Psychological problems Flashcards
1
Q
What is mental health?
A
A person’s emotional and psychological wellbeing; this allows them to cope with the normal stresses of everyday life and to function in society.
2
Q
What are mental health problems?
A
Diagnosable conditions in which a person’s thoughts, feelings, and behaviours change and they are less able to cope and function.
3
Q
What are some characteristics that a mentally healthy person will display?
A
- Not overcome by difficult feelings.
- Having good relationships with others.
- Being able to deal with disappointments and problems.
- Being able to cope with stresses and demands of everyday life.
- Effectively coping with difficulties and challenges.
- Being able to make decisions.
- Functioning as part of society.
- Positive engagement with society.
4
Q
What is important to bear in mind with these characteristics?
A
Not having all of these, does not mean that someone has a mental health problem.
5
Q
How do mental health problems affect an individual?
A
They affect the way you think, feel, and behave.
6
Q
What are the most common mental health problems?
A
- Depression.
- Anxiety.
7
Q
What are the least common mental health problems?
A
- Schizophrenia.
- Bipolar disorder.
8
Q
What are the two different ways of identifying and diagnosing mental health problems?
A
- International Classification of Diseases. (ICD-10)
- Associates Diagnostic and Statistical Manual of Mental Disorders.
(DSM-5)
9
Q
What affects different beliefs surrounding mental health problems?
A
Cultural variations.
10
Q
What has been believed throughout history about mental health problems?
A
Throughout history, mental health problems have often been believed to have a supernatural or spiritual origin.
11
Q
If supernatural was a cause, what would they say it was affected by?
A
Suggested causes for people’s symptoms included possession by evil spirits, being cursed, and being a witch.
12
Q
What did European and North American people believe during the 14th to 16th centuries?
A
Many people, especially women, were accused and tried for being witches.
13
Q
What is one explanation behind people being tried for being witches in the 16th to 17th centuries?
A
It is now believes that mental health problems may have resulted in some of the behaviours that led to people being accused.
14
Q
In which cultural group is having mental health problems seen as shameful?
A
In Asian cultures, mental health problems are strongly stigmatised and seen as a form of personal weakness.
15
Q
What does this stigma lead to?
A
Can result in people experiencing economic, social, and legal discrimination.
16
Q
What does stigma mean?
A
Situations, people, or characteristics that are disapproved of and seen as shameful by much of society.
17
Q
What happens in cultures where a person’s behaviour reflects on their whole family?
A
It is common for people with mental health problems to be kept away from other people and cared for by their family.
18
Q
What do cultural beliefs as a whole affect?
A
The type of treatment people receive. Treatments are closely linked to beliefs about the cause of mental health problems.
19
Q
What is the treatment offered in cultures where it is seen as a biological cause?
A
Medication is commonly used.
20
Q
What is the treatment offered in cultures where it is seen as a spiritual cause?
A
Treatments may range from prayer to exorcisms.
21
Q
What is the treatment offered in cultures where it is promoted to share openly about yourself and your emotions are valued?
A
Self-help groups and therapy.
22
Q
What is the treatment offered in cultures where it is seen to be shameful to have mental health problems?
A
People may be kept completely isolated and unable to talk to anyone about what they are experiencing.
23
Q
What does emerging data suggest about mental health problems?
A
Worldwide, more people than ever before are being diagnosed with a mental health problem.
24
Q
Which mental health problem is staying at a consistent rate?
A
Schizophrenia.
25
Which mental health problem has a growing rate of diagnosis?
Depression.
26
What do psychologists believe that one of the explanations is for the rising diagnosis levels may be caused by?
Some medical professionals believe that changes in the classifications of some conditions mean that more people now meet the criteria for diagnosis
27
What do psychologists believe that another of the explanations is for the rising diagnosis levels may be caused by?
More people are also seeking medical and psychiatric treatment as many cultures come to rely less on traditional methods of dealing with mental health problems.
28
So what is the main factor for the uprise in diagnosises?
Changes in diagnosis levels may explain some of the upward trend in mental health problems, but there may also be other factors involved.
29
What is something that really affects mental health?
Modern living.
30
What can living in a more populated area do to your mental health?
It can increase stress.
31
How do we know that it can increase stress?
Brain scans show that people living in cities have a more active amygdala than people living in less populated areas. One role of the amygdala is responding to threats.
32
What living situations can take a toll on your mental health?
Loneliness and isolation can be factors in mental health problems such as depression and anxiety.
33
What does isolation mean?
Being or feeling alone and separate from other people.
34
What is a survey that backs this up?
A recent survey for the Mental Health Foundation found that one in ten people in the UK report feeling lonely and this is increasing amongst young people.
35
What may be increasing our levels of loneliness?
Changes in the way that we live.
36
What is an example of why we could change the way in which we live?
More people are living on their own, often some distance away from family members. This may be down to needing to move for work, family breakdown, and people living longer.
37
What has changed the way that people interact?
- Technology.
