Dependence is an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
In the drug dependence field there used to be a primary distinction between physiological dependence and psychological dependence, but this distinction has fallen increasingly into disfavor for a model that integrates neurological and behavioral aspects of addiction. Another classification is the distinction between positive and negative reinforcement mechanisms of dependence that operate through the integration of neurological and behavioral levels. Here are two informative articles:
Wise, R. A., & Koob, G. F. (2014). The development and maintenance of drug addiction. Neuropsychopharmacology, 39(2), 254-262.
Qureshi, N. A., Al Ghamdy, Y. S., & Al Habeeb, T. A. (2000). Drug addiction: a general review of new concepts and future challenges.
To my dad,"How can we differ an alcoholic from a normal person? An alcoholic drinks even if he doesn't want to drink.A normal person doesn't drink,if he doesn't want to drink."Alcohol affects a human being in different ways.Some people try to sleep, others fall into rage and jealousy,others become merry and talkative,others-gloomy.It depends on the level of dopamine.One group of genes controls metabolism (ADH2*2),other group is responsible for behavior.They are heritable. Social dissatisfaction,depression,loneliness can cause alcoholism."One person dies from alcoholism every 10 sec.in the world".Sven Stockrahm.
http://www.zeit.de/wissen/gesundheit/2014-05/alkoholkonsum-alkoholsucht-who-bericht
The World Health Organisation does not use the word 'dependence' but uses difference definitions of 'misuse' :
Unsanctioned use - Not approved by society
Hazardous use - Leading to harm or dysfunction
Dysfunctional use - Leading to impaired psychological or social functioning
Harmful use - Known to cause tissue damage or psychiatric disorders.
However, there are different perspectives on 'dependence' which could usefully be broken down into:
Biological model - has a purely biological explanation:
“dependence on a drug, resulting in tolerance and withdrawal symptoms when the addict is deprived of the drug.” (Rosenhan & Seligman, 1989)
Medical model - Addiction is a disease (biological within a 'treatment' context)
Genes, neuroanatomy or a chemical abnormality must be responsible
Treatment should include abstinence (Minnesota model). It is beyond the person's own control.
Psychological model - explained through behaviour:
“Addiction: an attachment to an appetitive activity, so strong that a person finds it difficult to moderate the activity despite the fact that it is causing harm.” (Jim Orford, 2001). Behavioural – rewarded by relief or approval
Psychosocial – modelled by others as ‘normal’ & need to ‘fit in’.
Personality – attractive to extrovert risk-takers & to avoidant anxious.
Sociological - dependence requires interaction with certain environments.
Need exposure to substances to develop use.
Environment determines level of exposure X age.
Influenced by culture and level of acceptability.
Moral model - Historical belief system about addictive behaviour which still influences thought and service provision:
The addict is weak willed, is responsible for his/her actions,
needs spiritual guidance and education to overcome the addiction (the AA model).
you an see how the WHO definitions are influenced by these different perspectives.
Physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)
Psychological dependence – dependence that involves emotional–motivational withdrawal symptoms (e.g., dysphoria and anhedonia)
• reinforcing stimuli – increase the probability of repeating behaviors paired with them
• rewarding stimuli – the brain interprets as intrinsically positive or as something to be approached
• sensitization – an amplified response to a stimulus resulting from repeated exposure to it
• tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose
• withdrawal – symptoms that occur after chronic use of a drug is reduced abruptly or stopped
http://medlibrary.org/medwiki/Psychological_dependence
Psychological dependence is a form of dependence that involves emotional–motivational withdrawal symptoms (e.g., a state of unease or dissatisfaction, a reduced capacity to experience pleasure, or anxiety) upon cessation of drug use or engagement in certain behaviors. Physical and psychological dependence are sometimes classified as a facet or component of addiction, such as in the DSM-IV-TR; however, some drugs which produce dependence syndromes do not produce addiction, and vice versa, in humans. Addiction and psychological dependence are both mediated through psychological reinforcement, a form of operant conditioning, but are associated with different forms of reinforcement.
See link for many.
https://en.wikipedia.org/wiki/Psychological_dependence
Dear Ali A R Aldallal,
People suffering from addiction, cannot control what they do, accept or use.
Everyone is familiar with these types of addiction, like drugs and alcohol, which can significantly impair quality of life and lead to tragic consequences.
But today, the list of types depending greatly expanded, and anything ranging from chocolate to computer games, may cause physical and psychological addiction.
Workaholism. Workaholics often deserve respect in the modern world where every minute means you can earn more.
Depending on the TV.
Dependence on exercise.
Shopogolizm.
Tanning addiction.
Internet addiction.
Dependence on plastic surgery.
Dependence on drugs.
Best regards, Shafagat
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