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PSY240 > PSY240 5. Substance Abuse > Flashcards

PSY240 5. Substance Abuse Flashcards

1
Q

Externalizing Disorders

A

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2
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Externalizing Disorders

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3
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Externalizing Disorders

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4
Q

Substance use

A 
• Substance: Any product with psychoactive effects • ~50% have tried an illegal substance (U.S.)
– 15% in the past year
• Problematic use differs
• Across the lifespan
• Across different cultures
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5
Q

Substance use

A

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6
Q

Substance use

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7
Q

Substance use

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8
Q

Categories of Substances

A
  1. CNS Depressants
  2. CNS Stimulants
  3. Opioids
  4. Hallucinogens and phencyclidine (PCP) 5. Cannabis
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9
Q

Categories of Substances

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10
Q

Categories of Substances

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11
Q

Categories of Substances

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12
Q

Substances Used

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13
Q

Substances Used

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14
Q

Substances Used

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15
Q

Frequency of DSM-IV Disorders

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16
Q

Frequency of DSM-IV Disorders

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17
Q

Frequency of DSM-IV Disorders

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18
Q

Frequency of DSM-IV Disorders

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19
Q

Substance-Related Conditions (DSM-IV)

A 
• Substance intoxication:
– Maladaptive symptoms due to effect of
substance on CNS
• Substance withdrawal:
– Distress/impairment in function due to cessation/reduction of use
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20
Q

Substance-Related Conditions (DSM-IV)

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21
Q

Substance-Related Conditions (DSM-IV)

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22
Q

Substance-Related Conditions (DSM-IV)

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23
Q

Substance-Related Conditions (DSM-IV)

A 
• Substanceabuse:
– Recurrent substance useharmful consequences
• Substancedependence:
– Recurrent substance use
• physiological dependence
• Significant impairment
• Significant distress
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24
Q

Substance-Related Conditions (DSM-IV)

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25
Q

Substance-Related Conditions (DSM-IV)

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26
Q

Substance-Related Conditions (DSM-IV)

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27
Q

Substance Abuse (DSM-IV)

A

1+ symptoms occurs during a 12-month period:
1. Failure to fulfill important obligations
2. Repeated use in hazardous situations
3. Repeated legal problems
4. Use despite social problems
• Causes significant impairment or distress

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28
Q

Substance Abuse (DSM-IV)

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29
Q

Substance Abuse (DSM-IV)

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30
Q

Substance Abuse (DSM-IV)

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31
Q

Substance Abuse (DSM-IV)

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32
Q

Substance Dependence (DSM-IV-TR)

A

Maladaptive pattern of substance use (3+):

  1. Tolerance
  2. Withdrawal
  3. Substance taken in more/longer than intended
  4. Persistent desire/unsuccessful efforts to cut back/control
  5. Substance use is time-consuming
  6. Important activities are reduced because of substance use
  7. Use continued despite persistent problems
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33
Q

Substance Dependence (DSM-IV-TR)

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34
Q

Substance Dependence (DSM-IV-TR)

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35
Q

Substance Dependence (DSM-IV-TR)

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36
Q

Substance Dependence (DSM-IV-TR)

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37
Q

Substance Dependence (DSM-IV-TR)

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38
Q

Substance Dependence (DSM-IV-TR)

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39
Q

CHANGES IN DSM-5: Criteria and Terminology

A

Diagnostic Thresholds

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40
Q

CHANGES IN DSM-5: Criteria and Terminology

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41
Q

CHANGES IN DSM-5: Criteria and Terminology

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42
Q

CHANGES IN DSM-5: Criteria and Terminology

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43
Q

CHANGES IN DSM-5: Criteria and Terminology

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44
Q

CHANGES IN DSM-5: Criteria and Terminology

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• Severity is based on the number of criteria endorsed: – Mild disorder: 2–3 criteria
– Moderate disorder: 4–5 criteria
– Severe disorder: 6+ criteria

