Prev Med 2

Question 1

> 4 vs 5 vs 6 ACE inc chances of what?

Answer 1

500% inc alc use vs 7x inc illicit drug use vs 46% inc IVDU

Question 2

3 strats to dec prevalence of ACE

Answer 2

counter/buffer effects of ACE in children:
1. pos childhood exp
2. healthy stress management
3. engage w/ fam, community, faith

Question 3

social vs emotional vs cog/physical stress characteristics

Answer 3

social exp shape neuro & bio systems; Unsupportive environments during childhood -> low self-esteem and emotional reg in adults vs unaddressed toxic stress = harmful to developing brain –> lifelong physical/mental/soc issues; >50% of mental health d/o in childhood, 75% of them dx <25yo vs amyg, hippo, cerebellar vermis; too much stress –> dec emot reg –> poor development/mental health issues, toxic stress –> f/light –> inc cortisol –> inflam & immunity

Question 4

s/s of ACE in young vs old children. other s/s?

Answer 4

bedwet, baby talk, crying mre, new fears vs substance use, academic difficulties, juvenile offending, suicide, sex. can’t focus, irritable/anger, disturbed sleep or appetite

Question 5

protective factors of ACE vs strats to inc resilience in kids

Answer 5

social & emot support for kids, parental support & resilience, nurturing & attachment vs build emotional connections, problem solving skills, coping skills, embrace mistakes, build indep

Question 6

trauma-informed care approach. 6 principles? goal?

Answer 6

healthcare team/org needs to have big picture of pt’s life situation (past & present) to give effective health service. safety, transparency, humility, peer support, empowerment, collab. improve pt engagement, tx adherence, health outcomes

Question 7

intox vs tolerance vs w/drawal vs substance-related d/o. does ‘addict’ fall w/in DSM5 criteria?

Answer 7

temporary & reversible condition affecting CNS -> alters judgment, thinking, behavior vs dec response to substance d/t prolonged/rpt exposure; physio system achieved stability to constantly changing environ vs sxs following cessation of substance vs alc & cannabis examples. no -> person w/ substance use d/o or person w/ an addiction

Question 8

3 stages of addiction cycle: binge/intox vs withdrawal/neg affect vs preoccupation/anticipation

Answer 8

incentive salience -> seek reward/pleasure -> DA released in nucleus accumbens/BG -> like the feeling -> want more -> habit circuitry/craving/compulsive seeking vs dec in reward -> inc stress NT in amyg -> anxiety/fear/stress -> hate the feeling -> compulsive seek vs inc gluE/dec DA in prefrontal cortex -> compromised exec fxn (attn, thinking, judg)-> overactivate “go” system, underactivate “stop” system -> im/compulsive seek

Question 9

what kind of factors tell you if person will develop substance use d/o?

Answer 9

substance itself, genetic vulnerability, freq/amt/duration of substance use, h/o prior trauma

Question 10

protective factors of substance use d/o. comprehensive approach to address substance use in US

Answer 10

KABS, resilience, social support. prevention policies, edu/awareness, tx services, recovery services, public policies/financing strats

Question 11

SBIRT approach

Answer 11

comprehensive & integrative approach to pts w/ alc/drug use risks
screening -> ID unhealthy use; “how many times have you used this drug?”; pos if >5x men, >4x women
BI -> edu, insight, awareness abt risks; informal or structured counseling
RT -> facilitate access to addiction assessment & tx if BI doesn’t work; gets pt engaged in specialized tx

Question 12

universal vs selective vs indicated interventions of substance use

Answer 12

all pops -> seatbelts, minimum drinking age vs target communities d/t exposure/risk factors -> children of substance-using parents or difficulty social skills vs aim at those already involved w/ substance use but not yet d/o -> teens arrested for use

Question 13

determinants of mental health. general risk factors vs psych risk factors

Answer 13

bio, psych, social, environ (SES, personality, chem), cx. genetics, endophenotypes (temperament/inherited traits), hormonal/CNS change, daylight, disturbed circadian rhythm (rotating work shifts) vs suicide/violence, maladaptive thoughts, glorification/media; being around ppl using -> substance use d/o

Question 14

protective factors for mental health behavior

Answer 14

attachment in infancy, developmental milestones, cog achievement; strong religion; pos attachment to fam/friends/peers; physical & nutritional health

Question 15

DSM5 criteria for drug use. why can this criteria & ICD10 be controversial?

Answer 15

impaired ctrl, risky use, social dysfxn, pharm criteria. perpetuates frag of care, classifies which pts to/not tx -> artificial separation of mental & physical health

Question 16

how to improve mental health?

Answer 16

improve/integrate healthcare in general, nutrition & housing, access to work & edu, limit access & advertising substances; early screen, evidence-based tx (CBT, DBT)