Lecture 4 Flashcards
What are individual factors ?
Personal vulnerability factors
* Biological or genetic predispositions
* Psychological factors ( i.e: personality, attitudes, etc)
What are situational factors ?
Social enviroment (i.e: family, culture, etc)
What are structural factors ?
Nature of the substance or addictive behaviour ( not hypothetically possible to become addicted to anything, i.e., gardening)
What is the developmental theory ?
Impact of addictive behaviours on life course development & development of SUD
What does the developmental theory state ?
- Prental/fetal developmental period marks the peak sensitivity for being negatively affected as result of exposure to alcohol and other substances
- First use of a substance ( tobacco, alcohol, cannabis) during an earlier age (i.e: adolesence) is associated with increases in the risk of developing a SUD
What is the learning theory ?
Presents classical & operant conditioning processes as explanation of how addictive behaviour patterns may develop, be maintained & become extinguished
What is involved in the craving stimulus ?
The craving stimulus from the enviroment may involve any of the 5 senses
What can also trigger craving ?
Familiar internal states (i.e: anxiety)
How may an individual develop a CR to a stimuli ?
An individual may develop a CR to stimuli that are repeatedly associated an addictive substance/activity
What is cue-induced response ?
Exposure to those triggering cues (enviromental cues) increasing the risk of relapse
What is one goal in CBT ?
Helping patients identify personal triggers & develop strategies for managing situations where encountered
What is cue-exposure treatment ?
Patients are repeatedly exposed to enviromental cues (CS) without experiencing the UCR
* Relearning rather than unlearning the association
What is negative reinforcement ?
removing an unpleasant stimulus
What is positive punishment ?
Adding an unpleasant stimulus
What is a negative punishment ?
Removing a pleasant stimulus
What do withdrawl symptoms do ?
They punish abstinence & challenge the addict’s attempt to avoid the addicted behaviour which has previously been rewarding
What other things can operant conditioning be used for ?
It can also be used to extinguish addictive behaviour - if an addict stops experiencing positive consequences following the additive behviour
What does Naltrexone do ?
Blocks the “high” feeling following drinking alcohol
What is Disulfiram ?
Use results in quickly developing unpleasant physical effects to punish drinking alcohol
How is the the sequence of events important ?
Consequence following a behaviour first has a greater influence over future behaviour compared to a consequence experienced later
How is the Timing of consequences important ?
If too much time passes between the behaviour & consequence, the power of the consequence ( to shape behaviour) is weakened
What is the Social learning theory ?
interventions desgined to shape the learning enviroment of individuals
What does the Social learning theory state ?
- Providing positive behaviour models & emphasizing positive consequences experienced by them
- Removing negative behaviour models & emphasizing negative consequences experiences by them
What major principles did Albert Bandura state ?
- Learning can occur through observing others’ behaviours & their consequences
- Complex behaviours can be learned through observing & imitating behaviours modeled by others
What are expectancies ?
Individuals evaluate the likely consequences of engaging in specific behaviour which affects the probability of engaging in the behaviour
When are expectancies learned ?
They are learned from an early age
What is information processing ?
- Stimulus: exposure to information
- Input: attend & perceive information
- Storage: store in short-term memory then long-ter memory
- Retrieval: retrieve from memory
- Output: Influence behaviour
What is learning ?
Learning is state-dependent - what is learned under normal conditions, may not be recalled when under influence of a substance & vice versa
*Re-learning materials learned while under influence of substances is needed during recovery
What does the personality theory state ?
Certain personality traits are more common among individuals who misuse substances - low levels of conscientiousness, but high levels of:
* Impulsivity/disinhibition
* Difficulty delaying gratification
* Disagreeableness
* Antisocial behaviour
* Social alienation
What do addicts represent ?
Addicts represent a diverse and heterogeneous population - it is possible for anyone to develop an addiction
What is the psychodynamic theory ?
Oral addictive behaviours may be explained by reactions to fixation of the oral zone during psychosexual development
How is substence misuse tied to the PDT ?
- Substance misuse may be an attempt to escape the intrapsychic conflict caused by tension b/w the id & superego
- Substance misuse as an attempt to cope with the formation of insecure attatchments early in life
What is self-medication hypothesis of substance misuse ?
Turning to addictive behaviours to “numb” the psychic pain as a result of insecure attatchments/ego deficits/negative or disturbing feelings
What are the limitations of the PDT ?
- Constructs involved are difficult to operationalize & objectively measure in research
- The presumed causes are experienced by many who do not engage in problematic additive behaviours
- Merely focusing on patients’ own insights of the problem neglects the power drugs of abuse have
- A combination of psychodynamic principles & other types of interventions addressing other aspects of the problem may be appropriate
What can social enviroments do ?
Social enviroments one is exposed to can protect them from, or predispose them towards, addictive behaviours
What is microsystem ?
Immediate (proximal) & regular social context interactions with the individual (i.e: close family, friends)
What is mesosystem ?
Interactions b/w microsystem elements & settings where the individual functions
What is macrosystem ?
Distal elements (i.e: policies, cultures)
How does the enviroment exert influence on a substance use behaviours ?
2 mechanisms:
* Social control: increased/decreased opportunities to engage in substance use/misuse
* Social triggers: enviromental aspects which amplify or dampen the behaviour, triggering addictive behaviours
What is circulatory of influence ?
Individuals play active roles in shaping their enviroments
What does the family system theory state ?
Adolescents lacking parental support or experiencing low levels of parental monitoring are more likely to use substances
What do parents who misuse substances do ?
- Reduce quality of parenting behaviours & monitoring
- Model substance misuse
- Increase access to substances for children
- Provide ambiguous social norms regarding substance misuse
- May expose children to adverse childhood events
How do peers influence substance abuse ?
- Substance use initiation & escalation to problematic levels are strongly associated with one’s peer’s use of drugs. during adolescents
- Peers are powerful resources in the initiation of substance use & in assisting recover
What are the important factors influencing substance misuse ?
- Easy access to substances
- Modeling of substance use
- Rate of crime and violence
- SES - disadvantaged neighbourhoods are associated with increased chances of substance use
How does neighbourhood & community influence substance misuse ?
- Poverty has a pervasive influence on health outcomes, through impacts on behaviour, exposure & opportunity
- Social determinants of health can be important intervention targets
- One’s neighbourhood enviroment can also shape daily experiences, health-related behaviours & health outcomes
How does culture influence substance misuse ?
- Protective factors against susceptibility to SUD - strong cultural identity & closeness to one’s culture of origin
- Risk factors - among immigrant: acculturation, reduced closeness with one’s family & increased exposure to peers who use substance
How do interactions influence substance misuse ?
- Gene x enviroment interactions explain individual variations in substance use behaviour (i.e: development & recovery from SUD)
- Circulatory of influence - individuals are not passively influenced by their enviroments
How does social stigma influence substance misuse ?
- Stigma about individuals with SUD can inhibit their efforts to self-identify as having a problem and seek treatment
- Encountering stigma is commonly reported in individuals experiencing SUD - having a pervasive impact on their daily lives, social relationships, healthcare experiences, internal states
