CHAP 4 / SLIDe 4 Flashcards
“A chronic , relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control.Those changes may last a long time after a person has stopped taking drugs” NIH
Brain disease model of addiction
Brain disease model of addiction: Criticisms
Challenges values about Self-determination & Personal Responsibility
Is a way of excusing Personal irresponsibility & Criminal Acts
Fails to identify genetic aberrations or brain atypicalities that consistently apply to all individuals with addiction
_______ /________ developmental period marks the peak ______ for being negatively affected as a result of exposure to alcohol & other substances
Prenatal / Fetal
Sensitivity
First use of a substance (tobacco, alcohol, cannabis) during an _______ is associated with increases in the risk of developing a SUD
earlier age
Developmental Theory of Addiction
Prenatal / Fetal developmental period marks the peak sensitivity for being negatively affected as a result of exposure to alcohol & other substances
First use of a substance (tobacco, alcohol, cannabis) during an earlier age (i.e., adolescence) is associated with increases in the risk of developing a SUD
“Continous process or trajectory”
“Developmental Trajectories” of addictive behaviours
- Addictive behaviours can result in different trajectories
- Its possible to transition between different trajectories
- The probability of different trajectories is affected by:
Individual characteristics, “addictive potential” of substances, attempts to change the behaviour in the past - There is no single “natural” trajectory to recovery either
- Presents classical & operant conditioning processes as explanation of how addictive behaviour patterns develop, are maintained & become extinguished
- Explain why environmental stimuli or bodily sensations trigger craving
Learning theory
This type of learning explains how drug cues are developed which trigger cravings that maintain addiction &/or increase the risk of relapse (cue-induced response)
Classical Conditioning (Pavlov)
The main two subtypes of Learning Theory are
Classical Conditoning (Pavlov)
Operant Conditioning (Skinner)
drug cues are not only an object or something that can be felt through any of the five senses, but can come from an _____ as well
internal state
Form of learning involving associations between previously neutral stimuli & stimuli that elicit an automatic response
Classical Conditoning (Pavlov)
Typically in a Learning Theory Approach, the drug cue from the environment may involve any of the _______
five senses
Typically _______ is associated with the development of drug cues. Even though the slide says this as well, it is possible for _________ to also form drug cues through consequences of direct behaviour
(ie; ______)
***MEMORIZE WITH CAUTION, SLIDE STILL SAYS FIRST ANSWER)
Classical Conditioning
Operant Conditioning
(Ie. Neutral room when using drugs may classically train person to get drug cues to said room in general when near it, however if the person is rewarded with the drug everytime they enter the room, they will also seek the room as a result because of the reward of their behaviour, both drug cues)
Dug cues are _______
person-specific
(Classical conditioning)
One goal in CBT for drug cues is to help individuals identify ______________
personal triggers & develop strategies for managing situations where encountered
Individuals are repeatedly exposed to drug cues (CS-Conditioned Stimulus) without experiencing the UCR (Unconditioned Response) (note: treatment isn’t very effective on its own, best used combined)
Cue-exposure treatment
review question for next week: which form of learning helps us understand how drug cues are formed
classical conditioning
Type of learning that is controlled by the consequences of one’s behaviours
Operant conditioning
any consequence that strengthens the probability of a behaviour
Reinforcement
adding a pleasant stimulus
Positive Reinforcement
removing an unpleasant stimulus
Negative Reinforcement
any consequence that weakens the probability of a behaviour
Punishment
adding an unpleasant stimulus
Positive Punishment
removing a **positive stimulus **
Negative Punishment
_____________ punish abstinence & challenge attempts to avoid the addicted behaviour/substance which has previously been rewarding
Withdrawal Symptoms
Operant conditioning can also be used to ____ addictive behaviours.
If _________ are no longer experienced following the _______
extinguish
positive consequences, addictive behaviour
_______ blocks the high feeling following alcohol
Naltrexone
________ use results in quickly developing unpleasant physical effects effects to punish drinking alcohol
Disulfiram
Note for exam: What is a cue-induced response?
