General Information Flashcards
What are the characteristics of an addiction? (MILLER)
-Something done regularly, repeatedly, and habitually
- A compulsive quality that seems partially beyond the person’s control
- Persists despite potential or actual adverse consequences
How is addiction defined according to the DISEASE model? (LEWIS)
Addiction as a brain disease (strongly biological)
How is addiction defined according to the PERSONAL CHOICE model? (LEWIS)
Addiction as a problem with the decision-making system (strongly cognitive)
How is addiction defined according to the SELF-MEDICATION model? (LEWIS)
Addiction as a result of attempts to manage distressing symptoms
(strongly developmental)
As children and adolescents develop, emotional problems can erode their sense of well-being and try different strategies until they find something that works (i.e., psychoactive drugs are found to relieve anxiety, interrupt rumination, or brighten one’s mood).
What are the 5 models regarding the etiology of addiction?
PADSS Acronym
- Personal Responsibility Model
- Agent Models
- Dispositional Models
- Social Learning Models
- Sociocultural Models
What is the Personal Responsibility Model?
Addiction attributed at least partially to a failure of self-control, or a
violation of moral, ethical, or religious standards
Treated or prevented though legislation, education, repentance, punishment, and
social sanctions
Addiction as a choice
What is the agent model?
Addiction attributed to the power / strength of the substance and its
effects
The drug itself is to blame, so remove it from society
What is the dispositional model?
Addiction attributed at least partially to physical conditions of the addict,
though not to a lack of fortitude or willpower
Treatment through humane (often medicalized) routes, not punishment
Addiction as a (physical) disease
What is the social learning model?
Addiction arises due to basic learning principles such as classical and
operant conditioning, and social learning
Treatment through behavior modification and manipulations of experience
What is the sociocultural model?
Addiction attributed at least partially to social and cultural factors, such
as price / availability of alcohol or socioeconomic disparities
Treatment through alcohol/drug policy
What is the public health perspective?
groups causal factors into three categories: those involving the agent (in this case, the drug itself), the host (personal characteristics of an individual), and the environment.
What are the 5 stages of change?
PCPAM Acronym
- Precontemplation: individuals are not especially aware of their problems and
have no plans to change their behavior in the foreseeable future - Contemplation: individuals are aware of their problems but have not yet made a
serious commitment to do anything about them - Preparation: individuals have begun to make small changes in their problematic
behaviors with the intention of making more complete changes within 1 month - Action: successful (more complete) change has occurred for short time periods
- Maintenance: goal is to maintain the behavioral and attitudinal changes
Why is there a high rate of co-occuring disorders?
- genetic vulnerability: People may have genetic vulnerabilities that increase the likelihood of developing both disorders
- neurocognitive factors: For example, impairment in self-regulation, high impulsivity, cognitive control problems
- developmental factors: Early exposure to a substance may increase risk of developing MH symptoms / disorders
- environmental factors: Abuse, trauma, poverty, adverse childhood experiences
What are some of the over-represented disorders that co-occur with SUDs?
MAPS
Mood Disorder
Anxiety Disorders
Personality Disorders (Antisocial and Borderline)
Schizophrenia Spectrum and other Psychotic Disorders
What is the quadrant model?
offers a useful framework for conceptualizing subgroups of people with co-occurring conditions by understanding the severity of each disorder
Quadrant 1
display low severity of both substance use and mental illness. They may not seek treatment at all, and if they do they are usually treated in nonspecialist settings, with specialist consultation as needed.
Quadrant 2
display low substance use severity and high mental illness severity, and are usually seen in mental health settings. A collaborative or integrated model is preferred, in which substance use and mental health service providers collaborate, or where services are blended with a single team of providers.
Quadrant 3:
These individuals have high substance use and low
psychological severity, and are most often seen in addiction service settings. Similar to Quadrant II, a collaborative model is preferable, offering integrated treatment of disorders.
Quadrant 4:
People in this quadrant have severe substance use and
severe mental illness. They may be seen in mental health clinics or hospitals, correctional facilities, and emergency departments. They may also be bounced back and forth between mental health and addiction treatment facilities. It is for people in this quadrant that an integrated service model is most vital.
What are the 7 dimensions of addiction?
- Substance use: extent and pattern of the person’s use of psychoactive substances (i.e., how much, how often, and steady vs. periodic patterns of use).
- Problems: extent to which substance use or other addictive behavior has resulted in adverse consequences for the individual and those around him or her.
- Physical adaption: Drug tolerance, chronic tolerance, acute tolerance, physiological dependence
- Behavioral dependence: A more general pattern of behavioral dependence is that the drug gradually assumes a more central place in the person’s life, displacing other activities, relationships, and social roles that once had greater priority
- Cognitive impairment: Psychoactive drugs can also have acute (temporary) or chronic (long-term) effects on cognitive functioning, adaptive abilities, and intelligence
- Medical harm: Many psychoactive drugs also have the potential to damage physical health. Some harm is due to the acute effects of intoxication such as risk taking, aggression, and overdose. Other forms of medical harm are related to chronic use (i.e., cancer, heart disease, etc.)
- Motivation for change: Reluctance to recognize the need for change and take action is a common problem in addiction.
What is the purpose of motivational interviewing?
having a conversation about change that strengthens people’s own motivations and commitment; person-centered
What are the 4 themes of motivational interviewing?
- Collaborative: partnership in which clients are recognized as experts on themselves
- Evocative: calling forth people’s own insights, motivations and resources, rather than trying to install things that clients are presumed to lack
- Acceptance respecting and supporting clients’ autonomy (their right and power to make decisions about their own lives and behaviors)
- Compassion fundamental commitment to clients’ best interests and well-being as prime priority
What are the 4 processes of motivational interviewing?
- Engaging process: listening to and developing a working alliance with clients (Can we walk together?)
- Focusing: developing shared goals for the journey (Where are we going?)
- Evoking: person’s own motivation for change (Why do you want to go there?)
- Planning: treatment plan (How will we get there?)
