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The function of biological and genetic factors in the development and maintenance of substance use and substance use disorders has been widely documented. Research has also indicated that cognitive-social learning variables, such as acquired expectations about substance use consumption and self-efficacy, can influence the development and maintenance of substance use and substance use disorders. Substance use researchers have long sought to understand the antecedent events and reinforcing consequences of substance use behaviors in an effort to provide better prevention efforts, intervention and treatment options, and tools for the maintenance of sobriety for substance abusing and substance dependent patients. An antecedent event is an event that precedes a substance use behavior and may tend to cause that behavior to occur. A consequence is the outcome of engaging in the substance use behavior, and if that outcome is reinforcing, it will increase the likelihood that the behavior will occur again. This entry focuses on the development of the cognitive-social learning model of substance use from social learning theory, the role of expectancies about self-efficacy and expectancies about the outcome of substance use, and treatment modalities and relapse prevention techniques that have arisen from the cognitive-social learning model.

Introduction

Albert Bandura's social learning theory proposed that a great deal of human behavior is learned from the environment, particularly the social environment. This theory postulated that human behavior was not controlled solely by the environment or solely by internal drives, but rather by a combination of environmental events, internal processing, and reinforcing feedback. This view of multiple influences on human behavior differed widely from the predominant psychological theories of the time (i.e., psychoanalytic, associative learning).

As it relates to the study of addictive behaviors, social learning theory may be applied to both the development and maintenance of substance use and substance use disorders. Bandura cited social modeling as a major factor in the development and maintenance of substance use. Modeling may be defined as learning that arises by observing the behavior of others and imitating their behavior. Bandura also cited the negative reinforcement of substance use as a major factor in the development and maintenance of substance use via the stress reduction that occurs in the individual's environment due to the physiological effects of alcohol. Coping skills and social resources are also identified as major components of the ability to change problematic substance use patterns and the ability to maintain these changes. Social learning theory postulates that substance use is largely an effort to reduce stress in the environment. Alcohol researchers have used social learning theory to understand the development of substance use disorders and to devise substance use treatment strategies. Additionally, researchers have built upon existing social learning theory to provide a more comprehensive view of the development and maintenance of substance use.

Expansion of Social Learning Theory

Arising from social learning theory, the cognitive-social learning model incorporates cognitive factors that mediate substance use behaviors in addition to the factors outlined in social learning theory, including self-efficacy expectancies and substance use outcome expectancies. Self-efficacy may be defined as the confidence that an individual can cope effectively with a prospectively stressful situation. Thus, self-efficacy expectancies may be defined as the belief that an individual can execute a specific behavior to attain a desired outcome. Substance use outcome expectancies may be defined as the belief about the probability of achieving a desired outcome if a particular behavior is exhibited. These substance use outcome expectancies are based upon past experiences in which a specific behavior resulted in a specific outcome or consequence. These cognitive factors and their relationship to substance use and substance use disorders are described in greater detail in the next sections.

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