CHAPTER 6 The Biopsychosocial Model of Addiction Monica C. Skewes*, Vivian M. Gonzalez $ * University of Alaska Fairbanks, Fairbanks, AK, USA, $ University of Alaska Anchorage, Anchorage, AK, USA OUTLINE Biopsychosocial vs. Biomedical Models of Addiction 61 Conceptual Models of Addictive Behavior 62 Biopsychosocial Model of Addiction 62 Biological Factors and the Development of Addictive Behaviors 63 Psychosocial Factors and the Development of Addictive Behaviors 64 Risk Factors in Children 64 Personality and Temperament 64 Classical and Operant Conditioning 64 Outcome Expectancies 65 Self-efficacy 66 Social Influences on Substance Use 66 Families 66 Peers 66 Spouses and Intimate Partners 67 Other Individual Difference Variables that Influence Substance Use 67 Ethnicity and Culture 67 Gender 67 Environmental Influences on Substance Use 67 The Biopsychosocial Model and Addiction Treatment 68 Natural Recovery 68 Medication 68 Psychosocial Factors in the Treatment of Addiction 69 Readiness to Change 69 Self-efficacy 69 Summary 69 BIOPSYCHOSOCIAL VS. BIOMEDICAL MODELS OF ADDICTION The biopsychosocial model of addiction posits that biological/genetic, psychological, and sociocultural factors contribute to substance use and all must be taken into consideration in prevention and treatment efforts. This model emerged in response to criticisms of the biomedical model, which has historically dominated the field of addiction studies. The traditional biomedical model was developed and is espoused by medical scien- tists for the study of disease, and its proponents also view addiction as a chronically relapsing brain disease with a genetic/biochemical cause. The biomedical or disease model of addiction views addiction as the mani- festation of disturbances in measurable biochemical or neurophysiological processes in the afflicted individual. Contemporary medical disease models acknowledge the influence of social, psychological, and behavioral dimensions of addiction; however, these dimensions are viewed as relatively less important in the etiology and treatment of addiction. The medical disease model favors reductionism, whereby underlying biomedical causes for addiction are primarily implicated in the etiology/cause of the disorder, and mind–body dualism, where the mind and the body are viewed as separate and as not significantly affecting one another. Despite widespread favor among many scientists and healthcare practitioners, evidence from research studies of addic- tive behaviors does not support the medical disease model of addiction; instead, a biopsychosocial model that gives equal importance to biological/genetic, psychological, and sociocultural factors better fits the available data. 61 Principles of Addiction, Volume 1 http://dx.doi.org/10.1016/B978-0-12-398336-7.00006-1 Copyright Ó 2013 Elsevier Inc. All rights reserved. Principles of Addiction, First Edition, 2013, 61–70 Author's personal copy