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45
Q

CHANGES IN DSM-5: Criteria and Terminology

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46
Q

CHANGES IN DSM-5: Criteria and Terminology

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47
Q

CHANGES IN DSM-5: Criteria and Terminology

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48
Q

CHANGES IN DSM-5: Criteria and Terminology

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49
Q

Changes in DSM-5

A

DSM-IV

DSM-5

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50
Q

Changes in DSM-5

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51
Q

Changes in DSM-5

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52
Q

Changes in DSM-5

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53
Q

Changes in DSM-5

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54
Q

Remission Status

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55
Q

Remission Status

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56
Q

Remission Status

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57
Q

Alcohol Use

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58
Q

Alcohol Use

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59
Q

Alcohol Use

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60
Q

Alcohol Use

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61
Q

Alcohol Intoxication

A
  • Mood

* Behaviour • Physiology • Cognition

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62
Q

Alcohol Intoxication

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63
Q

Alcohol Intoxication

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64
Q

Alcohol Intoxication

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65
Q

Alcohol Intoxication

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66
Q

Common Problems in Alcohol Use Disorder

A
  • 80% Engaged in daily or weekly heavily drinking • 70% Consumed 1/5 (26er) of liquor in one day • 62% Family objects
  • 59% Perceives self as an “excessive drinker”
  • 31% Was arrested while drinking
  • 21% Wanted to stop drinking but couldn’t • 14% Continued to drink with serious illness
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67
Q

Common Problems in Alcohol Use Disorder

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68
Q

Common Problems in Alcohol Use Disorder

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69
Q

Common Problems in Alcohol Use Disorder

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70
Q

Common Problems in Alcohol Use Disorder

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71
Q

Long-term Effects of Alcohol Abuse

A
  • Low-grade hypertension
  • Paranoia
  • Deficits in memory and cognition
  • Wernicke-Korsakoff ’s syndrome
  • Alcohol-induced dementia
  • Alcohol-induced persisting amnesic disorder
  • Fetal alcohol syndrome
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72
Q

Long-term Effects of Alcohol Abuse

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73
Q

Long-term Effects of Alcohol Abuse

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74
Q

Long-term Effects of Alcohol Abuse

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75
Q

Long-term Effects of Alcohol Abuse

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76
Q

Benzodiazepines and Barbiturates

A

• Benzodiazepines: Xanax, Valium, Halcion, Librium • Barbiturates: Quaaludes
– Legally manufactured – Sold by prescription

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77
Q

Benzodiazepines and Barbiturates

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78
Q

Benzodiazepines and Barbiturates

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79
Q

Benzodiazepines and Barbiturates

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80
Q

Benzodiazepines and Barbiturates

A

Signs of use/intoxication
• Mild euphoria
• Relief of tension, anxiety • Slurred speech
• Poor motor coordination • Impaired judgment
• Poor concentration
• Sleepiness

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81
Q

Benzodiazepines and Barbiturates

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82
Q

Benzodiazepines and Barbiturates

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83
Q

Benzodiazepines and Barbiturates

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84
Q

Benzodiazepines and Barbiturates

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85
Q

Benzodiazepines and Barbiturates

A

Long-term effects
• Chronic tiredness
• Breathing disorders • Vision Problems

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86
Q

Benzodiazepines and Barbiturates

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87
Q

Benzodiazepines and Barbiturates

A

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88
Q

Benzodiazepines and Barbiturates

A

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89
Q

Benzodiazepines and Barbiturates

A

Patterns of problematic use:

1. Adolescents’ recreational use 2. Increasing prescription dosage

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90
Q

Benzodiazepines and Barbiturates

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91
Q

Benzodiazepines and Barbiturates

A

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92
Q

Benzodiazepines and Barbiturates

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93
Q

Inhalants

A
  • Solvents

* Anesthetic gases and nitrates

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94
Q

Inhalants

A

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95
Q

Inhalants

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96
Q

Inhalants

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97
Q

Inhalants

A

Signs of use/intoxication
• paintorstainsonbodyorclothing • spotsorsoresaroundthemouth
• redorrunnyeyesornose
• chemicalbreathodor
• drunk,dazedordizzyappearance • nausea, loss of appetite
• anxiety,excitability,irritability

