Ch 12-Substance Use & Addiction

Question 1

Substance use disorders

Answer 1

problems related to using & abusing substances

Question 2

DSM-5 criteria of substance use disorders

Answer 2

1. impaired control
2. social impairment
3. risky use
4. Pharmocological criteria (tolerance & withdrawal)

Question 3

Compensatory Responses

Answer 3

equal & opposite physical responses to counteract effects of a substance (maintain homeostasis)

• can become entrained to environmental cues
• Helps to understand tolerance & predict withdrawal symptoms

Question 4

severity rating of substance use disorder

Answer 4

mild: 2-3 criteria
moderate: 4-5 criteria
severe: 6+ criteria

Question 5

Changes from DSM-4

Answer 5

Distinction of abuse & dependence

Abuse: psychological & behavioral sx’s

Dependence: tolerance, withdrawal, compulsive use

*changed because literature did not support distinction

Question 6

Substance-induced disorders

Answer 6

when INGESTION of a substance results in serious behavioral, psychological, & physiological signs & symptoms

Question 7

Substance intoxication

Answer 7

Sx’s: vary greatly depending on the substance, often resemble other disorders

Question 8

DSM specifiers of substance intoxication

Answer 8

The associated sx’s must be reversible

& there must be physical evidence the substance was recently ingested

Question 9

Alcohol-related disorders prevalence rates

Answer 9

Age: 21-34 years
Males highest
High rates of comorbidity with other disorders (self medication)
Dual Diagnosis

Question 10

Dual Diagnosis

Answer 10

Substance use disorder in addition to another disorder

Question 11

Pharmacological dependence

Answer 11

more typical at the severe end of the spectrum–>tolerance & withdrawal

Question 12

Abuse of alcohol

Answer 12

Failure to complete committed tasks due to intoxication or hangovers

May also involve legal problems (DUI, disorderly conduct)

Question 13

Alcohol intoxication diagnostic criteria

Answer 13

• Recent ingestion of alcohol
• clinically significant maladaptive behavior or psychological changes

1. slurred speech
2. incoordination
3. unsteady gait
4. nystagmus
5. impairment in attention/memory
6. stupor or coma
7. sx’s not due to a general medical condition

Question 14

Biological causes of alcohol problems

Answer 14

Genetically inherited?

Differences in metabolism of alcohol?

Question 15

Thomas et al. gene mutation in mice

Answer 15

Gabrb1

• mice with mutation preferred alcohol to water
• 85% of fluid intake = alcohol

Question 16

Psychodynamic causes of alcohol problems

Answer 16

issues with oral dependency

-problems during oral stages of development

Question 17

operant conditioning causes of alcohol problems

Answer 17

positively or negatively reinforced for drinking

Positive: feel good; have fun

Negative: reduces distress

Question 18

Multiple regulation theory

Answer 18

classical conditioning model:

• pair ingestion of alcohol with good feelings
• pair not drinking with neutral or negative feelcings

Question 19

Cognitive causes of alcohol problems

Answer 19

Cognitive expectations: expectations while drinking

-expect the experience & effects to be fun/positive, therefore it is

Question 20

Detoxification

Answer 20

Usually the first step

-cannot work with an impaired individual

Question 21

Treatments for alcohol problems

Answer 21

could be outpatient or inpatient

• some experience seizures or withdrawal
• delirium treatments (hallucinations & delusions)

Question 22

Alcoholics Anonymous

Answer 22

Alcoholism is a disease

-abstinence is key

Question 23

Learned behavior models for alcohol

Answer 23

problem drinking is learned behavior
–>therefore behavior can be modified

Harm reduction program

• assume people will drink
• teaches to drink in a manner that reduces harm

Question 24

Other substances

Answer 24

Diagnosis should specify which substance rather than just substance use disorder

Question 25

Gambling

Answer 25

Only non-substance addiction currently in DSM

• signs of tolerance & withdrawal
• life centered around gambling
• used as coping
• behavior continues after significant loss

Question 26

Internet Use Disorder

Answer 26

DSM-5 section 3 (further research needed)