Chapter 11 Part 2: Causes and Treatments of Dependence Disorders Flashcards

1
Q

which genes and chromosomes may influence alcoholism

A

genes on chromosome 1, 2, 7, and 11 may serve to PROTECT people from becoming dependence.

– twin and family studies indicate that certain people may be genetically vulnerable to drug abuse.

DRD2 gene enhances the sensitivity of dopamine receptors and can influence alcohlism by increasing the positive quality of these experiences.

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2
Q

what enzyme is involved in the metabolism of alcohol

A

alcohol dehydrogenase. Having an active ADH but slow ALDH (aldehyde dehydrogenase) promotes the rapid formation of acetaldehyde and can promote the BAD FEELINGS of alcohl, preventing alcoholism.

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3
Q

MOP-r receptors, neurons that release endogenous opioids, are spread throughout the central nervous system. they are primarly found in the ___ and ___ striatal areas and are highly influenced by the downstream activation of the dopaminergic ____ and ___ systems.

A

they are primarly found in the DORSAL and VENTRAL striatal areas and are highly influenced by the downstream activation of the dopaminergic MESOCORTICOLIMBIC and NIGROSTRIATAL systems.

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4
Q

explain how drug dependence is both based on positive and negative reinforcement?

A

a drug provides pleasurable experiences ( positive reinforcement) but also removes unpleasant experiences (negative reinforcement).

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5
Q

neurobiology of how many drugs such as alcohol and sedative-hypnotics cause anxiolytic effecst

A
  • involves the septal-hippocampal nuclei system, which includes a large number of GABA-sensitive neurons.
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6
Q

opponent process theory

A

posits that an increase in positive feelings will be followed by an increase in negative feelings a short time later. There is an integration of both the positive and negative reinforcement processes.

  • this mechanism is strengthened with use and weakened by disuse. A person who has been using a drug for some time will need more of it to achieve the same results. At the same time, the negative feeling that follows the drug use tend to intensify.

causes a bad cycle.

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7
Q

expectancy effects

A

a cognitive factor that heightens a persons perception of the effects of a substance. ex/ a person who expects to be less inhibited when he or she drinks alcohol will act less inhibited whether that person actually drinks alcohl or a placebo.

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8
Q

expectancies are shaped by media and by peers. ___ expectancies about the effects of lacohol or marijuana use predicted who was more likely to use and increase their use of these drugs three years later.

A

POSITIVE expectancies (believing you will feel good if you take a drug) about the effects of alcohol or marijuana use predicted who was more likely to use and increase their use of these drugs three years later.

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9
Q

in terms of cognitive factors, how does tolerance to drugs work?

A

as the CONDITIONED COMPENSATORY RESPONSE develops, it works against hte unconditioned drug effect, reducing the subjective experience of the drug effect for the user.

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10
Q

in terms of cognitive factors, how does craving drugs work?

A

when the user is exposed to cues normally associated with drug taking, this initiates the conditioned compensatory response which is experienced subjectively as craving for the drug.

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11
Q

alcohol myopia

A

a state of shortsightedness in which superficially understood and immediate aspects of experience have a disproportionate influence on behaviour and emotions.

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12
Q

equifinality

A

refers to the fact that a disorder may arise from multiple and different paths, and seems particularly relevant to substance-related problems. Repeated drug use may lead to biological and cognitive reactions that contribute to dependence

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13
Q

social dimensions of dependence

A

media and peer exposure to psychoactive substances is a necessary prerequisite to their use and possible abuse.

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14
Q

two social views on dependence

A

1) moral weakness view

2) disease model of dependence

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15
Q

moral weakness view

A

a social view of dependence in which drug use is seen as a failure of self-control in the face of temptation. Drug users lack the character to resist the lure of drugs.

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16
Q

disease model of physiological dependence

A

a psychosocial view of dependence that assumes that drug use disorders are caused by an underlying physiological cause ( a biological perspective).

17
Q

motivational enhancement therapy

A

helps individuals with substance use disorders to increase their motivation to change and move toward a stage where they are ready to work on modifying their problematic substance use.