- Social networking sites.
38
Why have these things changed the way in which people interact?
People can connect with others all over the world, but there are also concerns that technology may be making isolation worse as it increasingly replaces face-to-face communication.
39
What are some results that back this up?
18% of participants in the Mental Health Foundation survey said they thought they spent too much time communication with family and friends online rather than in person.
40
What is the Current Western understanding of mental health?
It concerns biological and psychological causes and they began to develop during the nineteenth century. At this time classification systems and psychiatry became a specific area of medicine.
41
What did the twentieth century see in terms of the Western understanding of Mental Health?
The early twentieth century saw the development of psychoanalysis and the mid-twentieth century saw drugs increasingly become the most common way of treating mental health problems.
42
What is the traditional understanding of mental health?
It has generally focused on supernatural and spiritual factors. Although biological and psychological causes are now becoming more accepted, myths and misconceptions are still widespread, especially in rural and developing countries.
43
As a whole, what increases worldwide diagnosis rates?
As more people recognise the biological and psychological nature of mental health problems, they are also more likely to seek medical and psychiatric treatment.
44
Why was the term 'metal health' used?
It was first used in the early twentieth century to try to reduce stigma by focusing on health rather than illness. But a hundred years later, being diagnosed with a mental health problem can still be hugely stigmatising.
45
What were the findings of the National Attitudes to Mental Illness survey?
It shows that opinions in the UK are changing.
46
What were these changing opinions a result of?
This may be a result of a variety of things, including campaigns such as ''Time to change'' and well-known personalities speaking about their own experiences.
47
What does the WHO think about stigma and discrimination towards people with mental health issues?
As one of the worlds most important health issues. Although one reason for diagnosis levels increasing may be the lessening of social stigma, in order for everyone to be able to seek the treatment they need, more needs to be done.
48
What are some examples of how people with mental health problems can have difficulty coping with everyday life?
Trouble sleeping, low energy levels, and poor concentration levels all make being in education or work more difficult.
49
What effect does developing a mental health problem earlier in life have on their everyday life?
Developing a condition earlier in life can stop individuals from finishing their education or training.
50
What is a statistic that backs up the fact that people struggling find it harder to cope with everyday life?
People in the UK who have a mental health problem are four times more likely to be out of work.
51
What are two factors of everyday life that can make mental health problems work?
Unemployment and low income can increase stress and anxiety and may well make mental health problems worse.
52
What can mental health problems also impact?
Physical wellbeing.
53
What is an example of mental health problems affecting physical wellbeing?
People can find it hard to follow treatment programmes for their mental health condition or other health conditions they may have.
54
What is an explanation for this struggle?
Possible reasons for this include anxiety about side effects of taking medication, being too depressed to attend appointments, and forgetting to take medication due to concentration difficulties.
55
What can result in weight loss or gain?
Changes in appetite and side effects of medication.
56
What can reduce physical exercise levels?
Low energy and mood.
57
Can relationships also be damaged by mental health problems?
Yes, and in a number of ways.
58
What does research suggest about the correlation between having a family member whos struggling and developing a mental health problem?
Research suggests that 50 per cent of family members of someone with a mental health problem may also develop some form of mental health problem.
59
Why does this happen?
Family members may end up becoming caregivers, which can increase stress and cause conflict. The effect on the household income can also increase stress levels. Children may not understand why their parents are different or unable to care for them and they may blame themselves.
60
What may happen in terms of some children and their parents' care?
Some children end up being their parents' caregiver and others may end up in the care system.
61
What is one last explanation between the correlation of having a family member whos struggling and developing a mental health problem?
People can also become very isolated. The stigma of mental health problems may mean that people choose not to talk about their situation and low mood can lead people to simply withdraw into themselves.
62
What are the effects on society of mental health problems?
The implications for the economy are one of the main societal effects of mental health problems.
63
What did a study by WHO find in relation to the economy and mental health?
A study by the WHO found that in developed countries such as the UK, 15 per cent of the economic cost of all health issues is due to mental health problems.
64
What did the Sainsbury centre for mental health find out about decreased work productivity and mental health?
Decreased work productivity due to mental health problems cost the UK economy over 15 billion pounds every year.
65
What is said about the danger of mental health problems?
Most individuals with mental health problems do not commit violent crimes, and people with mental health problems are actually more of a danger to themselves.
66
What did the ministry of justice find out in relation to the percentage of mental health problems in prisoners, and in the general population?
A Ministry of Justice study found that 49 per cent of female and 23 per cent of male prisoners were suffering from anxiety and depression. This compares to 19 per cent of females and 12 per cent of males in the general population.
67
What link may these figures suggest?
These figures may suggest a link between mental health problems and crime or they may indicate a link between imprisonment and mental health problems.
68
Overall, what may mental health problems mean for the costs of society?
Mental health problems may mean that social care costs increase. A person with a mental health condition may have a variety of needs to be met. In a welfare state such as the UK, this can result in increased spending in areas such as the health system, social housing, and benefit payments.
