Exam PSYC 3604 A Flashcards
What is addiction?
The tendency to persist with an appetitive or rewarding behavior that produces pleasure states and desire, despite mounting negative consequences that outweigh these more positive effects
How does a person feel with addiction?
The person feels caught in this appetitive behavior, and does not want to or cannot seem to moderate or stop it
What do negative consequences include?
Preoccupation and compulsive engagement with the behavior, impairment of behavioral control, persistence with or relapse to the behavior, and craving and irritability in the absence of the behavior
Prevalence of substance use disorders?
Lifetime: 33.1%
12 month: 10.1
What did Stanton Peele say?
“Psychoactive chemicals are perhaps the most direct means
for. But any activity that can absorb a person in such a way
affecting a person’s consciousness and state of being as to
detract from the ability to carry through other involvements is
potentially addictive. It is addictive when the experience
eradicates a person’s awareness; when it provides predictable
gratification; when it is used not to gain pleasure but to avoid
pain and unpleasantness; when it damages self-esteem; and
when it destroys other involvements. When these conditions
hold, the involvement will take over a person’s life in an
increasingly destructive cycle.”
What causes a person to lose control?
It is not the substance - It is the underlying neural circuitry that fires when presented with the reward the substance provides
In substance addiction, what does seeing a drug stimulus do? (i.e., the dealer or syringe)
Seeing a drug stimulus can activate the brain reward system and thus become reinforcing
What else activates the brain reward systems and becomes reinforcing?
Gambling, gaming, related stimuli
How is substance use disorder classified?
Each specific substance is addressed as a seperate use disorder (e.g., alcohol use disorder, stimulant use disorder, etc)
Nearly all substances are diagnosed based on the same overarching criteria, which are:
Meeting at least two of the following occurring in a 12 month period:
1. Taking the substance in larger amounts or for longer than intended
2. Wanting to cut down or stop using the substance but not managing to
3. Spending a lot of time getting, using, or recovering from use of the substance
4. Cravings and urges to use the substance
5. Not meeting major work, home, or school obligations due to substance use
6. Continuing to use, even when it causes problems in relationships
7. Giving up social, work, or recreational activities due to substance use
8. Recurrent use of substance in situations that are physically hazardous
9. Continued use even when you know you have a physical or psychological problem
that could have been caused or made worse by the substance
10. Needing more of the substance to get the effect you want (tolerance)
11. Withdrawal symptoms and/or substance used to alleviate/avoid withdrawal
What are addictive disorders?
Non-substance behavioral addictions (gambling disorder)
Explain the diagnostic criteria of gambling disorder
A. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress as indicated by the individual exhibiting four (or more) of the following in a 12 month period:
- Needs to gamble with increasing amounts of money in order to achieve the desired excitement
- Is restless or irritable when attempting to cut down or stop gambling
- has made repeated unsuccessful efforts to control, cut back, or stop gambling
- often preoccupied with gambling
- often gambles when distressed
- after losing money gambling, often returns another day to get even
- lies to conceal the extent of involvement with gambling
- has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling
- relies on others to provide money to relieve desperate financial situations caused by gambling
B. The gambling behavior is not better explained by a manic episode
What are the biological perspectives of SUD?
Familial and genetic influences
Neurobiological influences
What are neurobiological influences of SUD?
Abused substance affects the internal reward system of the brain
What is the neurobiology of reward? (rats example)
The reward centre in the brain. When certain areas were stimulated with small amounts of electricity, rats behaved as if they received something very pleasant.
Where is the reward centre in the brain?
Exact location in human brain is still subject to debate, but believed to involve the dopaminergic system and its opioid-releasing neurons
Mesolimbic Dopamine System includes the:
Prefrontal cortex, nucleus accumbens, and ventral tegmental area
How do amphetamines move from outside the neuron into the cell?
Via dopamine transporters or directly by diffusing through the neural membrane
What are amphetamines similar in structure to?
Dopamine
Once inside the cell, what do amphetamines do?
Force dopamine out of their storage vesicles and expel them into the synapse
Addiction is thought to be the result of repeated stimulation of the mesolimbic system, which triggers…
Reorganization in the brain’s neurocircuitry
What does reorganization in the brain’s neurocircuitry do?
May mediate positive reinforcement, motivation, craving and relapse for the drug
As people become more driven to use a drug, what could happen?
The drive can also progress to a state of negative reinforcement (i.e., to alleviate negative symptoms associated with withdrawal)
What is neuroplasticity?
The brain’s ability to reorganize itself by forming new neural connections throughout life
What are the neural mechanisms underlying vulnerability to addiction?
Neuroplasticity and neuroadaptation
What does neuroplasticity allow neurons to do?
Allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment
Why is neuroplasticity important?
Important for learning and memory
What is neuroadaptation?
The process whereby the body compensates for the presence of a chemical in the body so that it can continue to function normally
What does neuroadaptation lead to for people who abuse substances?
Tolerance and dependence on a substance
When does sensitization occur?
