Biopsychosocial Aspects of Addiction

Addiction is a complex, multifactorial disease including biological, psychological and sociological elements. Family, twin and adoption studies demonstrate that addiction has a biogenetic basis that is transmitted within families. The core of the predisposition is a set of genes that are responsible for the feeling of reward derived in the mesolimbic system of the brain. Individuals with an inherited hypodopaminergic functioning are more prone to seek substances or behavior that stimulate dopamine release and thus provide reward. Recognition of addiction as an inherited, reward deficiency disease provides a biological basis of understanding and helps to alleviate social stigma.

Acknowledging that a positive family history of alcoholism elevates one’s risk for alcohol abuse, Finn, Sharkansky, Brandt and Turcotte (2000) conducted research designed to elucidate the mechanisms that lead from increased risk to alcohol abuse. They found evidence of two distinct personality-related pathways that suggest different bio-psychosocial mechanisms. Firstly, proneness for social deviance or antisociality was directly associated with alcohol problems suggesting that addiction is a manifestation of a general difficulty in regulating behavior. This personality trait was significantly associated with a family history of alcoholism. Secondly, excitement/ pleasure-seeking was found to be a basic approach tendency that promoted increased drinking, which, in turn, leads to alcohol problems. However, it could also be argued that alcohol use can promote impulsive, excitement-seeking behavior. This raises the question of whether the expressions of such genetic traits are shaped by the environment.

The effect of environment on genetic expression has been examined. Genotype-environment correlations have been made to better understand the extent to which individuals are exposed to environments as a function of their genetic predispositions. Alcohol abuse was correlated with environments that activate or maintain the expression of the underlying genetic liability for alcoholism. Specifically, decreases in family moral-religious emphasis, family cohesion, and increased organization (strictness) were associated with pathological alcohol use.

While there is clearly a genetic predisposition, environmental factors seem to significantly affect the likelihood of the expression of the disease.

Without further elaboration, it becomes abundantly apparent that this is a complex topic, with a multitude of interacting variables as causative factors in the development and manifestation of addiction. It is a gross over simplification to state that addiction is caused by any one of the various factors. Appreciating the multifactorial aspect of the disease, it is clear that prevention and treatment approaches require a diverse and complementary range of individualized therapies.

Source by John Derry

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