Exam 4 Flashcards
Substance Use
- Low to moderate use, and does not produce problems with social or occupational life.
Psychoactive drugs
- Affect the way you think, emotion, behavior
- Decreases blood flow to the brain.
New in DSM 5 - previously (substance abuse and substance dependence)
Substance Abuse DSM 4
- Disrupts social or job function
Substance Dependence DSM 4
- Developed a tolerance to drug
Substance Use Disorder
- Using amounts more than intended and longer than intended
- Persistent desire / unsuccessful efforts to cut back on use
- Great deal of time trying cop some of the shit, or recover from the effects.
- Craving for the substance
- Use of substance interferes with fulfilling major role obligations
- Important activities given up because of the substance
- Using the substance to where it is physically bad
- Develop tolerance - need more of the substance.
- Withdrawals - physical or psychological (depression or anxiety).
> The use of one drug is often a gateway drug.
> Severe mental disorders - (½ have substance disorder) - comorbidity/ dual diagnosis
Caffeine
- most used substance
- central nervous stimulant
- Increases sense of awareness / wakefulness
- Better concentration
- Can lead to tolerance, dependence, withdrawal
- Increased anxiety symptoms - / stress hormones in the blood stream.
- DSM 5* no caffeine use disorder.
Nicotine
- Stimulant and depressant
- Alert, produces adrenaline, increase the production of glucose, and increases blood pressure
- Releases dopamine - activating pleasure center in brain - then releasing GABA.
- Removed from the body pretty quickly- passes the blood brain barrier.
Alcohol
- Increased production of GABA
- Affects frontal lobe of your brain
- Becoming more uninhibited - affects reasoning / judgement
- Memory is affected -
- Cerebellum - motor movement, balance
- Medulla - where blackout comes into play
> bleeding in stomach and intestines, liver disease, immune system is weakened, heart failure, decreased sex drive.
cognitive tasks impaired, brain shrinks -
heavy drinkers - 12 yrs shorter.
Korsakoffs
- Long term drinking, causing confusion
- Confabulate- bs
Fetal Alcohol Syndrome
- Effects on unborn baby
- Low body weight, intellectual and physical development.
> Children with behavioral problems, hyperactive, aggressive - increased likelihood to develop the disorder
Family conflict - lack of cohesiveness in family (closeness)
Academic failure.
Social pressure to use drugs
Rejection
> Effects are different for everyone - food, women metabolize alcohol less effectively - also, smaller amounts needed to get turnt.
> .50 - passes out .55 people can die (ABL)
No nutritional value - excessive drinker = malnutrition
Benzo
- Given when person is going thru withdrawal - (valium, xanax)
- Lowers seizures and tremors
Acetaldehyde / ADh (what breaks it down)
- What alcohol is broken down initially to
- Is very toxic - causes nausea -
Acetic Acid / AlDh (what breaks it down) - Alkoholdehydrogenase
What alcohol is broken into next
> Bio causes - releases dopamine
Genetic link -
> Behavioral causes - alcohol and drugs are reinforcing -
> Cognitive - the way you think about the situation - (“when I drink, good things happen”)
Marijuana
- Lasts a couple of hours
- Tranquility - more calm
- Increased sensory awareness
- Increased hunger
- Increase BP, HR, Ability to process information is reduced, - Paranoia
- There are cancer causing agents in weed.
> prescribed for pain - chemo, glaucoma
pharma companies spend money to not legalize weed
Amphetamines
- Increased energy, more alert,
- Reduces appetite
- Increased BP, HR
- Blood vessel damage - stroke
- Increases psychotic symptoms
> big tolerance for “speed”, along with withdrawal symptoms
Cocaine
- Releases dopamine
- Also serotonin, norepinephrine
Benzodiazepines
- Anti-anxiety medications (valium, xanax)
- Very addictive
- Over sedation
- Stopping abruptly increases seizures
Opioids
- Reduce physical pain
Detoxification
- Rehab, depression, anxiety
- After heavy drinking stops 6-24 hours
Impatient program
- Live there bruh
Outpatient Facility
- Not living there - 3-5 times a week.
