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Clinical Psychology > 7: Addiction & Substance Use > Flashcards

7: Addiction & Substance Use Flashcards

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1
Q

Addiction defintion (WHO)?

A
  • repeated used of psychoactive substances
    = user periodically, chronically intoxicated
  • shows compulsion to find and obtain it
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2
Q

DSM Substance used disorder

A 
Need at least 2: 
- determines intensity 
....
- intense craving
- confused large amount
- considerable time to obtain
- continued use despite knowing negative consequences
- increased tolerance
- withdrawal symptoms
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3
Q

What are the major specific substance use disorder?

A
  • Alcohol
  • Tobacco
  • Cannabis
  • Opioid
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4
Q

What is the prevalence of substance used disorder?

A

16%
- starts early in life
9/10 start before 18
- 9% = multiple substance use disorder

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5
Q

What is the biggest substance used disorder killer?

A
  • tobacco

- 20% of adults globally smoke, predominately men

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6
Q

Which 2 substance contribute/ cause more than 70 other conditions requiring medical care?

A
  • Tobacco
  • Alcohol
  • drug use
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7
Q

Describe the characteristics of dependent substance users?

A
  1. LT use
  2. Solitary/ small group
  3. Loss of control
  4. Usually increasing quantities
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8
Q

What is the process of addiction?

A
  1. Tolerance
  2. Dependence
    - shift in homeostasis response
    - withdrawal
  3. Compulsion
  4. Relapse
    - high vulnerability
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9
Q

What are Addictive disorder?

A

There to show that it doesn’t have to be just substances which you are addicted to
- eg gambling

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10
Q

What is the Disease model of addiction?

A 
Island approach:
Genetics/ persistent drug-induced changes in brain affect psychological processes 
= addiction
- incurable
- only solution = abstinence
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11
Q

What is the medical model of addiction?

A
  • symptoms of drug addiction are physiological + should be treated accordingly (substitutes)
  • assumes psychological features of addiction are due to physiological causes
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12
Q

What support is there for the disease model?

A

Alcohol anonymous

  • life long condition
  • once you become an alcoholic = either an alcoholic abstaining or not
  • no such thing as controlled drinking
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13
Q

According to Alcohol anonymous, how can u start recovery?

A

12 steps - bases for recovery

  • admit helplessness
  • trust in program + higher power
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14
Q

How effective is AA (Gossop et al, 2003)?

A

seems pretty effective

  • significant improvements in drinking behaviours, psychological problems + Q of life
  • frequent attendance = superior drinkning outcome
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15
Q

What are some problems with AA results?

A
  • seem to only improve drinking problem and not other psychiatric problems that follow up
  • often, people who don’t succeed kicked out
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16
Q

What neurotransmitter seems to be at the heart of Neuroscience of addiction?

A

Dopamine

  • Psychoactive substances bind to receptor in brain = changing it
    1. Heroin
  • binds to opioid receptors + triggers dopamine
    2. Ecstasy (MDMA)
  • triggers serotonin + dopamine
    3. Cocaine
  • stimulate dopamine release
  • interfers with dopamine removal
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17
Q

What are the different ways drugs can take action?

A
  1. Direct agonists
    - bind directly to receptors
  2. Indirect agonist
    - increase neurotransmitter binding to receptor
  3. Antagonist
    - bind to receptor but have no effect on their own
    - just block receptors preventing agonist effect
18
Q

What is the speed of impact?

A
  1. Cocaine taken nasally = speedy impact

2. Cocaine smoked = impact in seconds!

19
Q

What is the dopamine theory of addiction?

A
  • affecting reward system of brain
  • makes things pleasurable + memorable
  • dopamine being key messengers
  • substances = more powerful + reliable than natural reinforcers
20
Q

What did the removal/ damage of the nucleus accumbens decreased?

A

Self-administration of heroin in animals

(Willuhn et al, 2010)

21
Q

What did they find about genetically engineered mice that lacked dopamine receptors? (Palmiter, 2008)?

A

starve to death

- restoring dopamine signalling in the reward pathway reversed effect

22
Q

What brain changes can be observed overtime through repeated drug administration?

