Addictive Disorders

Question 1

what is a brain disease conceptualisation of addiction

Answer 1

disease impairs capacity to control behaviour - responsibility is not on the person - bad implications for treatment - ‘addictive personality’

Question 2

what does the biopsychosocial concept of addiction say

Answer 2

there is not one single cause
bio - high impulsivity
psycho - anxiety
social - poverty, trauma

Question 3

what are the distal antecedents to addiction

Answer 3

neurobiological and psychosocial, intrapsychic and environmental -> lead to vulnerability and exposure to substance

Question 4

what is pre-morbid addiction syndrom

Answer 4

exposure and repeated use of drugs - driven by classical and operant conditioning

Question 5

what does exposure and repeated use of substances lead to

Answer 5

expression (drinking, smoking… etc)
sequelae (cancer etc)
manifestation (tolerance, comorbidities, social drift)

Question 6

2 addiction models of behaviour?

Answer 6

medical model and rational choice model

Question 7

whats the difference between the medical and rational choice models

Answer 7

medical model = impaired control over urges while rational choice model is characterised by voluntary behaviour under control

Question 8

which model is least stigmatizing

Answer 8

medical model

Question 9

what is the opponent process theory of addiction

Answer 9

characterised by two states highs (A) and lows (B). B occurs due to homeostasis. overtime B gets worse and need more of the drug to get A. there is reduced hedonic contrast overtime. A only brings you slightly above homeostasis. the affective system transitions to a lower allostatic level.

Question 10

what are the 2 reward systems that drugs affect

Answer 10

dopaminergic system and the endogenous opioid system

Question 11

how is the euphoria effect created when drugs are taken

Answer 11

the drugs prevent the reuptake of dopamine post-synapse leading to an overflow of dopamine in the synapse.

Question 12

what is I-RISA

Answer 12

impaired response inhibition and salience attribution

Drug addiction mediated by functional & structural changes in circuits modulated by dopamine

Question 13

what two brain areas are involved in addiction according to I-RISA

Answer 13

mesolimbic: memory and conditioning
mesocortical: decision making, salience, expectations

Question 14

what are the 4 clusters of behaviours under I-RISA

Answer 14

intoxication
craving
compulsive use
withdrawal

Question 15

how do withdrawal symptoms come about

Answer 15

through activation of the amygdala stress system

Question 16

what is the role of the hippocampus in addiction

Answer 16

it remembers the experience and context

Question 17

what is the role of the amygdala in addiction

Answer 17

it causes us to feel pleasure and happiness

Question 18

what does the PFC do during drug use

Answer 18

focuses attention on the drug

Question 19

what does the nucleus accumbens do during drug use

Answer 19

pleasure centre - causes urge to take more

Question 20

what does the rational choice model say

Answer 20

Explains compulsions as inability to resist acting on the desire
and equates compulsive behaviour (i want to) to compelled behaviour (i cant control)

Question 21

what is the focus of the public health approach

Answer 21

we must influence patterns of drug taking behaviour:

• socioeconomic constraints on drug taking: availability, price etc
• motivations: peers, genetics, reinforcement

Question 22

optimal treatment

Answer 22

isnt one but CBT is good