Risk factors affecting vulnerability to addiction

Another application-heavy section here - you'll often be presented with a scenario and asked to identify and explain risk factors that are present, and then evaluate the risk factors using supporting evidence. Remember to specifically signpost any research you take from this as supporting evidence - making sure it counts for AO2 rather than AO1

Black: AO1 - Description
Blue: AO2 - Evaluation - studies
Red: AO2 - Evaluation - evaluative points/IDAs
Purple: My notes/hints/tips

Stress: Increased stress levels are positively correlated with an increased vulnerability to developing dependencies, often initiating them as a maladaptive way of coping with stress. The self-medication cognitive model of addiction explains addictive behaviours as initiating in order to alleviate the effects of existing life stressors such as anxiety or a lack of self-confidence, suggesting that people initiate the specific addictive behaviour that they feel will help them best cope with a specific source of stress.

Childs + DeWitt (2010) investigated the effects of stress on cigarette smoking, looking specifically at its effects on cigarette craving, the subjective effects of smoking, and smoking behaviour in daily smokers. A sample of smokers was given a stressful task to complete, and then given a chance to smoke or earn money over a 2-hour period. Both before and after the task, stress was measured both objectively (through heart rate and cortisol levels) and subjectively (through self-reported anxiety and desire to smoke.) These measurements were also taken after they smoked a cigarette when given the chance to. Participants were more inclined to smoke for stress relief than to earn money. Stress did seem to increase cravings to smoke and pleasure obtained from smoking, but did not seem to increase the amount of cigarettes that were smoked.


Cleck + Blendy (2008) reported that people with stress-related psychiatric disorders such as depression and anxiety (that are often related to addictive drug usage and exposure to chronic stressful life conditions such as abuse) have an increased rate of nicotine, alcohol and cocaine usage, suggesting stress is an important factor in determining vulnerability levels to addiction.

These results can also be used to support self-medication cognitive model of addiction – the concept of nicotine taken to alleviate stress and anxiety supports the central concept of self-medication.


Peer group: Peer pressure is a very powerful factor that can influence the behaviour of an individual, especially during childhood and adolescence. Peer pressure can work as a form of operant conditioning – if peer groupings encourage and socially reward addictive behaviours, thrill seeking and experimentation, individuals within the peer group will have an increased vulnerability to both initiation and maintenance of addictive behaviours. Peers also act as a form of social learning, modelling addictive behaviours so others will observe and imitate them, and being rewarded by peer approval as a form of vicarious reinforcement.

Bricker et al (2006) investigated the extent to which childhood friends influenced smoking behaviour. A sample of 4744 children was studied and it was found that close friends influenced them:

• To try smoking 38% of the time
• To move on to monthly smoking 10% of the time
• To move on from monthly to daily smoking 11% of the time.

This study also found that close friends were 12% more influential in the initiation of smoking in the sample children than parents’ smoking was. However, close friends smoking were 16% less influential than parents smoking in the move to daily smoking. This suggests that peers play a role in initiation more than they do maintenance, when the family and parents become more important. This supports the role of social learning theory as an explanation of addictive behaviour initiation – 38% of children initiated an addictive behaviour due to observation and imitation.

Wagner and Anthony (2002) found that cannabis smokers were more likely to progress to cocaine usage due to being in peer groupings where there are opportunities for new drug experiences, suggesting that peers can act as a social context “gateway” to other addictive behaviours. This supports the role of peer groups in the initiation and maintenance of addictive behaviour.

However, cause and effect cannot be established with complete certainty when studying the role of peer groups in addiction – it is possible that instead of peer groups influencing dependency behaviours, individuals who are already dependent will seek out peer groups that accept and encourage their dependent behaviour – social selection rather than social influence.

Gender: it has been suggested that males and females take different factors into consideration when making the decision to initiate smoking. Men tend to be more likely than women to take part in most addictive behaviours and to have a larger repertoire of gambling activity than women.

Amos and Bostock (2007) carried out a qualitative study of 15-16 year old Scottish smokers, and found that smoking played a different role for the two genders, differences revolving around diverse social relationships, interests and activities. For example, boys were more likely to consider the impact that smoking would have on fitness and the ability to play sport, while girls focused more on the aesthetic effects of smoking, such as their clothes and bodies smelling of smoke. This supports the idea that different genders consider different factors when initiating addictive behaviour.

