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PSYC 100 - clinical > Substance Abuse reading > Flashcards

Substance Abuse reading Flashcards

1
Q

define substance related and addictive disorders

A

one of a range of probems associated with the use and abuse of drugs (alcohol, cocaine, heroine or other substances people use to alter the way they think, feel and behave). they are hugely costly to humans in financial terms

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2
Q

impulse control disorder

A

a disorder in which a person acts as on irresistible but potentially harmful impulses

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3
Q

polysubstance abuse

A

the use of multiple mind-behaviour altering substances such as drugs

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4
Q

define substance

A

chemical compound ingested to alter mood and behaviour

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5
Q

define psychoactive substances

A

substances such as ecstacy, that alter mood or behaviour

-safe drugs = no, nicotine, caffeine. greater mortality than all illegal combined

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6
Q

substance use

A

the ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational or occupational functioning

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7
Q

intoxication

A

a phsyiological reaction, such as impaired judgement and motor ability as well as mood changes reacting from the ingestion of a psychoactive substance

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8
Q

substance abuse

A

a pattern of psychoactive substance use leading to significant distress or impairment in social and occupational roles and in hazardous situations
DSM5 defines by how significnat interferes with life and not by amounts ingested

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9
Q

study of drug use and job outcomes

A

repeated hard drug (barbituates, amphetamines etc) use predicted poor job outcomes after college (with everything else controlled for)

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10
Q

how should we define addiction

A

a maladaptive pattern of substance use characterised by the need for increased amounts to achieve the desired effect when the substance is withdrawn, unsuccesful efforts to control its use and substantial effort expended to seek it or recover from it = addiction

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11
Q

tolerance

A

the need for increased amounts of a substance to achieve the desired effect, and a diminished effect without continued use of the same amount

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12
Q

withdrawal

A

a severly negative physiological reaction to removal of a psychoactive substance which can be alleviated by the same or similar substance
eg headache in the morning without caffeine
alcohol = delerium, hallucinations, body tremours
cocaine = anxiety, lack of motivation, boredom
LSD = severe physical
cannabis = nervousness, appetite change, sleep disturbance

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13
Q

drug seeking behaviours

A

measure of dependence

eg stealing, even standing outside in the cold, alone to smoke

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14
Q

how DSM5 describes substance abuse and addiction

A 
4 = abuse and dependence were different
5 = combined and described in terms of levels of severity
mild = 2 or 3 /11 symptoms
moderate = 4 or 5 /11 symptoms
severe = 6 or more /11 symptoms
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15
Q

why is use of substances dangerous full stop

A

we can use them and not abuse them but we do not know ahead of time who might lose control and abuse / dependence

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16
Q

can there be dependence but no abuse

A

yes

cancer patient dependent on morphine but not abusing it as manages their pain

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17
Q

diagnostic issues with sud

A

used to be part of other problems = sociopathic personality disturbances
sign of moral weakness
genetics and bio vulnerability was hardly acknowledged
researchers estimate 3/4 of those in treatment = an additional dis (mood, anxiety, PTSD)
=6 week rule

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18
Q

explain the six week rule

A

if symptoms appear during intoxication or within 6 weeks after withdrawal from drugs = not considered a separate disorder

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19
Q

how do we group drugs

A 
6 categories
depressant
stimulants
opiates
hallucinogens
other drugs
gambling
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20
Q

depressants

A

psychoactive substance that results in behavioural sedation eg alcohol, sedatives, hypnotic and anxiolytic drugs

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21
Q

stimulants

A

psychoactive substance that elevates mood, activity and altertness eg amphetamines, caffeine, cocaine and nicotine

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22
Q

opiates

A

addictive psychoactive substance (heroine, opium, morphine) that causes temporary euphoria and analgesia

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23
Q

hallucinogens

A

any psychoactive substance (LSD, mrijuana) that can produce delusions, hallucinations, paranoia and altered sensory perception

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24
Q

other drugs of abuse

A

other substances that are abused but do not fit neatly into one of the major drug categories (inhalants, steroids)

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25
Q

gambling disorder

A

unable to resist the urge to gamble = results in negative consequences

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26
Q

how depressents work

A

decrease CNS
reduce physiological arousal = relax
most likely to produce symptoms of physical dependence, tolerance and withdrawal

