Introduction to Addictive Behaviors, Second Edition

by Thombs, Dennis L.

• ISBN13: 9781572304116
• ISBN10: 1572304111
• Additional ISBN(s): 9780898623369, 9781593852788
• Edition: 2nd
• Format: Hardcover
• Copyright: 1999-06-11
• Publisher: The Guilford Press
• More Book Details
• Purchase Benefits

Summary

This popular text reviews and critiques major contemporary perspectives on alcoholism and drug dependence, including the disease models, psychoanalytic formulations, and theories based on conditioning, social learning, family systems, and sociology. Throughout, applications to the helping process are emphasized and learning is facilitated by case examples and review questions. With all chapters extensively revised to reflect the expanding knowledge base in addictive behavior, the second edition incorporates recent advances in such areas as behavioral genetics, neuroscience, dual diagnosis, contingency management, cognitive expectancy, children of alcoholics, drug subcultures, and motivation enhancement.

Author Biography

Dennis L. Thombs, PhD, is Associate Professor in the Department of Adult, Counseling, Health and Vocational Education at Kent State University. Dr. Thombs has worked in the mental health field, including substance abuse treatment and prevention, for more than 15 years. The author of numerous articles in the area of health behavior, his chief research focus is adolescent and young adult alcohol abuse.

Table of Contents

1 The Multiple Conceptions of Addictive Behavior and Clinical Practice Today	1	(28)
Conceptions of Addiction in U.S. History	1	(3)
Addiction as Immoral Conduct	4	(2)
Addiction as a Disease	6	(2)
Addiction as Maladaptive Behavior	8	(1)
The Need for Theory	9	(1)
What Exactly Is a Theory?	10	(1)
Formal Attributes of a Good Theory	11	(1)
Substantive Attributes of Theories on Addictive Behavior	12	(2)
Theory, Research, and Contemporary Clinical Practice	14	(2)
Barriers to Change in the Treatment Community	16	(2)
Practical Issues Ignored by Researchers	18	(1)
Recent Efforts to Bridge the Gap: Technology Transfer	19	(2)
Competently Administered Prevention and Treatment Programs Are Effective	21	(2)
Purpose of the Book	23	(1)
Review Questions	24	(1)
References	25	(4)
2 The Disease Models	29	(52)
Different Disease Conceptions	30	(1)
Tolerance and Withdrawal	31	(1)
Addiction as a Primary Disease	32	(2)
Genetic Origins of Addiction: The Susceptibility Model	34	(20)
Effects of Drugs on Brain Structure and Function: The Exposure Model	54	(7)
Loss of Control	61	(3)
Addiction as a Progressive Disease	64	(4)
Addiction as a Chronic Disease	68	(1)
Denial	69	(1)
Strengths of the Disease Models	70	(1)
Weaknesses of the Disease Models	71	(1)
Review Questions	72	(1)
References	73	(8)
3 Psychoanalytic Formulations	81	(28)
Freud	81	(1)
Psychoanalysis: A Type of Psychotherapy	81	(3)
Personality Structure	84	(2)
Anxiety, Defense Mechanisms, and the Unconscious	86	(3)
Psychosexual Development	89	(3)
Insights into Compulsive Substance Use	92	(7)
Contemporary Treatment of Addiction	99	(3)
The Importance of Psychoanalytic Concepts in Substance Abuse Counseling	102	(1)
General Criticisms of Psychoanalysis	103	(1)
Criticism of the Psychoanalytic View of Addiction	104	(1)
Review Questions	105	(1)
References	106	(3)
4 Conditioning Models and Approaches to Contingency Management	109	(35)
Conditioned Behavior	110	(4)
Initiation of Alcohol and Drug Use	114	(1)
Addiction	115	(1)
Relationship between Addiction and Physical Dependence	115	(1)
Cessation and Relapse	116	(1)
Blood Alcohol Discrimination	117	(2)
Behavioral Tolerance	119	(5)
Principles of Contingency Management	124	(1)
Applications of Contingency Contracting	125	(15)
Effectiveness of Contingency Management Approaches	140	(1)
Review Questions	140	(1)
References	141	(3)
5 Cognitive Models	144	(40)
Basic Social Cognitive Concepts	144	(4)
Modeling and Substance Use	148	(2)
Self-Efficacy and Treatment Outcomes	150	(3)
Role of Outcome Expectancy in Alcohol and Drug Use	153	(10)
Alcohol and Stress: Cognition as a Mediating Process	163	(3)
Stress Response Dampening	166	(1)
Tiffany's Model of Drug Urges and Cravings	167	(2)
Relapse	169	(8)
Project MATCH: A Test of Cognitive Therapy	177	(1)
Summary	177	(1)
Review Questions	178	(2)
References	180	(4)
6 The Family System	184	(52)
Clinically Generated Concepts	184	(12)
Bowen's Family Systems Theory	196	(7)
Codependency	203	(3)
Children in Alcoholic Families: Clinical Accounts	206	(2)
Role Behavior	208	(5)
The Process of Family Therapy	213	(3)
Findings from the Research Literature	216	(13)
Summary	229	(1)
Review Questions	230	(1)
References	231	(5)
7 Social and Cultural Foundations	236	(34)
Resistance to Considering the Social Origins of Alcoholism	236	(1)
Time and Place as Social Determinants of Illicit Drug Use	237	(2)
The Influence of Culture on Diagnostic Determinations	239	(2)
Sociological Functions of Substance Abuse	241	(1)
Social Facilitation	242	(2)
"Time Out" from Social Obligations	244	(2)
Promoting Group Solidarity/Establishing Social Boundaries	246	(5)
Drug Subcultures: Repudiation of Middle-Class Values	251	(10)
Implications for Counseling	261	(3)
Limitations	264	(1)
Review Questions	265	(1)
References	266	(4)
8 Conditions That Facilitate and Inhibit Change in Addictive Behavior	270	(20)
Addictive Behavior Models and Client Motivation	271	(2)
Stages of Change in Addictive Behavior	273	(5)
Coercion	278	(3)
Confrontative Treatment	281	(1)
Motivation Enhancement	282	(1)
Harm Reduction Approaches	283	(1)
The Impact of Managed Care	284	(2)
Review Questions	286	(1)
References	286	(4)
Author Index	290	(7)
Subject Index	297