CHAP 1 / SLIDE 1 Flashcards
Addiction is not limited to drug ingestion as many _____ can be addictive as well
behaviours
Conceptualizing & Defining ____ has been a matter of debate
Addiction
Addictive Behaviours Include ___ behaviours & ____ behaviours
substance, non substance
Some Characteristics of Addictive Behaviours are
Repetitive Pattern which increases the risk of Disease and / or personal & social problems
Feeling of “loss of control” over the behaviour - unable to achieve abstinence or moderate use despite wanting to
Include immediate gratification (short term reward) & delayed damaging effects (long term cost)
Attempts to change behaviour (i.e through treatment) results in high relapse rates
Viewing addictions as a black white / either or manner
Individuals with SUD
- Heavy users
Individuals without SUD
- Never drink
- Occasionally drink
- Regularly drink in moderate amounts
Viewing Addiction as a Spectrum; as a process of severity of use
Moderate use of substance behaviours
Moderate engagement in non-substance behaviours
Other end of the spectrum
Excessive use of substance behaviours
Excessive engagement in non-substance behaviours
Advantage using The Spectrum of Addiction vs Black and White
may reduce Stigmatization attached to the word “addiction”
____________ disorders are the most stigmatised mental disorders, followed by illegal drug use disorders
Alcohol Use Disorders
Is it possible to use drugs and not misuse them? / Is it possible to use drugs and not become addicted to Them?
Complicated, but likely.
-… but… impossible to know or predict ahead of time who will develop dependence
- Widely accepted system for diagnosing and describing mental disorders
- Has undergone revisions based on research findings regarding etiologies of different disorders, changes over time in societies standards, etc
DSM-5 / DSM-5 TR
Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)
In DSM-5, “addiction” is replaced with _______
“Substance Use Disorder”
In the DSM-5, SUDS includes ____ classes of drugs: _________________________________________________
10
1. alcohol
2. caffieine
3 cannabis
4. hallucinogens
5. inhalants
6. opioids
7. Sedative-hypnotic and anxiolytic drugs
8. stimulants
9. tobacco, and other substances
DSM-5 no longer consists the words _______ in its writings
“addict” or “substance abuse”
“range of problems associated with the use & misuse of drugs that alter the way one thinks, feels, or behaves”
Substance related & addictive disorders
Although the pharmacological mechanisms by which each class of drugs produces _____ is different, they all directly activate the brain __________ & _______ (an arousing “high” or a destressing “numbing” or _______)
reward, reward system & produce feelings of pleasure, both
______ overrides ______ due to expectation effects (ie. ____________________________________) (Both arousal and numbing)
Psychology, physiology, ie; nicotine can both give someone energy and make someone relax
The only Non substance related disorder categorized (in the DSM-5) currently is _____
Why? _____
Gambling Disorder
Gambling Behaviours - similar to drugs, activate the brain reward system & produce comparable behavioural symptoms
Other behavioural addictions not included in the DSM-5 (ie gaming) is due to ___________
insufficient research to identify them as mental disorders
Many individuals with SUD’s use substances or engage in addictive behaviour as a way of ______ & ________ through such __________
modifying their moods, and self medicating, through such reliable coping strategies
The two types of Substance Related Disorders include
Substance-use disorders
Substance-induced disorders
A cluster of cognitive, behavioural, and physiological symptoms, indicating that the individual continues using the substance, despite significant substance-related problems
Substance-use disorders
The specific conditions resulting from use of a substance (i.e - intoxication, withdrawal, substance-induced mental disorders: psychotic or depressive, etc)
Substance-induced disorders
Substance-induced disorders can include ______, ______, and _______
intoxication
withdrawal
substance-induced mental disorders: psychotic / depressive
Chemical compounds that alter one’s mood or behaviour (illegal and non-legal substances)
Substances
the ingestion of substances in moderate amounts that do not interfere with functioning
Substance use
overall physiological reaction to ingested substances (non-specific)
Substance intoxication
defined in terms of how significantly substance use interferes with one’s life (rather than the amount of the substance ingested) (People have different tolerances, medications, etc), also known as addiction.
