Page 15 - PhD GT

Chapter 1
Dependence 1.0 Introduction
The nature of dependence and the ways in which it develops have been the subject of some debate, while the nature of change in dependence once established has earned less consideration. Theories of dependence, broadly speaking, have fallen into two categories: those associated with the idea that dependence, once established, does not diminish but becomes covert in the absence of the use of the substance and those based upon the idea that dependence can and does diminish. The two sides of this dichotomy have been described under the headings of disease theories on the one hand and learning theories on the other hand (see Heather and Robertson 1997). The position which has come to be associated with the ‘disease concept’ is generally characterised by irreversibility, while the latter is embedded in social learning theory broadly asserting that behaviours which have been learned are capable of being extinguished, thus implying reversibility. However, this crude categorisation does not in fact distinguish the psychology of learning from the rest; those who understand dependence as a learned behaviour may occupy either category depending upon whether there is a belief that dependence, like other learned behaviours, is capable of extinction or that, due to the strength of the reinforcement potential of addictive substances, the behaviour once learned cannot be extinguished. It is the aim of this thesis to examine the question of whether dependence diminishes and, if so, to elucidate the nature of the change that occurs.
In this first chapter, an outline of the background to the hypotheses for the present study and an examination of the history of theorising about dependence in order to explain this background are presented. In the second chapter, studies which have examined the development of dependence, its maintenance and decline are described. In Chapter 3, the literature on self-report as the dominant method of collecting data on substance use and related physical, social and psychological phenomena in the field is explored; self-report methods of measuring dependence based in different perspectives and theories of dependence are then presented and discussed. Not all descriptions of dependence and methods of measuring dependence appear to be theory based but an attempt is made to give them a theoretical context. In the fourth chapter, the studies I conducted for the present thesis and the samples used in these studies are outlined. Further work on the Leeds
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