Neurobiology of addiction Flashcards
what prevents patients from coming forward and accessing high quality treatment
stigma
what is the moral model of addiction
criminalisation, hostile approach
what is the medical model of addiction
compassionate, better care and research
what is the ICD10 criteria for dependence
strong desire to take the substance difficulty controlling use physiological withdrawal state tolerance neglect of alternative pleasures persistent use despite evidence of harm
is there 1 specific criteria to dependence
no
list some addictive behaviours
drugs alcohol gambling gaming social media
what screening test is used for dependence
CAGE screening tool
what does CAGE stand for
Cut down - do you feel you should cut down
Annoyed - do people annoy you when criticising …
Guilty - have you ever felt guilty
Eye opener - do you use … first thing in the morning
what is incentive salience
attributing ‘want’ to a stimulus
what is the reward/motivational pathway
Ventral tegmental area VTA –>
Nucleus accumbens NA –>
Pre frontal cortex PFC
functions of dopaminergic activity in the mesolimbic pathway
motivating signal
incentivises behaviour
involved in normal pleasurable activities
drugs of abuse stimulate the mesolimbic pathway, true or false
true
what happens in behavioural addiction
develop tolerance to reward - ie need more to achieve satisfaction, need more DA to trigger same response
down regulation of dopamine receptors from overstimulation
molecular changes in the brain persist despite prolonged abstinence from substance use, true or false
true
due to repeated dopamine release, dopamine receptors down/up regulate
down regulate
what is positive reinforcement
initial stages of drug taking driven by reward
what is negative reinforcement
drug becomes a thirst
function of prefrontal cortex
helps intention guide behaviour
makes sound decisions
keeps emotions and impulses under control
essentially “puts a break on things”
when is the pre frontal cortex fully developed
mid 20s
which parts of the brain are important in memory and habits
amygdala, hippocampus and striatum
function of orbitofrontal cortex
how important something is in the grand scheme of things
key creator of motivation to act
there is too much/little dopamine in the brains of those who are dependent
too much
which brain circuits are involved in drug abuse and addiction
inhibitory control
motivation drive
reward/salience
memory and learning
in a normal non-addicted brain, PFC powerfully suppresses/stimulates OFC
PFC suppresses OFC
PFC puts a brake on things, true or false
true
OFC motivates you to act, true or false
true
which parts of the brain are involved in inhibitory control
PFC + ACG
pre frontal cortex and anterior cingulate gyrus
which parts of the brain are involved in motivation drive
OFC + SCC
orbitofrontal cortex and subcallosal cortex
which parts of the brain are involved in reward
nucleus accumbens and ventral pallidum
which parts of the brain are involved in memory and learning
amygdala and hippocampus
acute stress triggers release of dopamine resulting in increased/decreased motivation
increased
chronic stress leads to increase/dampening of dopaminergic activity which increases/reduces sensitivity to normal rewards
dampening
reduces
overstimulation of receptors leads to over/desensitisation
desensitisation
PFC is vulnerable during development, true or false
true
what is the most heritable complex psychiatric condition
dependence
