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psychology of addiction > Midterm 1 > Flashcards

Midterm 1 Flashcards

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1
Q

What are the 4 ways of knowing?

A

intuition, deduction, authority, observation

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2
Q

What is intuition?

A

i know its true because it makes sense (ex: logic, street smarts)

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3
Q

what is tenacity?

A

i know it’s true because it’s always been that way

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4
Q

what is authority?

A

i know its true because the bible, Koran, President, etc tell me it’ts true

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5
Q

what is science?

A

it’s true insofar as measurable evidence from reliable instruments verify it repeatedly

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6
Q

what 2 types of science is psychology considered

A

physical and social science

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7
Q

the 6 core influences in the ecological systems theory

A

(from outside to in)
1. chronosystem (development, time)
2. macrosystem
(social and cultural values)
3. exosystem
(indirect environment)
4. mesosystem
(connections)
5. microsystem
(immediate environment)
6. person

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8
Q

Invested parties in the macrosystem

A

political dynamics, economic systems, institutional influences

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9
Q

invested parties in the exosystem

A

parents’ workplaces, extended family cohesion, neighborhood resources

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10
Q

invested parties in the mesosystem

A

home and school, peers and family, family and church

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11
Q

invested parties in the microsystem

A

home, daycare, school, peers, teachers, social workers, therapists, psychologists

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12
Q

invested parties in a person

A

genetics, temperament, learning abilities, neurologists, pediatricians, psychiatrists, other practitioners

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13
Q

how many pages does DSM-5 devote to substance related addicted disorders

A

107 pages

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14
Q

how many addictive disorders are in DSM-5

A

40 different disorders

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15
Q

main categories of addictive disorders

A
  • alcohol related
  • caffeine related
  • cannabis related
  • hallucinogen related
  • inhalant related
  • opioid related
  • sedative, hypotonic, or anxiolytic related
  • stimulant related
  • tobacco related
  • other substance related
  • non substance related
  • gambling disorder
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16
Q

what do the DSM addiction categories focus on and what do they exclude

A

they focus on specific substances used but do not consider the etiopathophysiology

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17
Q

What is substance abuse?

A

Maladaptive use of substances which cause impairment or distress:
-School/job problems
-Family dysfunction
-Criminal problems (e.g., a DUI)
-Recurrent use in hazardous situations (e.g., driving drunk)

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18
Q

what is substance dependence

A

essential feature of substance dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that individual use of the substance despite significant substance related problems. there is a pattern of repeated self admin that can result in tolerance, withdrawal, and compulsive drug taking behavior

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19
Q

Tolerance Characteristics

A
  • a need for markedly increased amounts of the substance to achieve intoxication or desired effect
  • markedly diminished effect with continued use of the same amount of the substance
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20
Q

withdrawal characteristics

A
  • the characteristic withdrawal syndrome for the substance (ex: for cocaine; increased sadness, fatigue, appetite)
  • the same or closely related substance is taken to relieve or avoid withdrawal symptoms (ex: for alcohol; benzodiazepines (ex Xanax) might be substituted)
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21
Q

Although conceptually more sensible, there are no clean lines between_____________________?

A

1) heavy use
2) abuse
3) dependence
so differential diagnosis is unreliable

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22
Q

In class we focus on the ___________________ approach but what are other factors that play a role in addiction

A
  1. neuroscientific approach
  2. other factors include environments, families, neighborhood context, and sociopolitical influences along with biological vulnerabilities
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23
Q

Lifetime prevalence percentages of drug abuse and dependence

A

8% for abuse
3% for dependence

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24
Q

what is the ratio for people that will experience some form of substance use disorder in their lifetime?

A

1 in 7

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25
Q

What would be the total number of people that have some form of substance use disorder

A

20 million people over age of 12

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26
Q

Average number of people with alcohol related disorder from 2002 to 2013

A

Around 15.1

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27
Q

Average number of people with illicit drug related disorder from 2002 to 2013

A

Around 3.95

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28
Q

What drug addiction has increased rapidly over the past decade that is not seen in graphs of overall drug use

A

opioid addiction

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29
Q

What disorders have increased substantially from 2001-2002 to 2012-2013 across nearly all the demographic groups?

A

Alcohol use, high risk drinking, and alcohol use disorder

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30
Q

Which age group shows the highest increase in the graphs of alcohol use (AU), high risk drinking (HRD), and alcohol use disorder (AUD) seen in class?

A

People over sixty five had the highest increase
22.4% AU
65.2% HRD
106.7% AUD

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31
Q

what sex had the highest increase according to the AU, HRD, and AUD graphs

A

Women had the highest increase in all 3 graphs
15.8 AU
57.9 HRD
83.7 AUD

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32
Q

What two races/ethnicities had the highest increase in the AU, HRD, and AUD graphs

A

Black or Asian/Pacific Islanders have the highest increase percentages
Black rate include:
24.2 AU
62.4 HRD
92.8 AUD
Asian/Pacific islander rates:
29.1 AU
56.5 HRD
77.8 AUD

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33
Q

What is the single most abused substance

A

alcohol

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34
Q

What is the annual drag on the US economy due to excessive drinking

A

250 billion
- 180 billion in workplace productivity
- 28 billion in healthcare costs
- 25 billion in law enforcement costs
- 13 billion in motor vehicle accidents

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35
Q

what percent of males and females have experienced 1+ alcohol adverse events

A

60% of males and 30% of females

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36
Q

What percentage of intimate partner violence in the US involves alcohol

A

55% of cases of intimate partner violence

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37
Q

(1) what percent of women are sexually assaulted or raped by adulthood and (2) what percent involve alcohol use by male perpetrators

A

(1) 25%
(2) 12.5%

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38
Q

what is the leading cause of death among to 8 to 34 yo in the US

A

alcohol related traffic fatalities

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39
Q

What is the ratio of traffic fatalities that involve alcohol

A

1 in 3

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40
Q

what age group has the highest percent of alcohol use (heavy, binge, and normal use)

