Addiction and psychopathology: a multidimensional approach to clinical practice
Year: 1990
Type: dissertation
Abstract: The etiology of addiction has a long history of clinical and scientific \ninterest, which is characterized by differences in conceptual approach, conflicting \ndata and public controversy. There have been numerous attempts to describe the \nantecedents and consequences of addiction in theoretical models and by \nclassifying addicts on the basis of personal, pathological and environmental \ncharacteristics (Lettieri, Sayers, & Pearson, 1980). Despite these considerable \nefforts, the insights that emerged from theory and empirical research have not \nled to a clear understanding of the etiology and the course of addiction. Perhaps \nevenly important, the limited clinical applicability of theory and research has led \npractitioners in the addiction field to rely on their private theories about the \nnature of addiction and the significance of co-existent problems in the treatment \nof addiction. Complicating the issue, addiction is subject to considerable moral \ndebate, which includes opposing views on the types of drugs that are considered \nacceptable, the acceptability of drug use in general, law enforcement strategies, \nand treatment methods. \nPerhaps the most important trend that emerges from the past decades of \nmodel-development and research in the addiction field, is that scientist of \nvarious disciplines now agree that addiction is a heterogeneous concept in terms \nof its antecedents, concomitants, and consequences. Simply acknowledging the \nmultifaceted complexity of addiction however, does itself not necessarily lead to \na better understanding of the phenomenon, nor does it provide a guidance for \nclinical decisions. To expand our views on addiction, it has become extremely \nimportant to examine the interactions between the various components of the full \naddiction complex in detaiL Of particular importance is the question whether \naddiction constitutes a complex of highly interdependent problem areas that \ntogether form one underlying "addiction-dimension", or whether separate \ndimensions exist that are relatively independent from each other. Perhaps the \nmost intriguing issue in this question is the relationship between substance abuse \nand psychopathology, as psychiatric disorders are often assumed to antedate and \nprecipitate the onset and continuation of substance abuse. Clearly, the issue of \ndimensionality and the specific role of psychopathology in addiction is not only important from a theoretical point of view, but also bears relevance to the treatment of addiction. While the unidimensional concept of the full addiction complex would argue for a treatment approach that primarily focuses on reduction of the actual substance use, under the assumption that this will more \nor less automatically lead to reduction of addiction-related problems in other \n areas, the multidimensional concept of addiction would argue for focused \nattention on each of the specific problem areas, including psychiatric \nsymptomatology, independently. \nThis introductory chapter describes the context and perspective of the \ndissertation. First, the major models and research findings in the general field of \naddiction are briefly summarized as background of the study. Second, issues \nassociated with dimensionality conceptualizations of addiction are discussed. \nThird, the relationship between psychopathology and addiction is examined. \nFourth, the significance of psychopathology in the treatment of addiction is \ndiscussed. At the end of the chapter, the methodology and research questions on \nwhich this dissertation is based are described.
Author: Vincent M. Hendriks
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1955139478