- Individual and group counseling
AA
- 12 step program - it’s a support group.
- Believes it Is a disease , think of a higher power.
- Benefits - large support system of people who don’t drink.
- Gets you away from setting
> psychotherapist - help them see how alcohol is hurting them - how it is the enemy
> Triggers -
Abstinence Antabuse Naltrexone Covert Sensitization Relapse
you should know these terms
Aversion Therapy
- When you associate a negative behavior- like drinking and you pair with with a negative stimulus.
- “If everytime you smoke, you receive an electric shock”.
> start dealing with this at a young age
understand the negative effects
increase coping skills
Desire
Sexual fantasies, engagement
Sexual Drive
- motivation to engage in sexual activity
Related to levels of testosterone (men), estrogen (women) [both pretty equal]
Arousal Phase
- Direct stimulation increases, heart rate increases,
- Men - blood in penis (men- little need for emotional connection)
- Women - wet pussy. (women - more of emotional closeness to the partner)
Orgasm
- Release of sexual tension
Refractory period
- Men - after an orgasm - there is a period of time where it is difficult to cum again. (age,
- Women - don’t have it.
Resolution Phase
- Period after the orgasm phase.
Homosexuality
- Not a disorder because there is no higher incidence in mental disorders with gays. It’s physiological.
- Homosexuality is not a choice.
Sexual Desire Disorders
- Reduce or lack of sex drive, causes significant impairment with the person, distress.
Hypoactive
- Diminished or reduced desire *6 months or longer
Sexual Aversion
- Repelled by the idea of sex, you avoid it.
- Causes: sexual abuse, stress, hormonal changes, meds, depression, fear of losing control, fear of intimacy,
- Treatment: talk about the abuse
Arousal Disorders
- Have sex drive, but have difficulty getting aroused
- Men - ED. Women - dry pussy.
- W; marital conflict.
- Fear of closeness, need to maintain control over your emotions.
Erectile Disorder
Difficulty maintaining a boner.
Primary ED
- Guy who has never had an erection. Rare
- Caused by physical causes, see in hard upbringing. Made to feel guilty if you’re turn on or aroused
Secondary ED
- Has had one, but now is limp af.
- Use of alcohol, reaction to medication, aging, fatigue, and
Performance anxiety:
- Being nervous before performance,
Sensate Focus
- Treatment technique for men and women
- Non sexual massage
- Mutual pleasuring in a nonsexual way
Orgasmic Disorders
- Have desire, aroused, can’t have orgasm
- Most females don’t cum when they get fcked right in the pussy. hooyaaahh
- Position, stimulation inadequate, too much pressure
- Women - difficulty having the orgasm constantly.
Premature Ejaculation - Primary / Secondary
- Cums too quick (little bitch)
- Hypersensitivity
- Since day one / before he we g now he’s cums too quick.
Start / Stop
- Edging bruh basically.
- When you boutta nut - you stop then go back in a few.
Squeeze Technique
- We he’s about to nutt - squeezes nutts.
Delayed Ejaculation
- Does not cum, Fear of giving up control
Genito-Pelvic Pain / Penetration
Persistent difficulty with vag penetration, before, during, or after sex
Gender Dysphoria Disorders
- When person has discomfort with their physical characteristics with their assigned gender
- Women; feel that they are male - or vice versa
Sexual Orientation
- Your degree of erotic and emotional attraction with same or opposite sex.
- Is you gay or nah
- Bio, genetics, and cultural or social influences.
Transsexualism
- Seek a sex change, extreme discomfort
Paraphilias
- *6 month sexual disorder - distressed by recurring urges or fantasies or they acted upon it.
- Involved non-human objects, or non consenting people, inflicting pain on others.
- To have disorder: distressing to the person or the partner and causes significant impairment in interpersonal, social, and occupational functioning.
