Midterm #2 Flashcards
1
Q
What are common barriers to addiction recovery?
A
- Denial,
- stigma,
- lack of access to quality treatment,
- financial concerns.
2
Q
What is a fundamental issue with focusing on the future in treatment for addiction?
A
It can be anxiety-provoking.
3
Q
What does Dr. Wohl suggest focusing on instead of the future?
A
The past
4
Q
How does self-discontinuity induce nostalgia and behavior change?
A
By highlighting a disconnection between the present and the past.
5
Q
Why is behavior change particularly difficult for those living with addiction?
A
Despite the negative consequences of addiction (strained relationships, job loss), behavior change is hard due to barriers and a focus in literature on understanding these barriers rather than what motivates change.
6
Q
What is the concept of “self-continuity” in addiction treatment?
A
The idea that restoring a sense of continuity or wholeness to the self can help individuals regain a sense of self eroded by addiction.
7
Q
What benefits are associated with high levels of self-continuity?
A
- Psychological well-being,
- a desire to maintain well-being, and
- elevated levels of self-esteem.
8
Q
What is motivational interviewing, and what does it aim to do?
A
- reduce or minimize resistance and
- explore the discrepancy between current behavior and future goals to resolve ambivalence.
9
Q
How does focusing on the past versus the future affect behavior change in addiction?
A
Focusing on the past is beneficial because it is concrete and can motivate change through nostalgia, while focusing on the future can be anxiety-inducing due to the vague and uncertain nature of life without addictive behavior.
10
Q
What is the basic model Michael Wohl says
A
Self-Discontinuity → Nostalgia (for the pre-addicted self) → Readiness to change.
11
Q
How does nostalgia influence behavior change among problem drinkers and gamblers?
A
Nostalgia, triggered by a sense of self-discontinuity, can increase readiness to change and actual change attempts.
12
Q
What are “implicit theories of behavior” in the context of addiction?
A
The belief that behavior is either malleable (incremental theorists) or fixed (entity theorists), affecting one’s readiness to change addictive behaviors.
13
Q
How can nostalgia be both beneficial and detrimental to recovery?
A
Beneficial when focused on reclaiming life before unhealthy behavior, but detrimental when focused on the perceived benefits of the unhealthy behavior, potentially undermining recovery intentions.
14
Q
What are the key themes from Dr. Wohl’s presentation on nostalgia and behavior change?
A
- Nostalgia facilitates healthy behavior change when focused on life before unhealthy behavior.
- Nostalgia undermines healthy behavior change when focused on perceived benefits of unhealthy behavior.
15
Q
What role does denial play in addiction recovery?
A
Denial is a major barrier to addiction recovery, manifesting as an unwillingness to seek treatment and acknowledge the need for help
16
Q
How does stigma contribute to the difficulty of overcoming addiction?
A
Stigma creates shame about both the addiction itself and the act of seeking treatment, making individuals reluctant to admit their struggles or seek help.
17
Q
What impact does the lack of access to quality treatment programs have on addiction recovery?
A
Without access to quality treatment, individuals struggling with addiction may not receive the necessary support and resources to overcome their addictive behaviors.
18
Q
How do financial concerns affect the decision to seek addiction treatment?
A
The fear of the high costs associated with treatment can deter individuals from seeking help, due to concerns over affordability.
19
Q
How do treatment providers use the concept of self-continuity in therapy?
A
Providers aim to restore a sense of continuity to the self by focusing on life goals and a positive future, helping clients see beyond their addiction.
20
Q
Why is focusing on the future problematic in addiction treatment?
A
Focusing on an uncertain future without addictive behavior can provoke anxiety and hinder motivation for change, especially if the future is perceived as vague.
21
Q
How does nostalgia work as a motivator for change in addiction recovery?
A
Nostalgia for the pre-addicted self can inspire individuals to reclaim aspects of their past, thereby motivating positive behavior change.
22
Q
What is the role of nostalgia in behavior change, according to studies on gambling and drinking?
A
Studies have shown that feeling nostalgic about one’s life before addiction increases readiness to change and actual attempts at behavior change.
23
Q
What challenges do disorder-related nostalgias present in recovery?
A
Nostalgizing the perceived benefits of an unhealthy behavior (e.g., eating disorders) can undermine intentions to remain in recovery and potentially lead to relapse.
