PSY349 Final Flashcards
What outcomes are associated with the down-regulation of the endocannabinoid system?
Anxiety, difficulty sleeping, depressed mood, and reduced motivation
What is an important role of endogenous cannabinoids, such as anandamide, in the brain?
They are released to buffer and mitigate the impact of stressful or traumatic experiences.
What did the quantitative meta-analysis on cue reactivity in imaging studies, focusing on nicotine, alcohol, and cocaine users, reveal about the core circuits of drug craving?
Ventral striatum, anterior cingulate, and amygdala were identified as core circuits of drug craving.
What distinguishes voyeuristic disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)?
Recurrent, intense sexually arousing fantasies, urges, or behaviors involving the observation of an unsuspecting person undressing or engaging in sexual activity
According to Dr. Carnes (1989), what are the characteristics associated with sex addicts?
Severe shame and depression, tendencies towards suicidal thoughts
The association between highly processed foods and “food addiction” is linked to characteristics shared with drugs of abuse, such as _______ and ________.
High dose; rapid absorption
One reason for the resistance to using an addiction framework for compulsive sexual behavior and pornography use is the fear of pathologizing people that have an unhealthy sexual appetite. [True/False]
False
The Kinsey Institute, a premier research institute on human sexuality, reported findings related to high exposure to pornography videos, including:
Lower sexual responsivity with a partner.
Δ⁹-tetrahydrocannabinol has a high affinity for endogenous cannabinoid (CB1) receptors, whereas cannabidiol (CBD) does not. [True/False]
True
Behavioral or process addictions are similar to substance use disorders in the following way/s:
There is a shift in salience attribution.
Withdrawal is experienced.
What characterizes a behavior associated with process addiction?
Repetitive, persistent behaviors with an inability to stop despite negative consequences.
The subjects in the Kinsey study who reported high exposure to pornography videos also indicated:
Increased need for more extreme, specialized, or “kinky” material.
What qualities of modern pornography make it a potential problem for some individuals?
High-quality recordings with constantly improving image quality, affordability, accessibility without restrictions, and an unlimited offering of sexual content, including risky or illegal practices.
According to a research study discussed in classs: Similar to subjects with addictive disorders, obese subjects have lower baseline striatal D2 R density, which is directionally proportional
to BMI. [True/False]
True
Research discussed in class included a study that found, food consumption is associated with DA release in the dorsal striatum in healthy subjects, and the amount of dopamine released is correlated positively with ratings
of food pleasantness. [True/False]
True
Highly processed foods share similar pharmacokinetic properties [True/False]
True
Addiction [definition]
brain disorder is defined as a chronic, relapsing disorder characterized by compulsive drug-seeking and use despite adverse consequences
Why do we call addiction a disease?
treatable
preventable
modifies biology
genetic factors
IRISA
[Imapired Response Inhibition & Salience Attribution]
take drug –> craving –> binge –> withdrawal –> relapse
Cravings are induced by
triggers or stressors
Addiction shows impairment in which six brain networks:
executive
salience
reward
habit
self-directed
memory
In what ways can PFC functioning be a protective or risk factor?
PFC controls attention and decision making – impaired decision making associated with increased likelihood of doing drugs
Individual protective factor
perceiving substance abuse as risky
secure attachment
self-competence
healthy coping skills
Diathesis Stress Model
diathesis + stress = development of SUD
Adverse Childhood Experiences
stressful/traumatic events
early use of alcohol
higher risk of mental illness and substance use as adults
OUD Diagnostic Criteria
2 of 3 symptoms:
loss of control
risky use
social/vocational problems
What are opioids?
