alcohol and substance related disorders Flashcards
What Changed from DSM-4 to DSM-5 in relations to substance related disorders?
In the DSM-IV, substance-related disorders were classified into two separate categories: Substance Abuse & Substance Dependence – A more severe form of substance use, involving tolerance, withdrawal, and compulsive use.
In the DSM-5, these two categories were merged into a single Substance Use Disorder (SUD) with a continuum of severity (mild, moderate, severe). This change was made because research showed that substance abuse and dependence were not distinctly separate conditions but rather part of a spectrum.
what are the five main categories of substances
*Depressants
*Stimulants
*Opiates
*Hallucinogens
*Other drugs of abuse
What is the only non-substance-related addictive disorder recognized in the DSM-5, and what other behavioral addiction is being considered for future inclusion?
The only non-substance-related addictive disorder currently recognized in the DSM-5 is Gambling Disorder. Internet Gaming Disorder is included as a condition for future consideration.
Four main categories of symptoms used to diagnose Substance Use Disorders (SUDs) in the DSM-5 (it summarizes the 11 diagnostic criteria into broader groups)
- Impairment of Control: difficulty controlling or limiting their use of a substance, even if they want to or have tried to cut down.
- Social Impairment: how substance use affects a person’s social life and relationships
- Risky Use: increase the risk of harm due to substance use
- Pharmacological Dependence: physical changes in the body due to prolonged substance use
What genetic factor contributes to lower rates of AUD in East Asian populations?
ADH2*2
In general, do men or women tend to deteriorate more quickly once they develop AUD?
Women
What is one significant risk factor for AUD related to the age of first alcohol use?
Early drinking (before age ~15).
How does family history relate to the lifetime risk of AUD?
Relatives of individuals with AUD have a higher lifetime risk (30% vs. 14% in controls).
What did Jacob et al. (2003) find about the risk of developing Alcohol Use Disorder (AUD) in individuals with genetic vulnerability but low environmental risk?
Jacob et al. (2003) found that individuals with a genetic predisposition to AUD but low environmental risk (Groups 2 & 3) did not have a significantly higher risk of developing AUD compared to those with low genetic and environmental risk (Group 4). This suggests that genetic risk alone is not enough to increase AUD likelihood without environmental influences.
How does the alcohol sensitivity of sons of fathers with Alcohol Use Disorder (AUD) compare to that of sons of non-AUD fathers, and what does this suggest about their risk for developing AUD?
Sons of fathers with AUD may start out less sensitive to the effects of alcohol, showing better balance and coordination after drinking compared to sons of non-AUD fathers. This lower sensitivity to alcohol’s effects could contribute to an increased risk of developing AUD over time.
What did Catherine Fairbairn’s research (UIUC) suggest about why alcohol use may be more prevalent in males, and how does alcohol affect social smiling in men and women?
Catherine Fairbairn’s research suggests that alcohol use may be more prevalent in males because many men report bonding with other males primarily in the context of drinking. Alcohol was found to be more rewarding for men, as they experienced an increase in reciprocal smiling and longer smiles, making social interactions more interpersonally rewarding. In contrast, women in the placebo group showed no significant change in social smiling.
According to Negative Affect Regulation Theory, what effect does alcohol have on mood for some people?
Decreases negative affect (e.g., anxiety, sadness, self-consciousness).
What is the name of the neural pathway associated with dopamine, reinforcement, and craving in addiction?
The Mesocorticolimbic Pathway.
Study where they give monkeys juice : how did it explain addiction?
when a cue (e.g., a shape on the screen) predicts a reward (juice), dopamine activity increases at the sight of the cue, not just when the reward is received. If the cue appears but the reward doesn’t follow, dopamine activity decreases, leading to craving. This process explains addiction: seeing cues related to a substance (e.g., cocaine) triggers a dopamine boost, making it harder to stop because of the strong association between the cue and the rewarding experience.
What does the concept of “Deviance Proneness” suggest about the development of Substance Use Disorder (SUD)?
The concept of “Deviance Proneness” suggests that Substance Use Disorder (SUD) does not arise from attempts to regulate emotions or from a specific vulnerability to drugs. Instead, SUD is part of a broader deviant pattern rooted in childhood and is linked to deficient socialization.
How does alcohol affect the body while drinking and after drinking?
While drinking, alcohol acts as a stimulant, increasing elation, excitement, extroversion, and reducing fatigue, restlessness, depression, and tension. After drinking, it acts as a depressant, leading to decreased vigor, increased fatigue, relaxation, confusion, and depression.
How does alcohol cause stimulation in the body, and what is its relationship to impulsivity?
Alcohol causes stimulation by increasing levels of norepinephrine in the brain. Elevated norepinephrine is associated with increased impulsivity, leading to more impulsive behaviors.
What role does GABA play in the nervous system, and how does it affect dopamine neurons?
GABA is critical for reducing neuronal excitability by acting at inhibitory synapses in the brain. It inhibits dopamine (DA) neurons, helping to regulate brain activity and maintain a balance between excitatory and inhibitory signals.
What neurotransmitters are affected by amphetamines, and how are they affected?
Enhances the release of dopamine and norepinephrine while blocking reuptake
What neurotransmitter does cocaine affect, and how?
Blocks the reuptake of dopamine.
What’s the difference between opiates and opioids?
Opiates are natural chemicals in the opium poppy (plant), while opioids include both natural and synthetic substances with narcotic effects.
What happens at low and high doses of opioids?
At low doses, opioids cause euphoria, drowsiness, and slowed breathing. At high doses, they can lead to overdose and death.
What is the core belief/goal of “12-step programs” like AA?
Total abstinence.
Give an example of a pharmacological treatment for SUD that involves agonist substitution
Methadone (for opioid use), nicotine gum/patch (for nicotine use).
What is the primary aim of aversive treatment for SUD?
To make the substance/drug unpleasant.