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27
Q

alcohol-related disorders

A

cognitive, bio, bahevioural andsocial processes associated with alcohol use and abuse

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28
Q

effects of alcohol when ingested on the body

A

esophagous
stomach (small amounts absorbed)
small intestine (easily absorbed)
blood = contact with all major organs
lumgs = vapourised and exhaled - how cops test
liver = broken down into CO2 and water by enzymes

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29
Q

effects of alcohol on the brain

A

number of neurotransmitter systems
GABA - inhibitory neurotransmitter
-interfers with firing of neurons attached
Cl- ions enter cell = less sensitive to the effects of other neurotransmitters
alcohol seems to reinforce cl- ion movement
=difficualt for neurons to communicate with one another
GABA pathway = why alcohol decreases anxiety
glutamate = excitatory
learning and memory
how alcohol effects our cognitive abilities
serotonin = mood, sleeping and eating
- overall many neurotransmitter systems with complex effects

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30
Q

withdrawal from chronic alcohol abuse

A

withdrawal delerium
the frighteneing hallucinations and body tremours that result when a heavy drinker withdraws from alcohol. also known as delerium tremes (DTs) - medical treatment can reduce

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31
Q

what effects the damage caused by alcohol

A

genetic vulnerability
frequency of use
length of drinking binges
blood alcohol levels
whether body is allowed to recover from binges
long term use = liver damage, pancreatitis, cardiovascular disorder and brain damage

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32
Q

dementia

A

general loss of intellectual abilities and can be direct result of neuroanatomy by excessive amounts of alcohol
does not always go away once brain damage has occured
note mild / moderate drinking may serve a protective role in cognitive decline as we age

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33
Q

fetal alcohol syndrom

A

learning difficulties, behavioural deficits and characteristic physical flaws resulting from heavy drinking by the victims mother when she was pregnant
-white americans

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34
Q

students and binging

A

men in college most likely

a students binge less than d-f students

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35
Q

binge drinking definition

A

+5 drinks on one occacion at least once a month

heavy if more than 5 days in a month

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36
Q

progression of alcoholics

A

normal to be functional
20% with severe alcohol dependence = have a spontaneous remission and do not reexperience problems with alcohol
dependence course is progressive for most people but abuse may be more variabe
drinking at an early age (11-14) = predictive of later alcohol related dis

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37
Q

study following male impatients at alcohol rehad centre

A

3/4 = moderate consequences of their drinknig
20s = demotions at work
30s = regular blackouts and serious withdrawal
40s = long term consequencies (hallucinations, convulsions, hepatities, pancreatitis)
not inevitable for everyone
research on mechanism for differences in easly alcohol use = ones response to the sedative effects affects later ise
so those who no slurred speech, staggering etc = more likely to abuse it
concern as high caffeine drinks now used as mixer = increase likelihood of later abuse?

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38
Q

alcohol and violent behaviour

A

correlational links
lab studies = alcohol makes you more aggressive but if this was larer outside of the lab = lots of interrelated features
so alcohol does not cause aggressive behaviours but it may increase a persons likelihood of engaging in impulsive acts and impair the ability to consider the consequences of acting impulsively

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39
Q

barbituates

A 
a seditative (and addictive) drug such that is used as a sleep aid
originally prescribed to help sleep in the 30s and 40s
50s = most abused drug in america
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40
Q

benzodiazepines

A

an antianxiety drug (valium) also used to treat insomnia
effective against anxiety (and at high potency = panic dis)
show more side effects
eg cognitive and motor implications and may result in substance dependence
relapse rates are extremely high when drug discontinued
originally = miracle cure for anxiety
safer than barbituates
rohypnol = date rape drug

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41
Q

barbituates clinical description

A

low dose = relaxing and mild feeling of well-being
larger doses = slurred speech, walking problems, concentrating and work problems
extremely high doses = death by suffocation as diaphragm relaxes
barbituate overdose = common method of suicide

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42
Q

benzos clinical description

A

calm individual and induce sleep
muscle relaxant and anticonvulsant
pleasant high and a reduction in inhibition (similar to alcohol)
after continued use tolerance and dependece can develop
withdrawal felt when tried to stop

