Chapter 5 Flashcards
The DSM does not pathol-ogize the casual or recreational use of a drug
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The DSM uses the term addiction
f the DSM-5 includes diagnostic criteria for substance use disorders and substance-induced disorders
…. disorders are characterized by a cluster of cognitive, behavioral, and physiological symptoms that manifest with compulsive drug-taking.
Substance use
…disorders include drug-specific physiological and behavioral symptoms of intoxication, withdrawal, and other possible mental disor-ders resulting from the use of a drug
Substance-induced
a mild substance use disorder is suggested by the presence of … symptoms, moderate by … symptoms, and severe by … symptoms
two to three
four to five
six or more
the drug abuse criteria fit into what 4 categories
individuals impaired control over substance use.
Criteria 5 through 7 encompass social impairment associated with substance use.
Criteria 8 and 9 indicate risky use of a substance.
Criteria 10 and 11 are pharmacological in nature.
how did the DSM-IV-TR characterize sub problems
substance dependence and substance abuse.
…` entails intense preoccupation, strong desire, or an overwhelming urge to use a substance. T
Craving
The greatest conceptual shift presented in the DSM-5 chapter on addictive disorders is the inclusion of a non-substance-related disorder, what was it
gambling disorder
why is gambling disorder with the substance use disorders?
the same brain and behavior mechanisms responsible for drug addic-tion appear also to be involved in non-drug-related addic-tions
Individuals with non-substance and sub-stance-related addictions also share common neurobiological underpinnings, deficits in …3
decision making, personality traits, and negative personal consequences.
how is tolerance presented in gambling disorder
Needs to gamble with increasing amounts of money in order to achieve desired excitement
withdrawal in gambling?
Is restless or irritable when attempting to cut down or stop gambling
what are the neuroscience behind gambling addiction
impairments in the mesolimbic reward circuitry
simi-lar changes in the brain activity underlie gambling urges and cocaine craving
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how are gambling and substance addictions similar
-sion of incentive sensitization theory to gambling disorder includes evidence that: a bias of attention toward gambling-related cues exists in compulsive gamblers, a positive correla-tion between striatal dopamine release and gambling disorder severity, and increased striatal activity in problem gamblers in response to reward-related stimuli.
The opioid antagonist naltrexone, used in the treat-ment of alcoholism and heroin addiction, reduces gambling behavior in highly impulsive individuals
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how does the WHO classify addictions (ICD)
Harmful use and dependence syn-drome.
what do the DSM and ICD 10 have in common
(a) the addicted individ-ual demonstrates a loss of control, as indicated by an escala-tion in dose and sustained use of a drug and that (b) the drug use has harmful consequences
impaired control and drug-related harm are really different indicators of the same …
process
what is the hard part of drug categorization to notice
control: how can you tell if someone is in control
how can we tell if animals have a lack of control l
harm behavior must be out of control because no person or animal who has control of their behavior would deliberately injure themselves
what are the 5 types of harm
physical, psychological, occupational, social, or inter-personal.
the correlation between craving and subsequent drug use is poor
t , suggesting that the experience of drug craving may be used as an after-the-fact explanation of drug relapse
specifications are made as to the …—whether the individual is in early or late (sustained) remission.
course of the disorder
when did we start referring to addiction (medical) as exclusively to the excessive use of drugs and to replace such terms as intemperance and inebriety
Toward the end of the nineteenth century,
DSM worked to get addiction from disorder to …
disease
what are the 2 theories for how addiction is a disease
predisposition theories and
exposure theories
(a) predispo-sition theories, say what about how drugs are a disease
which say that people are either born with the disease or acquire it at some time before they begin abusing the drug.
what do exposure theories say
addiction is a dis-ease that is caused by repeated exposure to the drug.
who compared drug addition to an allergy
Jellinek proposed that alcoholism is not caused by alcohol. It is a disease that is inherited; people are born with it. People with an allergy to cats will have no allergic reaction if they do not go near cats.
did Jellinek propose a cure
said there wasn’t one
T: these theories propose that addiction is caused by exposure to the drug alon
drug exposure diseases
does this mean that addiction is a disease?
can be understood in terms of disease pathol-ogy, rather than lifestyle.
