Introduction

The four main contentious models relating addictive behaviour are Minnesota disease model, Behavioral Model, Cognitive Model and Psychosocial Model. Thus, the current stage in the development of society is characterized by the aggravation of social problems, general instability, tough political struggle, interethnic conflicts, and the destruction of social institutions. All this leads to a violation of the living conditions of the individual in childhood, and later to the dissatisfaction of his social and socio-psychological needs. The pressure of these needs on human behavior is so great, that they are beginning to dominate the physiological needs and sometimes even become stronger sense of self-preservation. 

Minnesota disease model

It is an effective treatment model, as it has shown high recovery in those who have been motivated to change their lifestyle, abandoning drug use and maintaining long-term abstinence through spirituality (Brand et al., 2019).

Although there are differences between these treatments, both models have proven their validity and efficacy, always bearing in mind that it must be the patient himself who wants to recover his life without consumption. However, it is observed that the cognitive-behavioral model constitutes a broader approach in that it encompasses both the mental sphere (thoughts) and the behavioral sphere (behaviors), with scientific studies that support its validity in people, while the Minnesota model focuses primarily on behaviors from a spiritual perspective (Brand et al., 2019). In any case, both models study how to deal with future problems, and leave drugs or maladaptive behaviors permanently.

The Minnesota model is based on the following basic assumptions:

1. Denial of the disease. The common component among alcoholics and / or addicts is that they drink / consume too much, regardless of their race, social class and way of drinking. His life becomes a heap of nonsense and self-destruction, but the alcoholic / addict continues to drink / consume without measure.
2. Alcoholism (and therefore addiction) is a chronic, progressive and fatal disease of necessity if not stopped.
3. The alcoholic patient (the addict) is not guilty with his actions; the disease has not been sought. Being a disease, the alcoholic (addict) is not guilty (basic to understand the model).
4. It is a chronic and primary disease. It is not an underlying disease or symptom.
5. The consumption of alcohol and / or drugs is a symptom of the disease. For this reason, many professionals when consumption is eliminated believe that the disease has been cured.

Behavioral Model

These processes determine how much it is possible for to accomplish what is learned through observation, whether it is realized what is needed to accomplish this behavior. A person can carefully observe a monkey jumping from a tree to a tree, remembering its movements accurately, but it is unthinkable to be able to learn and repeat this behavior, since human physical data does not allow for this. Consequently, it is important for learning that a person be able to implement behavior. In the process of behavior formation, teacher feedback is also important, what the student did well and what needs to be improved, and the student observing his or her own behavior.

The notion that addiction behavior is largely an automated activity is supported by other authors. Within the bioinformatics model, PAS-related effects are represented by “propositional” neuronal connections that encode cognitive, physiological, and behavioral aspects of addictive behavior and implement them when exposed to appropriate stimuli, sometimes not realized (Jun and Choi, 2015). This model is based on the concept of three parallel neuro-psychophysiological processes: 1) conditioned-reflex learning, when neutral stimuli that coincide with drug use become specific stimuli for further behavior; 2) “explicit learning” – establishing a connection between key signals; and 3) the formation of addiction – strengthening the connection between stimulus and response.

Social learning models linking craving to positive reinforcement are, in turn, constrained by the notion that continued addiction is associated with hedonic effects of use. However, this is contradicted by data from studies showing the possibility of maintaining addictive behavior in the absence of positive sensory reinforcement. However, the relationship between the addictive drives itself and the main manifestations of compulsive-habitual behavior remains unclear and, in many respects, contradictory. The addiction to the use of psychoactive substances (psychoactive substances (PAS) in the context of the problem under discussion mean narcotic substances, alcohol and nicotine) has been devoted to an immense amount of research. Hence, the most important aspects of addictive behavior remain insufficiently clarified. So, due to differences in theoretical approaches, it is not possible to formulate a single concept of one of the key phenomena of addiction – attraction to psychoactive substances (Webb et al., 2010).

