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PSYC 442: Behavioral Dysregulation Disorders > Part 1: Substance Use & Addiction > Flashcards

Part 1: Substance Use & Addiction Flashcards

1
Q

Drug

A

substance taken by body that alters body processes

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2
Q

4 steps that drug is processed

A

administration, distribution, metabolism, elimination

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3
Q

Types of drug administration

A

ingestion, inhalation, injection, absorption

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4
Q

Types of drug injection methods

A

intramuscular, subcutaneous, intravenous

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5
Q

Define drug distribution

A

how efficiently drug moves through body (solubility, blood-brain barrier)

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6
Q

Define drug metabolism

A

drug reached site, experience drug effects

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7
Q

Main types of drug elimination

A

sweat, urination

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8
Q

Psychoactive substances

A

chem compounds that affect CNS (penetrate BB barrier)

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9
Q

Reasons for taking psychoactive substances

A
  • medical
  • recreational
  • entheogen (spiritual/transcendence, change consciousness)
  • purposeful (performance)
  • research (efficiency? side effects?)
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10
Q

Effects of psychoactive substances

A

alter mood, behavior, consciousness

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11
Q

Levels of drug involvement

A

use, intoxication, abuse, dependence (and/or addiction)

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12
Q

Describe use - psychoactive

A

intake does not sig interfere w social/educ/occupational fxning

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13
Q

Describe intoxication + changes - psychoactive

A

physiological rxns

changes depend on substace/person:
energy, HR, mood, motor ability, speech, state of consciousness

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14
Q

Describe drug abuse

A

how sig it interferes w life, harmful use (drunk driving, job, attendance)

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15
Q

Characteristics of drug dependence

A

-tolerance: diminishing effect from repeated administration
//
-withdrawal: body’s rxn to obstaining

mediated by neg reinforcement

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16
Q

What phenomenon mediates drug dependence? How?

A

neg reinforcement: continue taking substance to avoid neg state

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17
Q

Describe drug addiction

A

compulsive use despite neg consequences = change in beh

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18
Q

What phenomenon mediates drug addiction? How?

A

pos reinforcement: pursue pos effects of high (euphoria)

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19
Q

Symptoms of psychological withdrawal (4)

A

emo-motivational symptoms:

-dysphoria, anx, anhedonia, dissatisfaction

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20
Q

Symptoms of physical withdrawal (7)

A

phys-somatic symptoms:

  • fatigue, vomit, chills, pain, diarrhea, headache
  • alcohol withdrawal delirium (tremens)
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21
Q

Which psychoactive substance causes no phys withdrawal?

A

LSD

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22
Q

Drug-seeking behaviours of dependence-addiction

A

repeated use, desperate need, likelihood that use will resume post-abstinence

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23
Q

Substance use: DSM-IV

A

DSM-IV:

  • separated abuse & dependence
  • separate symptoms for abuse vs dependence
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24
Q

Substance use: DSM-5

A

DSM-5:

  • combined abuse/depend. into substance use disorders
  • severity of symptoms (mild = 2-3, med = 4-5, severe 6+)
  • diff substances as separate use disorders
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25
Q

What is the diagnostic issue with SUDs?

A

unclear cause-effect relationship with other comorbid disorders (50%)

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26
Q

Reasons for high comorbidity of SUDs (3)

A
  1. intoxication-withdrawal cause other disorder symptoms: dep, ANX, psychosis, risk-taking
  2. disorders can cause substance use disorder
  3. chance
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27
Q

What are the different bases of SUD classification? (4)

A
  1. substance from which it’s derived
  2. effect on CNS* (stimulant/hallucinogen)
  3. route of administration (inhalant/injection)
  4. other: recreational/street, illicit/legal, soft/hard
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28
Q

Name the 10 categories of DSM-5 substances

A
  1. depressants: sedatives, hypnotics, anxiolytics
  2. inhalants
  3. stimulants
  4. caffeine
  5. tobacco
  6. alcohol
  7. hallucinogens
  8. cannabis
  9. opioids
  10. other
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29
Q

Diagnostic criteria: SUD (11 symptoms)

