- Email: [email protected]
Scientific basis of drug dependence
391
BOOK REVIEN’S T. X. BARBER: Hypnosis:
A Scienrific
Approach.
Van
Nostrand
Reinhold
Company,
N.Y.,
1969.
52.95.
DR. B.ARBERhas been publishing numerous empirical studies of hypnotic phenomena in recent years, and the present book which summarizes them and his theoretical contributions is a valuable contribution to the literature on hypnosis. The so-called hypnotic state has always been something of a mystery; Barber proposes to cut the Gordian knot by abolishing the concept entirely and concentrating rather on the various dependent and independent variables involved in hypnotic research. Much of his book is highly critical of previous vvork, but there is no doubt that much of the criticism is deserved. His major conclusion is every conceivable empirical that “since a construct hypnosis can be used in an ad hoc manner to “explain” finding, it is questionable whether it actually explains anything at all. Furthermore, since theories which pivot around the construct hypnoric slate can use at/ hoc reasoning to account for all possible experimental outcomes, there can be neither proof nor disproof”. Whether the evidence entirely supports such a farreaching conclusion, the reader must judge for himself; Barber certainly makes out a very strong case. However, even if vve simply regard all ‘*hypnotic” phenomena as due to suggestibility, the possibility still remains that “hypnotic state” might be, as Hull suggested, a state of heightened suggestibility induced by repeated suggestions to accede to all other suggestions made by the experimenter! In view of Barber’s rejection of the hypnotic state, it seems odd that he does not discuss in more detail the experimental evidence relating to suggestibility; 1 would have thought that this was exceptionally relevant to his thesis. There are a number of other minor criticisms which could be made. The account and interpretation Barber gives of his factorial study of his battery of hypnotizability tests is incomplete and difficult to follow; it is not even clear whether factors were rotated or not. Occasionally he leaves out important references which could change the conclusions; dealing with the Furneaux and Gibson study and its replication by Hilgard this agrees with his thesis that and Bentler, he says that they “presented diametrically opposed results”; widely different results have been reached in correlating personality with hypnotizability. He does not mention Furneaux’s answer in which he points out why the observed differences have arisen. and that they do not in fact contradict his main thesis. However, such aberrations are rare, and the book as a whole constitutes an extremely salutary exercise in debunking which should be widely read. H. J. EYSENCK
HANNAH STEINBERG(Ed.):
429
Scie~rtific Basis c?f Dr1l.7 Depetr&rcc.
J. & A. Churchill
Ltd.,
London,
1969.
pp. f5.
T~IIS book reports the proceedings of an international symposium held in London in 1965. The symposium dealt mainly with the area formerly called “drug addiction”; of the twenty-six papers only three relate to dependence on alcohol, the remainder to heroin, the amphetamines, the barbiturates, etc. These papers are spread over the disciplines of pharmacology, biochemistry, experimental psychology, social psychology, psychiatry, sociology and epidemiology. The coverage is good and reasonably representative of current areas of interest. Inevitably, however, there are some important omissions, such as discussion of the use of methadone and cyclazocine in treating narcotic addicts, or of more papers on abuse of stimulant drugs. One problem with collecting together papers from such a range of disciplines is that members of one may not be able to fully appreciate the contributions of others. Thus, while two-thirds of the book will bc intelligible to the average psychologist, the third devoted to pharmacology and biochemistry will probably have little to offer him. This book provides a welcome opportunity for the collection of much of the relatively unknown recent British research in this area. Of particular interest to readers of this journal are three papers, by Thompson and Pickens, Deneau, animals. Such studies have shown that rats and monkeys, given the chance, will learn to self-administer a wide range of drugs which produce dependence in humans. The effects of drug-deprivation, administration of extra drug by the experimenter, changes in environment, and variations in the size of the drug reinforcement and reinforcement schedule on such “drug-seeking” behaviour have been investigated. It has been shown that previously neutral external stimuli can acquire secondary reinforcing properties by association with primary drug reinforcement. It has also been demonstrated that such stimuli can acquire the ability to evoke conditioned withdrawal symptoms by their paring with a state of drug withdrawal. The role of such factors in determining “relapse” in “ex-addict” animals has been investigated.
39s
BOOK REVIE\\‘S
The results of these studies strongly su ggest the importance of powerfui behavioural forces maintaining drug-using behaviour in human addicts. Unfortunately, little research has been done to test directly the role of such forces in laboratory investigations of drug use in humans. Such studies obviously pose more problems than rat or monkey experiments, but a study by hlello, hlendelson and .IlcNames, experimentally investigating drinking patterns in alcoholics, reported in the volume under revievv, suggests that such s:udies are not unfeasible. Perhaps, in the present state of knowledge, the most direct evidence for the importance of behavioural factors in drug dependence in humans comes from the methadone and cyclazocine treatment programmes and the handful of cases in which behaviour therapy techniques have been employed. Neither of these areas are discussed in the book under review. The closest approach to the application of the results of animal experiments to dependence in humans in this book is Vaillant’s attempt to describe known facts about addicts and addiction in the language of learning theory. However, this, as the author concedes, is more a semantic exercise than an experimental validation of the importance of behavioural forces in human drug misuse. It would be unfair to criticize this book for omitting discussion of behaviourally based experiments on drug dependence in humans; the fact is simply that there are none. The book’s treatment of the animal experiments in this area is good. and gives a fair coverage of the present state of knowledge in thie field. Overall, this is an important book in the literature on drug dependence and is essential reading for any one seriously interested in the field. It is also likely to offer something of interest to psychologists and psychiatrists with more general interests. JOHN TEASDALE
BOOK REVIEN’S T. X. BARBER: Hypnosis:
A Scienrific
Approach.
