Risk Factors for Addiction

What is Addiction?

Addiction is a biopsychosocial disorder that emerges from the use of alcohol and drugs. The term biopsychosocial resembles the idea that there can be biological, social and psychological factors influencing addiction. An individual with an addiction is dependent on a given substance. The cessation of the consumption of such a substance evokes withdrawal symptoms in the person. The dependency on substances can either be psychological or physical.

Examples of psychological dependence on a substance include feeling emotions of irritability, anxiety and mood swings, among other symptoms.

Physiological signs include changes in heart rate and blood pressure, fatigue, difficulty sleeping and weight loss.

Risk Factors in Drug Addiction

Certain risk factors exist that exacerbate the risk of developing a drug addiction. These include genetic risk factors, stress and PTSD (post-traumatic stress disorder), personality risk factors, and family and peer influences.

The DSM-V contains a substance use disorder (SUD) diagnosis. The diagnosis is used to assess whether an individual presents a disorder, as well as how severely. The 11 diagnostic criteria fall under the categories of impaired control, physical dependence, social problems and risky use.

Although it may be tempting to state that individuals freely choose to start consuming substances, psychological research has established that there are risk factors for addiction. Let's take a closer look at this.

Risk Factors in Addiction: Psychology

The characteristics that make a person more likely to consume certain substances, and thus suffer from an addiction disorder, are called risk factors. The risk factors for addiction that psychological research has identified are genetic vulnerability, stress, personality and family and peer Influences.

Describe and Evaluate Risk Factors in the Development of Addiction

Before we delve into each risk factor, it is important we understand how studies, and the subsequent issues with research, support and oppose certain theories in addiction.

• One of the main difficulties that researchers need to face when investigating risk factors are the limitations of each experimental design. Correlational studies are able to detect whether two variables are related. However, lack the ability to explain why a relationship between variables exists.
• In this way, a correlational study may detect a relationship between stress and drug addiction, however, this does not mean these two variables are causally related.
• Similarly, quasi-experiments are able to establish cause-and-effect relationships. However, confounding bias cannot be fully controlled in quasi-experiments. These limitations altogether, make the research on risk factors a complex one.

Genetic Vulnerability as a Risk Factor in Developing Addiction

Research has shown that genes are a risk factor in the development of addiction disorders. It refers to the inherited characteristics or genes that make a person more likely to develop an addiction. The evidence of the role that genetics play in the development of addiction disorders comes from twin and adoption studies.

Twin study on Gambling (Slutske et al., 2010)

Slutske et al. (2010) noticed that in families where there was one addiction problem, there were likely to be more cases of addiction issues. This could either be because of the shared genetic information or the shared environment of the families influences addiction disorders.

They carried out a twin study.

• The sample consisted of 2,889 twin pairs from the Australian Twin Registry.
• Researchers interviewed all participants and used the DSM-IV diagnostic criteria to assess whether participants were gamblers. Further, they used already existing data that assessed twins' environmental similarity.

The results failed to provide evidence that environmental factors influence the later development of gambling behaviours. Genes, however, did influence the gambling behaviour of twins.

Although results did not suggest that genes were fully responsible for the development of addiction behaviours, they can be taken as evidence that genetic information plays a role in gambling behaviours.

Fig. 2 - Picture of an individual playing a slot machine

Twin study on Smoking Behaviour (Vink et al., 2005)

Vink et al. (2005) investigated 1,572 Dutch twin pairs with a mean age of 30.5. The study tested whether genetic or environmental influences could explain smoking behaviours in the sample by addressing smoking initiation and nicotine dependence.

• The results suggested that genes had a bigger influence on the dependence on nicotine than the environment had (75% compared to 25% respectively).

These results are further evidence that genes make individuals more vulnerable to the development of addiction issues.

Case Study on Smoking Initiation (Lerman et al., 1999)

Taking into consideration the evidence provided from twin studies, Lerman and colleagues wanted to further understand the genetic influence on smoking initiation.