24
Q
What is another common barieer Wohl looks at
A
reinforcing relationships or group memberships, can either hinder or facilitate behavior change, as social circles may encourage addictive behavior or support recovery efforts
25
What is the starting premise of many treatment modalities for unhealthy or addictive behavior?
They start with the premise that addiction can lead to a loss of the true sense of self.
26
What aim do treatment providers have when motivating people to change?
They attempt to build a bridge to a more positive future by focusing on individuals' life goals.
27
Define self-continuity in the context of addiction treatment.
core aspect of the self that traverses time and space, which addiction tends to shatter, creating a sense of self-discontinuity.
28
What is self-discontinuity?
A state where the individual believes that their core self does not exist anymore due to addiction undermining their identity.
29
How is self-concept relevant in treatment?
It involves understanding oneself through
1. self-schemas,
2. past self,
3. present self,
4. future/possible selves.
30
What has research shown about the effects of nostalgia?
1. heightened positive affect,
2. self-regard,
3. a strong sense of belonging,
4. meaning in life,
5. and self-continuity.
31
What were the findings of Michael Wohl's Study 1 on gambling disorder?
A sense of self-discontinuity associated with gambling disorder was linked to nostalgic reverie, and the more individuals nostalgized about life before gambling, the more ready they were to change their behavior.
32
What was the approach and finding of Michael Wohl's Study 2 on gambling disorder?
The study involved a manipulation highlighting the impact of addictive behavior on self-continuity. Those experiencing discontinuity felt heightened nostalgia and showed greater readiness to change
33
What is the butterfly effect in the context of behavior change?
Small changes in one's behavior or mindset can lead to disproportionate changes elsewhere in their life
34
What are the two themes from Michael Wohl's presentation?
1. Nostalgia facilitates healthy behavior change when focused on life before unhealthy behavior.
2. Nostalgia undermines healthy behavior change when focused on the perceived benefits of engaging in unhealthy behavior
35
How does alcohol affect the brain's neurotransmitters?
Alcohol binds to GABA receptors enhancing inhibitory signals, activates opioid receptors releasing endorphins, which in turn trigger dopamine release, and blocks glutamate receptors, preventing excitatory signals.
36
What are the consequences of alcohol consumption on neurodegeneration and withdrawal?
1. reduced neuron production,
2. changes in brain volume affecting executive functions,
3. impaired ability to inhibit impulsive behavior,
4. physiological withdrawal changes, and
5. delirium tremens (DT)
37
What is the legal status of cocaine in Canada?
Cocaine is a Schedule I drug under the Canadian Controlled Drugs and Substances Act, with penalties ranging up to life imprisonment for trafficking and production
38
Describe the neurobiology of cocaine addiction
Cocaine increases dopamine levels in the brain by blocking the dopamine transporter, leading to increased excitatory neurotransmitter activity and significant changes in brain function and structure.
39
What are the health consequences of cocaine use?
Health consequences include psychiatric symptoms like delusions and paranoia, psychosis, suicidality, withdrawal symptoms including negative affect and insomnia, and risks of overdose leading to seizures or death
40
How does nicotine addiction function in terms of neurobiology?
Nicotine stimulates glutamate release (increasing dopamine release) and blocks GABA release (maintaining dopamine levels), affecting the brain's reward pathways and leading to addiction.
41
What are the health consequences of tobacco smoking?
Consequences include risks of various cancers, cardiovascular diseases, respiratory diseases, and nicotine withdrawal symptoms such as irritability and cravings
42
How does the Fagerström Test measure nicotine dependence?
The Fagerström Test for Nicotine Dependence assesses the intensity of physical addiction to nicotine, considering factors like quantity smoked, dependency upon waking, and difficulty refraining from smoking in non-smoking areas.
43
What are the low-risk alcohol drinking guidelines?
The guidelines suggest limits for alcohol consumption to reduce the risk of alcohol-related harm, emphasizing moderation, not drinking in certain situations, and weekly drink limits.
44
What are risk and protective factors for drug use and abuse?
Risk factors include low educational aspirations and perceptions of drug use. Protective factors include high GPA, low depression, and having supportive relationships.
45
Explain the Multiple Risk and Protective Factors Model for drug use.
This model suggests that drug use and addiction are influenced by the balance of risk and protective factors, with the interaction between these factors predicting drug use outcomes.
46
What role does GABA play in alcohol's effect on the brain?
GABA, an inhibitory neurotransmitter, when bound by alcohol, enhances its inhibitory signal, contributing to alcohol's depressant effects on the brain.