A

21-25 yo w/ total percent of 69.3
26% normal use
30.2% binge use
13.1% heavy use

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41
Q

From 2002 to 2013 what drug use has decreased

A

cocaine use has trended down from 1.5 mill to .9 mill

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42
Q

from 2002 to 2013, what drug use has remained the same

A

marijuana

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43
Q

from 2002 to 2013, what drug use has increased

A

pain relievers

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44
Q

what drug increases rapidly due to prescriptions

A

opiate addiction because it starts as pain prescription which leads to addiction, contributing to addiction rates

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45
Q

what myth exists about opioid therapy

A

myth is that risk of addiction is low during prolonged opioid therapy for pain, esp when controlled release compounds are used, but it is not supported by research

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46
Q

by how much has opioid prescription death increased between 1999 to 2014

A

increased by six fold

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47
Q

what type of prescriptions have increased from 1999 to 2020

A

opioid prescriptions with synthetic opioids other than methadone (ex fentanyl)

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48
Q

what drug do people turn to after becoming addicted to prescription opioids and why

A

heroin because it’s cheaper and easier to get

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49
Q

how much have heroin related deaths increased by since 1999 to 2020

A

have increased by eight fold (from 1500 to 13,165)

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50
Q

what makes heroin more dangerous than prescription

A

the purity is unpredictable and can be mixed with stronger opiates such as fentanyl and carfentanil

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51
Q

What is the weakest opioid/analgesic

A

aspirin (non-opioid)

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52
Q

what is the strongest analgesic/opioid

A

carfentanil

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53
Q

how strong is carfentanil compared to morphine or codeine

A

10,000-100,000 stronger than morphine and 100,000-1,000,000 stronger than codeine

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54
Q

what was the leading cause of overdose in the US in 2016

A

fentanyl

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55
Q

what is carfentanil used for

A

it is used to take down elephants or rhinoceros

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56
Q

what 2 opiate overdose rates have significantly increased from 2011 to 2016

A

fentanyl and heroin

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57
Q

what benzodiazepine overdose rates has significantly increased from 2011 to 2016

A

alprazolam

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58
Q

what 2 stimulant overdose rates have significantly increased from 2011 to 2016

A

cocaine and methamphetamine

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59
Q

Much of vulnerability to substance used disorders is ________________

A

inherited

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60
Q

how much does the risk for alcoholism increase if a person has an alcoholic parent

A

increases by 400%

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61
Q

how much does the risk for alcoholism increase if a person has two alcoholic parents

A

increases over 600%

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62
Q

what percent of vulnerability to substance abuse is genetic

A

over 50%

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63
Q

what is age of onset determined by

A

by environment or opportunity

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64
Q

what is age of onset

A

age of onset is age one becomes dependent

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65
Q

what is determined largely by environment and what is largely due to heritability

A

age at first drink is determined by environment but dependence is due to heritability

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66
Q

what two factors discussed in class play a role in substance use disorders besides genetics

A

culture and environment

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67
Q

what country leads in cannabis use among the adult population

A

iceland

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68
Q

what country leads in cocaine use among the adult population

A

scotland

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69
Q

what country leads in ecstasy use among the adult population

A

austrailia

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70
Q

what country leads in amphetamine type stimulant and prescription stimulant use among the adult population

A

El Salvador

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71
Q

what country leads in prescription opioid and opioid use among the adult population

A

US

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72
Q

what country leads in opiate use among the adult population

A

Afghanistan

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73
Q

what country leads in tobacco use among the adult population

A

US

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74
Q

who first initiated the “war on drugs” term

A

Richard Nixon in 1971 when he stated that drug use was “public enemy Number 1”

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75
Q

who described how the war on drugs was invented for subversive political purposes

A

John Ehrlichman (assistant to Nixon for Domestic affairs) in an interview with Dan Baum

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76
Q

Famous John Ehrlichman quote from interview in 1994

A

“The Nixon campaign in 1968, and the Nixon White House after that, had 2 enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or Black, but by getting the public to associate the hippies with marijuana and Blacks with heroin, and then CRIMINALIZING BOTH HEAVILY, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did”

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77
Q

________________ played a role in Reagan’s radio campaign

A

political expediency

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78
Q

what was the probable cause of the increasing crime rates during Reagan’s presidency

A

crime rates increased due to economic downturn which lead to jobs being scarce

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79
Q

What programs were reduced when Reagan cut the “spider’s web of welfare”

A
  1. the Aid to Families with Dependent Children (AFDC) programs by 50%
  2. the supplemental nutrition assistance program (food stamps)
  3. Medicaid (all who lost AFDC funding lost Medicaid eligibility too)
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80
Q

what was the result of the cut of “the spider’s web of welfare”

A

poverty rates in US rose by about 35%

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81
Q

What did Reagan create to establish a stricter federal sentencing guidelines

A

Reagan created US sentencing commission and implemented the Sentencing Reform Act

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82
Q

Number of people incarcerated and the cost of maintaining that number imprisoned

A

2.3 million are in US prison system and costs about 80 billion annually

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83
Q

what percent of those incarcerated are there due to drug related crimes

A

50%

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84
Q

Who gets incarcerated (by race) and at what rates

A

Blacks use drugs at same rate as whites but are more likely to be arrested and incarcerated

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85
Q

Disproportionality in Incarceration (rates in US population versus prison population)

A

Latinos make up 12.55% of total US pop but make up 18.26% of prison pop
Blacks make up 12.32% of US pop but make up 43.91% of prison pop (4x more in prison than in US pop)

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86
Q

Blacks comprise _____% of US drug users, but _____% of those arrested for drug violations, _______% of those convicted, and ______% of those sentenced to prison