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43
Q

sedative hypnotic and anxiolytic related disorders

A

cognitive, bio and behavioural and social problems associated with the use and abuse of sedative, hypnotic and anxiolytic drugs
dont differ significantly from alcohol in DSM 5
both include maladaptive behavioural changes (inappropriate sexual or aggressive behaviour, variable moods, impaired judgement and social / occupational functioning, slurred speech, motor co-ordination)
GABA - but different mechanism to alcohol
drugs + alcohol = synergistic effects = dangerous levels

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44
Q

stats of bezos and barbituates

A

barbituates decreasing, benzos increasing

those who do seek help for treatment = female, caucasian and +35

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45
Q

stimulants

A

caffeine, nicotine, amphetamine and cocaine

more alert and energetic

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46
Q

amphetamines

A

low dose = elevtion and vigour and reduce fatigue
but will crash back down = crash, depressed, tired
used for asthma, nasal decongestant, also reduce appetite = weight loss
also used for people to pull all nighters / give a boost
used for ADHD in kids but can be abused for pscyh effect

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47
Q

amphetamine use disorder

A

stimulant medication used to treat hypersomnia by keeping the person awake during the day and to treat narcolepsy including sudden onset episodes by suppressing REM sleep
severe intoxication / overdose = cause hallucinations, panic, agitation and paranoid delusions
tolerance quickly builds
withdrawal = apathy, prolonged periods of sleep, irritability and depression

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48
Q

crystal meth

A

ingested through smoking
marked aggresive tendencies and stays in the system longer than cocaine = particularly dangerous
originally popular in the community but spread elsewhere
high risk for dependency
repeated use of MDMA = lasting memory problems

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49
Q

how amphetamines act on the brain

A

stimulate CNS by enhancing the activity of norepinephrine and dopamine (helps release the neurotransmitters and blocks their reuptake)
too much = hallucinations and delusions
this effect = ideas about the causes of schizophrenia

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50
Q

cocaine

A

replaced amphetamines as stimulant of choice 1970s
from leaves of coca plant
small amounts increase alertness, euphoria, increased bp and pulse and insomnia and loss of appetite
effects = short lived
cocaine induced paranoia = common in users (2/3)
heart beats more rapidly and irregularly = can be fatal
used medically as a local anesthic and narcotic

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51
Q

stats on cocain abuse

A

white males = most common users
17% = crack cocaine too (crystallised, snorted)
increasing proportion of users seeking treatment are young, unemployed living in urban areas
up seems to come from the dopamine system

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52
Q

how cocaine works

A

inhaled
enters bloodstream through lungs. in the brain in seconds
acts on the pleasure pathway in the limbic system. occurs at synapses
cocaine molecules bind to the dopamine transporter blocking the route by which dopamine would re enter the transmitter cell. so accumuates in the synaptic space

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53
Q

how cocaine is different to other drugs

A

does not resemble that of many drugs = typically people find they have a growing inability to resist taking more
few negative side effects at first
but then disrupted sleep, increased tolerance, paranoia, other negative symptoms
become socially isolated
chronic use may equal premature ageing in the brain
different withdrawal = feelings of apathy and boredom = visicious cycel can easily develop (due to this atypical withdrawal pattern meant people originally didn’t think was addictive)

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54
Q

tobacco-related disorders defined

A

cognitive, bio, behavioural and social problens associated with the use and abuse of nicotine

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55
Q

tobacco use stats / background

A

20% US smoke - decrease from the past

56
Q

how DSM defines tobacco related dis

A

DSM does not describe and intoxication pattern for tobacco related dis
instead lists withdrawal symptoms, inc depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness and increased appetite and weight gain

57
Q

nicotine clinical description

A

in small doses = stimulates CNS, relieves stress and improves mood. bp increases and increased risk of heart disease and cancer
high doses = blurry vision, confusion, lead to convulsions and cause death
once dependent = withdrawal starts if stopped
smoking = linked with negative affect (depression, anxiety, anger)

58
Q

how nicotine acts on the body

A

inhaled
enters bloodstream, brain after 7-19 seconds
stimulates nicotinic acetylchloride receptors nAChRs n midbrain reticular formation in the limbic system = site of brains pleasure pathway
smokers dose throughout the day = keep nicotine at steady levels in the bloodstream

