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Abnormal Psychology > Chapter 11: Substance-Related Disorders > Flashcards

Chapter 11: Substance-Related Disorders Flashcards

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1
Q

What are psychoactive substances?

A

Substances that affect mental functioning in the central nervous system (CNS), such as alcohol, nicotine, barbiturates, tranquilizers, amphetamines, heroin, Ecstasy, and marijuana.

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2
Q

What is substance abuse?

A

involves an excessive use of a substance resulting in (1) potentially hazardous behaviour such as driving while intoxicated or (2) continued use despite a persistent social, psychological, occupational, or health problem.

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3
Q

What is substance dependence?

A

includes more severe forms of substance use disorders and usually involves a marked physiological need for increasing amounts of a substance to achieve the desired effects. Dependence in these disorders means that an individual will show a tolerance for a drug and/or experience withdrawal symptoms when the drug is unavailable.

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4
Q

What is tolerance?

A

the need for increased amounts of a sub-stance to achieve the desired effects—results from bio-chemical changes in the body that affect the rate of metabolism and elimination of the substance from the body.

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5
Q

What is withdrawal?

A

refers to physical symptoms such as sweating, tremors, and tension that accompany abstinence from a drug.

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6
Q

T or F: WHO recommends the term alcoholism over “harmful use of alcohol”.

A

False. WHO no longer recommends the term alcoholism but refers instead to the harmful use of alcohol - “drinking that causes detrimental health and social consequences for the drinker, the people around the drinker and society at large, as well as the patterns of drinking that are associated with increased risk of adverse health outcomes”

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7
Q

What does the WHO define heavy episodic drinking as?

A

The consumption of six or more alcoholic drinks on at least one occasion at least once per month

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8
Q

T or F: The life span of the average person with alcohol dependence is about 12 years shorter than that of the average person without this disorder.

A

True.

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9
Q

T or F: Organic impairment, including brain shrinkage, occurs in a high proportion of people with alcohol dependence.

A

True.

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10
Q

T or F: Alcohol abuse and alcohol dependence is NOT found across all age, educational, occupational, and socioeconomic boundaries.

A

False; the image of the alcohol-abusing person as an unkempt resident of skid row is clearly inaccurate.

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11
Q

T or F: In a heavy drinker, damage to the liver shows up long before brain damage appear

A

False. Heavy alcohol use can be manifested in organic brain damage before liver damage is detected.

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12
Q

T or F: The physiological withdrawal reaction from heroin is considered more dangerous than is withdrawal from alcohol.

A

False. The physiological symptoms accompanying withdrawal from heroin are no more frightening or traumatic to an individual than alcohol withdrawal. Actually, alcohol withdrawal is potentially more lethal than opiate withdrawal.

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13
Q

Are men or women more likely to be problem drinkers?

A

Men, but recent epidemiological research has suggested that the traditional gap between men and women has narrowed when it comes to the development of substance abuse disorders.

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14
Q

What is the highest ranking coexisting mental disorder for alcoholism?

A

Depression ranks high among the mental disorders often comorbid with alcoholism.

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15
Q

Explain the complex effects that alcohol has on the brain.

A

At lower levels, alcohol activates the brain’s “pleasure areas,” which release endogenous opioids that are stored in the body.

At higher levels, alcohol depresses brain functioning, inhibiting one of the brain’s excitatory neurotransmitters, glutamate, which in turn slows down activity in parts of the brain. Inhibition of glutamate in the brain impairs the ability to learn and affects the higher brain centers, impairing judgment and other rational processes and lowering self-control.

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16
Q

T or F: it is the amount of alcohol actually concentrated in the bodily fluids, not the amount consumed, that determines intoxication.

A

True.

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17
Q

How long can an individual experience symptoms of a hangover for?

A

Experiences symptoms of headache, nausea, fatigue and cognitive impairment for 8 to 24 hours after consuming alcohol

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18
Q

Why may the liver suffer when someone drinks in excesss?