When an individual experiences a craving / relapse when interacting with the drug-cue
In Operant Conditioning, What is rewarding / a punishment for one individual is not necessarily experienced __________
similarly by another
Operant conditioning Principles
- What is rewarding/ a punishment for one individual is not necessarily experienced similarly by another
- The sequence of events is important consequence following a behaviour first has a greater influence over future behaviours when compared to a consequence experienced later
- Timing of the consequence is important if too much time passes between the behaviour & consequence, the power of the consequence is weakened
In Operant Conditioning, The sequence of events is important
–> consequence following a behaviour ______ has a greater influence over future behaviours when compared to a consequence __________
first
experienced later
In Operant Conditioning, ______ of the consequence is important - if too much _____ between the behaviour & consequence, the power of the consequence is ___________
Timing
Time passes
Weakened
Who created Social Learning Theory?
Albert Bandura
In Social learning theory, Learning can occur through ____________________
observing others’ behaviours & their consequences
In Social learning theory, An individual is more likely to imitate behaviours displayed by those who:
___________
&
_____________
Are more similar to them
&
Are more salient to them
(noticeable / important)
In Social learning theory ______ & _________ classes of behaviours can be learned through observing & imitating behaviours modeled by others
Specific & entire classes
The Major principles in Social Learning theory relate to those surrounding _________
observational learning
Social learning theory informs interventions designed to shape the ________ of individuals
learning environment
ie.
- Providing positive behaviour models & emphasizing positive consequences experienced by them
- Removing negative behaviour models & emphasizing negative consequences experienced by them
(Social Learning Theory)
Evaluating the likely _____ of engaging in a behaviour affects the probability of that behaviour occurring, this is known as an ________
Consequences
Expectancy
(Social Learning Theory)
Expectancies are ________ of behaviour
Powerful predictors
(Social Learning Theory)
expecting positive consequences increases the likelihood of engaging in the behaviour
- Increases motivation
Positive outcome expectancy
(Social Learning Theory)
expecting negative consequences decreases the likelihood of engaging in the behaviour
- Decreases motivation
Negative Outcome Expectancy
(Social Learning Theory)
______ determines whether positive/negative outcome expectancy takes precedence
Self-efficacy
(Social Learning Theory)
Holding _____ alcohol expectancies is associated with better alcohol treatment outcomes at treatment initiation
negative
(Social Learning Theory)
Expectancies can originate from ___________
Expectancies are learned from an ________
Different sources
Early age
INFORMATION PROCESSING VIEW SLIDE!!!!!
In Personality theory, Certain personality traits are more common among individuals who misuse substances –>
-Low levels of conscientiousness, but high levels of:
- Impulsivity / Disinhibition
- Difficulty delaying gratification
- Disagreeableness
- Sensation seeking
- Antisocial behaviour
- Social alienation
The Five Factor “BIG FIVE” Model Of Personality????
There is no predisposing “addictive personality” (T/F)
TRUE
However, there is an association between substance misuse & certain personality traits, but no way to tell between vulnerability factors or consequences of misuse itself?
Individuals with addiction represent a diverse & heterogeneous population - Therefore ___________
it is possible for anyone to develop an addiction
Who developed the big 5 personality traits?
