Table of Contents
Introduction
For this research study, I have chosen to focus on reasoning and decision making when it comes to addiction. People have argued that addiction prevents people from proper decision making and self-control. Other people have argued that addiction is autonomous and that people make choices of their addiction. By possibly defining the causes of poor decision making and reasoning behind addiction, we can hope to treat this problem.
Over time, there have been various degrees of decision making and reasoning that goes along with addiction. Some state that the person suffering from addiction is in control of their actions, despite the known consequences of their addiction. We know that many factors go along with addiction and that a person has many contextual factors that go into their decision making and reasoning.
Literature Review
In Unconscious Influences on Decision Making, Newell and Shanks reference four studies that cover unconscious influences on multiple-cue judgment, deliberation without attention, awareness in decisions under uncertainty, and primes and primes-to-behavior. These processes are all inconclusive and do not point to any definite unconscious influence over our decision making. The authors argue that the appeal of the unconscious mental influence is that they ‘make good stories’ and have a greater appeal to a vast audience, primarily when they deal with ‘expert decision making’ (Newell & Shanks, 2014).
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This article references the weak evidence of unconscious influences on decision making. It states that we are under full conscious control of our decision making, or it can be reasonably explained without unconscious resources.
The Voluntary Nature of Decision-Making in Addiction, The authors argue that the capacity of individuals with addiction to make autonomous decisions involving their drug or choice typically involve one of two theories: full ability or not full ability. The authors propose that each individual needs to be independently treated, based on interpersonal relationships, and contextual factors (Racine & Rousseau-Lesage, 2017).
Racine and Rousseau reference persons with addiction, and the control of their urges and cravings. Specifically, the decision-making processes and treatment of the addiction, whether or not their addiction is voluntary (Racine & Rousseau-Lesage, 2017). It also references that free will comes with different shades of grey and that addiction impedes the ability of voluntary conscious decision making (Racine & Rousseau-Lesage, 2017).
In another study, The Treatment of Substance Addicts, Westenberg, Koele, and Kools study the treatment matching of persons suffering from addiction, and the judgment analysis that goes into the treatment. The judgment analysis of the addict consists of different steps: identification of the judgment problem, construction of a judgment task, performance of the judgment task, statistical analysis of the data, and cognitive feedback (Westenberg, Koele & Kools, 1998).
Westenberg, Koele, and Kools present interviews with therapists and found that while there is a broad agreement about the nine characteristics defined as ‘important,’ they disagreed on the way the characteristics were to be handled when deciding treatment programs (Westenberg, Koele & Kools, 1998).
In Implicit Cognition and Addiction: An Introduction, Weirs, and Stacy reference the problem with substance abuse and addictive behaviors. The study presents implicit cognition as procedures in which attitudes of the substance abuser are indirectly inferred from behavior. They construct a mental bias and create actions that we tend to do within our conscious, and are exacerbated by the addiction (Wiers & Stacy, 2006).
Specifically, acknowledging that the problem is not that abusers do not understand the disadvantages of continued drug abuse; instead, they have difficulty resisting their automatic triggered impulse to use. The authors argue that “implicit and explicit cognitions explain unique variance or different aspects of behavior” (Wiers & Stacy, 2006, p. 2)
In another study by O’Leary, Masse, Pihl, Stewart, Seguin, and Conrad, “substance use and binge drinking during early adolescence are associated with neurocognitive abnormalities, mental health problems, and an increased risk for future addiction” (O’Leary-Barrett et al., 2017, p. 1872). The authors attempt to evaluate the protective effects of an evidence-based substance use prevention program on the onset of alcohol and drug abuse, as well as on cognitive, mental health, and addiction outcomes over five years. The study creates a course of cognitive development in high-risk youth for delaying alcohol use. The developmental sequences of alcohol use and cognitive development annually assess the symptoms that can be used to create early prevention (O’Leary-Barrett et al., 2017).
In the study Cognition and Addiction, Verdejo-Garcia and Garcia-Fernandez study the current knowledge on substance-use disorder related deficits. Research suggests that several cognitive processes are impaired across users of different drugs, including selective attention, episodic memory, executive functions, and reward-based decision making (Verdejo & Garcia, 2019). This study presents a combination of cognitive and biological approaches for treatment plans that have shown strength in cognitive function, specifically patients with high impulsivity and poor executive functioning. Cognitive make-up and variation will start to make its way into future treatment plans for persons suffering from substance abuse disorder (Verdejo & Garcia, 2019).
Research Design
Addiction is a complex disease and needs a dynamic assessment of the individuals in order to create a finer-grained evaluation. By understanding the addiction as well as the reasoning that goes into why persons decide to further their addiction or stop it, we can allow better treatment. The studies that exist cast a wide net of various causes behind addiction and the reasoning behind it, but if we could pinpoint various triggers and commonalities between drugs of choice, we could rationalize the behaviors behind the lack of autonomy in choice making.
This leads us to the research question, “How does substance abuse disorder effect deciding proper treatment?” This study would follow students in a high school setting, and in the cases deemed worthy, would study the effects of persons afflicted with substance abuse disorder. We would attempt to give students the proper tools and assessments in order to accurately diagnose and treat addiction. We would look at both short- and long-term effects in order to understand the disease and perfect treatment plans.
High school students would be asked to complete a confidential online questionnaire, with parental consent given if needed. Through the questionnaire process, we would access demographical data, such as gender, ethnicity, age, and sex. The data collected on substance abuse, drugs of choice, and addiction would be analyzed against behaviors in order to determine ideal candidates for a psychological examination. Any students not displaying addictive behavioral problems would still be given resources in order to reach out if needed for further help.
The students participating in the longitudinal study addressing substance abuse would be assisted first in the treatment of the addiction, by in- or out-patient help. Then they would be given doctors suggestive ongoing treatment plans in order to allow them the greatest success possible.
This research study would follow all the ethical principles of the APA code of conduct and ethical standards. The research would abide by 8.02 informed consent to research, as well as 8.05 Dispensing with informed consent for research. Maintaining confidentiality through code 4.01 would protect information given by subjects (APA, 2017). It will follow section 9.02 with the use of assessments that require psychologists to administer and score the assessments needed for the study as well as utilizing reliable and valid assessment tools (APA, 2017).
References
- American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. Retrieved from https://www.apa.org/ethics/code/
- Newell, B., & Shanks, D. (2014). Unconscious influences on decision making: A critical review. Behavioral and Brain Sciences, 37(1), 1-19.
- O’Leary-Barrett, M., Mâsse, B., Pihl, R., Stewart, S., Séguin, J., & Conrod, P. (2017). A cluster-randomized controlled trial evaluating the effects of delaying onset of adolescent substance abuse on cognitive development and addiction following a selective, personality-targeted intervention programme: The Co-Venture trial. Addiction, 112(10), 1871-1881.
- Racine, E., & Rousseau-Lesage, S. (2017). The voluntary nature of decision-making in addiction: Static metaphysical views versus epistemologically dynamic views. Bioethics, 31(5), 349-359.
- Verdejo-Garcia, A., Garcia-Fernandez, G., & Dom, G. (2019). Cognition and addiction. DIALOGUES IN CLINICAL NEUROSCIENCE, 21(3), 281–290
- Westenberg, M., Koele, P., & Kools, E. (1998). The treatment of substance addicts: a judgement analysis of therapists’ matching strategies. Clinical Psychology & Psychotherapy, 5(1), 39-46.
- Wiers, R., & Stacy, A. (2006). Implicit Cognition and Addiction. Current Directions in Psychological Science, 15(6), 292-296.