69
What is a misconception between depression and sadness?
Because depression is often linked with its main symptoms of sadness or low mood, many people are unsure of the difference between them.
70
What is sadness?
Sadness is a normal emotional reaction to certain situations or events, while depression occurs without any obvious trigger. Sadness may seem like it goes on for a long period of time, but is not a continuous feeling that lasts for weeks or months. Sadness hurts and is unpleasant, but it is normal and it does not last.
71
What is depression then?
Depression affects every part of our daily lives and often does not fet better without medical or therapeutic treatment.
72
What are the two types of depression?
- Unipolar depression.
- Bipolar depression.
73
What is unipolar depression?
A mood disorder that causes an individual to feel constantly sad, to lose interest and enjoyment, and to have reduced energy and activity levels.
74
What is unipolar depression also known as?
Clinical depression or depression.
75
What do people with depression generally suffer from?
They have a continuous low mood, and loss of enjoyment and energy.
76
What is a characteristic of unipolar depression?
Those suffering from it only experience a change of mood in one direction.
77
What is bipolar depression?
A mood disorder that causes an individual's mood, energy, and activity levels to change from one mood to another.
78
What do people with bipolar depression generally suffer from?
As well as having depressive type symptoms such as low mood, people with bipolar disorder also have high moods known as mania.
79
What happens during a manic episode?
During a manic episode, people may have increased energy and feelings of extreme excitement. They may be unable to sleep, be more talkative, and may do risky or extreme things.
80
What is a characteristic of bipolar depression?
Someone with bipolar depression experiences two types of mood change.
81
Who can give formal diagnosis of depression?
Only a doctor.
82
How do doctors diagnose depression?
Doctors ask a number of standard questions based around the diagnostic criteria set out in the ICD-10 and DSM-5.
83
What do doctors do because some medical conditions also have similar symptoms to depression?
A doctor may also do a physical examination as well as blood and urine tests.
84
What gives a number of possible symptoms for depression?
The ICD-10.
85
What does the number and severity of the symptoms an individual experiences determine?
Whether a depressive episode is considered to be mild, moderate, or severe.
86
What is very important to note about the length of the symptoms?
Symptoms would generally need to be continuously present for at least two weeks for a diagnosis of depression.
87
What are the symptoms given in the ICD-10 for a depressive episode?
- Low mood.
- Reduced energy and activity levels.
- Changes to sleep pattern.
- Changes to appetite levels.
- Decreased self-confidence.
- Lack of interest and enjoyment.
- Reduced concentration and focus.
- Feelings of guilt and worthlessness.
- Negative thoughts about the future,
- Suicidal thoughts.
88
What are the three theories that explain the cause of depression?
- Biological.
- Psychological.
- Social.
89
Which two theories will we look in depth at?
- Biological.
- Psychological.
90
What is the biological explanation for depression?
The influence of nature.
91
What is nature?
It is the idea that our characteristics and behaviors are inherited.
92
So, what is suggested by this theory when it comes to depression's cause?
It is suggested that whether an individual will suffer from depression is predetermined by their genes and biology.
93
Bearing that in mind, what is one biological explanation for depression then?
It is that depression can be caused by an imbalance of neurotransmitters (chemicals).
94
How does the brain use neurotransmitters?
The brain uses these chemicals to communicate with itself and with the nervous system and the body. These chemical messages are received and sent by the brain's neurons (nerve cells). Neurons are constantly communicating with each other using neurotransmitters, and this communication is very important for the brain to function properly.
95
What are the two main neurotransmitters linked with depression?
- Serotonin.
- Norepinephrine.
96
What does serotonin do?
Serotonin helps to control biological functions like sleep patters, aggression levels, appetite, and mood.
97
How did researchers investigate the link between serotonin and depression?
Researchers used PET scans to study the brains' of depressed people and compared them to the brain of people who were not depressed. They measured levels of a serotonin receptor and found less in the brains of the depressed people, especially in the hippocampus.
98
What is the hippocampus?
The hippocampus is part of the temporal lobe and it is involved in storing our memories and connecting them to our emotions.
99
What have MRI scans also found out about the hippocampus?
MRI scans have also found that people who are de[ressed have a smaller hippocampus.
100
What does norepinephrine do?
It gets the brain and beady ready for action and high levels are released during the fight or flight response.
101
What have autopsy studies revealed about norepinephrine?
Autopsy studies of people who have had many depressive episodes have found that they have fewer neurons that release norepinephrine.
102
What has other research found in terms of norepinephrine and serotonin levels? (Their correlation)
Other research has found that in some people, low levels of serotonin may cause a decrease in norepinephrine levels.
103
What is important to consider when thinking about the biological explanation for depression?
Although research does suggest that neurotransmitters are somehow involved in depression, it is very difficult to actually measure the levels of chemicals in the brain. The brain is also very complex and there are many chemical reactions that affect your mood in some way.
