Substance Abuse and Gambling Flashcards
The DSM states that addiction is when the reward seeking behaviour is ____ ___ _____, evidence by attempts to ____ which are unsuccessful. Further, large ____ are consumed over a ______ period than intended. It may lead the individual to be in _______ situations. ______ is usually observed, where greater and greater amounts of the drug are needed for the _____ effect
out of control cease large longer dangerous tolerance desired
Addiction is defined as a primary _______ of brain _______, motivation, memory, with potential for _______ and _______. Physical and psychological dependence results in ______, cravings/urges and _______ symptoms
disease reward relapse recovery tolerance withdrawal
The dominant framework for addiction is the __________ model
biopsychosocial
Some neurobiological antecedents are seen, such as _____, and reward _______. These combine with psychosocial and environmental factors, such as social _______, lifestyle, _______, and _______ escape, to lead an individual to be __________. The individual is exposed to the substance, and they undergo a _____ shift, where the substance becomes the ________. They then repeatedly use.
genetics sensitivity learning poverty emotional vulnerable subjective solution
The medical disease model of addiction states that addiction is a _______ which can be _____. It suggests control over _____ is impaired due to effects on the brains _______ systems. There is substantial evidence for this, however critics say that this absolves the individual of _____, and ignores ______ factors
disease cured urges/cravings reward responsibility societal
Prolonged exposure to a drug means there is more of the drug in the synaptic cleft. The brain, to maintain ________, causes a _______ of receptors
homeostasis
downregulation
Describe the I-RISA model and how this reinforces the medical model
Drug addiction mediated by functional and structural brain changes.
mesolimbic system - emotion and motivation - reinforcement, memory, conditioning - amygdala, hippocampus
mesocortical system - conscious experience - salience - expectation - cravings - inhibitory control of decision making - pFC - oFC
Soloman and Corbit’s tolerance model states that…
the “high” process from a substance will be counteracted with a “low” process. When someone is addicted the a processes decreases but the b process increases with each exposure…this accounts for the withdrawal symptoms seen, and more and more desire for the drug to give you that “high”. Motivation for the drug is more related to counteracting the withdrawal symptoms than for pleasure.
What are the four clusters of behaviour involved in addiction?
Intoxication/excitement - high DA, incr. activation of reward circuits
Craving - classical and operant association of cues - memory consolidated
Compulsive use - continued use when no longer pleasurable
Withdrawal - dysphoria, anhedonia, irritability
The addiction as a choice model sees addiction as a _______ behaviour under ______ control. They see the urges are _____ to resist, but possible. The desire/urge _____ a particular choice, impairing _______. There are a loss of normal capabilities for ______ self-control. Evidence for this is that ____% of addicts stop cold-turkey. And cravings are significantly reduced on _____ flights
voluntary conscious difficult coerces control rational 70 long
The addiction as a choice model emphasises the perceived benefits over perceived costs rationale, and a tension reduction model which somewhat supports this. Explain both of these
When an individual is faced with an opportunity, they weigh up perceived benefits over perceived costs, and these are balanced against each other. The pierced benefits is related to the individuals urges for the substance and the perceived costs is related to their self- control. Both of these and the amount they influence the individuals behaviour, leads to addictive behaviour. They see the perceived costs are less than the perceived benefits.
The tension reduction model feeds into this, as it states that an individual uses a substance to modify their mood and it becomes salient in their lives.
- increase pleasure or decrease tension
- the craving overtakes any other natural reward they may use
- emotional escape - depression, anxiety, low self-esteem
No single treatment is sufficient for addiction, as it has to address many psychological, medical and social factors. What are the treatment targets for addiction?
- learning based approaches - change bx patterns - identify high-risk situations and events - rehearse non-drug alternatives to cues
- target cognitions which enhance drug use - one drink won’t hurt me, etc
- emotion regulation skills - non-drug alternatives to coping with negative affect
What is the difference between problem gambling and pathological gambling?
problem gambling is when you have behavioural or social harm from excessive gambling, but pathological gambling is when you meet DSM criteria
Gambling Disorder Criterion A: 4+ of
- preoccupation - psychological dependence
- increased amount gambled (tolerance)
- Irritability and restlessness on cessation (withdrawal)
- escape from stress (negative rft and motivation)
- Chasing losses
- Lying
- Repeated failure to cease (impaired control)
- Risked significant relationships/jobs
- Bailout
–> illegal acts removed from DSM-5
Something which is an excessive behaviour is not necessarily addictive - shopping, eating, love, etc. Elaborate on this, what else needs to be there to make it an addiction?
Functional impairment involved
Stability of the behaviour - amount, control, which contexts does it apply
