treatment plans?
Fig. 1 - Aversion therapy explores various ways to reduce Addiction.
Behavioural interventions are treatments based on behaviourism, which believes that we learn from our environment through operant and classical conditioning. Therefore, to treat issues such as addiction, one must unlearn addictive behaviours.
Behavioural interventions tackle addictive behaviours through the method mentioned above, such as aversion therapy and covert sensitisation. Aversion therapy and covert sensitisation involve exposure to an unpleasant stimulus associated with the addiction.
Aversion therapy is a behavioural intervention which states that stimuli frequently occurring together will become associated. Unpleasant stimuli are paired up with addictive behaviours.
Covert sensitisation differs in that the person imagines the unpleasant stimulus, unlike aversion therapy, where they are actually exposed to it.
Both interventions are carried out safely by professional psychologists in a therapeutic setting. Aversion therapy looks different depending on the type of addiction, but the general treatment principle is the same, using a process known as counter-conditioning.
For example, suppose substance addictions are learnt through the association of the drug and its pleasant effects.
In that case, addiction can be unlearned by replacing the pleasant stimuli with an unpleasant response, such as vomiting. Instead, a new, less pleasant association is made, creating an aversion to the original substance.
We will look more at aversion therapy used in reducing alcohol addiction next.
Aversion therapy is frequently used to treat alcoholism. In this process, professionals give the patient an emetic, a pill that causes severe nausea and vomiting. Having a strong alcoholic drink in a nauseous state causes vomiting.
An alternative is a disulfiram (e.g., Antabuse) drug. These drugs interfere with metabolising (breaking down) alcohol so that the patient experiences severe nausea and an instant hangover when they drink.
However, the risk of vomiting and nausea in social situations where alcohol is available is high. It could lead to embarrassment for the patient, raising ethical issues about using aversion therapy.
Antabuse and emetic drugs are also used in aversion therapy for reducing drug addictions.
Fig. 2 - Emetic pills cause nausea and vomiting.
There are other examples of devices (other than drugs) used to help reduce addiction in other addictions.
Aversion therapy devices can be used in everyday life and don't always relate to a particularly serious or life-debilitating addiction.
For example, gels or polishes that taste unpleasant are put onto fingernails to stop people from chewing them.
Here we will identify some aversion therapy devices used for gambling and nicotine addictions.
For behavioural addictions like gambling, aversion therapy uses external stimuli such as electric shocks. The shocks are strong enough to be painful but not harmful.
Barker and Miller (1966) reported how a man came to them to seek treatment for his Gambling Addiction. They recorded his habits in a gambling shop and then recorded his family in a separate video detailing the pains his gambling is putting them through.
Treatment can occur in different ways.
For example, treatment can involve writing down sentences related to the person's gambling behaviour on cards. The gambler reads the sentences aloud and is shocked for two seconds if the card is related to gambling.
The cards should also contain unrelated behaviours so that the player associates the gambling behaviour with the shocks. The intensity of the shock is chosen beforehand, which is done in a safe, therapeutic environment.
Rapid smoking can create an unpleasant stimulus associated with smoking that may help reduce smoking habits for those with Nicotine Addiction. Smoking rapidly causes nausea, dizziness, headaches, sore throat and increased heart rate.
Negative imagery (covert sensitisation) or a shock from snapping a rubber band when thinking of smoking are also aversion therapy devices that could be used to reduce Nicotine Addiction.
There are devices available to help people reduce cigarette smoking that isn't related to aversion therapy. They can, however, still have unpleasant side effects themselves, despite their purpose to reduce the unpleasant symptoms of nicotine withdrawal.
These include nicotine replacement therapy (that comes in the form of skin patches, gum, tablets, nasal or throat sprays), prescribed medication and e-cigarettes (vapours of which still contain nicotine but not carbon dioxide or tar, which is extremely harmful).
Fig. 3 - Aversion therapy and other devices can be used to reduce smoking.
The effectiveness of aversion therapy varies between the addictive behaviour and the individual themselves; due to individual differences, some people find some therapy more helpful than others.