47
How does alcohol trigger the release of dopamine?
Alcohol activates opioid receptors, inducing endorphin release, which then binds to dopaminergic neurons in reward centers, triggering dopamine release and reinforcing alcohol consumption.
48
What are the key components of the AUDIT (Alcohol Use Disorders Identification Test)?
AUDIT assesses hazardous alcohol consumption, dependence symptoms, and harmful alcohol use through items focusing on consumption patterns, dependency, and negative consequences.
49
What sparked the American Crack Epidemic of the 1980s, and what were its consequences?
The epidemic was fueled by the widespread availability of inexpensive crack cocaine, leading to increased crime, violence in inner cities, and stringent "war on drugs" policies targeting drug use and distribution.
50
What are the acute symptoms of nicotine withdrawal?
1. fatigue,
2. irritability,
3. gastrointestinal upset,
4. intense cravings for nicotine,
5. and can resolve in about 5 days, though cravings may persist for months.
51
What did the Canadian Addiction Survey (2004) reveal about youth tobacco use and alcohol consumption?
The survey revealed that youth smokers (aged 15-19) consumed alcohol more frequently and in larger quantities on days they drank, compared to their non-smoking counterparts, highlighting a link between tobacco use and problematic drinking behaviors.
52
Explain the concept of nicotine being known as the "chameleon drug."
because it can act as a sedative when the smoker is anxious and as a stimulant when the smoker is fatigued, showing versatile effects depending on the smoker's state.
53
What are the key differences between gambling and substance addictions?
Gambling is a hidden addiction without a saturation point, leading to significant financial problems, but individuals can still function at work and cannot be detected through biometric tests.
54
What are common similarities between gambling and substance addictions?
Both exhibit preoccupation, negative impact on major life areas, tolerance, immediate gratification, and loss of control.
55
What activates the brain's dopamine reward system in disordered gambling?
Chance monetary rewards from gambling activate the brain's dopamine reward system, providing unpredictable bursts of dopamine with each play.
56
How heritable is gambling behavior based on twin studies?
Gambling behavior is moderately heritable, with identical twins more likely to both be gamblers compared to non-identical twins.
57
What are common comorbidities with gambling disorder?
High rates of nicotine dependence, substance use disorders, mood disorders, and anxiety disorders are common comorbidities.
58
What psychological theory explains risk-taking in gambling?
Risk Sensitivity Theory, where high need or relative deprivation leads to preferences for riskier strategies to eliminate need deficiencies.
59
How is gaming addiction defined?
Gaming addiction is characterized by excessive and harmful engagement in gaming activities, potentially leading to significant life impairment
60
What are potential benefits of gaming?
Educational, rehabilitation, cognitive benefits, and psychological well-being through a sense of belonging and social connection.
61
What are the criteria for Internet Gaming Disorder?
Criteria include
1. preoccupation with gaming,
2. tolerance,
3. unsuccessful control efforts,
4. loss of interest in other activities,
5. continuation despite problems,
6. escape from negative mood, and
7. jeopardizing relationships or opportunities.
8. withdrawal symptoms,
9. Deception
62
How does the Game Transfer Phenomenon manifest?
It involves carry-over effects from gaming into real life, such as visualizing game elements in real-world situations, indicative of severe gaming habits.
63
What issues are associated with diagnosing Gaming Disorder?
Concerns include the low quality of research, reliance on substance use and gambling criteria, lack of consensus on symptomatology and assessment, and potential for moral panic leading to premature diagnoses.
64
What is the global prevalence of Gaming Disorder?
The worldwide prevalence is approximately 3.05%, with higher rates among males, younger individuals, and notably higher in Asian compared to European countries.
65
What are the neurobiological correlates of gaming addiction?
1. activation in reward-associated brain regions,
2. reduced activity in impulse control areas,
3. impaired decision-making, and
4. structural brain changes like reduced gray-matter volume.
66
Difference between gambling and substance addictions
- Hidden addiction
- Can't overdose
- Huge financial problems
- Can function at work
- Can't be tested biometrically
- Doesn't require ingestion
67
Similarities between gambling and substance addictions
- Preoccupation
- Negative impact on major life areas
- Tolerance
- Immediate gratification
- Loss of control
68
Broader concept of addiction
- Addiction is about enacting or performing a behaviour (e.g. drug taking or gambling)
- Treatment involves stopping or reshaping that behaviour and replacing it with alternative activities
- All addictions are behavioural
69
The influence of consumption
As exposure to a stimulus increases, the most vulnerable are the first to be "infected" --> we may see increases in gambling participation near epicentres of gambling --> then there is a period of adaptation
70
What did a meta-analysis of 18 twin studies find out about gambling behaviour?