A
  • enhances brain reactivity to drugs + reduces sensitivity to non-drug rewards
  • Amphetamine = structural changes in dendritic spines
  • changes lasted more than a month in rates
23
Q

What are the LT consequences of the brain changes?

A 
Build up of tolerance 
- neuron is adapting 
= resetting of reward threshold 
= increase in maintenance 
otherwise result in withdrawal 
- body only functions normally in the presence of drug
24
Q

What other areas of the brain, other than the reward system, are affected by substance misuse addiction?

A

Reward system also connected with other brain areas

  • PFC - hypoactivity
  • loss of inhibitory control
  • loss in decision making
25
Q

How is the reward pathway and cognitive control relates?

A
  • exposure to drug-related cues = memory of expected reward = over-activation of reward circuit
  • whilst decreasing activity in cognitive control circuits
    = inability drive to seek + consume drug
26
Q

What are the 2 main focus of treatments?

A
  1. need to recalibrate brain structure/ reward system

2. increasing cognitive control

27
Q

What conditioning treatment method is used?

A

Substitue drugs

  • making them sick when they have alcohol
  • conditioning
  • only working with reward system tho!
  • wanna combine with CBT
28
Q

Experiments with skinner’s rats found that rats began to prefer drugs over natural reward. However, what was found when rats were put into social cages?

A
  • caged = more morphine consumption vs social rats
  • social rats - hardly affected and don’t really become addicted to it
  • caged rats consumed 20x amount vs social rats
  • psychological isolation?
29
Q

Why is Vancouver thought be the most drug addicted city?

A
  • majority of population born elsewhere (dislocation)
  • overwhelming native Canadians
  • natives’ culture removed
  • alcoholism nearly 100% in some place where European culture has overpowered their culture
30
Q

What is psychosocial intergration?

A

Cannot see individual without the role of relationships + environment
- state in which people flourish simultaneously as individual + members of their culture

31
Q

What can insufficient psychosocial integration be a precursor to?

A

addiction via

  • dislocation, free market economy, trauma, imprisonment etc
  • they adopt substitute lifestyle
32
Q

What can be concluded about addiction according to research on rats and psychosocial intergration?

A
  1. Drugs do not have high addictive value as such
    - rats becoming addicted due to being isolated
  2. Addiction need not be limited to drugs
    - general condition in western society
33
Q

What was found to be desired by people in a survey?

A

basic bodily needs

  • food, sleep, need to belong
  • addictive substance were rated as below average
34
Q

Most addicted Vietnam soldiers gave up their narcotic use voluntarity/ w/ brief detoxification (Robins et al, 1974), how?

A
  • heroin readily available
  • variety of drugs used before entering service related to likelihood of drug use in Vietnam
  • after 1 year of addiction, still only small portion remained addicted
35
Q

What does the findings of the Vietnam soldiers suggest about addiction?

A
  • addicts not doomed for life

- supports view that addiction is an adaptation related to psychological circumstances

36
Q

Trauma is a significant risk factor to…?

A
  • Psychological integration

- later substance use

37
Q

In survey of adolescents receiving treatment for substance abuse, what % of patients had a history of trauma exposure?

A

70%

Deykin + Buka, 1997

38
Q

Historically, the word ‘addiction’ means being given over/ devoted to something. How has the societal structure causing people to adopt certain unhealthy lifestyles which we cling onto?

A
  1. Social structures causes people to priorities certain rewards over other
    - could be unhealthy life style
  2. Cling onto it because there is no way of achieving psychosocial integration
39
Q

What relationship is there between power and cocaine?

A

Power has similar effects to cocaine on the reward system (Robertson, 2013)
- much potential for harm

40
Q

What is thought to be key to understanding addiction?

A

Psychology of desire + pleasure

- addiction = temporary relief for what we are missing in life

41
Q

What is an alternative treatment approach for addiction other than trying to rewire reward pathway and increasing cognitive control?

A
  1. What is causing the pain?
  2. Take into consideration society + people’s lives
  3. Consider psychological interventions
42
Q

What is the biopsychosocial approach?

A

Continent approach

  • bio
  • psychological
  • environment

Clinical Psychology (17 decks)

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