This thesis examines decision-making about risks under conditions of uncertainty. Research specifically studies adolescents and smoking to uncover which information sources play influential roles in forming smoking risk perceptions. Findings aim to offer policy-related, theoretical and methodological meaning This study looks at two key issues. First, it links risk perceptions to smoking decisions to highlight the motivation for understanding the predictors of risk perceptions. Second, research investigates how individuals use information sources (ex. parents, doctors, peers, health warning messages) employing a Bayesian decision-making model. This thesis performs empirical analysis using The Canadian Youth Smoking Survey (2002) (19,018 respondents, 10-15 years) and The U.S. National Survey on Drug Use and Health (2004) (18,294 respondents, 12-17 years). Across both datasets, adolescents' risk perceptions and likelihood of having never smoking a cigarette were found to be positively related. However, smoking behaviors were never found to significantly predict risk perceptions once controlling for endogeneity between risk perceptions and behaviors. This suggests that adolescents rely on exogenous information sources about smoking risks rather than personal experiences to form perceptions of smoking risks. From a policy perspective, medical professionals talking with adolescent patients about smoking, parents' smoking, societal smoking prevalence (more than peers' smoking), awareness of tobacco package warning labels and knowledge of school smoking rules (but not the rules themselves) were found to predict adolescents' risk perceptions. From a theoretical perspective, this thesis alters the Bayesian model to include environmental and social effects. It also finds support for the role of affect heuristics in decision making involving risks. Findings also point to evidence of principal-agency relationships between medical professionals and adolescents. Analysis also highlights how spatial proximity impacts the credibility adolescents attach to behavioral examples and opinions regarding smoking. From a methodological standpoint, evidence suggests that adolescents' expressions of their assessment of risk depend upon elicitation methodology used and that work focusing on predictors of risk perceptions should include direct (ex. parents discussing risks) and indirect (ex. societal smoking prevalence) sources of information.

This literature review focuses on the research relating to facial expressions of emotion, first addressing the question of what they are and what role they play, before going on to review the mechanisms by which they are recognised in others. It then considers the psychiatric and drug-using populations in which the ability to recognise facial expressions is compromised, and how this corresponds to the social behaviour that characterises these groups. Finally, this review will focus on one particular population, opiate users. The relevance of studying this population will be discussed and the evidence relating to recognition of facial expressions in this group will be presented.

This paper reviews recent gains in knowledge of addiction, with particular reference to cocaine. It starts by considering the history and prevalence both of recreational cocaine and chronic abuse. It goes on to describe what is known about acute cocaine action in the human brain, before reviewing developments in theories and models of processes in addiction. It concludes by discussing how current models do not yet account for ongoing, stable and controlled social use of cocaine, and suggests that tools used to measure inhibitory control and incentive sensitisation might be used to assess these attributes in recreational cocaine users in order to gain insights into controlled use as well as to further understandings of addiction processes.

This critical reading aims to evaluate the extent to which evidence-based practice meets the intervention and care provision needs of minority patient groups. Among problem drug and alcohol users, certain sub-populations such as ethnic minorities, women, extreme age groups and those with complex problems present particular challenges for identification of needs and appropriate service provision. People from ethnic minorities are under-represented among substance use treatment populations, and young males are identified as presenting high suicide risk and either experiencing, or at risk of experiencing, social exclusion and criminality, but at the same time have greater difficulties accessing treatment pathways. There is also an increasing clinical concern about young, aged and female substance misusers, and recognition that there is limited knowledge about their particular service access and intervention needs. Current practices and policies for substance misuse services, however, may often be based on medically dominated evidence established from the majority patient population, leading to provision targeted at the needs of, often, white, middle-aged men who have the easiest access to services. The methodological approach of this thesis is a critical reading of existing research underpinning current evidence-based practice, with an analysis of how, and in what ways, quantitative methodological approaches favoured in medicine fail to recognise and accommodate the needs and presentations of minority sub-groups. In this way, the analysis focuses on the manifest and latent limitations of each quantitative approach, identifying and exploring evidence regarding sub-populations for whom the findings, and therefore the evidence-based practice, may not apply. The investigator's own studies will be included in the critical reading and alternative methodologies will also be examined. It is argued that, in addition to acute and chronic illness, lifestyle health problems such as substance misuse represent a third category of health concern by being subject to contextual influence and behaviour change. It is therefore less suited to a disease model approach to evidence for practice and demands evidence based on behavioural and psychological change processes rather than treatment outcomes.

