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Exam 3: anxiety > substance abuse > Flashcards

substance abuse Flashcards

1
Q

is substance abuse higher in bipolar or depression?

A

bipolar

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2
Q

dual diagnosis:

A

individual who has both mental disorder and substance use disorder

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3
Q

What does having dual diagnosis mean?

A

greater severity of illness, worse course of illness, greater difficulties in overall functioning, poorer treatment response

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4
Q

Secondary psychiatric disorder model:

A

incidence of SUD increases risk for mood disorder

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5
Q

secondary substance abuse model:

A

incidence of mood disorder increases risk for SUD

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6
Q

Bidirectional model:

A

each disorder involve separate etiologies, but exacerbate each other

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7
Q

Third variable or common factor models:

A

shared mechanisms for development of both disorders

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8
Q

criteria of substance use disorder, manifested by at least 2 of the following:

A

-increased drug taking
-unsuccessful efforts to cut down
-a great deal of time spent obtaining, using, recovering from the drug
-craving to use
-social activities reduced due to drug use
-physically hazardous use
-tolerance (increased dose to achieve desire effect)
-withdrawal

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9
Q

Categories of this disorder depend on:

A

categories for type of drug, intoxication, or withdrawal. e.g. categories for opioids: opioid use disorder

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10
Q

Specifiers for SUD:

A

mild (2-3 symptoms), moderate (4-5 symptoms), severe (6 or more symptoms)

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11
Q

what is addiction?

A

a primary chronic disease of brain reward, motivation, memory and related circuitry

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12
Q

addiction is characterized by these 4 things:

A
  1. inability to consistently abstain from use
  2. impairment in behavioral control and craving
  3. diminished recognition of significant problems with ones behaviors and interpersonal relationships
  4. dysfunctional emotional response
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13
Q

how many shifts are there as addiction progresses?

A

2 shifts

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14
Q

what are the 2 shifts?

A
  1. shift from positive reinforcement to negative reinforcement
  2. shift from impulsivity to compulsivity
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15
Q

what is the positive reinforcement in addiction progresses?

A

addition of a reinforcing stimulus, I take the drug because it makes me feel good

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16
Q

what is the negative reinforcement in addiction progresses?

A

removal of an aversive stimulus; I take the drug so I dont feel bad anymore

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17
Q

what system do drugs impinge on to cause rapid drug addiction increases?

A

mesocorticolimbic dopamine system, Ventral segmental area to nucleus accumbens

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18
Q

dopamine is involved in:

A

motivation and learning

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19
Q

drug addiction biological frameworks:

A

binge/intoxication
withdrawal
preoccupation/anticipation

20
Q

binge/intoxication stage:

A

habits, goal directed action, reward seeking e.g feeling euphoric, feeling good, escaping dysphoria

21
Q

withdrawal stage:

A

dysphoric, negative emotional states, irritability, stress, anxiety

22
Q

preoccupation/anticipation

A

craving, decision-making, self-regulation (inability to resist strong urges), memory impairments

23
Q

addiction 2 diathesis components:

A
  1. addiction has a heritable component of this disease (40-60% of addiction risk is due to genes)
  2. early life experiences/environment can affect vulnerability
24
Q

twin studies in addiction:

A

higher rate of shared substance use disorder observed in monozygotic twins than between dizygotic twins

25
Q

adoption studies in addiction:

A

higher rate of shared substance use disorder observed in adoptees who’s biological parents had history of substance abuse

26
Q

diagnostic confounding:

A

overlapping of symptoms of addiction and mood disorders can confuse the diagnostic process and lead to misdiagnosis. drug abuse symptoms/states can mimic mood disorder symptoms

27
Q

symptoms in mood disorder and drug addiction comoribity:

A

euphoria, increased energy, decreased appetite, paranoia, grandiosity, anhedonia, depressed moos, suicidal ideation, apathy, lack of concentration, restlessness, agitation

28
Q

a substance abusing patient who exhibits symptoms of a mood disorder could be exhibiting:

A

substance induced mood disorder

29
Q

substance induced bipolar:

A

disturbance in mood developed during or soon after substance use that is characterized by elevated, expansive or irritable mood with or without depressed mood/ or markedly diminished interest or pleasure in all, or almost all, activities

30
Q

evidence that it is substance induced bipolar:

A

symptoms developed during or soon after substance intoxication or withdrawal or after exposure to a medication and substance/medication is capable of producing the indicated symptoms

31
Q

evidence of an independent mood disorder could include:

A

the symptoms precede the onset of the substance/medication use and the symptoms persist for a substantial period of time (e.g one month)

32
Q

what to specify in substance induced bipolar:

A
  1. onset during intoxication
  2. onset during withdrawal
33
Q

disorder fostering disorder/kindling hypothesis:

A

one disorder may sensitize the brain to make individuals more vulnerable for another disorder when a potential stressor occurs

34
Q

self-medication:

A

treat symptoms via drugs of abuse to relieve distress/suffering/emotions (drugs used to cope)

35
Q

are there medications developed to treat dual diagnosis?

A

no

36
Q

what is the strategy for medication for comorbid treatments?

A

wait to start medication until after detox/withdrawal ends

37
Q

integrated group therapy:

A

form of CBT specifically designed to treat dual diagnosis of bipolar and substance use disorder

38
Q

central theme of integrated group therapy

A

rather than viewing the patient as having two distinct disorders, the patient/therapist should view it as having a single disorder, “bipolar substance abuse”

39
Q

goal of integrated group therapy:

A

treat both disorders with equal weight to the point that its viewed as one disorder and understand the relationships between the 2

40
Q

integrated group therapy steps:

A

starts with a check in (did you use any drugs this week? how was your overall mood?) then analogous relapse and recovery thoughts

41
Q

combination therapies:

A

relative treatment efficacy when combining psychosocial treatments usually with CBT

42
Q

motivational interviewing plus cbt:

A

shifts clinical from authoritarian stance to empathetic/collaborative approach to elicit patients’ point of view1

43
Q

contingency management plus cbt:

A

uses tangible incentives/rewards to encourage sobriety

44
Q

dual recovery therapy:

A

integrates relapse prevention therapy, motivational enhancement therapy, and aspects of the 12 step program

45
Q

relapse prevention therapy:

A

form of cbt used to anticipate/cope with triggering situations that may cause relapse

Exam 3: anxiety (4 decks)

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