- Gambling behaviour is moderately inheritable --> identical twins who were gamblers were more likely to have a twin who was also a gambler than non-identical twins
- Gambling behaviour is moderately influenced by non-shared environmental factors unique to each twin (e.g. unshared peers)
71
Gambling problems co-exist at a high rate with alcohol dependence and problematic substance use. What is this concept called?
Comorbidity
72
What is the Pathways Model of Disordered Gambling?
A conceptual framework that categorizes gamblers into three distinct subtypes based on etiological risk factors and motives behind their gambling behavior
73
What are the three subtypes identified by the Pathways Model?
1. Behaviorally Conditioned,
2. Emotionally Vulnerable,
3. Anti-Social Impulsivist.
74
Describe the "Behaviorally Conditioned" gambler subtype.
Individuals who develop gambling problems primarily due to the reinforcement contingencies of gambling, without premorbid psychopathology. They are influenced by cognitive distortions related to gambling, such as the illusion of control and beliefs in luck.
75
What characterizes the "Emotionally Vulnerable" gambler subtype?
Gamblers who share characteristics with the behaviorally conditioned subtype but also have biological and emotional vulnerabilities, such as a family history of gambling disorder, neuroticism, mood/anxiety disorders, life stress, and adverse childhood experiences (ACEs).
76
Who are the "Anti-Social Impulsivist" gamblers according to the Pathways Model?
Individuals who exhibit traits of impulsivity and anti-social personality, engaging in multiple maladaptive behaviors beyond gambling, such as drug taking and criminal behavior. This subtype includes those with behaviorally conditioned and emotionally vulnerable characteristics, plus additional severe impulsivity and anti-social traits.
77
How does the Pathways Model explain the development and maintenance of gambling disorder?
By identifying specific risk factors and motives that lead to gambling addiction, the model helps in understanding the complex nature of disordered gambling and suggests targeted approaches for treatment based on subtype.
78
Why is the Pathways Model important for treating disordered gambling?
It highlights the heterogeneity among individuals with gambling problems, suggesting that tailored treatment approaches may be more effective than one-size-fits-all solutions, by addressing the unique combination of biological, psychological, and social factors influencing each subtype.
79
What is Risk Sensitivity Theory?
- Situations of high need induce a shift toward preferences for riskier goal attainment strategies
- When people in a state of high need believe that they will come up short by pursuing low-risk options, they will prefer high-risk options that have a small chance of comply eliminating the need deficiency.
80
concept of behavioural addictions
in substance addiction, even seeing a drug stimulus (eg. dealer or syringe) can activate the brain reward system and thus become reinforcing
81
(behavioural addictions) What causes a person to lose control
Is NOT the substance, it is the neural circuitry that fires when presented with the reward the substance provides
82
(behavioural addictions) In games what will gaming (eg. defeating an enemy, sounds/visuals) stimuli activate
may activate the brain reward systems and become reinforcing.
83
internet gaming disorder
- Preoccupation with internet games
- Withdrawal symptoms when gaming is taken away
- The need to spend increasing amounts of time engaged in internet games
- Loss of other interests
- Continued excessive use of internet games despite knowledge n consequences
- Use of internet games to relieve a negative mood
- Gaming has jeopardized or lost a relationship/job/opportunity
84
game transfer phenomenon (GTP)
- When virtual worlds bleed into real life
- Carry-over effects from video games into real life
- One gamer saw a list of potential responses pop up after he was insulted
- People with severe GTP are more likely to have problematic or addictive gaming habits
85
What are issues with gaming disorder?
- The quality of the research base is low
- Current info leans too much on substance use and gambling criteria
- No consensus on the symptomatology and assessment of problematic gaming
- Moral panics around the harm of video gaming might result in premature application of a clinical diagnosis and a lot of false-positive cases
- Healthy gamers will be affected by stigma and changes in policy
86
How do non-substance-based addictions differ from substance-based addictions?
Non-substance-based addictions, such as gambling and gaming, do not involve the ingestion of substances but share similar behavioral patterns, psychological impacts, and neurobiological mechanisms with substance-based addictions.
87
What are common characteristics between non-substance and substance-based addictions?