Substance use disorder (key term version)
Using increasingly greater amounts of the drug(s) to experience the same effect
Tolerance
the need for an increased amount of the substance to achieve the desired effects, or a diminished effect with continued use of the same amount
tolerance
Experiencing a negative physical response when the subject is no longer ingested
Withdrawal
The degree to which tolerance develops ______ across individuals and substances
varies
Experiencing negative physiological reactions to the removal of a substance which can be reduced or diminished by the use of the same or a similar substance
Withdrawal
__________ vary across different classes of substances = separate criteria sets are provided in ______
Withdrawals, DSM-5
Which substance causes withdrawals of primarily, “experiencing hallucinations and body tremors, vomiting, nausea, insomnia, etc”, and what is the withdrawal defined as? _____
Alcohol, Alcohol withdrawal delirium or DT’s (delirium tremens)
Tolerance and Withdrawals are example of
Physiological dependence
DT’s (delirium tremens) is always the result of
Alcohol withdrawals
Which substance causes withdrawals of “anxiety, sleep changes, lack of motivation & boredom”
Cocaine
Which substance causes withdrawals of “irritability, nervousness, appetite change, and sleep disturbance”
Cannabis
behavioural reactions to drugs, like Drug-seeking behaviours (ie. stealing money, being cold to smoke) are examples of
Psychological dependence
Examples of physiological dependence
Tolerance and Withdrawal
Examples of Psychological dependence
Drug-seeking behaviours
(ie, stealing money to use, going in cold weather to smoke even though u dont want to)
_____________ are physically addictive / result in physical withdrawal (i.e ____ / _______)
Not all substances, LSD / hallucinogenics
DSM-5 DIAGNOSTIC CRITERIA FOR SUBSTANCE USE DISORDERS would say that a mild prescence of a substance-use disorder would consist of _______
2-3 symptoms
In order to meet the criteria for a substance use disorder, ____________ DSM-5 symptoms must be met in the last ____ which has resulted in __________________.
Also must specifiy ______
Minimum 2
Last Year
Clinically significant impairment or distress (ie life function, job, school)
Severity!
DSM-5 DIAGNOSTIC CRITERIA FOR SUBSTANCE USE DISORDERS would say that a moderate presence of a substance-use disorder would consist of ______
4-5 symptoms
DSM-5 DIAGNOSTIC CRITERIA FOR SUBSTANCE USE DISORDERS would say that a severe presence of a substance-use disorder would consist of ______
6 or more symptoms
The first 4 (1-4) symptoms of DSM-5 SUD criteria, merged into group one, known as the “Impaired Control” group over substance use, include
- Substance is often taken in larger amounts or over a longer period
than was originally intended - There is persistent desire, or unsuccessful efforts, to
Cut down or control substance use - A great deal of time is spent in activities necessary to obtain the
substance, Use the substance or recover from its effects - Craving, or strong desire or urge to use the substance
The 5th, 6th, and 7th symptoms of DSM-5 SUD criteria, merged into group two, known as the “Social Impairment” group over substance use, include
- Recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home
- Continued use despite having persistent or recurrent social or
interpersonal problems caused or exacerbated by the effects of the substance - Important social, occupational or recreational activities are given up or
reduced because of use
The 8th and 9th symptoms of DSM-5 SUD criteria, merged into group three, known as the “Risky Use” group over substance control, include
- Recurrent use in situations in which is it physically dangerous
- Use is continued despite knowledge of having a persistent or
recurrent physical or psychological problem that is likely to have been caused
or exacerbated by the substance
The 10th and 11th symptoms of DSM-5 SUD criteria, merged into group four, known as the “Pharmacological Criteria” group over substance control, include
- Tolerance – defined as either or both of the following:
* A need for markedly increased amounts of substance to achieve intoxication or
desired effect
* A markedly diminished effect with continued use of the same amount of
substance - Withdrawal, as manifested by either of the following:
* The characteristic withdrawal symptoms of the substance (due to removal of substance)
* The substance – or a closely related substance – taken to relieve or avoid
withdrawal symptoms
How many symptoms are in the DSM-5 Criteria for a SUD, and what is the minimum needed to classify as having one?
11
Minimum 2 in the last year
Despite there being 11 symptoms criteria in the DSM-5, some drawbacks that undermine their objectvitiy are
. Some minor variations in symptoms across different substances:
* Some symptoms are less salient- for some substances
* Some symptoms do not apply to some substances (i.e., withdrawal
symptoms are not specified for inhalant use disorders)
What is a psychological disorder / dysfunction ? (Not SUD)
A “psychological dysfunction” within an individual that is associated with 1. distress or 2. impairment in functioning & a response that is not typical or culturally expected
If someone has the minimum of two DSM-5 Criteria symptoms but is without significant distress or impairment in function, they likely ____________
do not qualify for a disorder
EVEN INCLUDING THE MINIMUM 2 DSM-5 Substance Use Disorder Criteria Symptoms involved in the individual diagnosis, All 3 elements have to be present to OFFICIALLY DIAGNOSE AN INDIVIDUAL ___, _____, & _______
(distress, impairment, and 2 symptoms in last year)
What does being “atypical or not culturally expected” represent when discussing the definition of a “psychological disorder”.
- Atypical behaviour which violates social norms in a culture
- Important to consider cultural differences in psychological disorders
The idea that “Addiction is an interconnected process involving the integration & interplay between various different factors”
BIOPSYCHOSOCIAL APPROACH TO ADDICTION
In the BIOPSYCHOSOCIAL APPROACH TO ADDICTION, “Biopsychosocial” represents which factors
**Individual factors -> personal vulnerability factors
- Biological or genetic predispositions
- Psychological factors (i.e.,personality, unconscious motivations, _attitudes, beliefs, etc.)
&
Situational factors -> social environment (i.e., CULTURE, FAMILY , friends, etc.)
&
Structural factors -> nature of the substance or addictive behaviour
hence biopyschosocial