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98
Q

Inhalants

A

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99
Q

Inhalants

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100
Q

Inhalants

A

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101
Q

Inhalants

A 
Harmful Effects
• Brain damage, memory loss
• Hearing loss, Slurred speech
• Nose bleeds, loss of smell
• Suffocation, sudden death
• Irregular heart beat, heart attack
• Nausea, vomiting
• Liver damage, kidney damage
• Etc…
102
Q

Inhalants

A

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103
Q

Inhalants

A

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104
Q

Inhalants

A

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105
Q

Inhalants

A

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106
Q

Inhalants

A 
Chronic use
• Respiratory irritations, rashes
• Permanent CNS damage, organ failure, death
At-risk populations
• Prepubescent and early teen boys
• Aboriginal youth
107
Q

Inhalants

A

-

108
Q

Inhalants

A

-

109
Q

Inhalants

A

-

110
Q

Stimulants: Cocaine

A 
Affective/Cognitive symptoms:
• Euphoria
• Affective blunting
• Impaired judgment
Somatic Symptoms:
• Fight-or-flight response
• GI symptoms
• Seizures, coma
111
Q

Stimulants: Cocaine

A

-

112
Q

Stimulants: Cocaine

A

-

113
Q

Stimulants: Cocaine

A

-

114
Q

Stimulants: Cocaine

A

-

115
Q

Stimulants: Amphetamines

A 
Uses:
• Combat depression, fatigue
• Boost energy and self-confidence
• Appetite suppressant
• Symptoms similar to cocaine intoxication
116
Q

Stimulants: Amphetamines

A

-

117
Q

Stimulants: Amphetamines

A

-

118
Q

Stimulants: Amphetamines

A

-

119
Q

Stimulants: Amphetamines

A

-

120
Q

Amphetamines and Neurotransmitters

A

-

121
Q

Amphetamines and Neurotransmitters

A

-

122
Q

Amphetamines and Neurotransmitters

A

-

123
Q

Stimulants: Nicotine

A

• Affects CNS & PNS
• Releases DA, NE, 5-HT, endogenous opioids
• Withdrawal symptoms:
– https://www.youtube.com/watch?v=a7MIpyUpEcE
• No DSM-IV-TR diagnosis Æ new to DSM-5

124
Q

Stimulants: Nicotine

A

-

125
Q

Stimulants: Nicotine

A

-

126
Q

Stimulants: Nicotine

A

-

127
Q

Stimulants: Nicotine

A

-

128
Q

Stimulants: Caffeine

A 
• Most heavily used stimulant
– ~2 cups / day (U.S.)
– 1 cup = 100 mg caffeine
• Affects CNS
• Increases DA, NE, & 5-HT
129
Q

Stimulants: Caffeine

A

-

130
Q

Stimulants: Caffeine

A

-

131
Q

Stimulants: Caffeine

A

-

132
Q

Stimulants: Caffeine

A

-

133
Q

Stimulants: Caffeine

A

-

134
Q

Opioids

A 
Derived from the opiate poppy:
– Morphine
– Heroin
– Codeine
– Methadone
• Derived naturally from the body:
– Endorphins
– Enkaphalins
135
Q

Opioids

A

-

136
Q

Opioids

A

-

137
Q

Opioids

A

-

138
Q

Opioids

A

-

139
Q

Opioids

A

Intoxication
• Mood
• Cognition
• Physiology

Withdrawal
• Mood
• Physiology

140
Q

Opioids

A

-

141
Q

Opioids

A

-

142
Q

Opioids

A

-

143
Q

Opioids

A

-

144
Q

Hallucinogens and PCP

A 
Hallucinogens
• e.g., LSD, MDMA (ecstasy), and peyote.
PCP (angel dust)
• Snorted or smoked
• Not technically a hallucinogen, but has similar effects
145
Q

Hallucinogens and PCP

A

-

146
Q

Hallucinogens and PCP

A

-

147
Q

Hallucinogens and PCP

A

-

148
Q

Hallucinogens and PCP

A

-

149
Q

Cannabis

A
  • Intoxication
  • Mood
  • Cognition
  • Physiology
  • Moderate to high dose may cause
  • hallucinations
  • depersonalization
  • paranoia
150
Q

Cannabis

A

-

151
Q

Cannabis

A

-

152
Q

Cannabis

A

-

153
Q

Cannabis

A

-

154
Q

Non-Substance-Related Addictions

A

Examples: gambling, sex, exercise,

video games, work, shopping, etc.