A

The work of alcohol metabolism is done by the liver, but when large amounts of alcohol are ingested, the liver may be seriously overworked and eventually suffer irreversible damage

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19
Q

What is cirrhosis of the liver?

A

A disorder that involves extensive stiffening of the blood vessels.

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20
Q

T or F: mild to moderate drinking can adversely affect memory and problem solving

A

True.

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21
Q

What are alcohol-induced psychotic disorders (and name them)?

A

Reactions marked by a temporary loss of contact with reality after long-term excessive drinking. These disorders include: alcohol withdrawal delirium and alcohol amnestic disorder.

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22
Q

What is alcohol withdrawal delirium (alcohol-induced psychotic disorder)?

A

This reaction usually happens following a prolonged drinking spree when the person enters a state of withdrawal. Slight noises or suddenly moving objects may cause considerable excitement and agitation.

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23
Q

What are the symptoms of alcohol withdrawal delirium (alcohol-induced psychotic disorder)?

A

The full-blown symptoms include (1) disorientation for time and place, (2) vivid hallucinations, particularly of
small, fast-moving animals, (3) acute fear, in which these animals may change in form, size, or colour in terrifying ways; (4) extreme suggestibility, in which a person can be made to see almost any animal if its presence is merely suggested; (5) marked tremors of the hands, tongue, and lips; and (6) other symptoms including perspiration, fever, a rapid and weak heartbeat, a coated tongue, and foul breath.

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24
Q

How long does alcohol withdrawal delirium (alcohol-induced psychotic disorder) typically last?

A

3 to 6 days and is generally followed by a deep sleep.

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25
Q

What is alcohol amnestic disorder (alcohol-induced psychotic disorder)?

A

*Previously known as Korsakoff’s syndrome & is one of the most severe alcohol-related disorders

The primary symptom is a memory defect (particularly with regard to recent events), which is sometimes accompanied by falsification of events (confabulation). People with this disorder may not recognize pictures, faces, rooms, and other objects that they have just seen, although they may feel that these people or objects are familiar. Such people increasingly tend to fill in their memory gaps with confabulations that lead to unconnected and distorted associations.

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26
Q

T or F: The symptoms of alcohol amnestic disorder result

from malnutrition, specifically the lack of vitamin B (thiamine).

A

True. If symptoms are correctly diagnosed within the first 48 to 72 hours, treatment with thiamine leads to a reversal of this condition and memory functioning appears to be restored with prolonged abstinence. However, if undiagnosed and with disease progression beyond several days, the brain damage causing this condition becomes irreversible.

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27
Q

Why is the mesocorticolimbic dopamine pathway (MCLP) important?

A

MCLP is the center of psychoactive drug activation in the brain. The MCLP is made up of neuronal cells in the middle portion of the brain known as the ventral tegmental area (see Figure 11.2) and connects to other brain centers such as the nucleus accumbens and then to the prefrontal cortex. This neuronal system is involved in such functions as control of emotions, memory, and gratification. Alcohol produces euphoria by stimulating this area in the brain.

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28
Q

T or F: heredity plays an important role in a person’s developing sensitivity to the addictive power of drugs like alcohol

A

True.

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29
Q

What is alcohol flush reaction?

A

The suggestion that certain ethnic groups,
particularly Asians and Native Americans, have abnormal physiological reactions to alcohol. Asian and Eskimo subjects have shown a tendency to have a hypersensitive reaction including flushing of the skin, a drop in blood pressure, heart palpitations, and nausea following the ingestion of alcohol.

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30
Q

Are individuals with antisocial personality, depression, and schizophrenia more vulnerable to substance abuse disorders?

A

Somewhat. About half of those with schizophrenia have either alcohol or drug abuse or dependence as well. In addition, antisocial personality disorder, alcohol, and aggression are strongly associated

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31
Q

T or F: Those with substance abuse disorders tend to have high levels of trauma in their prior histories?

A

True.

