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Psychiatry > Neurobiology of Addiction > Flashcards

Neurobiology of Addiction Flashcards

1
Q

Outline the criteria for dependance as stated in ICD-10.

A
  • A strong desire to take the substance
  • Difficulties in controlling substance use
  • A physiological withdrawal state
  • Tolerance
  • Neglect of alternative pleasures
  • Persistence despite evidence of harm
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2
Q

CAGE

A

Cut-down.
Annoyed.
Guilty.
Eye-opener.

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3
Q

What is CAGE used for?

A

As a screening test to help identify potential problems with addiction/dependence

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4
Q

What is meant by ‘incentive salience’?

A

Attributing ‘want’

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5
Q

What parts of the brain does the reward pathway involve?

A
  1. Ventral tegmental area (VTA)
  2. Nucleus accumbens
  3. Prefrontal cortex
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6
Q

What kind of signalling is DA activity in the mesolimbic pathway?

A

A motivating signal

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7
Q

What does DA signalling in the mesolimbic pathway do?

A

Incentivises behaviour.

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8
Q

What type of experience is DA signalling in the mesolimbic pathway involved in?

A

Normal pleasurable experiences

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9
Q

What do natural rewards elevate?

A

Dopamine levels

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10
Q

How is the pleasure pathway blocked?

A

By cutting the pathways or by administering dopamine antagonists

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11
Q

As a person becomes addicted to something, they can tolerate ______ levels, D2 receptors ________ and it takes ____ for them to be stimulated

A

HIGHER
DECREASE
MORE

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12
Q

Non- addicted controls had increased blood flow to the striatum upon winning

A

TRUE

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13
Q

What receptors are decreased by addiction?

A

Dopamine D2 receptors

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14
Q

What does tolerance to reward occur due to?

A

Repeated dopamine release, meaning that dopamine receptors down regulate

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15
Q

What is increased during abstinence from an additive substance?

A

Threshold for rewards

Normal experiences don’t evoke adequate reward response

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16
Q

Even with PROLONGED ABSTINENCE from substance abuse, there is still an increased threshold for rewards

A

TRUE

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17
Q

In relation to drug-taking, what is positive reinforcement?

A

Occurs in the initial stages of drug taking which are driven by reward.

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18
Q

In relation to drug taking, what is negative reinforcement?

A

How, eventually, drug taking becomes a thirst.

19
Q

What does the pre-frontal cortex help to do?

A

Helps intention guide behaviour

20
Q

What does the prefrontal cortex modulate?

A

The powerful effects of the reward pathway

21
Q

What other roles does the prefrontal cortex play?

A
  • Sets goals and focuses attention
  • Makes sound decisions
  • Keeps emotions and impulses under control to achieve long term goals
22
Q

Explain how cortical maturation occurs.

A

Progresses in a back-to-front direction, beginning in the primary motor cortex and spreading anteriorly over the superior and inferior frontal gyri, with the prefrontal cortex developing last.

23
Q

What direction does cortical maturation occur in?

A

Back to front

24
Q

Compared to limbic (emotional) systems, when do frontal lobe areas that mediate executive functioning mature?

A

Later

25
Q

What does dopamine release affect?

A
  • Ability to update information within the PFC.
  • Ability to select new goals.
  • Ability to avoid compulsive repetition of a behaviour.
26
Q

What is the affect of addictive drugs on the prefrontal cortex?

A

They provide a potent signal that disrupts normal dopamine-related learning in the PFC.

27
Q

What is the relationship between age at which drug experimentation starts, and duration of relationship with drugs?

A

The earlier the age at which drug experimentation starts, the longer the relationship with drugs.

28
Q

What are the hippocampus, striatum and amygdala critical in?

A

Acquisition, consolidation and expression of drug stimulus learning

29
Q

What type of learning is the i) striatum ii) hippocampus responsible for?

A

i) Habit learning.

ii) Declarative learning.

30
Q

What does the orbit-frontal cortex do?

A

Provides internal representations of the saliency of events, and assigns value to them

31
Q

What is the KEY function of the orbit-frontal cortex?

A

MOTIVATION TO ACT

32
Q

What happens to the orbit-frontal cortex when drug addicts are presented with cues?

A

There is increased activation of this area

33
Q

What does hyperactivity of the orbit-frontal cortex correlate with?

A

Self-reported drug cravings, following exposure to cues

34
Q

Overall changes in the OFC still stay even with abstinence

A

TRUE

35
Q

Does addiction have a genetic component?

A

YES

36
Q

How much of the risk of addiction is due to genetics?

A

40-60%

37
Q

In relation to drugs, what may genetics affect?

A
  • The way we respond to drugs metabolically
  • Behavioural traits that predispose us to take drugs
  • How rewarding we find drug taking
38
Q

What impact do DRD2 receptor levels have on risk of addiction?

A

Low DRD2 receptors result in high risk

39
Q

In relation to dopamine, what does acute stress trigger?

A

Release of dopamine in the neural reward pathway

40
Q

In dependent individuals, what can a rapid increase in release of dopamine do?

A

Motivate drug seeking in dependant individuals

41
Q

What is the effect of chronic stress on dopaminergic activity? What are the results of this?

A

Chronic stress leads to dampening of dopaminergic activity through down-regulation of D receptors

  • this reduces sensitivity to normal rewards
  • encourages exposure to highly rewarding behaviours
42
Q

Overstimulation of the reward pathway leads to ____________

A

DESENSITISATION

43
Q
  • Pre frontal cortex dysfunctional in addicted people
  • Pre frontal cortex puts the brakes on the reward pathway
  • Pre frontal cortex matures late and is vulnerable whilst developing
A

TRUE
TRUE
TRUE

Psychiatry (31 decks)

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