104
Bearing that in mind, what is the conclusion that we could draw from the biological explanation for depression?
Therefore, it is unlikely that an imbalance of one neurotransmitter completely explains why depression occurs.
105
What is the psychological explanation for depression?
The influence of nurture.
106
What is nurture?
The idea that our characteristics and behaviour are affected by our environment.
107
What is cognitive theory?
It is a psychological approach that believes our thought processes affect our behaviour.
108
What are our behaviours and emotions affected by, according to cognitive theory?
Behaviours and emotions are influenced by the way people explain things that happen to them and the views that they have about themselves and the world.
109
What affects the way we think about things?
The schema we have of ourselves, and the world around us.
110
What are schemas based on?
Schemas are based on our previous experiences and are developed and changed to fit with new experiences and information.
111
What type of schemas have been linked to depression?
Negative schemas.
112
What are negative schemas?
A biased, cognitive model of people, objects, or situations, based on previous information and experience that directs us to perceive, organise or understand new information by focusing on what is bad.
113
What may cause negative schemas to be created?
Traumatic events in childhood may cause negative schemas to be created.
114
What do these events and negative schemas mean about how we perceive things?
These schemas mean that people view themselves and the world in a negative way.
115
What can people with negative schemas do?
They can make errors in their thinking.
116
What is an example of a thinking error?
If we were called into the principles office. One error would be believing we are going to get into trouble even though we know we have not done anything wrong. We might exaggerate how bad things will get, such as believing that we will be permanently excluded from school. We might even ignore the fact that our psychology teacher had told us we might get a headteacher's award for our class project.
117
What has also been linked to depression?
Attributions.
118
What are attributions?
The ways people explain situations and behaviour.
119
What are the two dimensions of attributions?
- Internal-external.
- Stable-unstable.
120
What is internal attribution?
People explain situations or behaviours as being caused by dispositional factors , such as personality or ability.
121
What is external attribution?
People explain situations or behaviours as being caused by situational factors, such as the economy or the weather.
122
What are stable attributions?
They explain situations or behaviours as being caused by factors that do not change, such as gender.
123
What are unstable attributions?
They explain situations or behaviours as being caused by factors that are only temporary, such as tiredness.
124
What is an example of an internal and stable scenario?
Someone who fails a psychology test, and believes it is because they are not clever enough and that they cannot do anything about this, explains the failed test as internal and stable.
125
What is an example of an external and unstable scenario?
But someone who fails the test and believes it is because they did not do enough revision because their dog was ill, explains the failed test as external and unstable.
126
What are the attributions usually made by people with depression?
Internal and stable.
127
So, what is said about people whose attributions are external and unstable?
They will see bad things as being cause by factors beyond their control and only temporary. They are less likely to be depressed.
128
What are antidepressants?
They are a type of medication used to treat depression.
129
How do antidepressants work?
They work by increasing the levels of neurotransmitters such as serotonin and noradrenaline.
130
Is there a wide range of antidepressants?
Yes, there are almost 30 different kinds of antidepressants.
131
What are the most commonly prescribed antidepressants in the UK?
They are Selective Serotonin Reuptake Inhibitors (SSRI's).
132
What do SSRI's do?
They stop the reuptake of serotonin.
133
What is reuptake?
After a neurotransmitter has communicated its message to the neurons, the message needs to be prevented from being constantly communicated. To do this, the neuron reabsorbs the neurotransmitter it released.
134
Why is stopping re-uptake effective?
Stopping it increases the levels of the neurotransmitter, which may reduce the effects of depression.
135
When did antidepressants become available?
In the 1950's and have been increasingly prescribed since then.
136
What is the trend between antidepressant prescriptions between 2000 and 2010?
Statistics show that the use of antidepressants in Europe increased by 20% each year between 2000 and 2010.
137
Which nation has the fourth highest level of antidepressant use in Europe, with more than 50 million prescriptions being written every year?
The UK.
138
What is an issue with antidepressants?
Despite the large number of people using antidepressants, there is some uncertainty as to how effective they actually are.
139
Why are people uncertain about them?
Although many people experience some improvement as a result of taking anti-depressants, especially in cases of severe depression, the research suggests that they may not be as effective for mild depression.
140
What did the Royal College of Psychiatrists say on the topic of anti-depressants and their effectiveness?
They say that 50-60 % of people with depression will improve as a result of taking antidepressants. However, 25 to 30 % of people will also improve when they take a fake pill, or placebo.
141
So what have researchers concluded in terms of the effectiveness of anti-depressants?
Research into the effectiveness of treating depressed children and adolescents with antidepressants concluded that almost all antidepressants have a very similar effect to that seen when a placebo is taken.
142
What are some side effects of antidepressants?
- Weight gain.
- Insomnia.
- Dry mouth.
- Induced aggression.
- Suicidal thoughts.
143
What is cognitive behavioural therapy?
It is a talking therapy that can help you manage your problems and emotions by changing the way you think and behave.
144
What is CBT based on?
