Temperance Model:
Substance itself: the cause of addiction. Evolved into the prohibition movement.

Legalizing caused conceptual dilemma because most believed that alcohol problems were caused by the nature of the substance itself. Solution:

Disease Model (Medical Model)
1957 AMA declared alcoholism a disease on the basis of 3 criteria:
(1) a known etiology [cause]
(2) the progression of symptoms that get worse over time,
(3) a known outcome: dependence, physical symptoms, and eventual death

1. Addiction is a medical disorder as much as diabetes.
2. Alcoholism is a progressive condition that is qualitatively different from social drinking.
3. There is a biological disposition toward addiction.
4. Rests on the assumption that some people have a biological vulnerability to the effects of a chemical or chemicals which is expressed as a loss of control over their use.
5. Alcoholics are different and are incapable of drinking in moderation.
6. Central symptom of alcoholism is the loss of control over alcohol, the inability to stop drinking once a person has taken a drink.

Genetic Model:
Blum et al. 1990 identified a link between the receptor gene for the neurotransmitter dopamine and alcoholism. Established clearly the significance of a genetic factor in predisposing people to alcoholism.

Adopted sons of alcoholic biological parents are 4X more likely to become alcoholics than adoptees whose biological parents were not alcoholics.
Identical twins [100% shared genes] vs fraternal [50% shared genes] studies show 71% – 32% concordance, 26% – 12%,
Psychological Model

Psychological vulnerability: prior psychological factor that makes a pattern of substance dependence more likely to develop.

Personality Traits:
1) High emotionality.
2) Anxiety and over reactivity
3) Immaturity in interpersonal relationships
4) Low frustration tolerance
5) Inability to express anger adequately
6) Anger over dependence and ambivalence to authority
7) Low self-esteem with grandiose behavior
Perfectionism
9) Compulsiveness
10) Depression.
11) Dependence in interpersonal relationships
12) Rigidity and inability to adapt to changing circumstances
13) Simplistic, black and white thinking

Conditioning Model:
Problems with drinking are simply learned habits.
Drinking: alcohol is rewarding: such as tension reduction; removal of inhibitions; reinforced through peer pressure.

If learned it can be unlearned. Try to teach an alcoholic to drink moderately.