D. W. Fiske?? WHO EVEN KNOWS NOT ON SLIDE
Learning is “___________” what is learned during intoxication, may not be recalled when no longer under the influence of the substance & vice versa
state-dependent
Individuals display unsuccessful __________ of complex information provided in early recovery phase (brain isn’t fully recovered from the substance)
information processing
Psychodynamic theory
Oral addictive behaviours reactions to fixation of the oral zone during psychosexual development
Substance misuse may be an attempt to escape the intrapsychic conflict caused by tension between the id & superego (reflecting ego deficits)
Substance misuse as an attempt to cope with the formation of insecure attachments early in life
Self Medication hpypothesis of substance misuse using addictive behaviours to “numb” the psychic pain due to insecure attachments/ego deficits/negative or disturbing feelings
using addictive behaviours to “numb” the psychic pain due to insecure attachments/ego deficits/negative or disturbing feelings
Self Medication hypothesis of substance misuse
Psychodynamic theory: limitations
- Constructs involved are difficult to operationalize & objectively measure- lacking adequate empirical support
- The presumed causes are experienced by many who do not engage in in problematic additive behaviours
- Merely focusing on individuals’ own insights of their problem neglects the addictive power substances have
- A combination of psychodynamic principles & other types of interventions may be appropriate
Psychological principles operate in conjunction with ______ & ______ context forces
(Hint, all in one approach)
biological & social
Social factors can be_____ or _______ in Addiction
protective or risk factors
immediate (proximal) & regular social context interactions with the individual
Microsystem
interactions between microsystem elements & settings where the individual functions
Mesosystem
distal elements
Macrosystem
Social contexts represent mechanisms through which the environment may _________________________________________
By invoking _____/____ & _____, _____, __ _____or _______ biological & psychological effects
modify one’s vulnerabilities or resilience around engaging in addictive behaviours
- By invoking constraints/triggers & enabling, triggering, disrupting or strengthening biological & psychological effects
Social Stigmas in Addiction
Stigma about SUD can inhibit efforts to self-identify as having a problem & seeking treatment
Encountering stigma is commonly reported in individuals experiencing SUD having a pervasive impact on their daily lives, social relationships, healthcare experiences, Internal states
Environments exert influence on substance use behaviours through 2 mechanisms:
Social Control: increased/decreased opportunities to engage in substance use/misuse
Social Triggers: environmental aspects which amplify/dampen the behaviour (i.e., exposure to violence), triggering addictive behaviours
Social control & social trigger forces can serve as _______/________ functions
protective/exacerbating
Individuals play active roles in shaping their environments
Individuals are not passively influenced by their environments
“Circularity of influence”
What theory involves;
- Adolescents lacking parental support or experiencing low levels of parental monitoring are more likely to use substances
Parents who misuse substances:
- Reduce quality of parenting behaviours & monitoring
- Model substance misuse
- increase access to substances
- Provide ambiguous social norms regarding substance misuse
- May expose children to adverse childhood events
- Protective factors against substance misuse in children –>establishing clear prohibitive norms regarding substance use, parental monitoring, and positive parent-child relationships
Family systems theory
(Family systems theory)
Transitioning into important ______ is associated with reduced substance use
Family systems are important in the _____ & ____ of addictive behaviours as well as ______
social roles
initiation, & course, as well as recovery
Substance use initiation & escalation are strongly associated with ______ use of drugs, espescially among adolescents
peers
Peers are powerful forces in the initiation of substance use & in assisting recovery peer support during recovery instills feelings of hope & well-being, engagement & reduced use
Neighborhood & community in addiction
Important factors influencing substance misuse:
Easy access to substances
Modeling of substance use
Rate of crime & violence
SES disadvantaged neighbourhoods are associated with increased chances of substance use
strong cultural identity & closeness to one’s culture of origin =
Potential Protective factors against susceptibility to SUD
Some immigrants may engage in substance use in response to __________ or instances of ________
(this connects to the ________)
acculturative stress
discrimination & isolation
self medication hypothesis
Gene- environment interactions explain ______________
individual variations in substance use behaviour & recovery
______ has a pervasive influence on health outcomes, through impacts on behaviour, exposure & opportunity
Poverty
Poverty (& accompanying deprivations) may create chronic stress
Drug trafficking enhances access to substances & exposure to models of substance misuse
Poverty may affect access to treatment
One’s neighbourhood environment can also shape daily experiences, health-related behaviours & health outcomes
disadvantaged neighbourhoods are associated with__________ of substance use
increased chances
Interactions in addiction
- Different social contexts (in the different system levels, micro-) interact in different ways:
i.e., high levels of parental monitoring weakens the strong influence of associating with peers who engage in substance use - Gene- environment interactions explain individual variations in substance use behaviour & recovery
- Circularity of Influence Individuals are not passively influenced by their environments
