Key points
- The biopsychosocial model of addiction provides a holistic, multifaceted conceptualization of the disorder.
- Rather than one cause, numerous biological, psychological, and social factors increase or decrease the risk of addiction among individuals.
- Genetics, biology, mental health concerns, trauma, social norms, and availability all contribute to the risk of addiction.
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In light of the toll addiction takes on individuals, their families, communities, and society at large, it is understandable that many people want to know the answer to the question: What causes addiction? Why does one person end up using substances compulsively despite highly negative consequences, while another person can use substances occasionally without a loss of control?
Addiction can occur regardless of a person’s character, virtue, or moral fiber. The prominent belief several decades ago was that addiction resulted from bad choices stemming from a morally weak person. However, that view has long been discredited by scientific research. It is now known that biology plays an essential role in the disorder. In fact, in 1956, the American Medical Association declared alcoholism a disease that should be addressed with medical and psychological approaches (Mann et al., 2000).
However, considering one’s biological makeup only has its drawbacks, and research efforts have found that addiction is not that simple. There is no “addiction gene” or genetic sequence that accounts for all the variance in the experience of addiction. Instead, it is now known that many factors contribute to the development of addiction. Grisel (2019) noted, “the bottom line is that there are likely as many pathways to becoming an addict as there are addicts.”
The Biopsychosocial Model
So how are we conceptualizing the cause of addiction? The multifaceted disorder needs a multifaceted conceptualization, and we find that in the biopsychosocial model of addiction (Marlatt & Baer, 1988). Rather than pinpoint the one thing that causes addiction, we now understand that a constellation of factors contributes to a person being more or less at risk for addiction.
Some aspects are universal (e.g., the activation of the reward system by drugs of abuse). Yet many other elements are idiosyncratic, such as the intensity of the experience of reward and the functioning of the individual’s mesolimbic dopaminergic pathway in the brain. The biopsychosocial model provides a means of considering the myriad of factors that can contribute to the risk of addiction. Let’s take a look at each dimension of the model.
The Meaning of "Bio"
Genetics and biology are a part of the picture—albeit not the entire picture. Although there is no “addiction gene” to definitively identify a person as being at risk for addiction, it is evident through twin studies, adoption studies, family studies, and more recently, epigenetic studies that addiction has a genetic component. Individuals who are genetically predisposed for addiction enter the world with a greater risk of becoming addicted at some point in their lives.
There are many hypotheses to explain this genetic predisposition, such as the Reward Deficiency Syndrome (Blum et al., 1996; Blum et al., 2014), which posits that some individuals are born with underactive reward circuitry (referred to as hypodopaminergic functioning) that subsequently primes them to be more susceptible to the rewarding effects of drugs of abuse (Febo et al., 2017).
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Additionally, many neurotransmitters are involved in the experience of reward (dopamine, opioids, GABA, serotonin, endocannabinoids, and glutamate; Blum et al., 2020). Thus deficiencies in any combination of these neurochemicals may contribute to a predisposition to addiction. It is important to note that one person’s reaction to the reward experience may be quite different from another’s. This realization should help us cultivate empathy for those with addiction—it is very likely that others truly do not know how drugs make them feel.
The Meaning of "Psycho"
Along with genetics, another contributing factor to the risk of addiction is one’s psychological composition. This factor is as broad as it sounds and includes personality traits (like sensation-seeking and impulsivity), mental health concerns (like anxiety and depression), psychological constructs (like self-esteem and self-worth), and the psychological impact of an individual’s life experiences (such as trauma). Some individuals may be more affected by the rewarding effects of drugs of abuse because they are trying their best to regulate painful emotions.
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For example, researchers have found a robust association between trauma and addiction (Dube et al., 2002, 2003; Giordano et al., 2016). Indeed, in the original Adverse Childhood Experiences (ACEs) study, Felitti et al. (1998) found that more ACEs increased the odds of subsequent drug and alcohol use. One explanation for this trend is that the toxic stress from trauma leads to a dysregulated stress response. An individual’s stress hormones (cortisol and adrenaline) are chronically elevated (Burke Harris, 2018; van der Kolk, 2014).
These individuals may experience constant hyperarousal, hypervigilance, anxiety, and abuse drugs may be an effective way to regulate these emotional experiences (Felitti et al., 1998). Thus, numerous psychological factors and experiences can increase the risk of changing how one feels (or regulating emotions) via drugs of abuse.
The Meaning of "Social"
The third factor in the biopsychosocial model is the social environment. Social norms, availability, accessibility, legality, modeling, expectancies, societal approval, visibility, targeting practices, and cultural beliefs all influence the experience of addiction. An individual exposed to drug use at an early age can be influenced by social modeling (or learning via observation). Additionally, certain environments have specific social norms related to drug use (e.g., “Everyone experiments a little with drugs in college”).
Furthermore, some communities are targeted more heavily with alcohol and tobacco advertisements and have more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019). Therefore, the social environment in which one exists contributes to their risk of addiction.