59
Q

maternal smokers

A

can predict later substance related disorders in their children (appears to be environmental rather than bio)

60
Q

caffeine related disorders

A

most common
gentle stimulant - thought to be least harmful of addictive drugs
some energy drinks baned in Fr and other countries
smalle doses = elevates mood and decreases fatigue
larger doses = jittery, cause insomnia
takes 6h to leabe body = disturbs sleep
esp pronounced in those already suffering from insomnia
moderate caffeine = ok for fetus
tolerance and withdrawal = headaches

61
Q

defintion of caffeine use disorder

A

cognitive, bio, behavioural and social problems associated with the use and abuse of caffeine
DSM 5 = condition for further study

62
Q

caffeine effects on the brain

A

involve neuromodulator adenosine and also dopamine (to a lesser extent)
blocks adenosine reuptake
-but we do not yet know how the role of adenosine in brain function or whether its interruption = elation and increased energy

63
Q

opiods

A

opium poppy - narcotic effect (reduces pain, induces sleep)
disorder = bio, cognitive, behavioural and social problems associated with the use and abuse of opiates and their synthetic variants
induce euphoria, drowsiness and slowed breathing
high dose = death if respiration fully decreased

64
Q

withdrawal from opiods

A

yawning, nausea, vomiting, chills, muscle aches, diarrhea, insomnia = disrupts school, work and social relationships
symptoms = 1-3 days, withdrawal process complete in a week

65
Q

heroin

A

most commonly abuse opiod and rising

risks even beyond addiction and overdose. HIV and AIDS as inravenous injections

66
Q

longitudinal study following 80 heroin addicts

A

30 years later
22% dead - overdose and suicide
of those alive, 80% no longer using opiods, 20% treated with methadone

67
Q

brain and opiods

A

has its oen = enhephasis and endorphins
heroin activates this systme
discovery of this system = major breakthrough in neuropharmacology
also helped us treat people dependent on drugs

68
Q

cannabis-related disorders

A

most routinely used illegal drug
dried part of the hemp plant; a hallucinogen that is the most widely used illegal substance
use-dis = cognitive, bio, behavioural and social problems associated with the use and abuse of cannabis
grows in the wild throughout tropical and temperate regions of the world = weed
mood swings, dreamlike state (time stands still)
heightened sensory experience
different reactions in different people (more so than any other drug)
not uncommon for no reaction first time using the drug
appears people can turn off the high if sufficiently motivated

69
Q

cannabis clinical description

A

small doses = well being

high doses = change to paranoia, hallucinations and dizziness

70
Q

high school cannabis smokers

A

lower grades and less likely to graduate (not clear on direction of causation)
not clear if physiological problems preceed or cause - impaired memory, concentration, relationships with others and emplyment

71
Q

synthetic marijuana

A

K2, spice, herbal incense = alarm as can be purchassed legally and this reaction to its use can be extremely harmful (hallucinations, seizures, heart rhytmn problems, etc)

72
Q

tolerance for cannabis

A

contradictory evidence
chronic and heavy users report tolerance especially to the euphoric high - unable to reach the kind of pleasure they had earlier
also reverse tolerance reported = regular users experience more pleasure from the drug after repeated use

73
Q

withdrawal from cannabis

A

minor

period of irritability, restlessness, appetite loss, nausea and difficulty sleeping

74
Q

cannabis as medical treatments

A

chemo induced nausea and vomiting
HIV associated anorexia
neuropathic pain in MS
cancer pain

75
Q

smoking cannabis problems

A

carcinogenic

76
Q

cannabiods

A

80 cannabioids
most common = THC
brain makes it own THC = anandamide
only beginning research

77
Q

hallucinogenic-related disorders

A

dsm5 similar as cannabis

psychotic risks - can fly etc (maybe no worse risks than being drunk though)

78
Q

lsd

A

the most common hallucinogenic drug; a synthetic version of grain fungus ergot

79
Q

study comparing hallucinogen psilocybin versus control (ritalin)

A

individual reactions included perceptual changes and moof changes
2 months later rated the experience as having a spiritual significance
more research needed

80
Q

tolerance and withdrawal and lsd

A

develops quikcly
if taken repeatedly over a period of days = drugs lose their effectiveness
sensitivty returns after a week of abstinence
most hallucinogenics = no withdrawal reported