They suggested a real world application from the result of this study: stop-smoking campaigns aimed at girls and boys should be designed differently and with a different message to target the ill effects of smoking that each gender specifically focuses on in order to better target their message to their audience demographic.

Personality: Originally, it was suggested that addiction leads to personality defects, but research has indicated that certain personality traits can predispose an individual to the development of addiction. Traits associated with extroversion, introversion, neuroticism and psychoticism can increase vulnerability to addiction. . Extroversion involves sociability, liveliness, and thrill-seeking, and according to Eysenck’s theories, the thrill-seeking tendencies of extroverts make them more likely to develop an addiction. On the other hand, some introvert traits such as shyness and lack of confidence can make addiction more likely.  

Eysenck and Grosson (1991) used the EPQ (Eysenck Personality Questionnaire) to compare 221 addicts to 310 non-addicts, finding that addicts had many more personality items on the neuroticism scale linked to anxiety and depression. However, cause and effect is an issue here – being addicted to a substance could cause anxiety and depression, rather than anxiety and depression leading to self-medication through addictive substances.

Eysenck linked excess dopamine levels in people with a psychotic personality to addiction, but the rise in dopamine levels caused by many addictive drugs could lead to a rise in personality traits associated with psychoticism such as aggression and impulsivity – can’t determine cause and effect.

Francis (1996) found a link between alcohol, heroin and benzodiazepine and nicotine addictions, and higher than normal neuroticism and psychoticism levels – suggesting that personality factors can affect the likelihood of addictive behaviour developing. 

There is very little empirical evidence to suggest a causal link between the thrill-seeking dimension of extroversion and the initiation of addictive behaviours.

The concept of an addictive personality is supported by the fact that certain individuals can become dependent on many things, either simultaneously or over time. For example, a heroin addict overcoming their heroin dependency and becoming an alcoholic. This idea is also supported by the fact that many recovered addicts develop equally strong compulsions towards other activities not typically seen as addictive behaviours, such as long-distance running, or religious fervour.  

Age: Younger age groups are more likely to engage in online gambling 

The British Gambling Prevalence Survey found high prevalence of online gambling in younger age groups – 15% for those aged 25-34, 1% for those aged 75 or over, across both genders. Across both genders, problem gambling rates did not vary by age, but in men, problem gambling prevalence higher in younger age groups than older – 2.1% in 16-24 age group, 0.4% for 75+ age group. This suggests that belonging to a younger age group can put one at a higher risk for the development of addictive behaviour.

Media: Social Learning Theory suggests that addiction is learnt through observation and imitation, and that figures in the media such as celebrities or fictional characters can act as models for addictive behaviours. If the addictive behaviour is presented in a positive light or the model is rewarded for their behaviour, the viewers are more likely to imitate them and initiate the addictive behaviour themselves, an example of vicarious reinforcement.

Gunsekera et al (2005) carried out a content analysis of 87 popular films released over a period of 20 years. They found that: 8% featured cannabis, 68% featured tobacco, and 32% featured drunken behaviour, and  most that featured them tended to portray these drug-taking behaviours positively.

Dalton et al (2003) surveyed 3547 children aged 10-14, all of whom were non-smokers. 1-2 years later, a follow-up study found that those who had been exposed to the most smoking in films were significantly more likely to have started smoking. Dalton concluded that greater exposure to addictive behaviour in the media leads to an increase risk of developing that addictive behaviour themselves. However, determining cause and effect may be an issue here: it may have been that the type of children likely to start smoking were also more likely to seek out that kind of film. 

Distefan et al (2004) surveyed adolescent smokers and asked them to nominate a favourite film star. One third of participants named a star who smoked on screen – this was seen to play a large part in predicting these adolescents’ own smoking behaviour – particularly among girls. However, this was a correlational study, so we cannot rule out a third variable such as a thrill-seeking personality that could lead children both to start smoking, and to be more drawn to film stars that both smoke and star in more action-based films.

The British Gambling Prevalence Survey of 2011 reported that 73% of the adult population had participated in some form of gambling over the past year, a prevalence increase of 5% from the rate observed in 2007. This correlates with a 600% increase in exposure to gambling adverts on television since the 2005 Gambling Act. Although this is only correlational, it could suggest that the increased media exposure and gambling adverts led to the increase of gambling behaviour in the general public.