A

13; 37; 59; 74

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87
Q

lifetime likelihood of imprisonment for US residents born in 2001 for:
men
white men
black men
latino men

A

Men: 1 in 9
White men: 1 in 17
Black men: 1 in 3
Latino men: 1 in 6

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88
Q

How did the percentage change for the Blacks being sentenced more than Whites after the federal mandatory minimum sentencing

A

The average federal sentence was 11% for black than for whites before and after it was 49% higher

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89
Q

What is the significant difference in the mandatory minimum sentencing

A

the sentencing established a 100:1 ratio for powder versus crack cocaine

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90
Q

why is there a difference in the powder versus crack cocaine minimum sentencing

A

Based on assumption that crack is more dangerous than powder but in reality is probably due to the fact that people with lower income are more likely to deal with crack cocaine whereas people with more income will deal with powder cocaine

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91
Q

What are the 4 problems with the disparities in mandatory sentencing

A
  1. cocaine is cocaine (powder is converted to crack with water and baking soda)
  2. dealers are more likely to transport and sell powdered cocaine
  3. blacks are disproportionality poor, and poor people are more likely to use crack
  4. police (arrests) and judges (convictions) are far harsher on blacks than on whites
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92
Q

Rates of marijuana use and arrests among whites and blacks

A

Rates bw whites and blacks are the same when it comes to marijuana use but blacks are 2-3 times more likely to be arrested than whites

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93
Q

in poor neighborhoods what percent of black males go to prison and what is the most common crime

A

50% of black males will go to prison, most for nonviolent drug offenses

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94
Q

what are 3 reasons non violent drug users should NOT be sent to prison

A
  1. young men who go to prison, recidivism rates approach 60% over 6 yrs
  2. felony convictions eliminate opportunities for future employment and higher education
  3. prison rehabilitation programs have been eliminated
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95
Q

there are just as many black people in _________ as there are in ___________

A

prison; college

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96
Q

Bottom Line about drug use and criminalization in the US

A

The war on drugs is still being levied against our most vulnerable members of society, in poor urban neighborhoods that are disproportionately black and do not have resources to cope

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97
Q

Do black and white criminalization disparities pertain to first time offenders?

A

Yes the do. Statistically, black males are more likely to have previous run ins with the law and are more likely to be convicted when they engage in any form of criminal activity, even on first offense

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98
Q

Might apparent racial biases really be driven by prior offenses?

A

Priors do play a role but it is limited
Between 2012 and 2016, black men received 19.1% longer sentences than white men, controlling statistically for criminal history and a host of other potential predictors including guilty pleas, age, education, and citizenship

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99
Q

disparities among first time offenders only

A

-blacks are more likely to have their cases rejected or dismissed by prosecutors
- whites are more likely to be placed on diversion and have charges reduced to misdemeanors
-blacks are more likely than latinos who are more likely than whites to receive a prison term
- when sentenced, blacks and latinos receive longer terms than whites
-some disparities are result from historical difference of sentencing guidelines for possession of crack vs meth and heroin
- even for crack, blacks receive longer sentences than whites
-large disparities in arrests, diversion, and sentencing exist for crack vs opioids

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100
Q

Might apparent racial bias stem from differences in police presence in urban vs rural areas?

A

yes police is a factor but blacks are more likely than whites who go to urban neighborhoods to buy drugs to be arrested for doing so while in those neighborhoods

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101
Q

What disproportionalities and disparities suggest institutional racism

A
  1. disparities in first time offenders
  2. biases be driven by prior offenses
  3. differences in police presence in urban vs rural areas
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102
Q

what 2 things are built into structure of social institutions that continue to operate even without active support and maintenance of individuals

A

policies and practices

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103
Q

what is direct racism

A

policies that are purposefully designed to have discriminatory effects

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104
Q

example of direct racism

A

the original motivation for war on drugs as described by John Ehrlichman

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105
Q

What is indirect racism

A

practices that have disproportionate effects on people of different races without any intent to discriminate

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106
Q

example of indirect racism

A

increased police presence in poor urban neighborhoods can result in more young black people being arrested than white people who commit similar crimes

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107
Q

in 2013 what were federal prosecutors not allowed to specify

A

they could not specify the amount of drugs involved when charging low level AND nonviolent drug offenders

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108
Q

What was the result of not specifying the amount of drugs in low level, nonviolent cases

A

judges could then have more leeway in their sentencing than was required by the mandatory federal punishments

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109
Q

What is significant about US Attorney General Jeff Sessions and did he help or hurt the drug criminalization situation

A

He was the person who reversed the policy that gave judges the discretion to lower sentences

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110
Q

what is the Neighborhood Safety, Drug treatment, and Rehab amendment initiative that Ohio started in 2018

A

It is an initiative that would have
1. changed drug possession felonies to misdemeanors
2. prohibited prison sentences for technical probation violations
3. expanded the ability to earn up to 25% off a prison sentence through rehabilitative programning
4. redirected funds saved from reduced incarceration to drug treatment and victims’ services

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111
Q

explain the racial disparities in policing

A

Stats of police killing disproportionately

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112
Q

Stats of police killing disproportionately

A

people killed by police
31% black
12% hispanic
People killed while not attacking
39% black
12% hispanic

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113
Q

In how many cities do people kill more black men than the overall US murder rate

A

13 cities

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114
Q

For unarmed victims killed by police what is the ratio of white versus minorities

A

Minorities are twice as likely to be killed than whites when unarmed

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115
Q

What is the neural analysis of addiction

A

Sensitization of brain regions to drug cues (ex: greater DA neural reactivity in the striatum); down-regulation of brain function via allostatic load