Fetishism
- When the person has a strong sexual attraction, fantasies that involve inanimate objects. (seen more with guys)
- Sexual outfit, heels,
- must have this for the arousal to occur.
Transvestic Fetishism
- Transvestite - for the guy to be sexuall arroused, they need to be wearing laungere - mostly straight, not gay
- They straight but what turns them on is lady undies
Exhibitionism
- When the person has consistent urges or fantasies, exposing their shit to strangers. (typically a man).
- Underlying insecurities. (arousal; shock of the other person).
Voyeurism
- Consistent urges or acts - observing strangers having sex. (peeping tom).
Frotteurism
- Urges or acts - rubbing up against a nonconsenting person.
Pedophilia
- adult - erotic gratification - sexual conflict with a child.
- Most child molesters are married men - ⅔ of child molesters are fathers (have own child).
- Often a friend or relative of family.
- Most have been abused themselves
Effects of molested child
- Therapy, if molestation included intercourse- more difficult to overcome, longer periods of time, forceful
- If more than one molester - it’s more traumatic - blames self.
Plethysmography
- Not used much today - measures changes in the penis ; ethical problems
Antiandrogen Medication
- Treatment - lower sex drive
- Lower testosterone levels
Satiation
- Over exposure - arousal comes down.
Sadism
- Associated with inflicting physical or psycho pain on a person (non consenting)
Masochism
- The way they get turned on is to be the recipient of the pain.
HIV
- No cure, there is a vaccine
- 75% of people who get aids - gotten through heterosexual sex.
Deinstitutionalization
- 1960s - Getting them out of the hospitals and into community
Civil Commitment
- Patient with psycho disorders cannot take care of themselves
- Refuse voluntary treatment - danger to self or others
- Institutionalized against their will
- Least restrictive (shelter) that will still take care of them.
Competency to stand trial
- Must have a factual understanding of the proceedings
- Be able to rationally consult with the attorney
Criminal Commitment
- When a person with psycho disorder commits crime and they could be judged not guilty by reason of insanity or may be found to be incompetent to stand trial.
Not guilty by reason of Insanity
- Person who committed a crime but their psycho disorder - prevents them from understanding the seriousness of the crime.
- Sent to a mental hospital until attorneys can prove to the court that you are not in danger to yourself or others.
- Difficult to predict if a person is going to be violent
M’Naghten Rule
- The person did not know right from wrong at the time of the crime.
Irresistible Impulse
- DID know what they were doing was wrong but could not control their behavior
Durham Standard
- Person is not responsible for the crime if their psycho disorder interfered with their ability to demonstrate a capacity to resist impulses. And conform their behavior to the law.
- A 1954 U.S. rule used as a test of criminal responsibility and stating that an individual accused of a crime is not criminally responsible if the unlawful act was the product of mental disease or mental defect
American Law Institute
Person is not responsible for the crime if their psycho disorder interfered with their ability to demonstrate a capacity to resist impulses. And conform their behavior to the law.
Diminished Capacity
When you know that what you’re doing is wrong but you were on some shit so it interfered you being able to control your impulses. (twinkie defense)
Guilty but mentally ill
- Criminally guilty, but may not receive treatment in jail.
- Placed in treatment facility. They will remain in custody of department until full sentence is done. (20 years, but will serve elsewhere - full amount of time).
- Can refuse treatment
- Encourage least intrusive treatment.
- Endanger to self or others - can
Confidentiality
- What patient tells therapist - is between the them.
Exceptions:
- Must break: child abuse,elder abuse, harm or kill identifiable person
- May break: suicide (self or others - not directly identifiable)
Confidentiality: anything else is supposed to be only between you two
Privilege
- Legal term that prevents a therapist from sharing confidential information during a legal proceeding.
- If client brings up their mental health - this is the only exception.
Dual Relationship
- Can’t have outside relationship with your patient - unethical
(ex relationship - *2 years - it’s okay to engage a relationship with them, never okay to have sex with a patient)
