Chapter 12: Substance Use Disorders Flashcards
What are the categories of symptoms in substance use disorders?
- Impaired control
- Social impairment
- Rising use
- Pharmacological criteria
What is compensatory response?
Equal and opposite physical response to counteract the effects of a substance to maintain homeostasis
What is the severity rating of drug use disorders?
- Mild: 2-3 criteria
- Moderate: 4-5 criteria
- Severe: 6+ criteria
What is the difference between dependence and abuse?
- Abuse: psychological and behavioral symptoms
* Dependence: tolerance, withdrawal, compulsive use
Why was the DSM-IV distinction between dependence and abuse removed in the DSM-5 and instead calling it “substance use disorder”?
Due to confusion surrounding “dependence” - defining addiction as a substance use disorder is more inclusive way to ID people who need help. Also that there is not much real distinction between abuse and dependence
What are substance-induced disorders?
When ingestion of a substance results in serious behavioral, psychological, and physiological signs and symptoms
Diagnostic criteria for substance-induced disorders?
Specifies that the associated symptoms are reversible and there is physical evidence that it was recently ingested
What is substance intoxication?
- Symptoms vary greatly depending on the substance
- Symptoms often resemble other disorders - you don’t know if person is intoxicated or actually going through a psychological disorder
Prevalence of alcohol related disorders
- Prevalence rate highest between 21-34 years old
- Males have higher rates than females
- High rate of co-morbidity with other disorders - using alcohol as self-medication
What is dual diagnosis?
Substance use disorder in addition to another disorder
What is pharmacological dependence?
More typical at the more severe end of the spectrum - tolerance, withdrawal
What constitutes abuse of alcohol?
- Failure to complete committed tasks - usually due to intoxication or hangover
- May also involve legal problems - disorderly conduct, DUI’s, etc
Diagnosis of alcohol abuse
- Recent ingestion of alcohol
- Clinically significant maladaptive behavior or psychological changes (aggressive behavior, mood lability (swings), impaired functioning)
- Slurred speech, incoordination, unsteady gait, nystagmus, impairment in attention/memory, stupor, coma
Biological causes of alcohol behavior
- Genetically inherited
* Differences in metabolism of alcohol
Psychosocial causes of alcohol behavior
- Emphasis on oral dependency
* Problems during oral stage of development
Behavioral causes of alcohol behavior
- Positively or negatively reinforced from previous drinking - operant conditioning
- Multiple regulation theory - classical conditioning
What is multiple regulation theory?
Classical conditioning - person pairs ingestion of alcohol with “good” feelings, pairs not drinking with neutral or “bad” feelings, used to describe alcohol, cigarette smoking, etc
Cognitive causes of alcohol behavior
Cognitive expectancies - expect experience to be fun/positive, and by virtue of expectancies it is fun
What are delirium tremens?
Occurs during alcoholism treatment - person may develop hallucinations/delusions which require monitoring and inpatient care
What is the AA-disease model?
Alcoholism is a disease so alcohol triggers onset of alcoholism. Thus, the key is complete abstinence from alcohol
What is the learned behavior model?
- Says that problem drinking is a learned behavior, so behavior can be modified.
- Uses “harm reduction” program - does not prescribe abstinence
- What can we do to help you drink and have it remain a positive experience, not go into a negative experience
- Assumes people will drink - teaches them to drink at a level that reduces harm
What is the only non-substance addiction in the DSM?
- Gambling - has signs of tolerance and withdrawal
- Life is centered around gambling, it is used as coping
- Behavior continues after significant loss
What is internet use addiction?
Under DSM-5 as “conditions that require further research”
What are diagnostic criteria for internet use addiction?
- How often you lose sleep, try to cut down time but fail
- Tolerance and withdrawal, starts off and spends more and more time
- Take person off internet, get extreme reaction