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116
Q

Behavioral analysis of addiction

A

Use of larger amounts or over longer periods of time

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117
Q

Emotional analysis of addiction

A

Development of craving, a strong emotional urge to use

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118
Q

What are the 4 brain DA systems

A
  1. tuberoinfundibular
  2. nigrostriatal
  3. mesolimbic
  4. mesocortical
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119
Q

Tuberoinfundibular pathway

A

originates in the arcuate nucleus of the hypothalamus and projects to the pituitary gland

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120
Q

function of tuberoinfundibular pathway

A

releases Dopamine to limit the secretion of Prolactin; important for hormone regulation

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121
Q

Nigrostriatal pathway

A

originates in the Substantia Nigra, pars compacta and projects to the dorsal striatum

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122
Q

function of nigrostriatal

A

important for movement but also plays role in addiction

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123
Q

structures found in dorsal striatum

A

caudate and putamen

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124
Q

Mesolimbic pathway

A

originates in the ventral tegmental area (VTA) and projects forward to the ventral striatum, the nucleus accumbens, the amygdala, and the bed nucleus stria terminalis

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125
Q

mesolimbic function

A

implicated in all reward motivated behavior (food, self preservation, sex)

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126
Q

what DA systems are subcortical and phylogenetically old

A
  1. tuberoinfundibular
  2. nigrostriatal
  3. mesolimbic
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127
Q

mesocortical pathway

A

projects forward from portions of the mesolimbic system to cortical areas including the dorsolateral PFC, the medial PFC, the anterior cingulate cortex (ACC), and the temporal cortex

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128
Q

What DA systems is largely cortical and what does cortical mean

A

the mesocortical system; cortical means it is evolved fully in primates

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129
Q

how is mesocortical system regulated

A

it has a top down regulation over impulses generated by the subcortex

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130
Q

What is associated with mood states

A

Tonic DA activity is associated with mood states

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131
Q

what are the 2 tonic DA activities

A

high tonic DA and low tonic DA

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132
Q

what is high tonic DA

A

it is positive affectivity (affective component of euphoria)

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133
Q

what is low tonic DA

A

it is negative affectivity, irritability (affective component of craving)

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134
Q

What system activity is experience dependent

A

mesolimbic DA activity

135
Q

What does repeated phasic activation produce

A

it leads to reduced tonic activity and sensitization

136
Q

What do most drugs of abuse produce

A

they produce phasic increases in mesolimbic DA that exceed those produced by normal reinforces (Food, sex)

137
Q

what 3 things is addiction associated with when it comes to DA activity

A
  1. reduced tonic neural firing
  2. sensitized phasic neural firing
  3. sensitized phasic neural firing that begins with cue exposure
138
Q

what are two possible ways to induce reduced tonic neural activity

A
  1. induced by adaptive recalibration of neural firing (via altered numbers of DA receptors and transporters)
  2. long term (sometimes permanent) structural damage to DA neurons
139
Q

what is recalibration of neural systems in response to repeated activation called

A

allostatic load

140
Q

How long does it take for DA transporter recovery to occur for meth users

A

It is only after 14 months that a meth abuser begins to show normal levels of DA transporters

141
Q

what drugs can lead to permanent damage to midbrain DA neurons

A

meth and cocaine induced damage

142
Q

What is addiction defined as

A
  1. a compulsion to seek and take a drug
  2. loss of control in limiting intake
  3. emergence of negative emotional state (dysphoria, anxiety, irritability) when access to drug is denied
143
Q

how is addiction subdivided

A
  1. occasional, controlled, or social use
  2. abuse
  3. depedence/addiction
144
Q

what drug has the highest probability of abuse/dependence given any use

A

heroin, it is 3x more likely than the runner up (cocaine)

145
Q

what are the 11 statements that are currently used to define SUD according to DSM

A

refer to pg 15 of lecture 3

146
Q

what kind of disease is addiction known as and what is it characterized by

A

addiction is a progressive disease, characterized by chronic relapsing

147
Q

what are the steps leading to addiction and eventually recover

A
  1. acute reinforcement/social drug taking
  2. escalating/compulsive use binge drinking
  3. dependence
  4. withdrawal
  5. protracted withdrawal
    5.5 relapse
  6. recovery
148
Q

what kind of changes does addiction cause that can persist for months/years after quitting

A

structural and functional changes in brain circuits

149
Q

what aspects of addiction are not isomorphic

A

emotional and neural aspects of addiction

150
Q

how does associative learning play a role in addiction

A

the experience dependent down regulation of striatal DA activity produces dysphoria, irritability, and anhedonia which induces craving and changes to both structure and function of brain regions that are implicated in associative learning

151
Q

what are the 2 broad types of genetic studies in psychopathology research

A
  1. quantitative behavioral genetics
  2. molecular genetics
152
Q

other names for quantitative behavioral genetics

A

aka behavioral genetics, quantitative genetics, biometrical genetics

153
Q

objective of quantitative behavioral genetics

A

parse variance in behavior (trait, phenotype) into heritable (both genetic and non-genetic) and non-heritable (environmental) components using latent variable modeling

154
Q

how is variance studied in quantitative behavioral genetics studied

A

variance is studied by using twin, family, and adoption studies

155
Q

what are the assumptions of basic twin studies

A
  1. monozygotic twins have nearly 100% shared genetic polymorphisms
  2. dizygotic twins have 50% shared genetic polymorphisms
  3. both monozygotic and dizygotic twins share many features of the environment (intrauterine, development, parenting factors, education, SES, etc)
  4. non twin sib-sib pairs also share 50% genetic polymorphisms but share fewer features of environment (diff classrooms, fewer common friends, etc)
156
Q

What is the ace model

A

uses large groups of twins and other siblings, the attempt is to study percentage of overall variance in phenotype (addiction symptoms) that attribute to heritability (A^2), shared environment (C^2), and unique environment (E^2)

157
Q

What is shared environment (C)

A

events shared by both twins

158
Q

What is non-shared environment (E)

A

events experienced by only one twin

159
Q

how many and what are the assumptions about the ace model?