The study investigated the risk of smoking initiation, based on two genes:

• The dopamine transport (SLC6A3).
• The D2 dopamine receptor.

Their results indicated that individuals with SLC6A3 were less likely to start smoking and this effect increased in the presence of a D2 receptor. This suggests that there is an effect of gene interaction in smoking initiation. Looking further into the role of SLC6A3 on smoking, researchers found that those who presented the SLC6A3 genotype were less likely to have started smoking by the age of 16.

Stress and PTSD as a Risk Factor of Addiction in Adolescents

Stress is the response in which individuals feel emotional and physical tension. Stress can impact how people behave and there is evidence that people who experience high levels of stress are more vulnerable to presenting addiction issues. Evidence of the relationship between stress and addiction comes from studies investigating individuals diagnosed with Post-Traumatic Stress Disorder (PTSD).

PTSD and Addiction (Chasser, 2016)

Chasser (2016) carried out a study to investigate the demographic characteristics of adolescents that presented addiction issues.

In this cross-sectional study, 195 young individuals were interviewed. They all met the criteria for substance abuse disorder. The results from the study suggested that 59% of the participants had PTSD symptoms before their first consumption of substances.

Evidence from Chasser (2016) suggests that suffering from stress makes individuals vulnerable to the later development of addiction issues.

Personality as a Risk Factor of Addiction

Some researchers have suggested the existence of an "addictive personality", which posits that there are certain personality traits common to those suffering from addiction.

The addictive personality hypothesis suggests that personality traits such as impulsivity, sensation seeking, nonconformity and social deviance, are common to those developing addiction problems.

The personality hypothesis has been criticised by psychologists for being deterministic and for not considering individuals' ability to freely choose their actions. According to the theory, everyone presenting a given personality profile would then develop a problem with addiction, which is not necessarily the case.

Although the "addictive personality hypothesis" may not be the most accurate theory, there is evidence of the link between personality and addiction (Eysenck, 1999).

Eysenck (1997) explored the addictive personality. He noted an interesting case of US soldiers in Vietnam who smoked opium in an attempt to deal with the stress of war.

• Some were able to completely give up the substance upon return, however, others were not so fortunate, and they became addicted to the substance.

He referenced the three major dimensions of personality, Psychoticism (P), Neuroticism (N), and Extraversion (E) (Eysenck & Eysenck, 1985). He noted that psychoticism in particular has been correlated with addictive personalities. Eysenck (1997) also went on to discuss how excessive dopamine could be the reason behind this.

Personality and Addiction (Abadi et al., 2018)

Abadi et al. (2018) looked into the personality profiles of substance abusers. They interviewed 100 addicts who consumed one of five different types of substances. In this way, the study presented five groups of 20 individuals each. They based their study on the Big Five Personality Model, using the NEO Personality Inventory.

The results of the study showed that different personality characteristics were associated with the use of certain substances. For example:

• High levels of neuroticism were associated with the consumption of sedatives.
• High levels of openness to experiences were associated with the consumption of marijuana, hallucinogens and stimulants

In sum, there seems to be a relationship between personality and the later development of addiction issues. However, this relationship is not as simple as the "addictive personality" suggests.

Family and Peer Influences as a Risk Factor of Addiction

Addiction has also been explained in terms of the learning theory, which suggests that behaviour is learned by external forces, such as observing others engage in it. Based on this approach, research has established that addictive behaviours can be explained based on social influence.

Gambling and Social Influence (Reith & Dobbie, 2011)

Reith and Dobbie (2011) designed a study to investigate the social and cultural context of gamblers. More specifically, the study looked into how individuals start their addictive behaviours.

• 50 gamblers were interviewed for the study.

The results of the study suggested that individuals were not born gamblers, but that gambling was a learned behaviour. Even more, the results of the interview analysis supported the idea that individuals were introduced to gambling through their social networks, such as family and friends.