For instance, research has found a high success rate of aversion therapy for treating alcohol use disorders. 69% of participants involved in a chemical-aversion study (using emetic drugs) were still sober 12 months after the investigation started (Elkins et al., 2017).
We will look at why some aversion therapy might not be so effective for reducing other addictions in our evaluation of aversion therapy next.
This section will look into the evaluation of aversion therapy as one of the common behavioural interventions.
Inflicting extreme nausea and vomiting on patients is ethically questionable. As we have previously discussed, using aversive drug treatments such as disulfiram could cause embarrassment and shame if someone experiences these symptoms in public. Even private aversion therapy with a therapist could harm and embarrass the patient.
In other forms of aversion therapy, such as treatment for Gambling Addiction, even the eventual addition of allowing patients to choose their shock level was a tokenistic gesture to address these ethical issues.
Because aversion therapy uses unpleasant or traumatising stimuli, it has a low adherence rate. In practice and research, knowing the effectiveness of aversion therapy is challenging. Those less likely to respond to the therapy often drop out of treatment early. Thus, the research could be overly optimistic.
Aversion therapy seems only to be effective in the short term.
Hajek and Stead (2001) reviewed 25 studies of aversion therapy in nicotine addiction. They found it challenging to judge the effectiveness of the studies as they all suffered from glaring methodological issues.
One of the most significant errors was failing to make the procedures blind, i.e. participants knew if they had received the real treatment or a placebo. These inbuilt Biases might make the therapy appear more effective than it is.
McConaghy et al. (1983) directly compared aversion therapy to covert sensitisation for gambling addiction. At the one-year follow-up, he found that those who had received covert sensitisation were significantly more likely to have reduced gambling activity (90% versus 30%).
They also reported reduced gambling cravings. This finding suggests that covert sensitisation could effectively treat various addictions.
Behavioural interventions, therefore, treat addiction by associating the addictive substance/behaviour with unpleasant stimuli.
Aversion therapy for reducing alcohol addiction, for example, includes emetics or Antabuse drugs. Gamblers may receive electric shocks whenever they think or are around gambling-associated stimuli. Rapid smoking is an aversion therapy for nicotine addiction.
Covert sensitisation is a form of aversion therapy where the unpleasant stimuli are imagined rather than physically present.
Aversion therapy is a treatment for addiction that involves associating the addiction and an unpleasant response.
Aversion therapy is frequently used to treat alcoholism. In this process, the addict is given an emetic, a pill that causes severe nausea and vomiting. The addict is given a strong alcoholic drink, such as whiskey, in a nauseous state and then vomits. This associates alcohol with the unpleasant vomiting response.
Suppose drug addictions are learnt through the association of the drug and its pleasant effects. In that case, addiction can be unlearned by replacing the pleasant stimuli with an unpleasant response, such as vomiting. This process is known as counter-conditioning.
Using a process known as counter-conditioning. An unpleasant association is created with the addictive behaviour instead of the original pleasant one.
Research is mixed on the effectiveness of aversion therapy, it depends on individual differences and the type of addiction being treated.
Aversion therapies can be used for addiction by inducing unpleasant responses to addictive behaviour. For example, taking emetics or Antabuse drugs causes nausea and vomiting, creating an unpleasant association with the addictive drug.
Flashcards in Aversion Therapy22
Start learningDefine aversion therapy.
Aversion therapy is a treatment for addiction involving associating an addiction with an unpleasant stimulus/response.
According to research, what is more effective, aversion therapy or covert sensitisation?
According to McCongahy et al. (1991), covert sensitisation is 60% more effective than aversion therapy.
Why has aversion therapy fallen out of use?
Making a patient experience vomiting and nausea might be unethical because of the psychological and physical effects on the patient.
How can aversion therapy be used for gambling addictions?
For behavioural addictions such as gambling, aversion therapy uses external stimuli such as electric shocks. The shocks are strong enough to be painful but not harmful.
What was the main methodological issue Hajek and Stead (2001) uncovered?
A failure to make the studies blind, meaning that participants knew if they had a placebo or real treatment.
Why might a patient struggle to adhere to aversion therapy treatment?
Because the unpleasant stimuli, which are often painful or uncomfortable, make it difficult and unpleasant for the patient to receive treatment.
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