A

5 total and refer to lecture 5 for specifics

160
Q

how are environmental effects facilitated into shared versus non shared components?

A

study includes identical twins who are reared together and identical twins who are reared apart

161
Q

what is a major limitation of the ACE model

A

it does not account for GxE interactions or gene-environment correlations (rGE) which are unmeasured and subsumed within A^2, resulting in overestimates of heritability

162
Q

what accounts for initiation of alcohol use

A

peer influences

163
Q

what accounts for quantity and maintenance of alcohol use

A

heritability

164
Q

how does behavioral genetics differ from molecular genetics

A

molecular genetics involves direct assessment of genes

165
Q

objective of molecular genetics

A

identify specific genetic polymorphisms that increase vulnerability to psychopathology, including addiction

166
Q

what are polymorphisms

A

alleles/variants that are in only about 1% of the 30000 protein coding genese

167
Q

what is a single base pair

A

a DNA sequence variation that occurs when a single nucleotide of A, T, C or G in a genome differs between members of a species or between paired chromosomes with an individual

168
Q

what is a genotype

A

specific genes underlying a phenotype

169
Q

phenotype

A

observable characteristics of an organism that may or may not correspond with a particular genotype

170
Q

what is mendelian inheritance

A

inheritance pattern for single gene, dominant/recessive traits

171
Q

homozygotes vs heterozygotes

A

DD and dd are homozygotes
Dd and dD are heterzygotes

172
Q

is human behavior or disorders determined by a single gene

A

No

173
Q

what is a three factor cross

A

a trihybrid phenotype

174
Q

what is the ratio for inferring the genotype from the phenotype

A

only 1 in 4 cases

175
Q

what ratio can be inferred in a trihybrid phenotype

A

only 1 in 64 cases can the genotype be inferred from the phenotype

176
Q

what is polygenetic inheritance/determinism

A

the influence of multiple genes on a physical or behavioral phenotype

177
Q

what is penetrance

A

the proportion of individuals who carry genetic vulnerability (often called liability) and express the disorder

178
Q

what is an example of penetrance

A

almost 10% of individuals carry at least some genetic vulnerability to schizophrenia but less than 1% develop the disorder

179
Q

what is incomplete penetrance

A

Not all individuals with a mutant genotype show the mutant phenotype

180
Q

what is multifactorial inheritance

A

Multifactorial inheritance means that many factors are involved in causing a birth defect. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition.

181
Q

what are the neurobiological factors that contribute to blunted

A
  • neuro-hormonal modulators
  • environmental influences
  • genetic liability/burden
182
Q

what are the 3 levels of analysis in the multifactorial influences on striatal function

A

neurobiological, emotional, and behavioral

183
Q

what are the neuro hormonal modulators involved in blunted striatal responding

A
  • testosterone levels
  • L-HPA axis function
184
Q

what are the environmental influences involved in blunted striatal responding

A
  • TBI, hypoxia, teratogen exposure
  • epigenetic regulation of receptor function
185
Q

what are the genetic liabilities/burdens involved in blunted striatal responding

A

-epigenetic regulation of receptor function
- DAT, DRD, SLC6A4, and CACNA1C (vulnerability alleles)
- 18p11.32, 16p11.2, and CNV burden (heritable CNVs)
- disrupted neuro development (de novo mutations)

186
Q

what is the behavioral bias associated with striatal function

A

vulnerability to addiction

187
Q

what are the 3 approaches used to identify candidate genes for different disorders

A
  1. genetic linkage study
  2. genetic association study
  3. genome-wide association study
188
Q

what is genetic linkage

A

they refer to the tendency of alleles that are near one another on the same chromosome to be inherited together or “linked”

189
Q

what is done during a linkage study

A
  1. obtain large sample of families with two children with a trait or disorder
  2. collect genetic data from family members
  3. scan broad sections of genome (by historical standards) in searches for genetic markers with known chromosomal locations that may be linked to a gene for the disorder
  4. make educated guesses about the location of genes for complex disorders, which may be confirmed/refined in subsequent studies
190
Q

example of genetic linkage study

A

gene responsible of CF (cystic fibrosis) was found by linking the disease to genetic variant on long arm chromosome 7 within affected families. Followed by several other studies to find the CFTR (cystic fibrosis transmembrane conductance regulator) gene

191
Q

Problems with linkage studies

A
  1. they are expensive and lead to many false leads, and have not produced strong or replicable results for psychiatric disorders
  2. linkage studies are best suited for identifying risk loci for monogenic or oligogenic traits, whereas addiction is inherited multifactorially
192
Q

what is gene association

A

refers to situations in which specific genes are associated with certain phenotypes. In studies that attempt to identify allelic variants that segregate with the trait of interest in the general population

193
Q

what is done during gene association studies

A

begin with a specific candidate gene, and then compare allelic frequencies of the gene among people with and without the disorder (case control design) which provides more statistical power than linkage studies

194
Q

problem with gene association studies

A

-scientists have no idea where to look
- association studies indicate that all vulnerability genes combined account for only a few percent of variance any behavioral trait (including addiction) whereas behavioral genetics studies tell us that preponderance of variance in most traits is heritable (this is called missing heritability problem)

195
Q

what is a genome wide associated study

A

study where hundreds of thousands of genes are tagged across the genome in very large samples, and searches for associations with psychopathology are conducted using strong corrections for family wise alpha error rates

196
Q

what has been found due to GWAS studies

A

found 14 loci and had 8 hits on specific chromosome with 2.3 MB and several alcohol dehydrogenase genes that have previously been implicated in alcohol consumption. This contributes to the idea that alcohol consumption is a complex, multifactorial trait

197
Q

what number of SNPs explain 50% of population based phenotypic variation in schizophrenia liability

A

8332

198
Q

what is gene polymorphism

A

a DNA sequence variation that is common in the population. Polymorphic variants usually do not cause life threatening diseases directly, but may influence behavioral and other specific phenotypic propensities that interact with environments to confer susceptibility to disease including psychopathology

199
Q

are gen polymorphism inherited or taught

A

they are inherited

200
Q

what is a gene mutation

A

a change in DNA sequence away from ordinary variation observed in population.