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32
Q

T or F: Excessive use of alcohol is one of the most frequent causes of divorce and is often a hidden factor in the two most common causes—financial and sexual problems.

A

True.

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33
Q

T or F: available treatments for alcohol-related disorders show modest effects.

A

True. In general, a multidisciplinary approach to the treatment of drinking problems appears to be most effective because the problems are often complex, requiring flexibility and individualization of treatment procedures.

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34
Q

What is Disulfiram (Antabuse)?

A

A drug that causes violent vomiting when followed by ingestion of alcohol. May be administered to prevent an immediate return to drinking.

*However, such deterrent therapy is seldom advocated as the sole approach because an alcohol-dependent person may simply discontinue the use of Antabuse when he or she is released from a hospital or clinic and begins to drink again.

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35
Q

What is naltrexone?

A

An opiate antagonist that helps reduce the craving for alcohol by blocking the pleasure-producing effects of alcohol

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36
Q

What is the primary goals in treatment of withdrawal symptoms?

A

To reduce the physical symptoms characteristic of withdrawal such as insomnia, headache, gastrointestinal distress, and tremulousness. Central to the medical treatment approaches are the prevention of heart arrhythmias, seizures, delirium, and death.

*Drugs, such as Valium, have revolutionized the treatment of withdrawal symptoms.

37
Q

T or F: Pharmacological treatments with long-lasting benzodiazepines, such as diazepam, reduce the severity of withdrawal symptoms and have been shown to be effective.

A

True.

38
Q

Why are researchers starting to believe gradual weaning from alcohol instead of a sudden cutoff is better?

A

Because of the thought that treatment with drugs are simply transferring the addiction to another substance.

39
Q

Why is group therapy effective for substance-related disorders?

A

These group situations can be extremely difficult for those who have been engrossed in denial of their own responsibilities, but such treatment also helps them see new possibilities for coping with circumstances that have led to their difficulties.

*This can also be family therapy.

40
Q

T or F: An often effective form of treatment for alcohol-related disorders is behavioural therapy.

A

True.

41
Q

What are the several forms of behavioural therapy that are helpful for alcohol-related disorders?

A

One is aversive conditioning therapy, which involves the presentation of a wide range of noxious stimuli with alcohol consumption in order to suppress drinking behaviour.

Another is cognitive behaviour therapy, which combines cognitive-behavioural strategies of intervention with social-learning theory and modelling of behaviour. This approach relies on such techniques as impart-ing specific knowledge about alcohol, developing coping skills in situations associated with increased risk of alcohol use, modifying cognitions and expectancies, acquiring stress management skills, and providing training in life skills (modest effects though*).

Self-control training techniques, in which the goal of therapy is to get alcoholics to reduce alcohol intake without necessarily abstaining altogether, have a great deal of appeal for some drinkers.

42
Q

T or F: controlled drinking was more likely to be successful in persons with less severe alcohol problems.

A

True.

43
Q

What is an important aspect about Alcoholics Anonymous?

A

It appears to lift the burden of personal responsibility by helping alcoholics accept that alcoholism, like many other problems, is bigger than they are.

44
Q

What are Al-Anon family groups and Alateen?

A

Designed to bring family members together to share experiences and problems, to gain under-standing of the nature of alcoholism, and to learn techniques for dealing with their own problems living in a family with one or more affected individuals.

45
Q

What is motivational interviewing (MI) and why is effective for treating alcohol-related disorders?

A

A brief intervention that was designed to be a major departure from earlier confrontational approaches in which a clinician suggested that the drinker stop consuming so much alcohol. Instead, in MI the clinician guides the patient through a collaborative conversation in which the patient articulates the pros and cons of drinking and ultimately makes a decision about whether she or he is motivated to change.

46
Q

What are examples of opiates?

A

Heroin, opium

47
Q

What are examples of stimulants?

A

Cocaine, amphetamines, caffeine, nicotine

48
Q

What are examples of sedatives?

A

barbiturates

49
Q

What are examples of hallucinogens?