This thesis concerns how memory processes and biases may be implicated in substance dependence. The literature review begins by outlining different models of drug dependence and research into cognitive function in addiction. It then outlines the structure of long-term memory, before reviewing and discussing the implications of the limited evidence available for cognitive biases operating in semantic and episodic memory of individuals who are addicted. The review ends by discussing implications for future research and by suggesting additional paradigms that could be used to further investigate the role of memory in addiction. The empirical paper describes a study which investigated semantic priming and verbal learning in current opiate users on a methadone maintenance programme, ex opiate-users in rehabilitation and healthy non-using controls. It is one part of a joint project, the other part having been carried out by a fellow clinical psychology trainee who investigated response inhibition in the same sample population. Both current and ex-users showed preserved semantic priming. Ex-users showed a verbal learning impairment compared with controls, whilst both current and ex-users showed impairment in recalling semantically unrelated words, but intact recall of semantically related words. This may suggest a relative impairment in the ability of opiate users and ex-users to impose structure to unstructured information (e.g. use of mnemonic strategies) and a greater reliance on semantic memory when encoding new information. Providing opiate using clients with highly structured information may be beneficial to intervention. The critical appraisal gives a reflective account of the research process, the study and the treatment implications of the findings.

Most research on addiction has been dominated by quantitative methodologies, although there has been increasing interest in qualitative approaches. The primary aim of this thesis is to contribute to a psychological understanding of experiences of addiction and recovery, considered from a phenomenological interpretative perspective. This investigation adds to the small number of IPA studies in this field. It focuses on the experiences of addiction and recovery, the ways participants make sense of their experiences in the contexts in which they occur, and the interpretations which can be discerned from participants' accounts. The thesis consists of four empirical studies. The first study presents an in-depth single case study illuminating how experiences of addiction and accompanying feelings, thoughts and expressions appear to the participant in the context of her life. The second study broadened the enquiry by including a small group of participants. This provides an opportunity for examining similarities and differences between participants across cases and moving towards making more general claims. At the same time, because of the small sample size it was possible to maintain an idiographic focus on the individual participants' accounts of their experiences. The third study extended the scope of IPA's approaches to data collection and analysis by using visual material in conjunction with interviews. This provides another perspective from which to investigate how participants experience and understand their process of recovery from addiction in ways not possible with verbal accounts or visual material alone. The fourth study extended the scope of the research by focusing on the less well researched area of the experiences of long-term recovery from addiction, in contrast to the three previous studies in which participants have been involved in their respective programmes of recovery for between one and two years. The thesis concludes with critical reflections and an indication of limitations as well as possibilities for future research and practice.

Research in the substance misuse field tends to focus on the causes of addiction and why people misuse drugs or alcohol. Often, research provides an understanding of substance abuse and its etiology through reference to the different models of addiction. Limited attention is given to the complex nature of developing substance abuse and the process of `addiction' and recovery and what these processes mean to individuals having lived through addiction and recovery. Existing qualitative research shows that identity change and changes in self-esteem are important constructs in the recovery from addiction (Etherington, 2006; Kellogg, 1993; Koski-Jannes, 2002; Larkin &Griffiths, 2002; McIntosh & McKeganey, 2001; McIntosh & McKeganey, 2000; Shinebourne & Smith, 2009; Vaughn & Long, 1999; Weegmann & Piwowoz-Hjort, 2009). This research explores the lived experiences of 8 participants who are recovering or have recovered from addiction to substances, focussing particularly on how changes in identity and self-esteem may facilitate recovery and contribute to its maintenance. The data were analysed using the IPA (Interpretative Phenomenological Analysis) approach. The interpretation of the data suggests that early experiences such as loss of relationships, conditions of worth and an unstable identity may play an important role in understanding vulnerability to developing substance misuse and that identity issues and self-esteem are key features in this understanding. Theories of identity development offer an understanding into the difficulties that individuals may face in constructing an integrated and healthy identity and what factors influence healthy identity development. Themes revealed during the data analysis suggest that the role of identity transformation is constructed through a meaning making process in which change becomes possible, thus facilitating the recovery process. Furthermore, a transition to a healthy identity increases self-esteem and facilitates the maintenance of recovery. This has implications for those involved in the treatment of addictions, for example, Counselling Psychologists. More effective treatment may involve an understanding of the importance of identity and self-esteem in recovery and the ways in which both therapist and client can co-construct the meanings that client's attach to their experiences of addiction and recovery.

