AUD and SUD Flashcards
what is the HiTOP model for substance-related disorders?
disinhibited externalizing
-> substance abuse
-> substance-related disorders
how was alcoholism/drug dependence conceptualized in the DSM-I?
as a symptom of sociopathic personality disorder
how was alcoholism/drug dependence conceptualized in the DSM-II? what changed since the DSM-I?
- still conceptualized as a PD
- first specified the type of substance that was being used
- introduced some specific criteria, such as the inability to go one day without drinking
how was alcoholism/drug dependence conceptualized in the DSM-III? what changed since the DSM-II?
- substance use disorders became separated from PDs
- established a set of diagnostic criteria, distinguishing between abuse and dependence
what is the difference between substance abuse and dependence, according to past iterations of the DSM?
- dependence more severe than abuse
- abuse: use to the point of causing social or occupational problems
- dependence: use marked by either withdrawal effects or gradual increase in use
what are the specifiers for AUD in the DSM-V?
- severity
- mild: 2-3 symptoms
- moderate: 4-5
- severe: 6+ - remission and environmental specifiers when appropriate
- early remission: 3-12 months no alcohol
- sustained remission: 12+ months
- controlled environment: individual is confined to a place where alcohol is restricted
what are the 4 general groupings of indicators for AUD in the DSM-V?
- impairment of control
- social impairment
- risky use
- pharmacological dependence
what are the 5 main categories of substance-related disorders?
- depressants
- stimulants
- hallucinogens
- opiates
- other drugs of abuse
what are the top 3 most addictive substances?
- nicotine
- smoked (ice/glass) meth
- crack
what is the lifetime prevalence of AUD?
13.2%
what is the gender difference for AUD diagnosis?
- rates 2-5x higher in men, though the difference is smaller in the West
- women deteriorate more quickly
how common is comorbid diagnosis in AUD patients?
35-40%
what are the main social/behavioural correlates of AUD?
- vulnerability to injury
- marital discord
- IPV
- illness
- neurocognitive impairments
- decreased lifespan and suicidal behaviour
according to the results of George Vaillant’s study on AUD/SUD, how long does one have to be sober before chance of relapse is deemed very unlikely?
5 years
what are the 4 groups identified in the study from Witkiewitz et al on alcohol consumption? which groups are most vs least commonly seen in the population?
from most to least common…
1. high-functioning infrequent drinkers
2. high-functioning heavy drinkers
3. low-functioning infrequent heavy drinkers
4. low-functioning frequent heavy drinkers
what are the main vulnerability factors of AUD?
- early onset of drinking (before age 15)
- family history of AUD
- high tolerance
what is the neurobiology behind addiction and cravings?
- mesocorticolimbic pathway: VTA -> nucleus accumbens -> PFC
- dopamine is produced in the VTA -> nucleus accumbens, hippocampus, and amygdala -> increases response to rewards
- this dopamine response creates a learned association between a cue and a reward
- cue without reward leads to crash in dopamine activity
what is the deviance proneness theory of SUD?
SUD stems from a more general deviant pattern that has its roots in childhood and is attributable to deficient socialization
which neurotransmitter contributes to the stimulating effects of alcohol? what are its consequences in the body?
- increases in norepinephrine
- associated with increased impulsivity
what is the proposed relationship between GABA and AUD susceptibility?
- alcohol is a GABA agonist (mimics its effects)
- GABA reduces excitability in the nervous system by inhibiting the dopamine response
- certain genes governing GABA activity may be implicated in the risk of AUD
what is the most widely consumed/abused class of drugs?
stimulants
which neurotransmitter do amphetamines act on?
increases release of dopamine and norepinephrine and blocks reuptake, producing feelings of elation and reduced fatigue
what is the difference between an opiate and and opioid?
- opiate: natural chemical with narcotic effects
- opioid: broader class of natural and synthetic substances with narcotic effects
what is the criterion A for an AUD diagnosis? how many other symptoms are needed? over what period of time?
- displays a maladaptive pattern of alcohol use leading to significant impairment or distress
- +2 other symptoms
- 1 year period
what is the SORC model of alcoholism?
stimulus + organism + response + consequences
what is the SORC model of treatment for AUD?
- teach patient skills for reducing/eliminating excessive drinking
- help the spouse see their role in their partner’s drinking
- offer communication and problem-solving training to help improve marital functioning
what are the two proposed dimensional factors regarding cross-cultural alcohol dependence?
- wet vs dry cultures
- temperance vs non-temperance cultures
what is the etiological biopsychosocial model of alcoholism?
psychosocial factors:
- cognitions (expectancy theory, tension reduction theory)
- personality traits (antisocial traits, negative affect, impulsivity)
- environmental variables (social learning theories)
biological factors:
- genetics (alcohol sensitivity, metabolism)
- neurobiology (dopamine irregularities, psychostimulant theory, role of motivation and reward mechanisms
which 3 pharmacological treatments are found to be the most effective in treating AUD?
- acamposate
- naltrexone
- vivitrol
according to Zapolski et al, how do Black and white Americans differ in their alcohol use/problems? why?
for Black Americans, cultural factors protect against heavy use, but social/racial risk factors can lead to more negative consequences from use