18
Q

3 main classes of biological treatments to dependence disorders

A

1) agonist substitution: providing a person with a safe drug that has a chemical composition similar to the abused drug (ex/ methadone: gives the same pain relieving effects
2) antagonist treatment: involves drugs that block or counteract the positive effects of psychoactive drugs. Ex/ Naltrexone: the most commonly prescribed opiate-antagonist–> doesn’t allow for opiates to have an effect on the person
3) aversive treatments: involve the use of drugs to make the ingestion of abused substances extremely unpleasant. Ex/ Antabuse

19
Q

Cons about inpatient hospital treatment for dependence

A

very expensive. it’s often used to assist people through the withdrwawl stage of substance abuse and to provide supportive therapy so they can return to the community.

20
Q

Elements of alcoholics anonymous

A

12 step program that views alcohlism as a disease that people are powerless to overcome without help. Social support is a key element.

21
Q

TF AA condones controlled use

A

false. a tenet of AA is total abstinence.

Controlled use as an alternative to abstinence might be a better option; those who participated in controlled drinking gorup were functioning well 85% of the time, whereas those in the abstinence group were doing well nly 42% of the time.

22
Q

aversion therapy

A

a psychosocial treatment where substance use is paired with something extremely unpleasant. may use averive drugs (ex/ antabuse)

23
Q

covert sensitization

A

using imagination to picture unpleasant scenes with substance use, to create a NEGATIVE ASSOCIATION (also used in paraphilic disorder treatment)

24
Q

contigency management

A

a psychosocial treatment where behaviours that the client needs to change and decide on the reinforcers that will reward reaching certain goals.

ex/ clients receive cash vouchers for having cocaine-negative urine specimens.

25
Q

community reinforcement appraoch

A

a BEHAVIOURAL psychosocial treatment for dependence where a friend/relative NONABUSER participates in relationship therapy to help the abuser improve the realtionship with other important people

  • clients then are taught to identify the antecedents and consequences that influence their drug taking
  • cleints are given help on managing stressors like finances, employment etc.
  • person is helped to replace substance use with new activities.
26
Q

aspects of relapse prevention

A

therapy involves changing ambivalence about them stopping drug use, and works on the ability to identify high risk situations.

27
Q

Example of a method of harm reduction as a treatment

A

safe injection sites. (rates of vehicle break ins and theft have decreased in the area since the opening of SIDS in vancouver)

  • some evidence supports the idea that controlled drinking is a useful alternative to abstinence.

the harm reduction appraich recognizes that substance abuse happens in society and that appraoches should be done to minimize harm with substance use.

28
Q

prevention efforts have shifted from ___ -based appraoches to more wide-ranging approaches including the changes in the laws regarding drug posession and use, and ____-based interventions.

A

prevention efforts have shifted from EDUCATION -based appraoches to more wide-ranging approaches including the changes in the laws regarding drug posession and use, and COMMUNITY -based interventions.

29
Q

which regions of the brain are affected in those with a gambling disorder

A

similar brain systems appear to be involved with those addicted to gambling as seen in individuals with substance-related disorder

additionally, there is decreased activity in the brain reigions that are involved in impulse regulation when compared with controls, suggesting an interactin between the enbiornmentla cues to gamble and the brain’s response

the VENTROMEDIAL PFC AND THE ORBITOFRONTAL CORTEX do not function as normal in those with gambling disorder.

30
Q

3 additions to impulse-control disorders

A

1) intermittent explosive disorder
2) kleptomania
3) pyromania

31
Q

what is intermittent explosive disorder

A

episodes in which the person acts on aggressive impulses that result in serious assaults or destruction of property.

32
Q

what NTs and hormones may affect intermittent explosive disorder

A

NE, 5HT and testoserone imbalances may predispose someone to IED

33
Q

which brain regions are involved in intermittent explosive disorder

A

there is a disruption of the orbital frontal cortex’s role in inhibiting the amygdala. Combined with changes in the 5HT system, this can lead to IED.

34
Q

what’s one drug that has been shown to slightly improve one’s impuslivity to steal (kleptomania)

A

naltrexone, an opioid antagonist.

35
Q

T/F: kleptomaniacs often don’t remember shop lifting

A

true. there is often amnesia associated with stealing in kleptomaniacs. Kleptos often also have damage in areas of the brain associated with poor decision making

36
Q

main treatment for impulse control disorders

A

cognitive behavioural therapy