Alcoholism from a social learning theory perspective
Alcohol can be traced as far back as 8000 B. C. when the people of the Middle East created a drink from honey and wild yeast (Alcohol Facts, n.d.). Since then, it has been used in religious ceremonies such as communion, for medicinal purposes as well as during social events. When a person begins to abuse alcohol by drinking large quantities and/or daily consumption, it can lead to a condition referred to as alcoholism. Although alcoholism has often been referred to as a disease, research has often conflicted with this theory (Peele, 1984). Therefore, researchers are now looking at other theories to explain alcoholism including the social learning theory. The social learning theory supports the idea that alcoholism is a result of both cognitive thinking and the influence environmental factors (Peele, 1984). It suggests that people who exhibit patterns of abusive drinking behavior often have difficulty coping with the stress of daily living (Cooper & Russell, 1988). This paper will demonstrate that alcoholism can be successfully treated through concepts based the social learning theory.
In 1819, Dr. C. W. Hufeland of Germany was the first doctor to give alcohol abuse and its tendencies a name, which was dipsomania. In 1849, Dr. Magnus Huss was the first person to name alcohol abuse and its tendencies, alcoholism (Silva, 2010). Since that time, millions of Americans have been adversely affected by the consumption of alcohol. According to the National Council on Alcoholism and Drug Dependence (NCADD) (n.d.), 18 million Americans were treated for alcoholism or problems related to alcohol. As a result, our emergency rooms are swamped with alcohol related illnesses, accidents, and injuries (NCADD, n.d.). Although there are several programs available to help, most are developed on the belief that alcoholism is a disease. Researchers in the field of social science believe that alcoholism is not a disease and therefore treatment guidelines should follow the recommendations discussed in the social learning theory.
Research has been conducted throughout the years supporting the idea that alcoholism is based on both cognitive and environmental factors (Peele, 1984) There are very few programs that offer treatment based on the principles of the social cognitive theory (Peele, 1984). Most programs base their treatment on the idea that an alcoholic cannot control their desire to drink and therefore, complete abstinence is crucial (Peele, 1984). Social theorists believe that people have a choice and when given proper coping skills, positive reinforcement and modification of beliefs, it will help in the treatment of alcoholism (Cooper & Russell, 1988).
Epidemiology of Alcoholism
Alcohol has played a considerable role in how Americans socialize. Americans consume alcohol during meals and on special occasions not giving any thought to the negative consequences that can occur. Although most people will never develop an alcohol problem, some people can be overcome with the cognitive and environmental factors that lead to alcoholism. According to Falk, Yi, and Hiller-Sturmhofel (2001), the amount a person drinks, the drinking patterns, or both of these factors, contribute to the risk of becoming an alcoholic.
Almost every American in the United States has had at least one drink by the time they reach late adolescence (Falk et al., 2001). The lifetime alcohol rate is highest among men ranging in age from 25 to 55 (Falk et al., 2001). Although the rate of lifetime alcohol use is lowest in women of all ages, it is lowest in woman 55 and older (Falk et al., 2001). Men, ages 18 to 25 years of age, were at the greatest risk of becoming alcoholics and were among the highest known to binge drink (Falk et al., 2001). Research has also found that there is a correlation between alcohol use and violence. Studies found that as much as 86% of the violent offenders arrested for murder, 65% for rape and 83% for domestic violence, were drinking just before the crime (Falk et al., 2001).
Diagnosis of Alcoholism
There is not a specific test that can be given to diagnose alcoholism. If a doctor suspects alcohol abuse, he may ask several questions and ask the patient to fill out a questionnaire. In order to be diagnosed with alcoholism, a person must meet the criteria set by the Diagnostic and Statistical Manual of Mental Disorders (DMS) (Mayo Clinic, n.d.). A diagnosis is based on pattern of alcohol use during any given year (Mayo Clinic, n.d.). Alcoholism can be diagnosed if the patient experiences three or more of the following criteria:
How much alcohol does it take to become intoxicated?
Is there any withdrawal symptoms when alcohol is reduced or stopped?
Is more alcohol being consumed then intended?
Tired to quit but was unsuccessful.
Drink for long periods of time.
Do not participate in important social events.
Continued use despite the physical and psychological ramifications (Mayo Clinic, n.d.).
When person is diagnosed with alcoholism, treatment is recommended as soon as possible. The method used for treatment is dependent on whether the physician views alcoholism as a disease or a psychosocial problem.
Social Learning Theory
The social learning theory focuses on learning through social modeling (Bandura, 1977). In other words, environmental influences help determine how our behavior learned (Patock-Peckham, Cheong, Balhorn, & Nagoshi, 2001). Although most theorist credit Bandura as the founder of the social learning theory, the first group of researchers to introduce the possibility of social learning began in 1930. Researchers linked motivation to the learning process now known as the Hullian perspective (Nangle, Erdley, Adrian, & Fales, 2010). In 1941, Miller and Dollard suggested that imitation could be linked to the social learning theory (Patock-Peckham et al., 2001). Sears linked the cultural aspects of behavior in 1951 and Bandara began his research in the 60’s (Patock-Peckham et al., 2001). Social learning occurs many ways. It can occur through direct reinforcement, observation, environmental, or through cognition.