A

LSD, “acid,” mescaline, psilocybin, Ecstasy, and marijuana.

50
Q

What type of drug is oxycontin?

A

A pain medication.

51
Q

When is drug abuse and dependence most common?

A

Drug abuse and dependence are most common during adolescence and young adulthood

52
Q

Opium is a mixture of about 18 chemical substances known as…

A

alkaloids. In 1805, the alkaloid present in the largest amount (10–15 percent) was found to be a bitter-tasting powder that could serve as a powerful sedative and pain reliever; it was named morphine.

53
Q

If morphine was treated with an inexpensive and readily available chemical called acetic anhydride, it would be converted into another powerful analgesic called..

A

Heroin. The drug came to be widely prescribed in place of morphine for pain relief and related medicinal purposes. Unfortunately, heroin proved to be an even more dangerous drug than morphine, acting more rapidly and more intensely and being equally, if not more, addictive.

54
Q

T or F: When people addicted to opiates do not get another dose of the drug within approximately 8 hours of their last dose, they start to experience withdrawal symptoms.

A

True.

55
Q

The human body produces its own opium-like substances in the central nervous system and pituitary gland. What are they called?

A

Endorphins.

56
Q

What does the dopamine theory of addiction suggest about addiction?

A

Addiction is the result of a dysfunction of the dopamine reward pathway (which stretches from the ventral tegmental area to the nucleus accumbens, which in turn connects with other parts of the brain such as the amygdala and pre-frontal cortex)

57
Q

What does the reward deficiency syndrome suggest?

A

Addiction is much more likely to occur in individuals who have genetic deviations in components of the dopamine reward pathway, which leads them to be less satisfied by natural rewards (e.g., from food, sex, drugs, and other pleasurable activities), which in turn leads them to overuse drugs and related experiences as a way to adequately stimulate their reward pathway

58
Q

How do we treat those addicted to opiates?

A

After physical withdrawal has been completed, treatment focuses on helping the person make an adequate adjustment to his or her community and abstain from the further use of opiates. Traditionally, however, the prognosis has been unfavourable, with many clients dropping out of treatment.

59
Q

Discuss how methadone is useful to use in conjunction with a rehabilitation program.

A

Methadone hydrochloride is a synthetic narcotic that is related to heroin and is equally addictive physiologically. Its usefulness in treatment lies in the fact that it satisfies an addict’s craving for heroin without producing serious psychological impairment, if only because it is administered as a “treatment” in a formal clinical context and can result in reduced drug use and improved cognitive performance.

60
Q

T or F: Opiates slow down the central nervous system (depressants).

A

True.

61
Q

T or F: cocaine affects the brain in a different way than alcohol or opioids.

A

True.

62
Q

Explain the effects of cocaine on the brain.

A

Cocaine has its primary effect by blocking the presynaptic dopamine transporter (whose job it is to retrieve excess dopamine from the synapse), thus increasing the availability of dopamine in the synapse and increasing the activation of the receiving cells. The increase of dopamine activity in the nucleus accumbens is believed to be especially important in cocaine addiction, because specific parts of this brain region have been suggested to be “hedonic hot spots” that have been consistently associated with the experience of reward and pleasure

63
Q

What drugs have been used to reduce cocaine use?

A

Naltrexone and methadone have been used to reduce cocaine use.

64
Q

T or F: Psychological interventions have proven to not be effective in successfully treating cocaine dependence.

A

False. Both CBT and contingency management (CM) approaches are effective treatments for substance use disorders.

*CM is based on the principles of operant conditioning and offers rewards or financial incentives for meeting agreed-on treatment targets (e.g., drug-free urine). CM has been shown to be slightly more effective than CBT for cocaine dependence.

65
Q

What group of drugs are Dexedrine (dextroamphetamine) and Methedrine (methamphetamine hydrochloride) considered to be a part of?

A

Amphetamines.

66
Q

What are amphetamines typically prescribed for today?

