Lecture 1: The BPS+ model Flashcards
What kind of language should be used when referring to substance users?
Use neutral, medically accurate terminology when describing substance use. Use “people first” language, that focuses first on the indiviual(s) not the action. Language like this can help reduce the negative stigma
Define Addiction
The tendency to persist with an appetitive or rewarding behaviour that produces pleasure states and desire, despite mounting negative consequences that outweigh these more positive effects. Addiction is positive reinforcement coupled with low self control
Is addiction binary?
No, addiction is a continuum of use (Experimental/recreational, casual or situational, intensive, compulsive and then addiction) it is not simply having a problem or not having a problem.
What is the overarching criteria for a substance use disorder in the DSM-V?
They must meet at least 2 in a 12 month. Taking the larger amounts or for longer than intended (positive reinforcement), Wanting to cut down or stop using the substance but not managing to, Spending a lot of time getting, using or recovering from these of the substance, Craving and urges to use the substance, Not meeting major work, home or school obligations due to substance use, Continuing to use even when it causes problems in relationships.
What is the only non substance behavioral addiction in the DSM-v?
Gambling
What percentage of Canadians meet criteria for a substance use disorder or mental health problems?
A third of Canadians meet the criteria
Describe the social Dimension of the BPS+ model
The immediate interpersonal environment of a person who develops an addictive disorder (Social support, friendships, family). Broader socio cultural properties of the environment
(Social disadvantage due to race, poverty, culture)
Describe the psychological dimension of the BPS+ model
Affect and emotions, Positive and negative reinforcement, Cognition and beliefs, and Personality and predispositions
Describe the self determination theory
Need thwarting is having a social environment that is actively working against you, it leads to need frustration and ill being. People then feel the need to substitute for something that is missing in their environment. People also engage in compensatory behaviours: loss of self control, rigid behavioural patterns and oppositional defiance. Need satisfaction has the opposite effect
Describe the biological dimension
Familial and genetic influences
Neurobiological influences
(Abused substance affects the internal reward system of the brain and Neurochemistry)
What does the “+” represent in the biopsychosocial + model?
The cultural and spiritual dimensions
Describe the cultural factors
cultural understanding of addiction that takes into account cultural norms. Indications of a healthy community is a person living in a cultural surrounding that respects them, expects positive contributions from them, and that supports/protects those in need.
Describe the spiritual factors?
Religious and non religious spirituality may help people who are caught up in addictive behaviour:
Spirituality is a protective factor for health and well-being (associated with lower rates of addictive behaviour among other positive outcomes), spiritual affiliation may help with healing, recovery and growth (e.g., AA)
What is a stressor?
any event that triggers coping adjustment
What is strain?
the physical and emotional wear and tear reaction of a person attempting to cope with a stressor
What is stress?
the process by which we perceive and respond to events (stressors)
What are the 3 research focuses of stress?
The environment: stress as a stimulus (stressors)
Reaction to stress: stress as a response (distress)
Stress as a process that includes stressors and strains, but includes relationship between person and environment (coping)
What is the transactional model?
1) Encounter a potentially stressful event or situation
2) Cognitive Appraisals:
a. Primary appraisal- is this event positive, neutral or negative? And if negative how bad? (challenge or threat)
b. Secondary appraisal- do I have the resources or skills to handle the event/demand? i. If no, then distress/high stress occurs, if yes then moderate stress
Biological reactions to stress
Fight or flight. There is an Increase in Epinephrine and norepinephrine, cortisol and HR and BP. Decrease in blood flow to the kidneys, skin and gut
What is the role of the endocrine system during stress?
Hypothalamus orders the pituitary to secrete adrenocorticotropic hormone (ACTH) which is taken up by the adrenal glands. Adrenal glands: mediates most of our physiological responses to stress
Releases cortisol, epinephrine and norepinephrine
What are the 2 parts of the adrenal glands role in stress?
1) adrenal medulla (fast acting, secretes epinephrine and norepinephrine)
2) Adrenal cortex (delayed response that restores body to homeostasis, Hypothalamic-pituatary adrenocortical system)
What does the release of norepinephrine and epinephrine from the adrenal medulla increase?