Cognitive theory and the idea that our thought processes affect our behaviour and that behaviours and emotions are influenced by our thinking.
145
What is special about CBT?
Unlike some talking therapies, CBT focuses on 'here and now' problems instead of looking at ones from the past.
146
How can CBT sessions be delivered?
By a therapist one-to-one or in group sessions. Research has shown positive results for the use of CBT to treat depression.
147
What are the two perspectives?
- Reductionist.
- Holistic.
148
What is reductionist?
Understanding complex things like human behaviour by simplifying it to its most fundamental and basic parts.
149
What explanations are reductionist?
The biological explanation of mental health problems like depression can be considered to be reductionist. The biological explanation views depression as having a biological cause and as being treatable with drugs such as anti-depressants.
150
What is holistic?
The view that the parts of something are all connected and understandable only by studying things as a whole.
151
What is considered to be holistic?
Mental health problems like depression are often explained as a complex mix of biological, psychological, and social facors.
152
What is considered to be a holistic treatment approach to depression?
This kind of treatment is likely to involve a blend of medication, therapy, and positive lifestyle changes, such as increasing exercise levels.
153
What kind of approach does CBT take?
Reductionist.
154
Why is CBT reductionist?
Firstly it only looks at 'here and now' problems instead of looking at those from the past; this may mean that not all relevant psychological factors are being dealt with.
Secondly, CBT only considers an individual's thinking and does not look at biological or social factors.
155
What is the Aim of Wiles' effectiveness of CBT study?
To investigate the effectiveness of CBT in treating depressed people who have not improved after taking medication.
156
What is the study type of Wiles' effectiveness of CBT study?
Longitudinal field experiment carried out in the real-life environment of the participants. The researcher still manipulates the independent variable, but there is limited control of extraneous variables. Participants were living in the UK, aged between 18 and 75 years and had been taking antidepressants for at least 6 weeks with little or no improvement.
157
What is the method of Wiles' effectiveness of CBT study?
Participants were randomly allocated into two groups. A total of 234 participants were allocated to have CBT as well as antidepressants and other normal medical care for depressed patients. A control group of 235 participants were allocated and continued to take antidepressants and have normal medical care for depression.
Participants in the CBT group had 12, individual, one-hour sessions of CBT with a trained therapist. Participants were followed up regularly.
158
What are the results of Wiles' effectiveness of CBT study?
After six months, 90 per cent of participants were able to be followed up. At this point in the study, 46 per cent of the group having CBT showed a notable improvement in symptoms compared with 22 per cent of the control group. At 12 months, the perceived improvements to quality of life were found to be greater for the participants who had taken part in CBT sessions.
159
What is the conclusion of Wiles' effectiveness of CBT study?
When used in addition to antidepressants and other normal medical care, CBT is an effective way of reducing the symptoms of depression in people who do not respond to antidepressants on their own.
160
What are the advantages of Wiles' effectiveness of CBT study?
It showed that CBT could be an effective way of reducing the symptoms of depression in people who are not responding to antidepressants.
161
What are the disadvantages of Wiles' effectiveness of CBT study?
- Although nearly half of those in the group having showed a notable improvement in symptoms, 54 per cent of participants did not.
- This was a longitudinal study that took place over the period of a year. This makes it less likely that participants will complete the entire study. In this study, 32 percent of participants did not attend all 12 sessions of CBT. However, longitudinal studies are positive because they show changes and effects over time.
- A field experiment happens in a real-life environment in which it is not possible for researchers to control extraneous variables. However, in this study there were controls put in place to ensure that participant variables were limited. People who had bipolar disorder or substance addiction were not able to participate. People who were currently having CBT or counselling for their depression or who had previously had CBT were also not able to participate.
- Requiring depressed participants to not receive appropriate care in order to be in a research study would go against the ethical consideration of responsibility and is a limitation of research in this area. However, researchers in this study treated participants ethically by ensuring that all participants were able to continue with their usual medical care.
162
What was the support for Wiles' findings?
In another study, participants either took antidepressants, a placebo, or had CBT.
163
What happened to those who's symptoms improved after four months of taking medication?
Either kept taking the medication or began taking a placebo.
164
What happened to those who improved after having CBT?
They were stopped from having regular sessions and were only allowed three follow-up sessions.
165
What happened to the participants who were given a placebo?
Of the participants given a placebo, 76% had their symptoms return.
166
What happened to the participants who had CBT?
Only 31% of the participants who had CBT had their symptoms return.
167
What did this additional research show?
That CBT can have a positive and lasting effect in treating people with depression. However, research also shows that antidepressants do help many people, especially those with more severe depression.
168
What would the researchers have to do in order to treat participants' ethically?
It is important that they are fully informed and this would mean explaining any risks involved with taking a placebo rather than an antidepressant.
169
What could raise questions about the ethicalness of the additional research?
Giving participants a fake pill could be considered to be deception.
170
How can we avoid this deception?
