Chapter 4 Flashcards
Identify the DSM criteria for Alcohol Abuse.
Alcohol Abuse is a maladaptive pattern of use leading to significant impairment or distress, when one or more of the following have occurred in a 12-month period:
- Recurrent drinking that results in a failure to fulfill major role obligations at work, school, or home.
- Recurrent drinking when it is physically hazardous, such as while driving, or when involved with risky recreational activities.
- Recurrent alcohol-related legal problems.
- Continued drinking despite persistent social or interpersonal problems caused by aggravated use.
Identify the DSM criteria for Alcohol Dependence.
Alcohol Dependence is a maladaptive pattern of use leading to significant impairment or distress, when three or more of the following seven items occur in the same 12-month period:
- Tolerance can be evidenced either as a need for increased amounts of alcohol to achieve intoxication or the desired effect, or diminished effect with continued use of the same amount.
- Withdrawal is the presence of characteristic signs for alcohol withdrawal, or the use of the same or a closely related substance to relieve or avoid withdrawal.
- Drinking in larger amounts or over a longer period than was intended.
- A persistent desire or unsuccessful efforts to cut down or control drinking.
- Considerable time spent in activities related to drinking, or recovering from drinking episodes.
- Important social, occupational, or recreational activities given up or reduced due to drinking.
- Drinking continues even when it is know that physical or psychological problems are caused by or aggravated by continued use.
Identify Jellinek’s first phase.
Prealcoholic phase: the individual’s use of alcohol is socially motivated. However, the prospective alcoholic soon experiences psychological relief in the drinking situation. The individual learns to seek out occasions where drinking will occur- at some point connecting drinking with psychological relief. Drinking then becomes the individual’s standard means of handling stress, although the drinking behavior will not look different to an outsider. This phase can extend from several months to two or more years. An increase in tolerance gradually develops.
Identify Jellinek’s second phase.
The prodromal or “warning or signaling disease” phase: the behavior that heralds the change is occurrence of “alcoholic palimpsests,” or blackouts. Other behaviors emerge during this phase that testify to alcohol’s no longer being just a beverage, but a “need.” Among warning signs were sneaking extra drinks before or during parties, gulping the first drink or two, and feeling guilt about the drinking behavior. At this point, consumption is heavy but not necessarily conspicuous. To look “okay” requires conscious effort by the drinker. Jellinek thought this periouod could last from six months to four or five years, depending on the drinker’s circumstances.
Identify Jellinek’s third phase.
The crucial phase: the key symptom that ushers in this phase is loss of control. Taking a drink sets up a chain reaction. The drinker can no longer control the amount consumed after the first drink. Yet the drinker can control whether or not to take that first drink. So it is possible to stop drinking for a time. With loss of control, the drinking is now clearly different. It requires explanation, so rationalizations begin. Simultaneously, the individual adopts strategies to regain control. Tactics commonly adopted are deliberate periods of abstinence, changes in drinking patterns, or geographical changes to escape/avoid/be relieved of stress; similarly, job changes occur. All these attempts were thought doomed to fail. The individual responds to these failures by being alternately resentful, remorseful, and aggressive. Life becomes alcohol centered. Family life and friendships deteriorate. The first alcohol-related hospitalization is likely to occur. Morning drinking may begin to creep in, foreshadowing the next phase.
Identify Jellinek’s fourth phase.
The chronic phase: drinking begins earlier in the day, intoxication is an almost daily, daylong phenomenon. “Benders” are more frequent. The individual may also go to dives and drink with persons outside the normal peer group. Not unexpectedly, at this stage the person finds him- or herself on the fringes of society. When ethanol is unavailable, poisonous substitutes become a possible alternative. Marked physical changes occur. Tolerance for alcohol drops sharply; the individual becomes stuporous after a few drinks. Tremors develop. Many simple tasks are impossible in the sober state. The individual is beset by indefinable fears. Finally, the rationalization system fails. The long-used excuses are revealed as just that-excuses-and the individual is seen as spontaneously open to treatment. Often, however, drinking is likely to continue, because the alcohol-dependent person can imagine no way out of his or her circumstances.
What is alpha alcoholism?
Seen as a purely psychological dependence, without loss of control or an inability to abstain. “Problem drinking.”
What is beta alcoholism?
Involves physical concerns, such as cirrhosis or gastritis, but neither psychological or physical dependence. Jellinek though this species was possibly most common in societies where wide spread heavy drinking was coupled with an inadequate diet.
What is gamma alcoholism?
Considered the most prominent type in the US, is the variety depicted in Jellinek’s slope of alcoholic progression.
What is delta alcoholism?
Similar to gamma alcoholism, gut with one important difference. Although is is characterized by psychological and physical dependence, there is no loss of control. Therefore, on any occasion the drinker can control the amount consumed. The individual, however, cannot stop drinking for even a day without suffering withdrawal.
What is epsilon alcoholism?
Dubbed “periodic alcoholism” by Jellinek, is marked by bouts of heavy drinking interspersed with sober periods, and which he considered significantly different from other types.
When was alcoholism first labeled as a disease?
1952 in Jellinek’s published research
1980 in DSM-III
1993 in ASAM’s statement on alcoholism
What is the AA definition of an alcoholism?
Though AA has never had an official definition, Dr. Silkworth’s concept is cited by members as “an obsession on the mind and an allergy of the body.”
Another operative definition frequently heard among AA members is “an alcoholic is a person who cannot predict with accuracy what will happen when he takes a drink.”
What is E. M. Jellinek’s definition of an alcoholism?
“Alcoholism is any use of alcoholic beverages that causes any damage to the individual or to society of both.”
What is the World Health Organization’s definition of alcoholism?
“Any form of drinking which in extent goes beyond the tradition and customary ‘dietary’ use, or the ordinary compliance with the social drinking customs of the community concerned, irrespective of etiological factors leading to such behavior, and irrespective also of the extent to which such etiological factors are dependent upon heredity, constitution, or acquired physio-pathological and metabolic influences.”
