Etiology of the addictive disorders Flashcards
Personality traits
HIGH LEVEL OF
- sensation seeking
- impulsivity
- neuroticism
- alexithymia
LOW LEVELS OF
- self-esteem
- emotional intelligence
- coping strategies
Sensation seeking
Zuckerman - “seeking is varied, novel, complex and intense sensations and experiences, and the willingness to take physical, social, legal and financial risk for the sake of such experience”.
Sesantion seeking + drugs
High level: stimulants, hallucinogens
Low levels: depressants
Impulsivity
- lower level of sensitivity for the negative consequences of the behavior
- rapid, non-planned responses for stimuli
- ignoring long term consequences
Neuroticism
Big 5 - strongest relationship with N
Alexithymia
Sifneos
4 main characteristics:
- difficulties in identifying emotions and in differentiation between emotions and their bodily responses
- difficulties in expressing emotions
- deficits in imaginations, poor level of fantasy work
- stimuli connected, external cognitive style
strong relationship with alcohol use, abuse
Early psychoanalytic approach
- pleasure seeking, gratification, regression
- importance of oral functions, oral regression
- self-destruction, self-punishment
FREUD
- the only primary addiction: masturbation
- all the addictions are supplements of masturbation
Rado
regression; coping with negative emotional states (depression, frustration, pain)
Gover
Addiction as a defense mechanism against dissociation
Fenichel; Savitt
Struggle against depression
Abraham
Homoerotic tendencies behind alcoholism
Rosenfeld; Chein
substance use = adaptive mechanisms: help the adolescents to cope with adult roles and help them to palliate anxiety
Hartman
adolescence - attempt for palliate intrapsychic stress, painful emotions and depression
Krystal and Raskin
Damage of stimulus barrier between person and others -> cannot dead themselves against painful emotions
McDougal
overwhelming and elusive emotions -> obsessive way of regulating them
Self-treatment theory (Wurmser)
Wurmser
Treating themselves against problems, painful emotions- helps them coping
3 basic emotions
- anger (disruption of ideal self and ideal world)
- shame (discrepancy between ideal self and real self)
- rejection (the object does not give everything that the person wants)
These principle emotions increase craving (“addictive search”) as a psychological hunger.
Vicious cycle of obsessive substance use
- narcissistic crisis: very low self-esteem derived from early trauma; disappointing in oneself; her/his self-expectations are collapsed, losing self-control
- emotional regression: collapse of emotional defense -> overwhelming and archaic emotions
- Searching for emotional defense: primitive, mainly avoidant type (denial, repression) or dissociative type (isolation, splitting, fragmentation)
- Externalization: acting out of an unconscious conflict or problem; magical and omnipotent control over the uncontrollable
- Aggression: motivated by narcissism; derived from early trauma; against external world (parents) and the self
- Superego split: collapse of all the values, morals
- pleasure: immature, mainly oral forms of pleasure, narcissistic goals –> increasing self-esteem, recreate the originial regressive and narcissistic state –> back to the 1 step of the cycle
Self-medication theory
Khantzian
their drug of choice is the result of an interaction between the psychopharmacological action of the drug and the dominant painful feelings with which they struggle.
by unconscious choice
- depends on the deficits in personality, self-regulation, affect-regulation
- drug use a maladaptive coping: compensating neurological and developmental deficits
Basic principles of psychodynamic theories
- substance use is a manifestation of a latent psychological problem
- problem in the regulation of affect and pathological object relations are core difficulties
- the psychological problem causes substance use
- the view substance abuse disorders as homogenous
Family of drug users
- pathological family system
- family homeostasis
- sabotage against recovery
- as a secondary gain
Family of an opiate addict (man)
- missing of father (not only physically)
- father: cold, rude, hardly available, full of negative emotions, in inferior position in the family -> blocked identification with the father
- mother: overprotective, laissez-faire, manipulative; symbiotic relation with the child