A

Occasionally used medically for curbing appetite when weight reduction is desirable; for treating individuals suffering from narcolepsy (people cannot prevent themselves from continually falling asleep); and for treating hyperactive children.

67
Q

What does it mean that amphetamines are classified as Schedule II controlled substances?

A

= drugs with high abuse potential that require a prescription for each purchase.

68
Q

Methamphetamine is referred to what on the streets?

A

Methamphetamine, referred to on the streets as “crystal meth” or “ice” because of its appearance, is a highly addictive stimulant drug that can provide an immediate and long-lasting “high.”

*Methamphetamine is a form of amphetamine that can be “cooked” in large quantities in makeshift laboratories

69
Q

How does methamphetamine affect the brain?

A

Methamphetamine operates by increasing the level of dopamine in the brain, but is metabolized more slowly than other drugs such as cocaine and produces a high for a longer period of time.

70
Q

T or F: People who are addicted to methamphetamine are highly resistant to treatment, and posttreatment relapse is common.

A

True.

71
Q

T or F: nicotine may have an antianxiety property.

A

True. Nicotine use has been observed as being highly prevalent among those with anxiety disorders.

72
Q

Nicotine addiction might be controlled by a portion of the brain…

A

near the ear called the insula.

73
Q

Are barbiturates stimulants or depressants?

A

Depressants (slow down the CNS). They are commonly called “downers”

74
Q

Why are people who take barbiturates sometimes called “silent abusers”?

A

The people who do become dependent on barbiturates tend to be middle-aged and older people who often rely on them as “sleeping pills” and who do not commonly use other classes of drugs (except possibly alcohol and minor tranquilizers). These people have been referred to as “silent abusers” because they take the drugs in the privacy of their homes and ordinarily do not become public nuisances.

75
Q

What is the most potent hallucinogen?

A

LSD (can produce intoxication with an amount smaller than a grain of salt).

76
Q

T or F: LSD is not always pleasant and can be extremely traumatic.

A

True. The distorted objects and sounds, the illusory colours, and the new thoughts can be menacing and terrifying.

77
Q

Describe the unusual phenomenon of the “flashback” when taking LSD.

A

An involuntary recurrence of perceptual distortions or hallucinations weeks or even months after an individual has taken the drug.

78
Q

What is another term for ecstasy?

A

MDMA

79
Q

Ecstasy is both a hallucinogen and a…

A

Stimulant.

80
Q

T or F: The drug MDMA is an addictive substance and it is thought to be as addictive as cocaine.

A

False - it is not thought to be as addictive as cocaine.

81
Q

T or F: The use of Ecstasy has also been found to be associated with memory impairment and obstructive sleep apnea

A

True.

82
Q

Although marijuana can be considered a mild hallucinogen, what are some things that should be taken into consideration?

A

There are significant differences between the nature, intensity, and duration of its effects and those induced by drugs like LSD, mescaline, and other major hallucinogens.

83
Q

T or F: When abstaining from marijuana use, some users report having uncomfortable withdrawal-like symptoms such as nervousness, tension, sleep problems, and appetite change

A

True.

84
Q

What are Synthetic cannabinoids?

A

Substances that mimic the effects of tetrahydrocannabinol (THC), the active plant-derived substance in marijuana, and activate the human endocannabinoid system

*more likely than marijuana to have serious adverse side effects such as anxiety, tachycardia, hypertension, heart palpitations, seizures, and psychosis-like effects

85
Q

What are Synthetic cathinones?

A

Substances that mimic the effects of amphetamines and cocaine by activating the body’s monoamine system (i.e., bath salts).

86
Q

T or F: There is a high comorbidity between pathological gambling and alcohol abuse disorders

A

True.

87
Q

Are men and women both vulnerable to pathological gambling?

A

Yes. However, rates differ by subpopulation; for example, in some high-risk populations, such as alcoholics, the rates are higher.

88
Q

The most extensive treatment approach used with pathological gamblers is…

A

cognitive-behavioural therapy.

Abnormal Psychology (8 decks)

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