Increases…. • heart rate • respiration • perspiration • blood to muscles • metabolism • mental activity
In the adrenal cortex, what does cortisol influence?
immune function • metabolism • heart rate • blood to muscles • memory
Describe the general adaptation syndrome
Perceived stressor–> alarm reaction (fight or flight)–> resistance (arousal high as body tries to defend and adapt–> exhaustion (limited physical resources; resistance decreases; death
What can happen if stress continues?
Stress can effect cognitive performance (Vicious cycle)
Stress can affect our emotions (Fear and anxiety)
What are dysfunctional cognitive processes?
Catastrophizing – “It is the end of the world if I get
turned down when I ask for a date.”
Overgeneralizing – “I didn’t get a good grade on
this test. I can’t get anything right.”
Selective abstraction – Only seeing specific details
of the situation (e.g., Seeing the negatives but
missing the positive details).
What is the diathesis stress model?
Predisposing traits and stressors impact an individual’s mental and physical health
What is the relationship between stress and depression?
Stressor –> Negative attribution –> feeling sad, hopeless and depressed
What is the cognitive model
The way you think affects the way you feel. Triggering situation–> anxious thought/appraisal–> anxious thinking. It involves vulnerability that is magnified by certain dysfunctional cognitive processes.
What is acute stress?
Sudden, typically short-lived, threatening event (e.g., robbery, giving a speech)
What is chronic stress?
Ongoing environmental demand (e.g., marital conflict, work stress)
What are daily hassles?
Experiences and conditions of daily living that have been appraised as salient and harmful or threatening (e.g., misplacing or losing things, to many things to do, weight concerns)
What are uplifts?
Experiences & conditions of daily living that have been appraised as salient & positive or favourable (eating out, getting enough sleep, completing a task)
What is environmental stress?
Natural disasters, accidents, terrorism, war
What is post traumatic stress disorder?
1) threatened with death
2) response involves fear and helplessness
people with PTSD use addiction to cope
What does TRAUMA stand for?
T: traumatic event R: re-experience A: avoidance U: unable to function M: Month (at least) A: arousal
Measurements of ACE: emotional abuse?
How often did a parent, stepparent, or adult living in your home swear at you, insult you, or put you down?
How often did a parent, stepparent, or adult living in your home act in a way that made you afraid that you might be physically hurt?
Measurements of ACE’s: sexual abuse
During the first 18 years of life, did an adult, relative, family friend or stranger ever?
- touch or fondle your body in a sexual way?
- have you touch their body in a sexual way?
- attempt to have any type of sexual intercourse with you?
- actually have any type of sexual intercourse with you?”
Measurements of ACE’s: Physical abuse
Sometimes parents or other adults hurt children. While you were growing up, that is, in your first 18 years of life, how often did a parent, stepparent, or adult living in your home…
…push, grab, slap, or throw something at you?
…hit you so hard that you had marks or were injured?
Measurements of ACE: physical neglect
I didn’t have enough to eat
I knew there was someone there to take care of me and protect me
My parents were too drunk or too high to take care of me
I had to wear dirty clothes
There was someone to take me to the doctor if I needed it
measurements of ace: household dysfunction
Living with anyone who has an SUD
A Household member who has a mental illness (e.g., depression)
Mother treated violently (e.g., being hit or threatened)
A Household member who went to prison
What was the method for the ACEs and drug use study?
Retrospective cohort study involving adults who attended a primary care clinic in the US (N = 8613)
Completed survey about childhood abuse, neglect, household dysfunction, illicit drug use, and other health-related issues
DVs: self-reported use of illicit drugs, including initiation during 3 age categories( <14 years, 15 to 18 years, or as an adult) drug use problems, drug addiction, and parenteral drug use)
Results for ACEs and drug use study
Each ACE increased the likelihood for early initiation 2- to 4-fold
Higher ACE scores were strongly related to more severe drug use problems, drug addiction and parental drug use. Compared with ppl with 0 ACES, people with >5 Ace’s were 7- to 10- fold more likely to report illicit drug use problems and addiction to illicit drugs and parenteral drug use
What is the definition of stress?
The circumstance in which transactions lead a
person to perceive a discrepancy between the
physical or psychological demands of a situation
and the resources of his or her biological,
psychological, or social systems.