Putting It All Together
The factors that increase an individual’s risk for addiction are numerous, yet they all find their place in the biopsychosocial model of addiction (Marlatt & Baer, 1988). Taken together, this model provides a holistic conceptualization of addiction that acknowledges the complexity of the disorder and provides guidance toward a solution, which must necessarily be multifaceted and holistic as well. The more we know about the biopsychosocial model, the more we can foster accurate empathy for those with addiction and work toward effective treatment and prevention efforts.
References
Blum, K., Baron, D., McLaughlin, T., & Gold, M. S. (2020). Molecular neurological correlates of endorphinergic/dopaminergic mechanisms in reward circuitry linked to endorphinergic deficiency syndrome (EDS). Journal of Neurological Sciences, 411, Article 116733.
Blum, K., Cull, J. G., Braverman, E. R., & Comings, D. E. (1996). Reward deficiency syndrome. American Scientist, 84, 132-146
Blum, K., Oscar-Berman, M., Demetrovics, Z., Barh, D., & Gold, M. S. (2014). Genetic addiction risk score (GARS): Molecular neurogenetic evidence for predisposition to reward deficiency syndrome (RDS). Molecular Neurobiology, 50, 765-796.
Burke Harris, N. (2018). The deepest well: Healing the long-term effects of childhood adversity. Bluebird.
Dube, S. R., Anda, R. F., Felitti, V. J., Edwards, V. J., & Croft, J. B. (2002). Adverse childhood experiences and personal alcohol abuse as an adult. Addictive Behaviors, 27, 713-725.
Dube, S. R., Dong, M., Chapman, D. P., Giles, W. H., Anda, R. F., & Felitti, V. J. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The adverse childhood experiences study. Pediatrics, 111, 564-572.
Febo, M., Blum, K., Badgaiyan, R. D., Baron, D., Thanos, P. K., Colon-Perez, L. M., Demotrovics, Z., & Gold, M. S. (2017). Dopamine homeostasis: Brain functional connectivity in reward deficiency syndrome. Frontiers in Bioscience, 22, 669-691.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245-258
Giordano, A. L., Prosek, E. A., Stamman, J., Callahan, M. M., Loseu, S., Bevly, C. M., Cross, K., Woehler, E. S., Calzada, R.-M. R., & Chadwell, K. (2016). Addressing trauma in substance abuse treatment. Journal of Alcohol and Drug Education, 60(2), 55–71.
Grisel, J. (2019). Never enough: The neuroscience and experience of addiction. Scribe.
Mann, K., Hermann, D., & Heinz, A. (2000). One hundred years of alcoholism: The twentieth century. Alcohol and Alcoholism, 35, 10-15.
Marlatt, G. A., & Baer, J. S. (1988). Addictive behaviors: Etiology and treatment. Annual Review of Psychology, 39, 223-252
Primack, B. A., Bost, J. E., Land, S. R., & Fine, M. J. (2007). Volume of tobacco advertising in African American markets: Systemic review and meta-analysis. Public Health Reports, 122, 607-615.
Rose, S. W., Mayo, A., Ganz, O., Perreras, L., D’Silva, J., & Cohn, A. (2019). Perceived racial/ethnic discrimination, marketing, and substance use among young adults. Journal of Ethnicity in Substance Abuse, 18, 558-577.
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.
FAQs
What is the biopsychosocial model of the addiction? ›
The biopsychosocial model of addiction (Figure 1) posits that intersecting biological, psycho-social and systemic properties are fundamental features of health and illness.
How do you explain the biopsychosocial model? ›Biopsychosocial model helps primary care doctors to understand interactions among biological and psychosocial components of illnesses to improve the dyadic relationship between clinicians and their patients and multidisciplinary approaches in patient care.
What is the biopsychosocial model quizlet? ›biopsychosocial model. dynamic model suggesting that health and illness result from a combination of biological, psychological and social factors. Allows for a more holistic explanation of behaviour and takes into account the patients experiences and interpretations instead of viewing individuals as object.
What are the benefits of the biopsychosocial model addiction? ›The Biopsychosocial Model of Addiction gives weight to biological, psychological, and social factors in understanding the development and progression of substance use problems and should be considered in prevention and treatment efforts.
When was the biopsychosocial model of addiction developed? ›In the 1970s, the now famous psychologist George L. Engel came up with the biopsychosocial model of treatment. While many therapists were devoted to treating one particular aspect of a person's mental struggles, he found it was best to treat people from all angles.
What is an example of biopsychosocial summary? ›For example, if a patient experiences a physical illness while lacking social support, they may become depressed or anxious. Similarly, if a person has depression, they might withdraw from their friends and family and neglect self-care, impacting their physical and social wellness.
What is an example of biopsychosocial perspective? ›An example of this is someone with depression and liver problems. Depression does not directly cause liver problems. However, someone with depression is more likely to abuse alcohol and so, therefore, could develop liver damage.
What is the importance of the biopsychosocial model in mental health? ›The biopsychosocial model has another advantage. As well as being able to explain mental health in terms beyond the purely biomedical, it shows us there is potential to positively influence a person's mental health in the workplace.