Van
Nostrand
Reinhold
Company,
N.Y.,
1969.
52.95.
DR. B.ARBERhas been publishing numerous empirical studies of hypnotic phenomena in recent years, and the present book which summarizes them and his theoretical contributions is a valuable contribution to the literature on hypnosis. The so-called hypnotic state has always been something of a mystery; Barber proposes to cut the Gordian knot by abolishing the concept entirely and concentrating rather on the various dependent and independent variables involved in hypnotic research. Much of his book is highly critical of previous vvork, but there is no doubt that much of the criticism is deserved. His major conclusion is every conceivable empirical that “since a construct hypnosis can be used in an ad hoc manner to “explain” finding, it is questionable whether it actually explains anything at all. Furthermore, since theories which pivot around the construct hypnoric slate can use at/ hoc reasoning to account for all possible experimental outcomes, there can be neither proof nor disproof”. Whether the evidence entirely supports such a farreaching conclusion, the reader must judge for himself; Barber certainly makes out a very strong case. However, even if vve simply regard all ‘*hypnotic” phenomena as due to suggestibility, the possibility still remains that “hypnotic state” might be, as Hull suggested, a state of heightened suggestibility induced by repeated suggestions to accede to all other suggestions made by the experimenter! In view of Barber’s rejection of the hypnotic state, it seems odd that he does not discuss in more detail the experimental evidence relating to suggestibility; 1 would have thought that this was exceptionally relevant to his thesis. There are a number of other minor criticisms which could be made. The account and interpretation Barber gives of his factorial study of his battery of hypnotizability tests is incomplete and difficult to follow; it is not even clear whether factors were rotated or not. Occasionally he leaves out important references which could change the conclusions; dealing with the Furneaux and Gibson study and its replication by Hilgard this agrees with his thesis that and Bentler, he says that they “presented diametrically opposed results”; widely different results have been reached in correlating personality with hypnotizability. He does not mention Furneaux’s answer in which he points out why the observed differences have arisen. and that they do not in fact contradict his main thesis. However, such aberrations are rare, and the book as a whole constitutes an extremely salutary exercise in debunking which should be widely read. H. J. EYSENCK
HANNAH STEINBERG(Ed.):
429
Scie~rtific Basis c?f Dr1l.7 Depetr&rcc.
J. & A. Churchill
Ltd.,
London,
1969.
pp. f5.
T~IIS book reports the proceedings of an international symposium held in London in 1965. The symposium dealt mainly with the area formerly called “drug addiction”; of the twenty-six papers only three relate to dependence on alcohol, the remainder to heroin, the amphetamines, the barbiturates, etc. These papers are spread over the disciplines of pharmacology, biochemistry, experimental psychology, social psychology, psychiatry, sociology and epidemiology. The coverage is good and reasonably representative of current areas of interest. Inevitably, however, there are some important omissions, such as discussion of the use of methadone and cyclazocine in treating narcotic addicts, or of more papers on abuse of stimulant drugs. One problem with collecting together papers from such a range of disciplines is that members of one may not be able to fully appreciate the contributions of others. Thus, while two-thirds of the book will bc intelligible to the average psychologist, the third devoted to pharmacology and biochemistry will probably have little to offer him. This book provides a welcome opportunity for the collection of much of the relatively unknown recent British research in this area. Of particular interest to readers of this journal are three papers, by Thompson and Pickens, Deneau, animals. Such studies have shown that rats and monkeys, given the chance, will learn to self-administer a wide range of drugs which produce dependence in humans. The effects of drug-deprivation, administration of extra drug by the experimenter, changes in environment, and variations in the size of the drug reinforcement and reinforcement schedule on such “drug-seeking” behaviour have been investigated. It has been shown that previously neutral external stimuli can acquire secondary reinforcing properties by association with primary drug reinforcement. It has also been demonstrated that such stimuli can acquire the ability to evoke conditioned withdrawal symptoms by their paring with a state of drug withdrawal. The role of such factors in determining “relapse” in “ex-addict” animals has been investigated.
39s
BOOK REVIE\\‘S
The results of these studies strongly su ggest the importance of powerfui behavioural forces maintaining drug-using behaviour in human addicts. Unfortunately, little research has been done to test directly the role of such forces in laboratory investigations of drug use in humans. Such studies obviously pose more problems than rat or monkey experiments, but a study by hlello, hlendelson and .IlcNames, experimentally investigating drinking patterns in alcoholics, reported in the volume under revievv, suggests that such s:udies are not unfeasible. Perhaps, in the present state of knowledge, the most direct evidence for the importance of behavioural factors in drug dependence in humans comes from the methadone and cyclazocine treatment programmes and the handful of cases in which behaviour therapy techniques have been employed. Neither of these areas are discussed in the book under review. The closest approach to the application of the results of animal experiments to dependence in humans in this book is Vaillant’s attempt to describe known facts about addicts and addiction in the language of learning theory. However, this, as the author concedes, is more a semantic exercise than an experimental validation of the importance of behavioural forces in human drug misuse. It would be unfair to criticize this book for omitting discussion of behaviourally based experiments on drug dependence in humans; the fact is simply that there are none. The book’s treatment of the animal experiments in this area is good. and gives a fair coverage of the present state of knowledge in thie field. Overall, this is an important book in the literature on drug dependence and is essential reading for any one seriously interested in the field. It is also likely to offer something of interest to psychologists and psychiatrists with more general interests. JOHN TEASDALE