When repeated administration of a drug elicits escalating effects at a given dose
What is the DA Theory of Addiction?
DA release seems to apply better to stimulants (e.g., cocaine)
What should’ve given the field pause for thought?
Mixed results from non-stimulants
Research has largely focused on DA in the…
Striatum
Decision making for the most part takes place in the…
Cortex
What are the other likely roles of DA?
DA receptor availability may be linked to impulsivity (in rats)
Regulate motivation to seek addictive substances
What is the insula?
Involved in a network of brain regions that represent bodily states associated with emotions and decision making
How is the insula related to craving?
Drug seeking cues activate the insula, and activity in the insula is linked with self reported craving
Cue induced craving can be conceptualized as..
An emotion
What is automatic drug seeking mode?
Divorced from the value of drug taking
No subjective craving
Unaffected by insula lesions
What is goal directed drug seeking mode?
Tied to value of drug taking
Subjective craving
Abolished by insula lesions
What are psychological perspectives of SUD?
Affect and motivation
Cognition and beliefs
Positive and negative reinforcement
Personality and other predispositions
Cognitions and beliefs SUD
Expectancies about taking substance or performing the behavior
Positive and negative reinforcement SUD
Substance increases positive affect (e.g., excitement)
Substance alleviates negative affect (e.g., anxiety)
Personality and other predispositions SUD
Neuroticism
Attachment styles
What is neuroticism?
Proneness to experience negative affect
What are attachment styles?
How we relate to significant others
Why do people consume alcohol?
Positive reinforcement (because it is exciting, to get a high)
Negative reinforcement - Depression (forget painful memories, stop me from feeling so hopeless about the future)
Negative reinforcement - Anxiety (reduce my anxiety and forget my worries)
Social (as a way to celebrate, to be sociable)
Conformity (so i won’t feel left out, because my friends pressure me to use)
What are the three subscales of AUDIT?
1) Hazardous alcohol consumption (items 1-3)
2) Dependence symptoms (items 4-6)
3) Harmful alcohol use (items 7-10)
What does AUDIT stand for?
Alcohol use disorders identification test
What are the Big Five Personality traits?
Neuroticism, extraversion, agreeableness, conscientiousness, and openness to new experiences
What were the results of the “personality factors, drinking motives, and alcohol use disorder severity” study?
Greater conscientiousness was associated with less severe alcohol use via lower enhancement and lower coping-depression motives
Greater agreeableness was associated with less severe alcohol use via lower enhancement, social, and coping-depression motives
Greater extraversion was associated with more severe alcohol use via greater social and conformity motives
Greater neuroticism was associated with more severe alcohol use via coping depression motives
Openness to new experiences was not related to severity of alcohol use via drinking motives
What were the limitations of the “personality factors, drinking motives, and alcohol use disorder severity” study?
Cross sectional research design
Did not statistically control for shared variance between the personality traits
Did not examine interactive effects of personality on drinking motives and severity of alcohol use
Did not examine interactive effects of drinking motives on severity of alcohol
What are the social perspectives of SUD?
The immediate interpersonal environment of a person who develops an addictive disorder (social support, friendships, family)
Broader socio-structural properties of the environment (social disadvantage due to race, poverty, culture)
Community health and “the globalization of addiction”
What are some protective factors for drug use and abuse?
High GPA
Low depression
Having supportive relationships at home
Perceiving many sanctions for drug use
High religiosity
High self acceptance
High law abidance
What are some risk factors for drug use and abuse?
Low educational aspirations
High perceived adult drug use
High perceived peer drug use
Many deviant behaviors
High perceptions of community support for drug use
Easy availability of drugs
Low perceived opportunity
Predicting Concurrent Drug Use
Risk Factor Index by Protective Factor Index interaction was not predictive of all outcomes
Only for hard drug frequency (both sexes)
Cocaine and cigarette use (women only)
Buffering effect
What is linked to high drug use? (buffering effect)
High risk and low protection
What is linked to low drug use? (buffering effect)
Low risk and high protection
What did the risk factor index by protective factor index interaction predict about prospective drug use?
Was not predictive of all outcomes
Predicted greater cocaine and cannabis use 4 years later
Predicted greater alcohol problems 8 years later
T/F: Addiction increases as numbers of vulnerability conditions to which a person is exposed and with which they must cope increase
True
T/F: Addiction cannot be fully accounted for by any one or even a few etiological factors
True
T/F: SUDs and addictive disorders are multifaceted and complex
True
A single model cannot account for ___ when regarding addiction
The heterogeneous and complex pathways to addiction
A biopsychosocial perspective is helpful for ___ (addiction)
Conceptualizing the complex and varied pathways to addiction
What is linked to the development of addiction?
The experience of stress and trauma
What are biological treatment approaches for SUD?
Agonist substitution
Antagonist substitution
Aversive treatments
Drugs to help recovering person deal with withdrawal symptoms
What drugs work for opiate withdrawal?
Clonidine