201
Q

what are de novo mutations

A

Mutation that is present in a family member as a result of a mutation in a germ cell of one of the parents

202
Q

how do genes affect complex behavior

A

certain gene polymorphisms confer behavioral biases that render individuals susceptible to disease in certain environments (GxE)

203
Q

how do genes code for protein expressions

A
  1. transcriptions of DNA into mRNA
  2. translation of amino acids into proteins by tRNA
204
Q

who oversimplifies the genes that control complex traits

A

popular press accounts

205
Q

how do genes affect neurotransmitter system function

A
  1. alter neurotransmitter availability via synthesis and metabolism pathways
  2. alter efficiency of neurotransmission more directly
206
Q

what genes are implicated in impulsivity

A

MAO, COMT, DAT, and DRD4 which all can collectively alter DA function

207
Q

where are several candidate genes for alcohol and other substance dependencies expressed in

A

in the liver

208
Q

which genes are attributable to genetic differences in the alcohol metabolism

A

ALDH2, ADH1B, ra1693482, 4s698, ADH1C

209
Q

what gene is responsible for clearing alcohol

A

ALDH2, one copy of ALDH2 gene is inherited from each parent

210
Q

which gene variable will clear acetaldehyde slowly

A

ALDH2^2

211
Q

2 main components of nervous system

A

CNS and PNS

212
Q

Where is the CNS

A

brain and spinal cord

213
Q

where is the PNS

A

the nerves and ganglia outside of the brain and spinal cord

214
Q

3 subdivisions of the PNS

A
  1. sympathetic nervous system
  2. parasympathetic nervous system
  3. somatic nervous system
215
Q

what is the sympathetic nervous system

A

the excitatory component of PNS (accelerates HR, opens bronchial passage, dilates pupils, etc); largely adrenergic (adrenaline, epinephrine)

216
Q

What is the parasympathetic nervous system

A

the inhibitory component of PNS (deaccelerates HR, constricts pupils, aids in digestion); largely cholinergic (acetylcholine)

217
Q

what is the somatic nervous system

A

provides voluntary control over skeletal muscles; largely cholinergic

218
Q

Parts of brain that are part of the CNS

A

temporal lobe, frontal lobe, parietal lobe, occipital lobe, cerebellum, brain stem (includes midbrain, pons, medulla)

219
Q

the 2 main divisions of the systems within the PNS are separated into?

A
  1. autonomic (subconscious, control systems) 2. somatic (voluntary, muscle movement)
220
Q

what are the 2 systems found in the autonomic PNS

A
  1. parasympathetic (rest and digest)
  2. sympathetic (fight or flight)
221
Q

what is the enteric nervous system

A

it controls function of gastrointestinal tract; uses many transmitters, especially serotonin and dopamine

222
Q

what parts of the nervous system do drugs of abuse alter

A

they alter function of all human nervous system components

223
Q

what are the four major components of a neuron

A
  1. cell body
  2. axon
  3. dendrites
  4. synapses
224
Q

what is the cell body

A

includes a nucleus which contains the genetic material of the cell (machinery for generating neurotransmitters and action potentials)

225
Q

what is the axon

A

conducts action potentials (electrical impulses) to synapse to release neurotransmitters

226
Q

What are dendrites

A

receives signals from neurotransmitter release by pre-synaptic neuron

227
Q

what are synapses

A

“space between” pre and post synaptic neurons that allow for inter-neuronal communication

228
Q

what are the 3 major functions of neurons

A
  1. inhibition
  2. excitation
  3. modulation
229
Q

what is neuron inhibition

A

reducing the likelihood of action potentials at post synaptic neurons via release of inhibitory neurotransmitters

230
Q

what is neuron excitation

A

increasing likelihood of action potentials at post synaptic neurons via release of excitatory neurotransmitters

231
Q

what is neuron modulation

A

influencing neurotransmission of populations of neurons, usually through diffusion of neurotransmitters through tissue

232
Q

what are the 6 major steps in neurotransmission (NT)

A
  1. NT synthesis
  2. NT storage
  3. NT release from presynaptic terminal into the synapse
  4. NT inactivation via removal of the synapse by reuptake or metabolism
  5. activation of post synaptic receptor
  6. signal transduction
233
Q

what occurs in NT synthesis

A

molecule mechanism of peptide precursors and enzymes for further synthesis or cleavage

234
Q

what causes NT inactivation

A

removal from synaptic cleft through reuptake process or NT breakdown by enzyme in the synapse or presynaptic terminal

235
Q

what triggers postsynaptic cell response

A

activation of postsynaptic receptor

236
Q

what responds to NT receptor activation

A

subsequent signal transduction

237
Q

what are the support cells of CNS

A

glia cells

238
Q

what is the function of glial cells

A

They support neurons by supplying nutrients along with other functions including myelin synthesis and innate brain defense system against pathology

239
Q

what are oligodendrocytes

A

A type of glial cell that forms insulating myelin sheaths around the axons of neurons in the central nervous system.

240
Q

how does myelin affect NT speed

A

they increase speed via salutatory conduction where action potential jump across nodes of ranvier

241
Q

what are 3 types of glial cells

A

oligodendrocytes, astrocytes, microglia

242
Q

What are astrocytes?

A

These are abundant, star-shaped cells that account for nearly half of the neural tissue. These brace neurons and form barrier between capillaries and neurons. These also help control the chemical environment of the brain.