81
Q

how we think hallucinogenics work

A

not fully understood
most of these drugs resemblence to other neurotransmitters = similar to serotonin; others norepinephrine, other acetylcholine
but mechanism remains unknown

82
Q

inhalants

A

volatile solvents
spray paint etc
male, caucasian, rural or small town = typical users
higher levels of anxiety and depression + show more impulsivity and fearless tempermaments
drugs = rapidly absorbed into bloodstream through lungs
dizziness, slurred speech, incoordination, euphoria, lethargy
users build up tolerance and withdrawal (2-5 days) = sleep distrubances, tremors, irritability and nausea
use = aggression and anti-socail behaviour increase
long term use = damage bone marrow, kidneys, liver, brain. if startled can cause cardiac arrest

83
Q

anabolic-androgenic steroids

A

synthesised form of testosterone
legitimate medical uses = asthma, anemia, breast cancer, males with inadequate sexual development
but anabolic = increased body mass = illict use by bodybuilders
cycling = regular use for several weeks (or months) then break or combine several types of steroids = stacking
steroids = no high, body changes
long term effects = mood dis, serious physical consequences from regular use

84
Q

dissociative anesthetics

A

drowsiness, pain relief and feelings of being out of ones body
designer drugs
originally developed by pharmaceutical companies to treat specific diseases and disorders
MDMA, MDEA, BDMPEA
heightens a persons auditory and visual perception (also taste and touch)

85
Q

ketamine

A

associative anesthetic = sense of detachment along with a reduced awareness of pain

86
Q

GHB

A 
CNS depressant (originally marketed to stimulate muscle growth)
low dose = relaxation, increased tendency to verbalize
high dose = seizures, severe respiratory depression and coma
87
Q

bio causes of substance related dis overview statement

A

twin + family + adoption studies = genetic vulnerabilities

in general genetic risk factors cut accross all mood-altering drugs

88
Q

most bio research on causes focuses on

A

alcoholism

legal

89
Q

twin studies on substance related disorders

A

genetics play an important role but no reliable findings to specific genes as influenceing these disorders

90
Q

functional genomics

A

how these genes function when it comes to addiction

91
Q

genetic factors and drugs

A

may affect how people experience certain drugs = partly determines who may become abusers
also help predict which treatments may be effective

92
Q

neurobio influences on causing substance related dis

A

positve reinforcement when using drugs
natural pleasure pathway (up for discussion exactly where in the brain but inc dopaminergic system and its opiod releasing neurons- begins in midbrain ventral tegmental area then works its way forward through the nucleus accumbens and frontal cortex) = mediates our experience of reward - all abused substances seem to effect this
so psychoactive substances = ability to activate reward centre

93
Q

amphetamines and cocaine which bit of the brain

A

directly on the dopamine system

94
Q

opiates act on which bit of the brain

A

inhibit GABA
“brain police”
stops the GABA neurons inhibiting dopamine so more dopamine available for pleasure pathway
nicotine and alcohol too

95
Q

anxiolytic effects

A

ability to reduce anxiety (eg alcohol)
acts on septal hippocampal system including large numbers of GABA sensitive neurons
enhance GABA activity in this area = inhibits brains normal reaction to anxiety-producing situations

96
Q

individual differences in the way people respond to alcohol

A

compare individuals with and without family history of alcoholism
conc alcoholics may be more sensitive to alcohol when it is first ingested and then become less sensitive to its effects as the hours pass
significant as euphoric effects of alcohol = just after drinking but after a few hours = sadness and depression
so alcoholics may better appreciate the good without experiencing the bad so ideal candidates to continue drinking

97
Q

psych dimensions for causing substance related disorders

A

substances people use to alter mood and behaviour have unquie effects = still important to point out similaritites in ways people mentally react to these substances
positive reinforcement (many drugs pleasureable to animals so more than social and cultural influences)
social contexts may encourage its taking
negative reinforcement
people also reliably crash after taking drugs so why do they keep taking them

98
Q

adolescent vulnerability

A

just having a parent ith alcohol dependence was a major factor in predicting who would use alcohol and other drugs
also found adolescence who reported negative affect = more likley to use drugs
so to prevent = adress influences inc stress and anxiety

