Ch 12-Substance Use & Addiction Flashcards
Substance use disorders
problems related to using & abusing substances
DSM-5 criteria of substance use disorders
- impaired control
- social impairment
- risky use
- Pharmocological criteria (tolerance & withdrawal)
Compensatory Responses
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
severity rating of substance use disorder
mild: 2-3 criteria
moderate: 4-5 criteria
severe: 6+ criteria
Changes from DSM-4
Distinction of abuse & dependence
Abuse: psychological & behavioral sx’s
Dependence: tolerance, withdrawal, compulsive use
*changed because literature did not support distinction
Substance-induced disorders
when INGESTION of a substance results in serious behavioral, psychological, & physiological signs & symptoms
Substance intoxication
Sx’s: vary greatly depending on the substance, often resemble other disorders
DSM specifiers of substance intoxication
The associated sx’s must be reversible
& there must be physical evidence the substance was recently ingested
Alcohol-related disorders prevalence rates
Age: 21-34 years
Males highest
High rates of comorbidity with other disorders (self medication)
Dual Diagnosis
Dual Diagnosis
Substance use disorder in addition to another disorder
Pharmacological dependence
more typical at the severe end of the spectrum–>tolerance & withdrawal
Abuse of alcohol
Failure to complete committed tasks due to intoxication or hangovers
May also involve legal problems (DUI, disorderly conduct)
Alcohol intoxication diagnostic criteria
- Recent ingestion of alcohol
- clinically significant maladaptive behavior or psychological changes
- slurred speech
- incoordination
- unsteady gait
- nystagmus
- impairment in attention/memory
- stupor or coma
- sx’s not due to a general medical condition
Biological causes of alcohol problems
Genetically inherited?
Differences in metabolism of alcohol?
Thomas et al. gene mutation in mice
Gabrb1
- mice with mutation preferred alcohol to water
- 85% of fluid intake = alcohol
Psychodynamic causes of alcohol problems
issues with oral dependency
-problems during oral stages of development
operant conditioning causes of alcohol problems
positively or negatively reinforced for drinking
Positive: feel good; have fun
Negative: reduces distress
Multiple regulation theory
classical conditioning model:
- pair ingestion of alcohol with good feelings
- pair not drinking with neutral or negative feelcings
Cognitive causes of alcohol problems
Cognitive expectations: expectations while drinking
-expect the experience & effects to be fun/positive, therefore it is
Detoxification
Usually the first step
-cannot work with an impaired individual
Treatments for alcohol problems
could be outpatient or inpatient
- some experience seizures or withdrawal
- delirium treatments (hallucinations & delusions)
Alcoholics Anonymous
Alcoholism is a disease
-abstinence is key
Learned behavior models for alcohol
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
Other substances
Diagnosis should specify which substance rather than just substance use disorder
Gambling
Only non-substance addiction currently in DSM
- signs of tolerance & withdrawal
- life centered around gambling
- used as coping
- behavior continues after significant loss
Internet Use Disorder
DSM-5 section 3 (further research needed)
