Lecture 17: Non-substance use: beh addictions + gambling disorders

Question 1

concept of non substance beh addiction

Answer 1

• repetitive persistent behs= sig harm= functional impairment
• new disorders medicalise reward seeking behs by attaching medical names, diagnostic instruments

Question 2

changes in dms-5

Answer 2

• added new category
  
  • substance-related, addictive behs
  • non-substance-related
• reclassified pathological gambling as gambling disorder

Question 3

what is gaming

Answer 3

= gambling activities, video + arcade games

Question 4

internet gaming disorder

Answer 4

• beh similarities to substance use disorders

- sig public health implications

Question 5

DMS-5: non substance related disorders

Answer 5

A. 4 or more

• preoccupation
• increased amount gambled (tolerance)
• irritability / restlessness on stopping (withdrawal)
• escape from stress (- reinforcement)
• chasing losses
• lying
• repeated failure to stop (can’t control)
• risked sig relationships
• bailout

Question 6

what is gambling

Answer 6

= risking item of value on outcome of events determined by chance for personal gain

• machines
• numbers (lottery)
• wagering (horses, dogs)

Question 7

psychology of gambling

Answer 7

multiple treatments based on one single cause

Question 8

activation of neuro-cog. + psychophysiological processes

Answer 8

gaming–> money (gain reward)–> reward circuits in brain–> gaming

Question 9

pathway model of pathological gambling

what are 3 subtypes

Answer 9

• common phenomenology
• differ in aetiological factors
• differ in treatment requirements

Question 10

differneces across subtypes

Answer 10

• psychopathogy
  
  • pathway 1: symptoms are causal outcomes of gambling-related probs: psycho-edu, brief interventions
  • pathway 2: affective disturbances, poor coping skills, substance use–> gambling
  • pathway 3: deficits in reward pathways + impulsive: psychopharmacology + intensive interventions

Question 11

pathway 1: how to treat

Answer 11

psycho-edu, brief interventions

Question 12

pathway 3: how to treat

Answer 12

psychopharmacology + intensive interventions

Question 13

is there such thing as internet addiction?

Answer 13

no, doesn’t exist

• you can’t be addicted to a network
• more like specific domains of what you can access through the internet: pornography, games, chat rooms

Question 14

why do people keep doing it?

Answer 14

• escape from reality
• chasing loss (gain what they have lost)
• to feed narcissism, ego
• manage affective states: depression, anxiety

Question 15

whats the underlying concept of: pathways model of pathological gambling

Answer 15

• problem gambles= heterogeneous population
• symptoms might be similar BUT
• leading to problem gambling differs–> diff pathways

Question 16

explain pathway 1

Answer 16

gambling related problems have led to symptoms such as affective disturbance, criminal beh, substance abuse, impaired relationships

env–> arousal and excitement (distorted cognitive schemas)–> pathological gambling–> symptoms

Question 17

explain pathway 2

Answer 17

vulnerability factors:

• childhood disturbance
• personality– want sensation, bored
• arousal levels– depressed, anxious
• poor coping skills– life stresses, fam problems, substance abuse,
• these factors lead to gambling (emotional escape)
• comorbid conditions: anxiety, depression, lack of social support
• motivation: gambling with money, not for money= likely to engage in longer sessions for more escape
• bad problem solving skills and stress coping skills

Question 18

explain pathway 3

Answer 18

many factors come into play

• neural factors (dopamine, attention deficit disorder)
• early history of family instability, abuse
• intense impulsivity, anti-social behaviour– not good in school
• substance abuse, criminal behaviour, poor problem skills
• all this stuff leading to gambling
• gambling reflects one of many maladaptive behaviours