Both types of addiction exhibit preoccupation with the behavior or substance, negative impacts on major life areas, tolerance, immediate gratification, loss of control, and similar neurobiological changes in the brain's reward system.
88
Why is the addiction lens useful for understanding behaviors like gambling and gaming?
It helps identify and treat behaviors that absorb individuals to the detriment of their well-being, highlighting the potential for these behaviors to become compulsive and destructive, similar to traditional substance addictions.
89
How are all addictions considered behavioral according to the lecture
Addiction involves performing or enacting a behavior, whether it's the use of substances or engagement in activities like gambling or gaming, emphasizing the behavioral aspect central to both non-substance and substance addictions.
90
What role does the dopamine reward system play in both substance and non-substance addictions?
The dopamine reward system is activated by both substance use (like drugs and alcohol) and behaviors (like gambling and gaming), reinforcing the addiction through neurobiological changes that enhance the desire for repeated engagement.
91
What makes gaming and gambling potentially addictive without involving substances?
Their ability to provide immediate gratification, trigger significant neurobiological responses, and become behaviors that individuals rely on to avoid pain, seek pleasure, or escape reality, making them as compelling and potentially destructive as substance use.
92
Neurobiological correlates of gaming addiction
- Impaired decision making
- Decreased functional connectivity in brain networks related to cognitive control, executive function, motivation, and reward
- Structural changes like reductions in gray matter volume and white matter density
93
Physical and mental health consequences
- Sleep deprivation, day-night reversal, dehydration, malnutrition, seizures, and pressure sores.
- Irritability, physical aggression, depression, and a range of social, academic, and vocational problems
94
Social aspects
- Problems with peers, being bullied and bullying others, and having friends who are addicted to video games
- Low social self efficacy, loneliness, and reduced family relationship quality
- More likely to live in socially isolated environments compared to those without IGD
- Low SES and living in rural areas
95
What defines a behavior as potentially addictive according to Stanton Peele?
A behavior that absorbs a person to the extent of detracting from other involvements, provides predictable gratification, is used to avoid pain, damages self-esteem, and destroys other involvements, leading to a destructive cycle.
96
How does personal relative deprivation relate to gambling?
It is the emotion of feeling unfairly disadvantaged compared to others, which can motivate gambling as a means to achieve perceived financial equity.
97
What is the significance of the epidemic curve in the context of disordered gambling?
It is used to track the spread of gambling-related harm, showing that as exposure to gambling increases, so does participation and the potential for adaptation or harm reduction over time.
98
How does accessibility influence gambling behavior?
Increased accessibility, such as online gambling platforms, heightens the risk of disordered gambling by making it easier to engage in gambling activities anytime and anywhere.
99
How does the Biopsychosocial Model apply to gaming addiction?
It suggests that gaming addiction can be understood by considering biological factors like neurobiological correlates, psychological aspects like the model of gamer types, and social aspects like isolation or low social efficacy.
100
What is the first formal recognition of a behavioral addiction according to the DSM?
Disordered Gambling was the first behavioral addiction formally recognized by the DSM, initially placed in the Impulse Control Disorder section before joining Substance-related and Addictive Disorders as a Non-Substance Related Disorder.
101
Describe the concept of Personal Relative Deprivation in the context of disordered gambling.
Personal Relative Deprivation refers to the emotion of feeling unfairly disadvantaged compared to others. In gambling, this sense of deprivation can drive individuals towards gambling as a means to offset perceived inequities.
102
How does the "total consumption/single distribution" model apply to gambling, and what does it imply about the risk associated with different types of games?
The model suggests that the risk of disordered gambling does not follow a straightforward linear, J, or R shape, varying by the type of game played. This indicates that certain games may pose higher risks for addiction, and understanding this can help identify high-risk games. However, gambling addicts will play every available game.
103
Explain the relevance of the Exposure vs. Adaptation concept to disordered gambling.
This concept explores whether the relationship between exposure to gambling and harm is straightforward. It suggests that exposure increases participation and potentially harm, but there is also a period of adaptation where the impact may stabilize or reduce, highlighting the dynamic nature of gambling-related harm.
104
What is the role of the Dopamine Reward System in disordered gambling?
FMRI imaging has shown that gambling activates the brain's dopamine reward system with each play due to the unpredictable nature of monetary rewards. This neurobiological response, reinforced by social and environmental cues, contributes to the development and maintenance of gambling addiction.