If participants are informed that they may be given a placebo and consent to this, it would become acceptable. In order to be responsible and to protect participants from harm, they would need to be monitored in case their symptoms became worse and they were at risk of harming themselves.
171
What did Wiles' study allow all participants to do?
To continue normal medical care and this avoided any ethical issues around the use of placebos.
172
What is the case for substances?
Some substances are more addictive than others and some are more harmful than others, but they can all be misused and abused.
173
What is substance misuse?
Using a substance for purposes, or in amounts, that may be harmful and that is different to the reccommended pattern of use.
174
What is an example of misuse of medication or alcohol?
A misuse of medication would include not following the doctor's instructions, such as taking more painkillers than the prescribed dose to stop a toothache.
Misuse of alcohol is drinking more than the recommended limits, such as drinking more than 14 units in a week.
175
What can substance misuse leaf to?
- Substance abuse.
- Addiction.
176
What is substance abuse?
It is using a substance in a way that is harmful or dangerous, often because of a consistent pattern of use.
177
What happens to people around those who substance abuse?
Substance abuse often affects other people as well, such as family members.
178
Why does substance abuse also affect others?
Individuals who abuse substances often do so in order to experience an altered state or to help them deal with difficult emotions.
179
What does the abuse of substances usually lead to?
Side effects, including dependency and addiction.
180
What is addiction?
Repeated use of a substance resulting in an individual becoming entirely focused on the substance, which they need to have regularly in order to avoid withdrawal symptoms.
181
Are addiction and dependence the same?
No.
182
What is dependence?
Repeated use of a substance results in an individual's brain and body only functioning normally when a substance is present; when the substance is not present, withdrawal symptoms occur.
183
What kind of effect is dependence and what is it caused by?
It is a biological effect caused by repeated use of a substance.
184
What happens if the substance is not present when those are dependent on it?
If the substance is not present, the person will experience withdrawal symptoms. Withdrawal symptoms include headaches, irritability, nausea, anxiety, tiredness, and trouble sleeping.
185
What kind of effect is addictions?
Addiction has biological and behavioural effects.
186
What does continued substance abuse cause?
Biochemical changes in the brain as well as noticeable changes to behaviour.
187
What becomes the main focus of the addict?
Substance use, regardless of the harm they may cause to themselves or others.
188
How can addicts avoid withdrawal symptoms?
Addicts need to 'use' regularly in order to avoid withdrawal symptoms.
189
So, what is the correlation between addiction and dependence?
It is possible to be dependent without being addicted, but the two are very closely linked.
190
What is the medical term for addiction?
Dependence syndrome.
191
How does the ICD-10 describe addiction?
It describes it as when using a substance becomes more important than other behaviours and there is a strong and overwhelming need to take a substance.
192
What kind of criteria for diagnosis does the ICD-10 set out?
The ICD-10 sets out criteria for diagnosis as being the occurrence of three or more symptoms present together within the past year.
193
What are the symptoms given in the ICD-10 for dependence syndrome?
- A strong desire to use a substance despite harmful consequences.
- Difficulty in controlling use.
- A higher priority given to the substance than to other activities or obligations.
- Experiencing withdrawal symptoms when substance use is reduced or stopped.
- Increased tolerance to a substance which means that increasingly larger amounts are needed in order for the same effects to be experienced.
194
What substances may dependence syndrome be for?
Dependence syndrome may be for one substance, for a group of substances (such as opioid drugs like codeine and morphine), or for a variety of substances (such as alcohol or cannabis).
195
What are some theories for addiction causes?
- Biological.
- Psychological.
- Cultural.
- Social.
- Environmental.
196
Which of these two theories for addiction causes will we focus on?
- Biological.
- Psychological.
197
What is the biological explanation for addiction?
The influence of nature.
198
What does the biological explanation outline?
Some people may inherit a genetic vulnerability towards addiction.
199
What is genetic vulnerability?
A biological susceptibility towards developing certain conditions or disorders when other influencing elements are also present.
200
What does this genetic vulnerability mean?
It means that some people are more likely than others to become addicted to the substances they try because of the influence of nature. However other factors, such as environment, are also involved.
201
How do we know that there is a genetic vulnerability towards alcohol?
It cam from Kaij's twin study of alcohol abuse.
202
What do twin and adoption studies generally suggest?
That addiction to tobacco, alcohol, and illegal drugs all have a hereditary element.
203
What does hereditary mean?
Being transferred from parent to child through their genes.
204
What is the correlation between environmental and hereditary factors, found by researchers?
Research suggests that environmental factors have a greater effect on someone starting to use a substance, and hereditary factors have a greater effect on an individual's likelihood of moving from regular user to addict.
205
Why is the biological explanation not completely accurate?
Modern research methods and greater knowledge of DNA have allowed exact genes to be identified for many disorders and conditions, but although some progress has been made towards identifying the genes involved with addiction, there are though to be hundreds, possibly thousands, of genetic variations involved.
206
What is the psychological explanation for addiction?