Direct Positive and Negative Reinforcement
Positive reinforcement is reinforcing a behavior so that the behavior will be repeated in the future. As a person interacts with their family, peers, and society, they learn how to use various forms of social skills (Nagle et al., 2010). These skills are learned through a series of positive and negative reinforcements (Nagle et al, 2010). It is also important that reinforcements are as consistent as possible, although this is not likely to happen in the early stages of development (Nagle et al., 2010). Skills that are presented but are not consistently reinforced are likely to diminish over time (Nagle et al., 2010).
People often assume that observational learning is based on the idea that the observer learns or imitates the model when reinforcement is used (Bandura, 1965). However, it is difficult to prove this theory when often times there are no responses after the observer watches the model (Bandura, 1965). Therefore, the social learning theory supports the idea that learning is a completed through observation and symbolic representation (Bandura, 1977). A study conducted by Bandura, determined that in order for a participant to respond to a modeled activity, the response must be translated into images and symbols before the response can be given without the presence of the model (Bandura, 1977).
Environmental learning links the ability to learn to our surroundings. For example, the ability to learn is enhanced through recognition of a teacher, parent, or positive outcome. Environmental learning is flexible so specific learning methods may not apply to everyone (Zimmerman, 1989). According to Bandura (1991), another important aspect of environmental learning is enactive experience. Enactive experience allows a person to experience feedback, which motivates them to learn even more (Bandura, 1991).
Cognitive learning combines the theories of the self-regulation and the self-reflective processes. In other words, humans have the ability to symbolize, comprehend, and regulate the environmental influences that affect us (Bandura, 2001). Cognitive learning is responsible for processing external information and determining what information will be observed, stored as symbols, and recovered for later use (Bandura, 2001). Therefore, social cognitive learning is devolved through various forms of social factors, which influence the function of our cognition (Bandura, 2001).
Social Learning Theory and Alcoholism
Social theorists today are particularly interested in relationship between the social learning theory and alcoholism (Patock-Peckham et al., 2001). Studies have shown that the risk of alcoholism is higher in people that have low self-control or self-regulation (Patock-Peckham et al., 2001). People that are self-regulated are able to recognize when a behavior is destructive and can change either their behavior or the environment supporting the behavior (Patock-Peckham et al., 2001). A person low in self-regulation, may overeat, smoke, drink, and have more health related problems (Patock-Peckham et al., 2001). Further research has shown that people with low self-regulation tend to use drinking as a way of self-medicating (Patock-Peckham et al, 2001). This masks the various forms of emotional and/or psychological problems they may experiencing (Patock-Peckham et al., 2001).
Drinking to Cope
A person is at risk of becoming an alcoholic when they drink to cope. The social learning theory supports the idea that a person at risk of becoming an alcoholic, often drinks to temporarily mask negative emotions or escape their daily life (Copper & Russell, 1988). There has been several studies conducted which support this theory. For example, one study found that of the participants sampled, 93% of the participants drank to escape their problems (Cooper & Russell, 1988). Another study conducted by Marlatt and Gordon (1979) reported that of the relapsed alcoholics surveyed, ¾ admitted that their first drink was during a stressful situation.
The perspective of the social learning theory also finds that a person belief about alcohol can influence the decision of whether they may drink alcohol (Cooper & Russell, 1988). For example, if a person has learned and now believes that drinking can help overcome a crisis, increase the social attitude, or increase their sexual stamina, they are at risk of becoming an alcoholic. A person’s social environment may also affect a person’s belief about drinking. For example, For example, a study conducted in a bar, found that when participants were asked to evaluate their beliefs about alcohol, the results changed significantly after the participants was intoxicated (Wall et al., 2003). Pre-alcohol, the participants were less favorable about alcohol but once they were inebriated, their view was more positive (Wall et al. 2003). While this study did have some limitations, it does support the idea that drinking is learned from interacting and observing people in a social environment. A similar study conducted with women college students found that women were more likely to drink when joining a college fraternity because of the social expectations when pledging (LaBrie et al., 2007).
General Coping Skills
Coping skills are critical in assessing if a person is at risk of having alcohol related problems. It is important that a person learn acceptable coping strategies in order to respond properly during a stressful event. Coping skills that related drinking to both negative and positive outcomes has proven favorable (Monti et al., 1993). Coping skills taught while using actual alcoholic beverages as cues and presenting negative images seems to be one effective method used to create positive coping skills (Monti et al., 1993). Other methods include increasing cognitive and behavioral skills in order to raise self-regulation or self-esteem, teaching effective ways to manage stress and anxiety as well as increasing interpersonal skills (Botvin, Schinke, Epstein, & Diaz, 1994).
Alcoholism is a problem affecting millions of men and women today. It is used in several different social aspects including religious ceremonies, medicinal purposes, weddings, and pledging fraternities. Diagnosis of alcoholism is dependent on several different variables but it is important that treatment begin soon after diagnosis. Researchers are consistently developing new theories in which type of therapy is most effective. The social learning theory emphasizes that behavior change can be done though cognitive and environmental changes.
In sum, according to the social learning theory, drinking is a cognitive behavior that imitates what we have learned through family, friends, the media, and direct experiences (Wall, Thrussell, & Lalonde, 2003). Millions of Americans have alcohol related problems and treatment based on the disease theory has proven less than effective (Peele, 1984). Since we live in a culture that supports the use of alcohol during so many different social events, it is important that we learn effective measures to help prevent Americans from becoming alcoholics. Research studies into the theory of social learning have proven that alcohol abuse can be reduced if given the correct coping skills. Although there is no quick cure to this problem, the social learning theory provides a solution to the consistently rising number of alcoholics recorded each day.
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