chemical compounds that are derived from natural plant matter
Drivers of the Opioids problem
physicians disregarding the issues
readily accessible to the population
Opioid Withdrawal Symptoms
Anxiety
Insomnia
Muscle pain
Dysphoria
Gastrointestinal distress
Three Medication Options for OUD Treatment
agonist (methadone)
partial agonists (suboxone)
antagonist (antagonist)
Agonist [definition]
bind to receptors and produce a biological response
Partial agonist [definition]
bind to receptors but elicit partial functional response, regardless of the amount of drug administered
Antagonist [definition]
binds to receptors but produces no function response, while also preventing an agonist from binging at that receptor site
Effects of Alcohol on the Brain
calming/sedative effects
HPA axis is changed
decrease in top-down inhibition
Gut-Liver-Brain Axis
alcohol kills gut microbiota leads to have impaired cognitive function, mood changes, continued drinking behavior
chronic drinking increases risk of leaky gut
Psychotherapeutic Approaches
motivational interviewing
cognitive behavioral therapy
contingency management
OARS
community support
What are benzodiazepines?
DNS depressant with sedative, hypnotic, anxiolytic effects
Some commonly prescribed benzos:
Xanax
Klonopin
Valium
Librium
Benzodiazepine withdrawal
memory loss
disruption in menstrual cycle
increase in psychological symptoms
death in pre-clinical studies
Proponents of Chronic Overeating as an Addiction
behavioral similarities to drug addiction
classical and operant conditioning occurs
craving and withdrawal
cognitive control
Opponents to Chronic Overeating as an Addiction
What is exact substance that is addictive
Not enough data to support neurobiology
Binge-Eating Disorder Diagnostic Criteria
Recurrent and persistent episodes of binge eating
Marked distress regarding binge eating
Absence of regular compensatory behaviors
Cannabis Use Demographic
College students and young adults
Common Experiences of Marijuana Intoxication
slowed time perception
better interpersonal relationships
heightened sensory effects
issues with attention, focus, and short-term memory
Heavy/chronic users of marijuana reported impairment in neuropsychiatric, physical, and social domains through
decreased sense of life satisfaction
altered brain development and cognitive impairment
poor educational outcome
lower iQ
Cannabis-Induced Psychotic Disorder
disconnect from reality, hallucinations, delusions
DSM-5 Cannabis Use Disorder Diagnostic Criteria
at least 2 of the criteria
cannabis taken in larger amounts/longer period than intended
cravings, withdrawal, tolerance
failure to fulfill major obligations
persistent desire to cut down and continued use despite knowledge of having a problem
Cognitive Behavioral Therapy [definition]
a form of psychotherapy that teaches people to identify and correct problematic behaviors in order to enhance self-control and address problems to stop drug use
Contingency management
therapeutic management approach based on frequent monitoring of the target behavior and the provision of tangible positive rewards when the target behavior occurs
Motivational Interviewing
systematic form of intervention designed to produce internally motivated change
Process Addictions [definition]
repetitive, persistent behaviors, where there is an inability to stop despite negative consequences
Four C’s Model for Behavioral Addiction
Compulsive behavior
Impaired Control
Negative Consequences
Preoccupation/craving
Components to Behavioral Addiction
shift in salience attribution
internal/external conflict
tolerance, withdrawal, relapse
Pornography addiction [definition]
where the consumption of pornography may become harmful and compulsive
Potential issues for young [pornography] viewers
more frequent engagement in risky sex
sexually coercive partners
higher level of sexual aggression
What qualities make pornography a potential problem?
image quality
affordable and accessible
unlimited sexual content
ICD-11 Compulsive Sexual Behavior Disorder Diagnostic Criteria
a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior
sexual behavior has become a central focus of individuals life
unsuccessful effort to control desires/impulses
distress and shame about behavior
PATHOS Screening for Behavioral Addiction
Preoccupied
Ashamed
Treatment
Hurt others
Out of control
Sad
Resistance to Pornography Addiction as a diagnosable condition
potentially pathologizing a healthy sexual appetite
excuse to behave n ways that don’t align with societal norms
potential legal implications
Development of a paraphilia
“Trauma Induced Intimacy Disorder”
high probability of SA as a child
dysfunctional family
DSM-5 Gambling Disorder Diagnostic Criteria
persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distressed
need to gamble with increasing amounts of money for desired excitement
preoccupied with gambling
unsuccessful effort to cut back
the gambling behavior is not better explained by a manic episode
Similarities between Gambling Disorder and Other addictions
tolerance
withdrawal
cravings
salience attribution shifts
deceptiveness
Pathological Gambling is associated with
personality disorders
divorce
criminal offending
suicidal ideation and attempts
How do casinos target problem gamblers?