155
Q

Non-Substance-Related Addictions

A

-

156
Q

Non-Substance-Related Addictions

A

-

157
Q

Non-Substance-Related Addictions

A

-

158
Q

Non-Substance-Related Addictions

A

-

159
Q

Gambling Disorder

A
  • A pattern of gambling behaviour that causes harm
  • 12 month Canadian prevalence = ~ 2% (Cox et al., 2005)
  • DSM Classification
  • DSM-IV-TR: “Impulse-control disorders NOS”
  • DSM-5: Non-substance-related disorder
160
Q

Gambling Disorder

A

-

161
Q

Gambling Disorder

A

-

162
Q

Gambling Disorder

A

-

163
Q

Gambling Disorder

A

-

164
Q

DSM-5 Section III Conditions

A

Hypersexual Disorder:
• A pattern of sexual behaviour that is initially pleasurable
but that becomes unfulfilling and self-destructive
Internet Gaming Disorder:
• Persistent and recurrent use of the Internet to engage in
games, often with other players

165
Q

DSM-5 Section III Conditions

A

-

166
Q

DSM-5 Section III Conditions

A

-

167
Q

DSM-5 Section III Conditions

A

-

168
Q

DSM-5 Section III Conditions

A

-

169
Q

DSM-5 Section III Conditions

A

-

170
Q

Concurrent Disorders

A

Comorbid mental health and substance use problems
• Complex and difficult to treat
Substance Use Treatment Seekers
Psychiatric Treatment Seekers

171
Q

Concurrent Disorders

A

-

172
Q

Concurrent Disorders

A

-

173
Q

Concurrent Disorders

A

-

174
Q

Concurrent Disorders: Stress & Trauma

A 
Impact influenced by
• Stressor
• Individual differences
• Gender
• Age
• Genes
175
Q

Concurrent Disorders: Stress & Trauma

A 
Stress/Trauma => Negative
Affect /
Somatic
Symptoms => Poor
Coping
Skills  => Substance
Use =>Stress
Proliferation =>
176
Q

Concurrent Disorders: Stress & Trauma

A

-

177
Q

Concurrent Disorders: Stress & Trauma

A

-

178
Q

Concurrent Disorders: Stress & Trauma

A

-

179
Q

Concurrent Disorders: Stress & Trauma

A

-

180
Q

Concurrent Disorders: Stress & Trauma

A

-

181
Q

Concurrent Disorders: Anxiety & Mood Disorders

A 
Anxiety
• Risk of substance problems 2-5X higher
• In 75% of cases, anxiety came first
Bipolar Disorder
• Possible overlapping predispositions
• A “disorder-inducing disorder”
182
Q

Concurrent Disorders: Anxiety & Mood Disorders

A

-

183
Q

Concurrent Disorders: Anxiety & Mood Disorders

A

-

184
Q

Concurrent Disorders: Anxiety & Mood Disorders

A

-

185
Q

Concurrent Disorders: Anxiety & Mood Disorders

A

-

186
Q

Concurrent Disorders: Anxiety & Mood Disorders

A

-

187
Q

Concurrent Disorders: Psychosis

A

• Substance use can:
– Hasten onset of psychotic disorders
– Worsen symptoms and the course of illness
– Exacerbate negative consequences

188
Q

Concurrent Disorders: Psychosis

A

-

189
Q

Concurrent Disorders: Psychosis

A

-

190
Q

Concurrent Disorders: Psychosis

A

-

191
Q

Cultural Specificity

A
  • Some cultures impose strict sanctions on all drugs
  • Some cultures view it as a medical problem
  • Some distinguish soft vs. hard drugs
  • Some cultures normalize it
192
Q

Cultural Specificity

A

-

193
Q

Cultural Specificity

A

-

194
Q

Cultural Specificity

A

-

195
Q

Cultural Specificity

A

-

196
Q

Societal Costs

A

• Costs ~$14 billion CAD / year

197
Q

Societal Costs

A

-

198
Q

Motivational Models

A

• Desire for Mood Alteration
– Negative Affect Reduction (Emotionally vulnerable)
– Euphoria/Excitement Induction (Antisocial/Impulsive)

