ADC 515 Module 1 Psychological Factors in Addiction Example

Meaning It and Doing It Anyway: Psychological Factors Behind Addiction's Central Paradox

Student Name

Psychology and Addiction Studies Program, Aspen University

ADC 515: Psychology of Addiction

Instructor Name

Month Day, Year

Meaning It and Doing It Anyway: Psychological Factors Behind Addiction's Central Paradox

Denise, forty-six, is in her third admission to a residential alcohol treatment program near Grand Rapids, Michigan. Neither she nor the program is real; both were created to teach the material. She describes her last relapse this way: "I had decided I was done. I meant it. I drove past the store on the way home from my sister's, and I was in the parking lot before I'd even thought about it." This paper uses her account to introduce the psychological factors that the rest of the course will examine.

The Paradox

Addiction presents a puzzle for any account based on deliberate choice. People with addictions often sincerely want to stop, know the harms and make firm plans, yet return to use. Denise is not unusual in this; the pattern is common enough to define much of what clinicians call addiction. A psychology of addiction must explain how a person can mean one thing and do another.

Implicit Cognition

Stacy and Wiers (2010) argued that implicit cognition helps explain this paradox. Implicit processes are mental processes that operate without deliberate reflection: associations between drug cues and positive feelings, the automatic capture of attention by drug-related stimuli and tendencies to approach drug cues. These processes develop through repeated experience with a substance and can be triggered by cues such as places, people and moods, often without the person's awareness. Explicit processes, by contrast, involve deliberate reasoning about goals, consequences and plans. Stacy and Wiers proposed that in addiction, implicit processes become strong while the capacity to override them, which depends on executive functions, may be weakened, especially under stress, fatigue or the influence of the substance itself. The result is behavior that contradicts explicit intentions. They reviewed evidence that measures of implicit cognition predict drug use beyond what explicit measures, such as stated attitudes or intentions, can predict.

Self-Control Over the Life Course

Not everyone who drinks develops these patterns. Moffitt et al. (2011) followed a cohort of about a thousand children born in one New Zealand city from birth to age thirty-two. They measured self-control in childhood through observations and reports by parents, teachers and the children themselves. Children with lower self-control were more likely as adults to have poorer physical health, financial problems, criminal convictions and substance dependence, along a gradient across the whole range of self-control rather than only at the extremes. The associations held after accounting for intelligence and social class. The findings suggest that capacities for self-control, which shape how well explicit goals can override impulses, are a long-term psychological factor in addiction risk.

A Dynamic Model of Relapse

Witkiewitz and Marlatt (2004) revised the influential relapse prevention model to describe relapse as a dynamic, nonlinear process. They distinguished tonic processes, relatively stable risk factors such as years of dependence, family history and longstanding beliefs about alcohol's effects, from phasic processes, changing situational factors such as mood, craving, coping responses and immediate stressors. These interact, and because the system is nonlinear, a small change, such as a brief stressful encounter, can produce a sudden return to use in someone whose overall risk is high. Two elements sat at the center: self-efficacy, meaning how sure someone feels that they can get through a situation sober, and the coping skills they can call on.

Expectancies

One distal factor in the table deserves a word. Over years of drinking, people form expectancies, beliefs that drinking will calm them, keep loneliness at bay or get them through a hard evening. These beliefs operate partly outside awareness and can be activated by cues and moods. Denise said alcohol had always been "what took the edge off," an expectancy formed across two decades that her intention to stop had not erased.

Analyzing Denise's Relapse

Denise's account fits these ideas closely. Her decision to stop was a genuine explicit goal. On the day of her relapse, she had visited her sister, who had criticized her, leaving her upset, a phasic factor. Driving home in the evening, she passed the store where she had bought alcohol hundreds of times, a powerful cue. By her description, she reached the parking lot before deliberate thought engaged, consistent with an automatic approach tendency. Once there, the explicit goal was still available, but she was tired and upset, conditions under which Stacy and Wiers suggest that control over automatic impulses weakens. And she had no coping response prepared for that specific moment, a gap Witkiewitz and Marlatt's model would identify.

Why Intentions Are Not Enough

It would be easy to conclude from Denise's history that her intentions were weak or insincere. The research suggests otherwise. Explicit intentions predict behavior well when people have time, attention and energy to act on them, and less well when automatic processes are strong and control is depleted. Denise's intentions were real; they were simply not present in the moments that decided her relapses. Treatment that only asks her to recommit to sobriety addresses the part of the system that was already working.

What This Means for Treatment

If relapse involves automatic processes, treatment cannot rely solely on strengthening intentions. It may need to reduce exposure to cues, such as changing driving routes; to prepare specific responses for high-risk moments; to build capacities that support control, such as managing stress and fatigue; and, as later modules will show, perhaps to change the implicit processes themselves. Denise's counselor began by mapping her high-risk situations and planning a response for each.

Conclusion

The paradox of acting against one's intentions is central to addiction. Stacy and Wiers explain it through implicit cognition, Moffitt and colleagues show that self-control capacities shaped in childhood predict later dependence and Witkiewitz and Marlatt describe relapse as a dynamic process in which small changes can trigger sudden use. Denise's relapse shows these factors working together and points to treatment that addresses automatic as well as deliberate processes.

References

Moffitt, T. E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R. J., Harrington, H., Houts, R., Poulton, R., Roberts, B. W., Ross, S., Sears, M. R., Thomson, W. M., & Caspi, A. (2011). A gradient of childhood self-control predicts health, wealth, and public safety. Proceedings of the National Academy of Sciences, 108(7), 2693-2698. https://doi.org/10.1073/pnas.1010076108

Stacy, A. W., & Wiers, R. W. (2010). Implicit cognition and addiction: A tool for explaining paradoxical behavior. Annual Review of Clinical Psychology, 6, 551-575. https://doi.org/10.1146/annurev.clinpsy.121208.131444

Witkiewitz, K., & Marlatt, G. A. (2004). Relapse prevention for alcohol and drug problems: That was Zen, this is Tao. American Psychologist, 59(4), 224-235. https://doi.org/10.1037/0003-066X.59.4.224