What are psychological factors in the biopsychosocial model? ›The psychological factors in the biopsychosocial model refer to our thoughts, beliefs, and perceptions about our experiences, our environment, and ourselves. These cognitive patterns affect our perceived sense of control over our environment.
What best describes the biopsychosocial model of health quizlet? ›The biopsychosocial model of health emphasizes the idea that: health becomes something that one achieves through attention to biological, psychological, and social needs rather than something that is taken for granted.
How effective is the biopsychosocial model? ›
The biopsychosocial approach in healthcare can improve the effectiveness of diagnosis and treatment (12), which enhances patient satisfaction and can ease conflicts between doctors and patients.
What is the biopsychosocial approach and why is important quizlet? ›The biopsychosocial approach is a concept used to understand human behavior by looking at the biological, psychological, and social factors. These three influences coinside with one another to analyze and describe a behavior, disorder, or anything. This approach could be used to explain a student excelling in college.
What type of model is the biopsychosocial model? ›The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular.
What theory is a biopsychosocial model of development? ›The biopsychosocial model is a general model positing that biological, psychological (which includes thoughts, emotions, and behaviors), and social (e.g., socioeconomical, socioenvironmental, and cultural) factors, all play a significant role in health and disease.
What are examples of biopsychosocial questions? ›Describe your childhood: Did you experience physical, sexual, or emotional abuse or neglect growing up? If so, please describe: Do you know of any other traumatic events while growing up? If so, please describe: Do any family members have a history of mental illness or a problem with alcohol or drugs?
What does the word biopsychosocial mean? ›: of, relating to, or concerned with the biological, psychological, and social aspects in contrast to the strictly biomedical aspects of disease.
What is the purpose of biopsychosocial assessment? ›Definition: A Biopsychosocial Assessment is an assessment typically conducted by therapists and counselors at the beginning of therapy, which assesses for biological, psychological, and social factors that can be contributing to a problem or problems with a client.
What are the 4 P's of biopsychosocial model? ›The VCE Psychology Study Design requires students undertaking Unit 4 to use a 4P factor model (predisposing, precipitating, perpetuating and protective factors) as a subset of a biopsychosocial approach to analyse mental health and the development and progression of mental health disorders.
What is the conclusion of BioPsychoSocial model? ›In conclusion, the BioPsychoSocial model of medicine attempts to treat not just the injury, but the whole person, with an approach that is mindfulness and holistic—speeding the recovery of the patient on both a physical and psychological level, and leading to overall wellness.
Why is the psychosocial model important? ›Since the psychosocial model considers both an individual's psychological makeup along with the social context out of which it arises, it provides a more comprehensive and effective method for understanding mental distress and identifying treatment options.
What are the biopsychosocial needs of patients? ›
A biopsychosocial self-management approach requires health professionals who view patients as experts on their own lives and thus responsible for their own health. It also supposes that patients express their needs regarding their medical, emotional and role tasks.
Why is using the biopsychosocial approach important in understanding human behavior? ›It can specifically be applied to understanding overall health and health behaviors. It is a beneficial approach to us because it looks at all the possible biological, psychological, and social influences affecting overall health and health behaviors.
What are the four main assumptions of the biopsychosocial perspective? ›The Biopsychosocial Model (BPS) is a key part of this approach, as it takes into account four elements – biological, behavioural, psychological and social – and how they impact a client's health and wellbeing.
What is an example of biopsychosocial model? ›BIOPSYCHOSOCIAL APPROACH: People may start smoking for PSYCHOLOGICAL reasons, such as thinking it makes them less stressed or because of personality traits (extroverts are more likely to smoke). People may start smoking due to SOCIAL networks or perceived cultural norms.
What is a criticism of the biopsychosocial model of addiction? ›One of the most generally cited problems with the BPS model is that its inclusiveness results in an unscientific, “fluffy,” pluralistic approach where, in the words of the dodo bird in Alice in Wonderland, all perspectives have won and deserve prizes.
What are the 3 levels of the biopsychosocial approach? ›The biopsychosocial perspective is an integrated approach to psychology that incorporates three different perspectives and types of analysis: biological, psychological, and social-cultural.
What are psychological factors in biopsychosocial model? ›The psychological factors in the biopsychosocial model refer to our thoughts, beliefs, and perceptions about our experiences, our environment, and ourselves. These cognitive patterns affect our perceived sense of control over our environment.
What is a biopsychosocial summary? ›The biopsychosocial model is a general model positing that biological, psychological (which includes thoughts, emotions, and behaviors), and social (e.g., socioeconomical, socioenvironmental, and cultural) factors, all play a significant role in health and disease.
What is a biopsychosocial case summary? ›The Biopsychosocial Model and Case Formulation (also known as the Biopsychosocial Formulation) in psychiatry is a way of understanding a patient as more than a diagnostic label. Hypotheses are generated about the origins and causes of a patient's symptoms.
What are the 5 Ps in the BioPsychoSocial model? ›(2012). They conceptualized a way to look at clients and their problems, systematically and holistically taking into consideration the (1) Presenting problem, (2) Predisposing factors, (3) Precipitating factors, (4) Perpetuating factors, and (5) Protective factors.