Cognitive Model

In the cognitive processing model, regular use of psychoactive substances is viewed as an automated behavior that does not require cognitive effort. Craving requires the emergence of an obstacle to use – lack of access or conscious self-restraint. Only then does a non-automated, effort-demanding response arise. Depending on how this obstacle is perceived and interpreted, the key stimuli will provoke craving and the risk of relapse. Some authors believe that craving impairs cognitive function. In the experiment, patients with alcoholism needed more time to solve the problem under the conditions of presentation of key stimuli in comparison with neutral stimuli. The period of abstinence from the use of psychoactive substances is characterized by a subjective feeling of a slow passage of time. This is probably the reason for the conviction of some patients, often supported by doctors, that methadone withdrawal is more severe than with heroin. The withdrawal symptoms of methadone withdrawal, objectively not more pronounced, but longer, are more difficult to experience, as they seem endless.

Within the framework of the cognitive model, there is an assumption that the mental processes that control attraction and use are two independent systems. That is, the search for and use of surfactants may not be accompanied by craving, and craving may not lead to use. The compulsive nature of PAS use, being an automated behavioral pattern, explains the possibility of relapse after a period of prolonged remission. The mastered, after repeated repetition, motor and cognitive skills are activated by a specific configuration of internal and external stimuli, which leads to the resumption of use without prior intentions, without conscious attraction and without opposing efforts. The cognitive processing model coincides with the affective processing model in two respects. Both approaches recognize the importance of cognitive efforts to maintain abstinence, including in the face of disturbing affective influences. Also, both models assume that, given free access to drugs, drug use occurs without cognitive delays, at a “preconscious” level (Jun and Choi, 2015).

Psychosocial Model

Psychosocial models, on the other hand, understand drug dependence as behaviors or habits regulated by biological, psychological, and social factors. According to this model, addictive behavior or addiction is not an individual chronic disease but the result of the interaction of psychological, biological, and social determinants at a given moment. The implications of this view are also apparent (Berge and Robinson, 2016):

Treatment can be restored. Switching from risk to low risk consumption or exit is quite common. Like the natural recovery of neurosis, addiction can develop smoothly if in each case conditions are created that define behavior change. Due to the severity of the habit or severe deterioration of personal and social conditions, not all subjects can change their attitude behavior without outside help. But natural recovery seems to be the path most people who have “problems” with drugs follow (Web et al., 2010).

Repetition during treatment is the result of the interaction of various factors that determine the existence of a habit. This should not be seen as evidence of potential biological vulnerability, but rather as a failure of the subject to overcome the mechanism in the face of situational modulators of behavior. In other words, people’s impression of a certain mark overwhelms the overall impression of the person who bears the mark, thus realizing the transformation from mark to stigma. Therefore, the process of stigmatization begins with people’s perception and marking of deviant states that deviate from the norm, and on this basis, forms an overall impression of the deviant, and finally completes the establishment of a relationship between the mark and the deviant through attribution of responsibility. The direct connection damages the integrity of the personality and identity of the deviant.

References

Berridge, K.C. and Robinson, T.E., 2016. Liking, wanting, and the incentive-sensitization theory of addiction. American Psychologist, 71(8), p.670.

Berridge, K.C. and Robinson, T.E., 2016. Liking, wanting, and the incentive-sensitization theory of addiction. American Psychologist, 71(8), p.670.

Brand, M., Wegmann, E., Stark, R., Müller, A., Wölfling, K., Robbins, T.W. and Potenza, M.N., 2019. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neuroscience & Biobehavioral Reviews, 104, pp.1-10.

Heyman, G.M., 2013. Addiction and choice: theory and new data. Frontiers in psychiatry, 4, p.31.

Jun, S. and Choi, E., 2015. Academic stress and Internet addiction from general strain theory framework. Computers in Human Behavior, 49, pp.282-287.

Skinner, M.D. and Aubin, H.J., 2010. Craving’s place in addiction theory: contributions of the major models. Neuroscience & Biobehavioral Reviews, 34(4), pp.606-623.

Webb, T.L., Sniehotta, F.F. and Michie, S., 2010. Using theories of behaviour change to inform interventions for addictive behaviours. Addiction, 105(11), pp.1879-1892.

Webb, T.L., Sniehotta, F.F. and Michie, S., 2010. Using theories of behaviour change to inform interventions for addictive behaviours. Addiction, 105(11), pp.1879-1892.

West, R. and Brown, J., 2013. Theory of addiction. John Wiley & Sons.