243
Q

function of astrocytes

A

form blood brain barrier, help guide neural migration during circuit development, regulate NT and reuptake

244
Q

what are microglia

A

immune like cells that do not cross the blood brain barrier

245
Q

function of microglia

A

remove waste and foreign material and secrete growth factors and cytokines when activated

246
Q

how many names does a drug have and what are they

A

3 names
1. chemcial
2. generic (nonproprietary)
3. trade (proprietary)

247
Q

how are drugs classified

A

according to their psychotropic effects and the major NT they affect

248
Q

what are the main 3 classifications for drugs

A

behavioral, pharmacodynamic, and legal classification

249
Q

what are the 5 main categories for drug behavioral classification

A
  1. stimulants
  2. opioids
  3. sedative hypnotics
  4. antidepressants
  5. psychedelics
250
Q

stimulant behavioral effects

A

drugs that stimulate/produce arousal and behavioral activation

251
Q

opioid behavioral effects

A

natural/syn/semi-syn drugs that bind to opioid receptors and produce analgesia

252
Q

What is analgesia?

A

reduction of pain or elevation of pain thresholds

253
Q

sedative hypnotics behavioral effects

A

drugs that sedate/decrease arousal, producing anti-anxiety effects, hypnosis, or sleep

254
Q

antidepressant behavioral effects

A

drugs used to treat psychosis and include classic antipsychotics and modern 2nd generation drugs

255
Q

example of anti psych drug

A

haloperidol

256
Q

example of 2nd generation drug

A

olanzapine

257
Q

psychedelic behavioral effect

A

drugs that produce psychedelic experiences (mind altering)

258
Q

example of sedative hypnotic drug

A

examples include alcohol and benzodiazepines

259
Q

example of stimulants

A

examples include cocaine, amphetamines, nicotine, and caffeine

260
Q

examples of psychedelics

A

LSD, marijuana, psilocybin

261
Q

stimulant pharmodynamic effect

A

stimulants are indirect dopamine agonists

262
Q

opioid pharmodynamic effect

A

opioid are direct opioid receptor agonists ( primary pain relieving and secondary anti anxiety effects)

263
Q

sedative hypnotic pharmodynamic effect

A

directly/indirectly facilitate gamma-aminobutyric acid (GABA)

264
Q

antipsychotics pharmodynamic effect

A

dopamine antagonists and serotonin receptor antagonists

265
Q

antidepressant pharmodynamic effect

A

serotonin/norepinephrine reuptake inhibitors or combo of both NT

266
Q

psychedelic pharmodynamic effect

A

directly/indirectly facilitate serotonin by increasing serotonin release

267
Q

what are the 2 categories of drug legal classification

A

prescription vs nonprescription

268
Q

what is legal drug classification based on

A

based on specific criteria for potential of abuse and potential for depednence

269
Q

what is absorption

A

the movement of a drug through the bloodstream which is determined by several factors

270
Q

what are the different types of drug administration routes

A

-intravenous (IV)
-smoked
-intranasal
-subcutaneous (fatty tissue under skin)
-intramuscular (muscle injection)
-oral

271
Q

how does faster absorption affect potential for abuse

A

faster absorption such as IV or smoked means higher likelihood of abuse

272
Q

why do you get drunk when drinking on empty stomach

A

on empty stomach the ethanol levels are absorbed by the blood at a quicker rate than a full stomach

273
Q

what is drug elimination

A

the process through which drugs are removed from the body including how they are metabolized by the liver and excreted in urine by kidneys

274
Q

what kinetics does alcohol follow

A

zero order kinetics which means that the absolute amount of alcohol eliminated over time is constant

275
Q

what eliminates alcohol from body

A

alcohol is eliminated primarily by liver metabolism and excretion in urine

276
Q

what is the half life of alcohol

A

the amount of time it takes for blood levels to be cut by 50% via metabolism
the half life is about .01 gram percent per hour for a 154 lb. man

277
Q

what are drug receptors

A

cellular elements with which a drug interacts to produce its effects

278
Q

what are the 2 types of drug receptors

A

agonists vs antagonists

279
Q

what are agonists

A

drugs that bind to receptors & produce a stimulatory response like a natural substance such as a hormone would

280
Q

what are antagonists

A

drugs that bind to receptors and block effects of agonists, prevent receptor activation, and block a response

281
Q

restrictive definition of agonism

A

they can mimic a particular NT, bind to that NT postsynaptic receptor and either activate them or increase the NT effects

282
Q

restrictive definition of antagonism

A

they can mimic a particular NT, bind to the NT postsynaptic receptor enough to block NT binding

283
Q

why is cocaine a DA transporter antagonist according to Koob

A

cocaine blocks the DA transporter and blocks DA from being recycled by presynaptic neurons

284
Q

why is cocaine an agonist according to a more broad definition

A

Cocaine is a DA agonists because it increases availability of DA for neurotransmission

285
Q

what is dose response function

A

the relationship between the amount of a drug taken and the intensity and type of the resulting effect

286
Q

what does the normal dose response function look like

A

as drug dose increase, effects increase up to a point

287
Q

what is efficacy

A

maximal effect a drug can produce (y-axis).

288
Q

what is potency

A

amount of drug needed to produce a given effect relative to a standard.