No description available.

The term recovery has been recently re-launched within UK drug policy, with focus on individuals' engaging in treatment and achieving change. What constitutes recovery and the process of recovery is misunderstood, due to the term previously being attributed to an individual reaching total abstinence. Within the UK previous research has largely focused on the benefits of pharmacological interventions, rather than on recovery as a concept. To date there have only been two major studies regarding recovery as a process (Mclntosh and McKeganey 2000a; Best et al 2008). However, what these studies did not do was assess the process of recovery in real time. The aim of the thesis was to provide a comprehensive investigation of recovery, to add knowledge to this area regarding the overall process of the concept. The research includes a prospective study (n=45) to assess the lived experience of recovery from those entering treatment, combined with a retrospective study of oral histories (n=12) to evaluate respondents' drug using career using semi-structured interviews. The main finding of the research was in relation to the importance significant life events have on the individual's decision to stop or resume drug use. The results confirm that recovery should not be viewed as an end state, but as a process of change over time, one which may be influenced by factors extraneous to drug use such as relationships, health and employment. These events are a combination of positive and negative experiences which can initiate or impede change. The results suggest that early identification of these factors could enhance change by removing existing potential barriers. Within the study, the terms recovery and desistance were used, with recovery pertaining to change over time and desistance referring to periods of non-drug use. Reviewing the literature coupled with findings from the study suggest that utilising these terms would provide a more clear cut definition of change and allow policy makers, researchers, academics and service users alike to have a sound understanding of what recovery is, whilst acknowledging the process of change over time.

In this rational reconstruction, two rival research programmes are identified as dominating the Social Psychology of decision making. Behavioral Decision Theory and the Theory of Reasoned Action embody the Rationalist programme. Social Judgment Theory and Attributional Theory exemplify the Empiricist programme. As predicted by the Methodology of Scientific Research Programmes (MSRP), the negative heuristics are shown to condense as hard cores which remain protected from refutation. The historical reconstruction of Social Judgment Theory illustrates uneven development in algorithmic and propositional heuristics. Behavioral Decision Theory shows a progressive problem shift to Multi Attribute Utility Theory (MAUT). In a revision of MSRP to include practice shifts, the Theory of Reasoned Action illustrates progressive practice despite empirical anomalies. Attributional theory shows a progressive problem shift by predicting personal-efficacy to influence choice. Practice, however, is restrained through reliance on the ANOVA paradigm. The experimental study partitioned locus and stability attributes for subjects' choice of therapy programmes in an anti-smoking clinic. A significant main effect was found for stability expectancy, though this did not influence choice. The Lens Model algorithm was demonstrated to transpose successfully onto the Self-efficacy model with the intra-system capturing decisions combining the two forms of efficacy expectation. The Theory of Reasoned Action was augmented by transfer of MAUT techniques giving relative weighting to salience. Though Rationalist and Empiricist paradigms illuminate some aspects of stopping smoking, neither adequately addresses the decision-action gap perceived by smokers who disown their original intentions when the the correspondence is seen as inauthentic. An alternative model is proposed with a basis in Objectivist epistemology. Authenticated action is explained as a means of arriving at decisions through consideration of problem and practice shifts at the individual level.