The influence of nurture.
207
What does the influence of nurture outline?
Environmental conditions, part of the influence of nurture, are also thought to be a key explanation for addiction.
208
Why do we change our behaviour, according to psychologists?
Psychologists studying social influence and conformity have found that we change our behaviour as a result of social pressure. We do this in order to avoid rejection and to feel that we are part of a group.
209
What has research found about age and conformity?
Research shows that age is a factor affecting conformity and that young people are more likely to conform.
210
What is a report collected by the National Institute on Drug Abuse that highlights the existence of this correlation?
They found that 90% of cigarette users in the United States started smoking when they were teenagers. Most of them believe that they were strongly influenced by seeing others, such as their friends, smoking.
211
What has also been found to be a strong factor in the use of drugs during teenage years?
Peer influence.
212
What is a peer?
Someone who is from the same social group, or who is the same age or social status, or has the same background, abilities or qualifications, as someone else.
213
What did the study on peer influence reveal?
That individuals whose friends used drugs were more likely to start to use drugs. However, they also found that family members' attitudes towards drug use was an important fator,
214
How was peer influence also a positive thing?
Another study found that teenagers are also influenced by peers to not use substances. Researchers found that teenagers were influenced by the anti-alcohol views of. others, especially when the individual expressing these views was seen as popular amongst their peer group.
215
What does the theory that peer influence may affect the development of an addiction?
It does not take into consideration that people generally choose the groups they want to be part of. Our thoughts and views on substance use are also likely to have an effect on the peer groups we join.
216
What is the conclusion for the psychological explanation for addiction?
While peer influence may affect how likely someone is to start using substances, substance abuse and addiction may also be affected by genetics, mental health problems, personality, social and cultural norms, environment and experiences of trauma.
217
What was the aim of Kaij's alcohol abuse in twins study?
To see if hereditary factors influence the development of alcohol addiction.
218
What was the study type of Kaij's alcohol abuse in twins study?
Case study using a variety of methods, including questionnaires and interviews of the twins and other family members, and some psychological testing. Information from birth records and a public register of alcohol abusers was used to identify participants. There were 174 pairs of participants. 48 pairs were monozygotic (identical) twins and 126 pairs were dizygotic (non-identical) twins. All of the participants were male and they were all born in Southern Sweden after 1880.
219
What was the method of Kaij's alcohol abuse in twins study?
Using the information from the public register of alcohol abusers, and the information from the questionnaires and interviews, Kaij categorised each twin depending on their level of alcohol use. There were five categories ranging from not drinking at all to being a chronic alcoholic.
220
What were the results of Kaij's alcohol abuse in twins study?
Kaij found that 54 per cent of identical twins were in the same category of alcohol use but that only 28 per cent of non-identical twins were in the same category of alcohol use. He also found that as the level of alcohol use increased, there was a higher concordance rate for identical twins, with 72 per cent of chronic alcoholic twins being in the same category as their co-twin.
221
What was the conclusion of Kaij's alcohol abuse in twins study?
Kaij concluded that there are hereditary factors involved in the levels of alcohol usage and in alcohol addiction.
222
What are some advantages of Kaij's alcohol abuse in twins study?
It provides evidence that suggests some hereditary factors are involved in the levels of alcohol usage and in alcohol addiction.
223
What are some disadvantages of Kaij's alcohol abuse in twins study?
- The information on alcohol use was provided by the participant and other family members. This type of self-report method is subjective and there are many reasons why the information provided may not be accurate. These include lying about the level of alcohol consumed in order to give a sociably desirable answer.
- The study only looked at rates of alcohol abuse. Therefore, the findings cannot be generalised to include addiction to other substances.
- The sample is limited because all of the participants were twins, male, and Swedish. This means that the findings are not representative of people who are female or who are not twins or Swedish. The participants were also twins where at least one of them was publically known to abuse alcohol. Therefore, the results are not representative of those who abused alcohol but did so in private.
- Identical twins are often treated the same so it may be environment (nurture) and not genetics (nature) that was the cause of the similar levels of alcohol use.
- 46 per cent of the identical twins were not in the same category as their co-twin for alcohol use, which suggests factors other than genetic must also be involved.
- The numbers of identical twin pairs is a lot lower than for non-identical twins. There was also a very small number of identical twins who were categorised as chronic alcoholics. This decreases the validity of the conclusions drawn from these results.
224
What has other research revealed in relation to Kaij's alcohol abuse in twins study?
Research since Kaij's study has consistently shown that there are hereditary factors involved in the development of alcoholism in males.
While there is some evidence that alcoholism in women may also have a genetic element, the findings are not as strong.
225
What were the results found in these studies?
Studies suggest that around 20 to 25 per cent of male siblings and male children of alcoholics also become alcoholics. This is compared to only 5 per cent of female siblings and female children.
226
What was one type of research conducted in these studies?
In one study, pairs of twins were identified from hospital admissions information. While 30 per cent of participants were identical twins, the rest were non-identical twins, evenly split between same-sex and opposite-sex pairs.