289
Q

what is the therapeutic ratio

A

a means of indexing safety of a drug for a specific response

290
Q

how is therapeutic ratio calculated

A

divide the LD50/ED50

291
Q

what is LD50

A

dose that produces death in 50% of the population

292
Q

what is ED50

A

dose that produces desired therapeutic effect in 50% of the population

293
Q

what is the therapeutic ratio for morphine or alcohol

A

morphine is 8 and alcohol is 1

294
Q

why is alcohol not a safe anesthetic

A

bc the lethal dose is the same as the effective dose for the purpose. Morphine is a safer option for an anesthetic

295
Q

how do stimulants affect DA transmission in the NAc

A

they directly increase DA transmission

296
Q

how do opiates affect DA transmission in NAc

A

they indirectly increase DA transmission by inhibiting GABA interneurons in the VTA which will disinhibit VTA DA neurons.
They directly act on opioid receptors on NAc neurons

297
Q

how does nicotine affect VTA

A

Activates VTA DA neurons directly by stimulating nicotinic cholinergic receptors and indirectly stimulate its receptors on glutamatergic nerve terminals that innervate DA cells

298
Q

how does alcohol affect VTA and NAc

A

Alcohol promotes GABA receptor function and inhibits GABAergic terminals in VTA to disinhibit VTA Da neurons. It can also inhibit glutamatergic terminals that innervate NAc neurons

299
Q

how does cannabinoid mechanisms affect VTA and NAc

A

activate cannabinoid CB1 receptors on glutamatercig and GABAergic nerve terminals in the NAc and on NAc neurons

300
Q

PCP effect on VTA and NAc

A

inhibit NMDA glutamate receptors in NAc

301
Q

what are the 3 stages of addiction

A
  1. binge/intoxication
  2. withdrawal/negative affect
  3. preoccupation/anticipation
302
Q

what occurs during the binge/intoxication stage?

A

reward (mesolimbic DA) and motor (nigrostriatal DA) systems implicated heavily acute positive reinforcement effects predominate liking emotions (pleasure, contentment, enthusiasm)

303
Q

What occurs during the withdrawal/negative affect stage

A

central nucleus of the amygdala and bed nucleus ofthe stria terminalis (BNST) implicated heavily (in addition to reward and motor systems) acute punishment effects predominate aversive (negative) emontions (disgust, fear, malaise) are elicited

304
Q

what occurs during preoccupation/anticipation stage

A

prefrontal cortex, orbitofrontal cortex, and hippocampus implicated heavily (in addition to reward, motor, and punishment systems), obsessive effects predominate wanting emotions (craving, desire, preoccupation) are elicited

305
Q

what is ventral striatum responsible for in the brain

A

euphoria, reward

306
Q

what is dorsal striatum responsible for

A

habits and preservation

307
Q

what is the thalamus responible for

A

habits and preservation

308
Q

what is global pallidus responsible for

A

habits and preservation

309
Q

what brain structures are involved in binge/intoxication stage

A

ventral striatum, dorsal striatum, global pallidus, and thalamus

310
Q

what are the brain structures involved in the withdrawal/negative effect

A

amygdala, bed nucleus of the stria terminalis, and ventral striatum

311
Q

what is the amygdala and BNST responsible for

A

known as the extended amygdala and responsible for malaise, dysphoria, negative emotional states

312
Q

what is ventral striatum responsible for in withdrawal stage

A

decreased reward

313
Q

what brain structures are invovled in the preoccupation/anticipation stage

A

anterior cingulate, prefrontal cortex, orbitofrontal cortex, basolateral nucleus of amygdala, and hippocampus

314
Q

what is the prefrontal cortex, orbitofrontal cortex responsible for

A

subjective effects of craving, executive function

315
Q

what is the basolateral nucleus of amygdala responsible for

A

conditioned cues

316
Q

what is the hippocampus responsible for

A

conditioned contextual cues

317
Q

what is incentive sensitization theory

A

positive incentive value of drugs increases with repeated use in addiction-prone individuals (positive at first) but overtime become decoupled through neuroplastic changes in brain function. theory is imp bc it accounts for emotional components of addiction

318
Q

what is motivation

A

willingness to exert effort/perform work for desired outcome

319
Q

what is a primary reinforcer

A

an innately reinforcing stimulus, such as one that satisfies a biological need (food, sex, shelter)

320
Q

what is a secondary reinforcer

A

any reinforcer that becomes reinforcing after being paired with a primary reinforcer, such as praise, tokens, or gold stars (money, achievement, prestige, drugs)

321
Q

in addiction are drugs a primary or secondary reinforcer

A

they take on primary reinforcing properties

322
Q

what 2 major motivators play a role in addiction

A

willingness to exert effort/perform work for a commodity (reward) or a willingness to exert effort/perform work to avoid punishment both play a major role

323
Q

what is active avoidness

A

have to physically leave or run away to avoid

324
Q

what is passive avoidness

A

to hide under a table

325
Q

what are the 3 ways animal models quantify motivation

A
  1. ammount of food or water consumed
  2. persistance of operant behaviors to obtain incentives
  3. intracranial self stimulation (ICSS)
326
Q

example of amount of food or water consumed quantifying motivation

A

food deprived animals eat more than non food deprived animals meaning that food deprivation increases motivation to eat

327
Q

example of persistance of operant behaviors to obtain incentives demonstrating motivation

A

food deprived animals will work harder for food rewards than satiated animals

328
Q

what is a breakpoint

A

maximum number of operant responses (lever presses) a trained animal will engage in for drug delivery

329
Q

do alcohol dependent or nondependent rats have a higher breaking point

A

dependent rats will work for alcohol more meaning they will have a higher breakpoint

330
Q

what is classical conditioning

A

repeatedly pairing 2 stimuli until the conditioned stimulus elicits the same response as the unconditioned stimulus

331
Q

what is an unconditioned stimulus

A

A stimulus that elicits an unconditioned response
ex: cocaine laxative effects bc it it is reflexive

332
Q

what is a conditioned stimulus

A

a stimulus that after repeated pairings with the unconditioned stimulus will elicit the unconditioned response
ex: john takes crack and will learn to go to bathroom before consuming drug

333
Q

why is classical conditioning not a good measure of motivation

A

bc it does not require work

334
Q

what is operant conditioning

A

changing the occurrence, frequency, or magnitude of behavior through use of reinforcement

psychology of addiction (3 decks)

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