Chapter 2 Flashcards
Three Defining Aspects of Addiction
1) Repeated habitual behavior
2) Compulsive quality
3) Persistence despite adverse consequences.
Addiction Diagnosis
Addiction is not a diagnosis but an umbrella term encompassing Substance Use Disorders (SUDs) and related behaviors.
Seven Dimensions of Addiction
Use, Problems, Physical Adaptation, Behavioral Dependence, Cognitive Impairment, Medical Harm, Motivation for Change.
Physical Adaptation
Includes tolerance (needing more for effect) and withdrawal (unpleasant symptoms after stopping).
Behavioral Dependence
Drug or behavior becomes central, displacing activities, relationships, and roles.
DSM-5 and Addiction
Removed “abuse” and “dependence” labels, using SUD with severity levels (mild, moderate, severe).
Remission in SUDs
Early remission (3-12 months), sustained remission (12+ months) without symptoms except craving.
Public Health Model
Considers host (individual), agent (drug), and environment factors to address addiction.
Dispositional Models
Focus on internal causes like genetics or brain changes; emphasize treatment over blame.
Social Learning Models
Highlight influence of family, peers, and learned behaviors; interventions focus on environmental and cognitive changes.
Sociocultural Models
Emphasize societal influences like pricing, advertising, norms, and policies affecting substance use.
Agent Models
Focus on drug properties as primary risk factors for addiction (e.g., rapid dopamine release).
Cognitive Impairment
Temporary or chronic effects on memory, attention, and learning due to substance use.
Etiologies of Addiction
Multiple causes including self-control failure, genetics, social environment, and drug properties.
Defining Aspects of Addiction
Addiction involves three core aspects:
- Habitual Behavior: Repeated, regular, and consistent behavior.
- Compulsivity: Behavior feels beyond voluntary control.
- Persistence Despite Harm: Continues even when adverse consequences are present.
Popular vs. Clinical Understanding of Addiction
Popular View: Broadly applied to behaviors like shopping, gaming, or eating that dominate life and cause harm.
Clinical View: Requires a precise diagnosis based on specific patterns of symptoms, typically defined by systems like DSM or ICD.
Physical Adaptation
Tolerance: Needing higher doses to achieve the same effect.
Withdrawal: Unpleasant or harmful symptoms when use stops, often opposite to the substance’s effects.
Behavioral Dependence
A state where substance use becomes central to life, replacing other activities, roles, or relationships. Dependence often involves using substances to cope with specific feelings or situations.
DSM Evolution of Addiction Diagnoses
- DSM-I (1952): Addiction grouped under “sociopathic personality disturbances.”
- DSM-III (1980): Introduced separate categories for substance abuse and dependence.
- DSM-5 (2013): Combined abuse and dependence into a single diagnosis (SUD) with severity levels: mild, moderate, severe.
Remission in SUDs
- Early Remission: No symptoms for 3-12 months.
- Sustained Remission: No symptoms (except craving) for 12+ months.
- Remission is common; most individuals recover within 3 years of treatment.
Public Health Perspective on Addiction
Considers three interacting factors:
- Agent: The drug and its addictive properties (e.g., rapid dopamine release).
- Host: Individual characteristics (e.g., genetics, temperament, age).
- Environment: Social, cultural, and legal influences on behavior.
Agent Models
Addiction risk comes primarily from the drug’s properties, such as rapid effect, high potency, or interaction with neurotransmitters like dopamine. Examples: nicotine, alcohol, cocaine
Dispositional Models
Focus on internal factors like genetics or brain changes. Emphasize addiction as a chronic condition requiring long-term care. Often framed as a “brain disease.”
Social Learning Models
Highlight the role of environment, peer influence, and learned behavior. Interventions focus on social supports, cognitive changes, and developing alternative coping strategies.
Cognitive Impairment in Addiction
Acute Effects: Temporary memory, attention, and reaction impairments (e.g., intoxication).
Chronic Effects: Long-term or irreversible mental decline with prolonged substance use.
Medical Harm from Addiction
Acute: Overdose, accidents, or violence during intoxication.
Chronic: Long-term organ damage (e.g., liver damage from alcohol), malnutrition, and impaired chronic condition management.
Sociocultural Models
Emphasize societal and cultural factors such as availability, pricing, norms, and policies. Examples of interventions: alcohol taxes, minimum age laws, and public health campaigns.
Continuum of Addiction Severity
Addiction is not binary but exists on a continuum from mild to severe. DSM-5 recognizes severity levels and tailors treatment based on individual needs.