A

impairment/distress, 2+ symptoms in a 12-month period

  1. take more/for longer than intended
  2. unfulfilled desire/efforts o cut down
  3. lots of time spent obtaining, using, recovering
  4. craving
  5. results in failure to fulfill obligations
  6. use despite interpersonal problems
  7. social/job-related/recreational activities given up
  8. use in phys hazardous situations
  9. despite knowledge of phys/psyc consequences
  10. tolerance
  11. withdrawal
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30
Q

Depressants: name them, CNS effect, NTs

A
  • sedatives, hypnotics, anxiolytics
  • DEC CNS activity (calm, relax, sleep)
  • promote GABA/suppress glutamate
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31
Q

Which substance category is most likely to product tolerance-withdrawal?

A

sedatives, hypnotics, anxiolytics

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32
Q

Barbiturates & benzos are part of which substance category?

A

depressants

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33
Q

Which depressant induces/acts on sleep?

A

sedatives

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34
Q

Inhalants: CNS effect, AOO, list effects (9)

A
  • DEC CNS activity (depressants)
  • adolescence
  • mild-extreme: dizzy, slurred speech, impaired motor fxn, blurred vision, lethargy, tremors, peri-nasal abrasions, brain damage, kidney failure
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35
Q

Stimulants: CNS effect, NTs, name 3 types

A
  • INC CNS activity (active, alert, euphoria, fatigue-resistant)
  • block dopa + nore reuptake
  • methamphetamines, cocaine, caffeine
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36
Q

Caffeine: CNS effect, DSM category, concerns

A
  • stimulating effect (mood, HR)
  • “conditions for further study:
  • over-diagnosis, overlooking benefits
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37
Q

Tobacco: CNS effect, disorder name, onset

A
  • nicotine = stimulating
  • tobacco use disorder
  • adolescence
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38
Q

Alcohol effects & NTs

A

Stimulating, but mostly sedative effects of ethanol

-dopa then GABA

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39
Q

Factors that influence extent of alcohol effects (6)

A
  • prenatal alcohol exposure
  • fam history
  • initial age & how long (danger of adolescence)
  • how much/often
  • length of binge
  • BAC
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40
Q

Alcohol: short-term effects (5)

A
  • reduce inhibition, outgoing, relaxed
  • impaired motor fxn
  • blurry vision, lower hearing
  • impeded decision-making
  • blackout
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41
Q

Alcohol: long-term effects (6)

A
  • hand tremors
  • ANX
  • nausea
  • insomnia
  • withdrawal delirium
  • organic damages (hepatitis)
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42
Q

Describe Cirrhosis

A
  • liver damage from chronic alcohol use

- replaced by scar tissue

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43
Q

Brain damage from alcoholism (3)

A
  • brain shrinkage
  • reduced PFC volume
  • reduced cogn abilities
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44
Q

Describe Wernicke’s encephalopathy (3 symptoms)

A
  • disease of brain dysfxn
  • mental confusion
  • oculomotor disturbances (paralyzed eye mvmt nerves)
  • muscle coordination difficulty
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45
Q

What % of drinkers report some related problem?

Who’s more likely to experience alcohol problems?

A

9%

young, single males w lower income

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46
Q

Gender ratio of alcohol drinking

A

men drink more

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47
Q

What % of ppl w alcohol-dependence/abuse present spontaneous remission?

A

20% cured unexpectedly

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48
Q

Hallucinogens: effects (4), types (3), withdrawal

A
  • alter sensory perc, hallucinations, delusions, out-of-body exp
  • LSD, DMT, psilocybin [magic mush, natural mushroom]
  • low/no withdrawal
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49
Q

Which substance is most used by adolescent males?