Like a broken leg, if we think of addiction as an outcome, it may be more appropriately conceptualized as a type of …, rather than a disease
injury but its up to you
the fact that the DSM uses the term disorder acknowledges such conceptual distinctions because a disorder can include .. resulting from a disease or an injury.
disabling outcomes
theory that was disproven: Avoidance of the autotoxin’s effects was widely proposed as an explana-tion for compulsive opium use. what kind of reinforcement is this
negative
The ability of a drug to cause … (and, consequently, withdrawal) became accepted as the universal indication of an addicting drug, and the presence of …became the defining feature of an addict and an addiction
physical dependence
what is this well supported dependence model 2 criteria for addiction
(a) the state in which a drug pro-duces physical dependence (withdrawal symptoms occur when the drug is stopped) and (b) the compulsive self-administration of a drug (addiction).
serious flaw of dependance model
it is possible to have an addiction in the absence of dependence and to have dependence without addiction
e.g. of addiction without withdrawl
Powerful addictions can develop from intake of substances such as cocaine and cannabis, which cause only relatively mild withdrawal symptoms
dependance without addiction e.g.?
people can be physiologically dependent on medicines such as pain relievers and yet show no addictive behaviors such as craving and loss of control.
These people often became physically dependent on their medication, demonstrating signs of tolerance and withdrawal. is this the same as addiction
no, use to be used intergangably now not
he fact that people could become addicted to substances that did not cause severe physiological withdrawal was noted very early and created a much bigger problem for the ..
depen-dence model.
what emerged from dependance without addiction discovery
This alternative was later developed into the concept of psychological dependence (focused on mental, as opposed to physical, withdrawal symptoms)
what would be psychological symptoms
irrita-bility, negative affect, dysphoria, or craving
problem with the theory of psychological dependance?
may be used to describe a state of affairs, but it cannot also be used as an explanation (explained now)
. This problem does not arise with physical dependence because there is independent evidence—…—that physical dependence exists
withdrawal symptoms
One of the mysteries of casual drug use is that it does not seem to be associated with
any known motivation.
there is a natural drive to use drugs; that is, humans have a need to alter their state of consciousness.
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why did animal addiction go unnoticed for lots of research
thought only humans vcould be addicted so never studied rec use :conditioned taste aversion meant they weren’t liking drug
how did animals not developing addictions lead to social dilemmas of addicts
must be something defining humans from animals that make them addicts because humans had free will and nonhumans did not, humans could “sin” by choosing to take drugs and that this sinning was punished by the misery of addiction.
With this single development, our whole view of drug self-administration and addiction changed, what development
injecting animals
Similarities and Differences in Self-Administration between Humans and Animals: types of drugs
very similar
how do patterns of administration compare
similar
animals that were not physically dependent would self-administer doses of morphine so low that no physical dependence
ever developed It was also demonstrated that rats would press a lever to give themselves infusions of cocaine and other stimulants that do not cause marked
withdrawal symptoms
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… theory, postulates that addictive behavior arises in part from avoidance of drug withdrawal symptoms.
hedonic dysregulation
Drug addiction is conceptualized as a disorder that develops when behavior initially maintained by positive reinforce-ment (…) progresses to being motivated by nega-tive reinforcement (…)
intoxication
alleviating the unpleasant emotional state experienced during withdrawal
The model of drug taking that has developed as a result of self-administration studies we shall call the ….
positive rein-forcement model.
do positive reinforcers always have pleasant effect
there are plenty of examples of stimuli that can act as positive reinforcers but do not cause pleasure even electric shock
is any stimulus that increases the frequency of a behavior it is contingent upon:T
positive reinforcer
To demonstrate that an event can be a positive reinforc-ing stimulus, it must be shown that it will …
increase the frequency of a response it is contingent upon
how does positive reinforcement models explain behavior motivated by positive reinforcement should persist in the face of such punishing consequences
they are immediately experienced after behavior, whereas the punishing and painful effects are often delayed
most positive reinforc-ers, including drugs, can have negative and destructive effects that can motivate people to seek treatment to help them quit
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…. theory, which shows that drugs can sensitize certain parts of the brain that control positive reinforcement, and this too can explain addiction.
incentive sensitization theory
what is the problem of circularity with positive reinforcement?
?P 97
Various drugs differ in their capac-ity to act as positive reinforcers. This property of a certain drug is sometimes referred to as its …
abuse potential or abuse liability
larger doses of any drug are generally more reinforcing than smaller doses
t up until a point