Alcohol and Substance Use Disorders

Question 1

DSM-5 critera for alchohol/substance use disorder

Answer 1

2+ symptoms in 12 month period
1. consuming more, more often
2. failure to quit
3. lots of time spent acquiring/using/recovering
4. craving
5. recurrent failure to fulfill obligations due to use
6. continued use despite interpersonal probs
7. important activities given up because of use
8. recurrent use in dangerous situations
9. continued use despite psychological/physical problems
10. marked tolerance
11. withdrawal symptoms

Question 2

Genetic factors related to alcohol use and alcoholism

Answer 2

Children of alcoholics 4-5 times more likely to develop alc.
Family transmission problems seem to be general

Question 3

Family environmental factors related to alcohol use and alcoholism

Answer 3

1. Single-parent homes
2. Family conflict
3. Low SES
4. Higher parental drinking
5. Lack of parental communication/monitoring
6. Sibling use - especially if sibling is older but close in age, same gender

Question 4

Peer factors related to alcohol use and alcoholism

Answer 4

Level of peer drinking highly predictive of use
Overt peer pressure NOT as important initiation of drinking
Peer groups are usually similar to adolescent, reinforce existing behavior

Question 5

Common comorbidities for alcohol/substance use disorders

Answer 5

ADHD, CD, OCD
Depression/anxiety/social phobia
PTSD
Physical and sexual abuse

Question 6

Overall trends of substance use in use (90s and gender differences)

Answer 6

Drug use increased in 8th graders in 90s
FEW GENDER DIFFERENCES in NON-ALCOHOL DRUG-USE

Question 7

Associations between age of onset of use and later problems

Answer 7

Earlier use = more problems
Take into account frequency and severity of use
First drink between 11-12: 16% later issues
First drink after age 18: 1% later.

Question 8

Examples of contextual effects on the consequences of substance use

Answer 8

Addicted mice who were addicted died if given in unfamiliar context

Vietnam veterans were consuming heroine overseas, came back and didn’t.

Question 9

Example protective factors against the development of substance problems

Answer 9

DRD2 dopamine receptor: Higher DRD2 makes stimulants TOO intense. Low makes them more appealing.

Religion
Positive self-concept
Constructive activities
Anti-alcohol beliefs

Question 10

Common treatment approaches for substance use disorders

Answer 10

For addicts, DETOXIFICATION must be the FIRST STEP

Look at co-occurring mental disorders

Individual focused

Medication

AA

Cue Exposure, Desensitization

Harm reduction

Psychoeducational approaches

Question 11

General traits of alcoholics

Answer 11

Disinhibition, low restraint, sensation-seeking, P3 reduced amplitude signal, low autonomical arousal

Question 12

Heritability of alcoholism

Answer 12

30-70%

Question 13

Specific youth substance use disorder prevalence

Answer 13

6% in USA
60% in justice system
20% in child welfare system

Question 14

Harm reduction approach

Answer 14

Looking to help the AFTER-EFFECTS of alcohol consumption, recognizing there will be a degree of use

Question 15

Cue exposure/desensitization approach

Answer 15

Behavioral desensitization, show pic of drink and monitor response

Question 16

AA approach

Answer 16

Widely praised, but hard to research

Question 17

Medication approach

Answer 17

Substance specific drugs
Antibuse for alcohol, vomit

Question 18

ALDH2

Answer 18

Protective factor, FLUSH REACTION… unpleasant physical effects like sweating/warm, reduces desire to drink

Question 19

DRD2

Answer 19

Feel stimulants as TOO EXTREME - feel extreme already.