A

cannabis

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50
Q

Properties & effects of cannabis (4)

A
  • mostly depressant (relax) w stimulant (concentration) & hallucinogenic properties (higher dose)
  • reactions vary (history, predisp, THC dose)
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51
Q

Tolerance-withdrawal of cannabis

A

tolerance builds quickly (reduced binding potential) / low-no withdrawal

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52
Q

Describe amotivation

A
  • chronic weed use

- general loss of motivation

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53
Q

Fxns of endocannabinoid receptors

A

-physio processes: appetite reg, mood, memory, attention, pain sensation

54
Q

Describe the NT process of opioids

A
  • works on endogenous neuropeptides
  • endorphins

-EXCESSIVE dopa (euphoria) + activates opioid rec (sedative)

55
Q

Opioid effects

A
  • euphoric rush & sedative effects (pain-killing)

- slows down respiration = OD

56
Q

Genetic & heredity influences of SUDs [biological approach]

A
  • twin, family, adoption studies

- contribution of endophenotypes & gene combos

57
Q

Name 3 genes involved in SUDs [biological approach]

A

ALDH gene, GABA rec gene, dopa rec gene

58
Q

What’s the opioid epidemic?

A

most common cause of OD deaths

59
Q

Name 3 substances classified as “other”

A
  • prescription meds
  • over-the-counter drugs
  • anabolic steroids: synthetic T, can use medically (low weight puberty), enhance performance, too much = lose muscle
60
Q

Genetic & heredity influences of SUDs [biological approach]

A
  • esp alcoholism
  • run in family (twin, fam, adoption studies)
  • strong genetic basis of endophenotypes (impulsive endopheno = more likely)
  • combo of genes

shared genetic vulnerability w ASPD, schizo, BD

61
Q

Name 3 genes involved in SUDs [biological approach]

A

ALDH gene (alcohol), GABA rec gene (ASPD), dopa rec gene (sensitive to reward)

62
Q

Name 2 heritable traits that are risk factors for SUDs [biological approach]

A
  • impulsivity

- low alcohol sensitivity (drink more, lower ability to tolerate consequences, bad hangover)

63
Q

Which brain pathway influences SUDs? How?[neurobiological approach]

A

stimulates mesolimbic reward pathway
(dopa: VTA, Nucleus Accumbus, PFC, OFC, amyg, hippo)

  • affect dopa lvls/rec
  • affect reward-seeking, motivation, beh
  • sensitization (inc effects); desensitization; tolerance
  • PFC activity DEC over time (cogn ctrl)
64
Q

Define expectancy effect [cognitive factor, psyc approach]

A

expecting a given result from drug unconsciously affects outcome

65
Q

Describe the opponent process theory [psyc approach]

A
  • emo/physio responses come in opposite pairs
  • drug addiction/dep: intense pleasure followed by stronger withdrawal/neg feelings (dysphoria)
  • over time, process A becomes weaker / process B conditioned to env, starts sooner
66
Q

Describe the study findings about SUD stigma

A

“substance abuser”: blamed for problem, seen as socially threatening, believed to not benefit from punishment/treatment

67
Q

Cognitive factors of drug cravings [psyc approach]

A
  • cravings influenced by conditioned cues (internal/external)
  • INC OD risk in unfamiliar env (unconditioned effect)
68
Q

Define expectancy effect [cognitive factor, psyc approach]

A

expecting a given result from drug unconsciously affects outcome

ex. expecting inc sexual arousal from alcohol intake

69
Q

Social approach of SUDs

A
  • exposure via family, peers, media
  • poor adult supervision
  • cultural influences (norms)
  • flush face from alcohol: low alcoholism
70
Q

Brain disease theory vs Moral weakness theory [social approach]

A
  • SUD is brain disease = no ctrl over it

- weak person, unwilling to ctrl beh (stigma)

71
Q

Which SUD treatment works on the basis of cross-tolerance?