199
Q

Motivational Models

A

-

200
Q

Major Dopamine Pathways

AKA “the reward pathway,” “the pleasure centre”

A 
Manufactured in
• Ventral Tegmental Area (VTA)
Released to
• Nucleus Accumbens
• Prefrontal Cortex
201
Q

Major Dopamine Pathways

AKA “the reward pathway,” “the pleasure centre”

A

-

202
Q

Major Dopamine Pathways

AKA “the reward pathway,” “the pleasure centre”

A

-

203
Q

Major Dopamine Pathways

AKA “the reward pathway,” “the pleasure centre”

A

-

204
Q

Septal-Hippocampal Area

A 
• Connected via GABA-sensitive neurons
• ↑ GABA reduces anxiety
• ↓ GABA
– increases anxiety
– increased sensitivity to pain
– panic attacks, seizures
• Self-medicate with substances
205
Q

Septal-Hippocampal Area

A

-

206
Q

Septal-Hippocampal Area

A

-

207
Q

Septal-Hippocampal Area

A

-

208
Q

Genetic Factors

A

Behavioural Genetics Studies
• Moderate-to-high heritability
• Phenotypes (e.g., impulsivity) also heritable

Molecular Genetics Studies
• The role of specific genes is unclear
• Implicates gene variants linked to DA deficiency

209
Q

Genetic Factors

A

-

210
Q

Genetic Factors

A

-

211
Q

Genetic Factors

A

-

212
Q

Genetic Factors

A

-

213
Q

Psychological Theories

A

Behavioural
• Positive & Negative Reinforcement (self-medication)
• Modelling (parents, peers, culture, media)
• Maladaptive coping (comorbid social phobia)

214
Q

Psychological Theories

A

-

215
Q

Psychological Theories

A

-

216
Q

Psychological Theories

A

-

217
Q

Psychological Theories

A 
Dispositional
• Trait vulnerabilities
• Impulsivity
• Tendency to act without planning or restraint
• Strongest predictor of substance use
• Diathesis for substance use disorders
218
Q

Psychological Theories

A

-

219
Q

Psychological Theories

A

-

220
Q

Sociocultural Theories

A 
Adolescent Alcohol Use
• Experimentation
• Adolescents with alcoholic parents
• Stress in family home
• Opposite-sex friends
221
Q

Sociocultural Theories

A

-

222
Q

Sociocultural Theories

A

-

223
Q

Sociocultural Theories

A

-

224
Q

Sociocultural Approaches

A
  • Chronic stress + support/promotion of use
  • Advertising and media
  • Gender differences
225
Q

Sociocultural Approaches

A

-

226
Q

Sociocultural Approaches

A

-

227
Q

Sociocultural Approaches

A

-

228
Q

Integrative Model

A

-

229
Q

Integrative Model

A

-

230
Q

Integrative Model

A

-

231
Q

Integrative Model

A

-

232
Q

Treatments

A

Alcoholics/Narcotics Anonymous
• “12-step” programs
• Total abstinence
• 27% AA members sober after 1 year

233
Q

Treatments

A

-

234
Q

Treatments

A

-

235
Q

Treatments

A

-

236
Q

Treatments

A

-

237
Q

Treatments

A

Biological Treatments:
• Antidepressants & Antianxiety agents
• Antagonists (block reinforcing effects)
• Agonists (e.g., Methadone)

238
Q

Treatments

A

-

239
Q

Treatments

A

-

240
Q

Treatments

A

-

241
Q

Treatments

A 
Behavioural
• Aversive classical conditioning
• Covert sensitization therapy
• Cue exposure and response prevention
• Controlled Drinking (controversial)
242
Q

Treatments

A

-

243
Q

Treatments

A

-

244
Q

Treatments

A

-

245
Q

Treatments

A

Cognitive
• Identify and gain control in risk situations

Motivational Interviewing (MI)
• Therapists express empathy, support self-efficacy
• Help clients explore and resolve ambivalence

246
Q

Treatments

A

-

247
Q

Treatments

A

-

248
Q

Treatments

A

-

PSY240 (5 decks)

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