they make 90% of their profit from the 10% of addicted players
offering incentives
Cognitive Distortions and Gambling Disorder
Gambler’s Fallacy
Belief that they can control the outcomes of luck-based activities
Overall, how can one argue against the idea that addiction is caused by a lack of willpower?
people cannot control their behavior if the brain areas responsible for such behaviors are biologically compromised
Characteristics of Internet Gaming Disorder
attention bias
salience shift
impaired decision-making
Clinical Presentation of Internet Gaming Disorder according to ICD-11
persistent and recurrent use of games
preoccupation and withdrawal when not gaming
loss of other interests
unsuccessful efforts to cut down
Prevalence of IGD
overall increase since COVID-19
more males than females
5% of all adolescents
Neurobiological Mechanisms Underlying IGD
activation in brain regions associated with dopamine mediates reward mechanisms
Common Negative Consequences associated with IGD
neglect ADLs
loss of sleep
social isolation
family conflict
rage episodes
Treatment for IGD
assessment for any co-occurring mental health issues
outpatient
psychoeducational
CBT
motivational interviewing
Methamphetamine [definition]
schedule II Stimulant
derived from amphetamine
main effect is increased levels of dopamine, euphoria, alertness, increased energy
Reported Positive Effects of Methamphetamine
improved concentration and attention
increased libido and sexual performance
increases sense of well-being
decreased fatigue
hallucinogenic effects
Harm associated with Meth use
HIV progression
profound neuropsychological deficits
physical deterioration (premature aging, dental problems)
Treatment for Methamphetamine Addiction
contingency management
pharmacotherapy for psychostimulant disorders
Dual Diagnosis [definition]
refers to two or more illnesses that occur at the same time [SUD and mental illness] with no solid cause-and-effect relationship
Any mental illness (AMI) [definition]
a mental, behavioral, or emotional disorder - varies in impact (between no/little impairment to moderate impairment)
Serious/Severe Mental Illness (SMI) [definition]
a mental, behavioral, or emotional disorder that creates a serious impairment
interferes with or limits at least one major life activity
Why is the co-occurrence of MDD and SUD so prevalent?
abnormal functioning in PFC, ACC, and Dorsolateral prefrontal cortex
reduced brain volume
Primary Contributory Factors of Co-occurring diseases
genetic vulnerability
environmental factors
stress
mental illness can contribute to drug use (self medication)
substance use can contribute to mental illness (e.g. psychosis)
Co-Occurring Treatment
Integrated Mental Health and SUD Treatment
individualized treatment plans
Components of treating the dually diagnosed
detoxification
psychosocial interventions
inpatient rehab.
psychotherapy
medication
What happens as a result of the down-regulation of dopamine neurotransmitters?
lower dopamine receptor availability
What happens as a result of lower dopamine receptor availability?
no dopaminergic response to natural environmental stimuli
How is reward processing impacted by addiction?
EEG demonstrates drug-addicted individuals show the same brain activity to varying monetary amounts
Gray matter decrements in the PFC were shown to be positively correlated with the number of years using the drug [True/False]
True
The Cue-Elicited Craving Model explains
the cue conditioned stimulus may begin to gain salience with the AC and amygdala
The result of impaired response inhibition and salience attribution is
automatic, stimulus-driven behaviors (e.g. compulsive drug consumption) predominate
How does addiction override free will?
impairment in the areas of the brain responsible for decision-making result in compromised ability to choose freely between alternative courses of action