A

agonist substitution

72
Q

Describe the lifestyle balance model of SUDs

A
  • life imbalance inc risk & exposure to substance use through desire of gratification
  • means of coping OR resilience factor
73
Q

Inpatient facilities: pro and con

A
  • helps w initial withdrawal

- expensive

74
Q

Agonist substitution treatment + example

A
  • safer drug w similar makeup that works on same receptors
  • nicotine patch
  • risk of cross-tolerance
75
Q

Antagonist treatment

A

block effects of substance

naloxone for heroin: binds to & blocks opioid rec

76
Q

Aversion therapy

A

substance use paired w unplasant stim

77
Q

Aversive treatment + example (psychosocial)

A
  • make ingestion of substance unpleasant

- Disulfiram’s antabuse effect (alcohol)

78
Q

Community reinforcement approach & fam training

A
  • treatment monitoring

- teach ABCs: Antecedents (triggers), Behavior (drug use), Consequences

79
Q

Relapse prevention therapy

A
  • target pos beliefs & consequences of drug use
  • develop coping strategies for cravings
  • can recover from relapse
80
Q

Harm reduction therapy + effectiveness

A
  • main goal: minimize harm
  • social skills training
  • education- & community-based
  • more promising than “say no to drugs”, can end in abstinence
81
Q

Diagnostic criteria of gambling addiction

A

4+ symptoms in 12-month period:

  1. gambles w INC $$ to feel excitement
  2. restless/irritable when trying to cut down/stop
  3. failed efforts to ctrl/stop
  4. often preoccupied w gambling
  5. often gambles when distressed
  6. often returns after losing money to get even
  7. lies to conceal extent
  8. jeopardized or lost rel/job/opportunity
  9. relies on others for $ from losing it to gambling
    - not mania
82
Q

Describe severity categories of gambling disorder

A
  • mild: 4-5 symptoms
  • moderate: 6-7
  • severe: 8-9
83
Q

Gambling disorder: prevalence, gender, AOO

A

2%, M>F, in 20s

84
Q

Name 4 consequences of gambling disorder + %

A
  • 14% job loss
  • 19% bankruptcy
  • 21% incarcerated
  • 32% arrested
85
Q

Potential pathway of gambling disorder (4 steps)

A
  1. Ecological factors: INC availability + accessibility;
  2. CC/OC: subj arousal/physio excitement, irrational beliefs + illusion of ctrl [cogn schemas];
  3. Habituation
  4. Chasing wins, losing more than expected
86
Q

Name 2 unofficial behavioral addictions

A
  • internet gaming disorder

- eating addiction

87
Q

Describe the 3-step process of impulse-ctrl disorders

A

tension to do smt; instant gratification; relieve tension

88
Q

Name the 3 ICDs

A

klepto, pyro, intermittent explosive disorder

89
Q

What did pyro + kleptomania used to be categorized as? And now?

A
  • OCD

- disruptive, IC & conduct disorders

90
Q

Name 4 consequences of gambling disorder

A
  • job loss
  • bankruptcy
  • incarcerated
  • arrest
91
Q

Problem with ICD treatments

A

too little documented data

92
Q

Klepto: prevalence, gender, AOO

A
  • 0.6%
  • mostly female
  • 14 to 20 yrs (earlier for M)
93
Q

Pyro: prevalence, gender, AOO

A

.03%, mostly male, 18 yrs

94
Q

Criteria for intermittent explosive disorder

A
  • explosive violent & angry outbursts disproportionate to sit
  • verbal/phys aggro 2x/week for 3+ months
  • 3+ anger outbursts in a year
  • not premeditated
  • relieved but remorseful
95
Q

IED: lifetime prevalence, AOO

A
  • 0.8 to 6.2%: > in military, clinical pop, males

- 10 to 15 yrs

96
Q

Protective factor of IEDs

A

higher education lvls

97
Q

Describe comorbidity of IEDs (order)

A
  • IED comes first

- then: mood disorders, ANX, SUDs, PDs, PTSD

98
Q

List the cognitive-affective impairments of IED (4)

A

-maladaptive defense mechanisms
-poor emo reg
-hostile attribution bias
> neg affect / < pos affect

99
Q

Neurobiological underpinnings of IED (circuity, activity, NT)

A
  • impaired corticolimbic circuity
  • INC amyg / DEC OFC activity to angry faces
  • altered serotonin fxning
100
Q

Social/env factors of IED

A

trauma & PTSD

101
Q

Effects of metamphetamines in therapeutic doses (3)

A
  • improved cogn ctrl
  • INC libido
  • euphoria
102
Q

Effects of methamphetamine abuse (3)

A
  • DEC cogn abilities
  • depression
  • poor sleep/fatigue
103
Q

Describe Korsakoff’s psychosis (2 symptoms) + lobe affected?

