Psych

Question 1

Transtheoretical model of change:

Answer 1

Precontemplation - denies problem
Contemplation - acknowledges problem but is ambivalent or not willing to change
Preparation/determination - Committed to and planning for behavior change
Action/willpower - executes plan and demonstrates change in behavior
Maintenance: New behaviors become sustained, integrates into personal identity and lifestyle
Relapse - regression to prior behavior. (doesnt always happen)

Question 2

what is first line treatment for alcohol use disorder?

Answer 2

Naltrexone: this is a long acting opioid receptor inhibitor. This is used because alcohol is a depressant and alcohol use disorder increases amounts of dopamine plus endorphins to the point of addiction. Therefore, first line treatment is blocking mu-opioid receptors.

Second-line tx:
acamprosate (drug that modulates NMDA receptors to start increasing amounts of excitatory NT like glutamate and aspartate, SE: nausea, diarrhea)
disulfiram (drug that inhibits aldehyde dehydrogenase, which is an enzyme needed for metaboliziation of alcohol; this causes SEs such as sweating, flushing, N/V/D, palpitations)

Question 3

What characterizes MDD with atypical characteristics?

What is the best treatment for it?

Answer 3

MDD with atypical features is characterized by mood reactivity (mood improves in response to positive events), leaden paralysis (patient’s arms and legs are heavy), rejection sensitivity (overly sensitive to slight criticism), and increased sleep and appetite.

tx: MAOIs (phenelzine, tranylcypromine)

Question 4

treatment for opioid disorder

Answer 4

Methadone (full agonist with long half life which allows the med to suppress cravings and withdrawal symptoms) use to get clean
Buprenorphine (partial agonist. dont combine with full agonist)
Naloxone (antagonist for overose)
Naltrexone (long acting antagonist used after detox to PREVENT relapse) used after you are already clean to stay clean