227
What was concluded from that research?
Investigations showed that levels of drug use were fairly similar for identical twins of both genders and same-sex non-identical male twins, but far less similar for female non-identical twins.
228
What were the likely reasons for the gender differences seen in substance use and addiction are complex?
It is likely that the reasons for the gender differences seen in substance use and addiction are complex and suggest that genetic vulnerability and peer influence are just two of the factors involved.
229
What are the other factors involved?
Other factors include cultural and social norms, and personality type.
230
What is an example of these two factors coming in to play?
Women are twice as likely to be prescribed antidepressants as men and are far more likely to
seek therapy or counselling. It may be that cultural and social norms influence gender choices when dealing with emotional and psychological distress.
231
What link has been found between personality type and substance abuse?
A certain personality type has been shown to be more likely to abuse substances. For example, anti-social personality disorder (ASD) is more commonly found in males, and people with ASD are at risk of substance abuse and addiction.
232
What is aversion therapy?
A treatment to help individuals stop unwanted behaviours such as substance addiction; the individual experiences some form of unpleasantness when carrying out the unwanted behaviour.
233
Why does aversion therapy work?
This unpleasantness results in them learning to connect the behaviour with unpleasant feelings rather than with the previously enjoyable feelings such as 'being high'.
234
What is the usual form of aversion therapy used to treat addicts?
The form of aversion therapy used to treat addicts generally involves the individual taking medication or a substance that causes an unpleasant reaction when drugs, tobacco, or alcohol are used. This is usually an emetic, which is a medicine that causes vomiting.
235
What is the emetic usually given to alcoholics?
Disulfiram (also known as antabuse).
236
How would the emetic work for alcoholics?
Drinking even small amounts of alcohol while using this medication will result in instant and severe hangover-type symptoms.
237
What other type of aversion therapy is used?
Electrical aversion therapy.
238
What is electrical aversion therapy?
It is a safe but painful electric shock is given to the individual while they carry out the behaviour they wish to stop.
239
Is aversion therapy effective?
Research shows that aversion therapy is successful in treating addictions, however the research also suggests that the effects tend to be short-term.
240
When is aversion therapy seen to be the most effective and long-lasting?
When individuals also receive other support, such as attending counselling or self-management programmes.
241
What are self-management programmes?
An intervention designed to support and empower individuals so that they can take responsibility for their own choices and behaviour.
242
What are some other issues about aversion therapy?
Other issues with aversion therapy include the fact that it is a very unpleasant treatment to experience and this means that there is quite a high dropout rate. The unpleasant nature of the treatment also raises ethical concerns and it is important that the process is fully explained and consented to.
243
What kind of approach is aversion therapy?
A reductionist approach.
244
Why is aversion therapy a reductionist approach?
Aversion therapy is a reductionist approach because it only deals with an individual's learned desire to use a substance and does not look at other factors involved in addiction, such as biological, environmental, or social factors. Aversion therapy also focuses on the 'here and now' problem and does not look at problems from the past, which may have originally influenced the individual to start using substances.
245
What do self-management programmes provide?
Peer support, accountability, and opportunities to develop self-awareness.
246
Who monitors self-management programmes?
Groups may have a psychologist, therapist, or experience group member as a facilitator.
247
Why are self-management programmes effective?
Self-help groups are groups of people with a common problem. By sharing their experiences with others, they learnt that they are not alone.
248
How do individuals in self-management programmes help eachother?
The more experience members of the group can also provide an example to newer members. Both of these elements can be very important for someone who has felt hopeless and alone in their struggle with addiction.
249
What are the most known 12-step recovery programmes for addiction?
Alcoholics Anonymous (AA) and Narcotics Anonymous are two of the best-known 12-step recovery programmes for addiction.
250
What do these recovery programmes provide?
These 12-step programmes provide addicts with guidelines for moving towards, and remaining in, recovery.
251
What do these programmes consist of?
The 12 steps have a strong spiritual element, but they allow for a personal understanding of God rather than any set religious belief
252
What has research found out about those who have no belief in God at all in these 12-step programmes?
They are less likely to continue to attend meetings.
253
So, what is the other option for these people?
There are also non-religious 12-step programmes available.
254
Why are studies into the effectiveness of these groups difficult?
Studies into the effectiveness of self-management programmes are difficult because of the need to allow group members complete anonymity, and the fact that control groups cannot be used for ethical and methodological reasons.
255
What has research that has been carried out on these groups state?
Research that has been carried out suggests that these programmes have a similar success rate to other available treatments, and that they are most successful in helping those who attend regularly and for a longer period of time.
256
What approach do self management programmes have?
Holistic.
257
Why do self management programmes have a holistic approach?
They help people deal with their desire to use a substance as well as looking at other factors involved in addiction, such as environmental or social factors.
They also provide opportunities for individuals to look at and deal with issues from their past, present, and future.
258
259
