Impulse 3

Question 1

What is Habit Reversal therapy?

Habit reversal therapy is a useful treatment in what two disorders?

Answer 1

Habit reversal therapy entails 1) Increased awareness of behavior 2) developing competing responses to a pathological urge (tic or hair pulling) 3) Strategies to decrease overall tension

1. Trichotillomania
2. Tics in Tourettes Disorder

Question 2

What is the distinguishing feature between Oppositional defiant disorder and Conduct Disorder?

Answer 2

In ODD, there is a pattern of negativistic, hostile or defiant behavior directed towards adults or authority figures.

In Conduct Disorder, the negative behavior is directed at all others, regardless of authority figure or not. So Conduct Disorder has a wider ranging destructive nature.

Question 3

What is the relationship between Serotonin and aggression?

What is the relationship between Dopamine and aggression?

Answer 3

Low levels of CSF Serotonin is associated with increased aggression.

High levels of CSF Dopamine is associated with increased Aggression.

Question 4

What is the diagnostic criteria for Gambling disorder? What is the time frame for dx?

Answer 4

Persistent and recurrent problematic gambling that leads to impairment. 4-12 months

Question 5

What percentage of risk of substance use disorder is thought to be inheritable/genetic?

Answer 5

> 50%

Question 6

All addictive drugs, except LSD, affect mesocorticolimbic dopamine reward threshold…

What is the key reward structure of the brain?

Answer 6

Nucleus Accumbens

Question 7

Nucleus Accumbens is a key reward structure for addiction (mediated by DA)…

1. Which drugs act first to activate frontal cortex which in turn activates Nucleus Accumbens?
2. Which drugs first activate Ventral Tegmental Area which in turn activated Nucleus Accumbens?

3 Which drug activates Nucleus Accumbens directly?

Answer 7

1. Alcohol
2. Opioids
3. Opioids, cocaine and nicotine.

Question 8

1. “Standard Etoh drink” is how many grams of etoh?
2. How many ounces of beer, wine and spirits does this refer to?
3. How long does it take for the liver to metabolize one standard drink?

Answer 8

1. 14 grams of etoh
2. (12 ounce beer = 5 ounce wine =1.5 ounce spirits)
3. 1 hour per 1 standard etoh drink.

Question 9

What is the recommended limit of alcohol drinks for women vs men?

Answer 9

Women:
no more than 7 per week or 4 in a day.

Men:
No more than 14 per week or 5 in a day.

Question 10

What is the criteria for binge drinking for women vs men?

Answer 10

Women:
More than 4 drinks in 2 hour period

Men:
More than 5 drinks in 2 hour period

Question 11

What medication is ideal in treating comorbid Tourettes or TIC disorder and ADHD?

Answer 11

Guanfacine

Also…Atomoxetine (straterra bc non stimulant)