99
Q

opponent-process theory

A

increase in positive feelings = followed shortly by an increase in negative feelings
similarly increase in negative feelings will be followed by a period of positive feelings
the mechanisms this is strenghtened with use and weakened by disuse
so person uses drug for a long time = need more to achieve same results
at same time negative feelings that follow tend to intensify
so motivation for drug taking = shifts from desiring the euphoric high to alleviating the increasingly unpleasant crash
=insidious cycle

100
Q

self-medication study

A

study treated a group of cocaine addicts who had ADHD with ritalin = they hypothesised that these individuals used cocaine to help focus their attention. once their ability to concentrate improved with ritalin, the users reduced their use of cocaine

101
Q

cognitive dimensions of causing substance related disorders

A

what people expect to experience = influences how they react to drugs
eg less inhibited whether given alcohol or placebo told its alcohol = expects to become disinhibited
adolescents may begin using alcohol / drugs because they belive these substances will have positive effects
expectations change as people experiment with drug
use triggered by factors like availability, contact with things associated with the drug, specific moods, having a small dose of the drug

102
Q

social dimensions of causing substance related dis

A

drug addicted parents = less time monitoring their children, self-perpetuating pattern
societal view dictates how drug-dependent

103
Q

moral-weakness model of chemical dependence

A

drug users lack moral fibre to resist lure of drugs

104
Q

disease model of dependence

A

drug dependence is caused by an underlying physiological disorder (bio perspective)
AA and similar organisations work from this viewpoint

105
Q

cultural dimensions of substance abuse

A

must reconsider abnormal for each culture
different consequences
different social situations
different genes eg ALDH2

106
Q

integrative model

A 
need drug
exposure
cultural expectations
use = abuse
-major stressor
-genetic influence
-psych dis
107
Q

neuroplasticity

A

continued use of certain substances change the way our brain works
so brain increases drive to obtain the drug and decreases the desire for non-drug experiences

108
Q

personal motivation for treatment

A

important but not necessarily critical

109
Q

treatment must focus on

A

mutliple areas
help through withdrawal process
ultimate goal = abstinence
community wide approach to screen for drug abuse in settings like doctors offices etc important as only 25% come forward for treatment

110
Q

agonist substitution

A

a replacement of a drug on which a person is dependent with one that has a similar chemical makeup, an agonist
used as treatment for substance dependence
eg methadone for heroin - but can develop tolerance for methadone

111
Q

buprenorphine

A

blocks the effect of opiods and encourages better compliance then would a non opiod or opiate agonist

112
Q

nicotine patch

A

patch placed on the skin that delivers nicotine to smokers without carcinogens in the cigarette smoke
somewhat more successful than nicotine gum because it requires less effort by the wearer and delivers the drug more constantly; should be coupled with conselling to stop smoking relapse

113
Q

antagonist treatments

A

the medications that block or counteracts the effects of a psychoctic drug
naltrexone = opiate antagonist
-produces immediate withdrawal symptoms
-so a person must be free from withdrawal symptoms completely before starting naltrexone and must be highly motivated to use as removes euphoric effects of opiods
acamprosate = decrease cravings in people dependent on alcohol
best in highly motivated people who are participating in psychosocial interactions

114
Q

aversive treatment

A

clinics may prescribe drugs that make ingesting the abused substances extremely unpleasant
= associate feelings of unplesantness with the drug
antabuse = enduces nausea, vomiting, elevated heart rate and respiration after drinking alcohol
should be taken each morning before the desire to drink arises
but problem of noncompliance = can start drinking again

115
Q

clonidine

A

treat hypertension for people withdrawing from opiates

116
Q

using benzos for treatment

A

sedative, often prescribed to minimise discomfort for people withdrawing

117
Q

psychosocial treatment

A

all need social and therapeutic intervention

lots of models = invalidated and untested

118
Q

inpatient facilities

A

help people through initial withdrawal period and provide supportive therapies so can go back to their communities
expensive
research = may be no real difference with outpatient care in outcomes of alcoholics and drug abus ein general and outpatient = much cheaper