A
  • learning & anterograde memory impairment (forming new ones)
  • temporal lobe
104
Q

Comorbidity of wernicke & korsakoff

A

90% comorbidity

105
Q

Describe Korsakoff’s psychosis (2 symptoms) + lobe affected?

A
  • learning impairment
  • anterograde amnesia (new memories)
  • temporal lobe
106
Q

Alcohol brain disease associated with thiamine deficiency

A

Wernicke-Korsakoff

107
Q

Drinking tendencies of average person

A
  • in moderation

- drinking pattern fluctuates

108
Q

Which pattern of levels of involvement (alcohol) is assoc w aggression/violence?

A

progressive pattern

109
Q

Which hallucinogen is referred to as “business trip”? Why?

A

DMT: effects last 10-15 min

110
Q

Distinguish btw the 2 categories of hallucinogens

A
  • classical = psychedelics: changes in mood/perc/thoughs

- recent = dissociatives: out-of-body experience (depers-dereal)

111
Q

Distinguish btw the 2 categories of hallucinogens

A
  • classical = psychedelics: changes in mood/perc/thoughs

- recent = dissociatives: out-of-body experience (depers-dereal)

112
Q

Describe delirium from hallucinogens (3)

A

confusion, confabulation (memory error), agitation

113
Q

Which hallucinogen has been showed to help treat depression? Brain effects?

A
  • psilocybin
  • dec amyg blood flow
  • greater brain connectivity
114
Q

Positive effects of LSD?

A
  • chance cognitive perspectives
  • alleviate fears, anx/dep
  • single dose assoc w optimism
115
Q

Hallucinogens are chemically similar to what NT and how?

A
  • common site of action = agonists of serotonin rec
  • functionally (effect) & structural (binding)
  • cortical excitation (sensory perc)
116
Q

To which substance category does cannabis belong? Where does it originate from?

A

its own

cannabis sativa

117
Q

Consequences of chronic cannabis use

A

agitation/paranoia, impaired problem-solving/decision-making

118
Q

Describe tolerance in terms of endocannabinoids

A

modifies concentration of default/endogenous endocannabinoids

body doesn’t produce correct amount anymore + lower binding potential = tolerance and imbalance

119
Q

Medicinal purposes of cannabis

A

reduce some unpleasant symptoms: chemo, chronic pain, reg appetite

120
Q

Endocannabinoid effects on other NTs

A

indirectly INC dopa by inhibiting GABA

121
Q

Process of THC in brain

A

THC competes to bind to cannabinoid rec that affect dopa

reduces GABA in striatum; dopa INC; pos feelings

122
Q

THC consequences on the brain

A

THC activates cannabinoids throughout brain; affect emos, mvmt, learning, memory, decision-making

123
Q

Consequences (brain) of using cannabis in adolescence

A

overstimulates reward system; changes wiring; addiction, mental disorder, lower IQ

124
Q

Describe NT process of THC in brain

A

THC competes to bind to cannabinoid rec that affect dopa

reduces GABA in striatum; dopa INC; pos feelings

125
Q

Where is the reward circuit & what does it do?

A

limbic system; regulates ability to feel pleasure

126
Q

Natural NT response when we receive reward

A

burst of dopa; transporters quickly remove excess

127
Q

Describe NT process of cocaine in brain

A

blocks transporters on presyn cell; dopa accumulates in synapse; abnormally high levels, remains longer

reward circuit hyperactivated = euphoria

128
Q

Describe NT process of meth in brain

A

low doses: meth blocks re-entry of dopa in presyn cell

higher dose: INC release of dopa + blocked transporters

postsyn cell activated to dangerously high levels

euphoria = very addictive

129
Q

Mildest opioid

A

morphine

130
Q

Opioid 3 neg consequences

A

addiction, OD, HIV infection

PSYC 442: Behavioral Dysregulation Disorders (5 decks)

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