119
Q

AA and its variants

A

foundation = alcoholism is a disease and alcoholics must acknowledge their addiction and its destructive power over them
addiction = more power so must submit to a higher power
freedom from stigmatization
social support provided through groups meetings
research = people who regularly participate in AA or similar, follow its guidelines carefully are more likely to have positive outcomes - so effective for highly motivated people, but dont know who it will and wont wor for

120
Q

controlled use

A

research = a portion of several substances may be capable of becoming social users without returning to abuse

121
Q

controlled drinking

A

an extremely controversal treatment appraoch to alcohol dependence in which severe abusers are taught to drink in moderation
classic study = 40 male alcoholics in an alcohol treatment program and thought to have a good prognosis
controlled drinking
2 years later and 10 years later followed up
sobell study = problematic as concluded it worked without checking up on controls
so in USA not really implemented but is in UK

122
Q

covert sensitization

A

imagining unpleasant scenes eg beginning to snort cocain interrupted with visions of becoming violently ill

123
Q

contingency management

A

clinician and client together select the behaviours the client needs to chnge and decide on reinforcers thay will reward certain goals
eg recieve cash for clean urine samples

124
Q

community reinforcement program

A

spouses, friends, relatives etc who are not a substance abuser help abuser improve relationships with other important people
clinician teaches client to identify antecedents and consequences that influence drug taking and avoid certain friendships
help with finances, education etc
new recreational options
empirical support for this with cocaine

125
Q

obstacles for successful treatment

A

lack of personal awareness

unwilling to change

126
Q

motivational enhancement therapy

A

behavioural changes in adults is more likely with empathetic and optimistic counselling and focus on personal connetion with the clients core values
reminding client what they cherish most
=improves individuals beliefs any changes made will have positive outcomes

127
Q

CBT

A

addresses multiple ascpects of the dis
reactions to cues that lead to substance abuse
thoughts and hierarchies to resist use

128
Q

relapse prevention

A

the extending therapeutic program by teaching the client how to cope with future troubling situations
learned aspects of dependece and sees relapse as a failure of cognitive and behavioural coping skill
high risk situationss identifies and strategies are developed to deal
relapse = dealt with as a occurence from which people can recover from
may be particularly effective for alcohol and other substance related dis

129
Q

prevention

A

education
laws
community
DARE - drug abuse resistnce education = no drug use instilled by fear of consequences, rewards for commitments to not use drugs and strategies for rejecting drug offers. may not have intended effects
cultural strategies must be powerful - role of society

130
Q

gambling disorder

A

clinically significant impairment or distress as the result of persistent and recurrent problematic gmabling
job loss, bankrupcy
same pattern of urges as in substance abuse = so classified with them

131
Q

study of gambler watching other people gamble

A

detected level of activity observed in regions of the brain that are involved in impulse regulation when compare with controls
= interaction between environmental cues to gamble and the brains response
abnormalities in the dopamine system (pleasure of gambling) and serotonin (impulse behaviour) also found

132
Q

treatment of gambling

A 
hard as usually denial, impulsivity and continuing optimism 
cravings
gamblers anonymous like AA (70-90% dropout). desire to quit must be present before starting treatments 
cognitive behavioural = looks promising 
-setting financial limits
-planning alternative activities
-prevent relapse
-imaginal desensitization
133
Q

internet gambling disorder

A

condition for further study

134
Q

intermittent explosive disorder

A

the epidoes during which a person acts on aggressive impulses that result in serious assaults for destruction or property
-controversial as may be used for legal defence
-serotonin and norepinephrine and testosterone levels and psychosocial influences
help people identify triggers and drugs to control

135
Q

kleptomania

A

a recurrent failure to resist urges to steal things not needed for personal use or their monetary value
rare
hard to study as illegal
tensions before strealing, pleasure / relief when theft committed
impulsivity = unable to judge their immediate gratification of stealing comapred with the long term negative consequences
often no memory of act of shoplifting
high comorbidity with mood dis, act of stealing acts as an anti-depressant

136
Q

pyromania

A

impualse control dis that involved having an irresistible urge to set fires
parallels with kleptomania
preoccupation with fires and associated equioment
3% of arsonists
family history of fire setting and comorbid impusle control dis
cbt - identify signals that initiate the urges and teaching coping strategies

PSYC 100 - clinical (13 decks)

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