Task 9 Flashcards
Name the four conditions which are needed to identify a substance abuse disorder:
- Intoxication
- Withdrawal
- Substance abuse
- Substance dependence /drug addiction
What is meant by intoxication ?
-behavioural and psychological changes as a response to the substance
What is meant by Withdrawal ?
- behavioural and psychological responses that occur in response to cut off a substance after heavy use
- main factor while u take the drug !! -> to form normal
What is meant by Substance abuse ?
- when recurrent use results in harmful consequences and still continued with taking it (legal problems)
- frequent within the last 12 month
What is meant by sunsatnce dependence or dug aditcion ?
- Dependent people develop tolerance and thus need higher doses
What are the 4 criterias of subatsance abuse disorder regarding the DSM 5 ? Also how many symptoms must be present for a diagnostic ?
- Impaired centre control
- Social impiarment
- Risky use
- Pharmacological criteria
- 2 or more symptoms
Name the Symptoms of impaired centre control according to the DSM :
- Over intake and longer intake of substance
- Craving occurs
- ongoing desire to control substance abuse
- Much time spent on gaining using or recovering from substance
Name the Symptoms of Social Impairment according to the DSM :
- Inability to meet responsabilites (home/work/school)
- Important activites are even cut back cause of substance abuse
- Even social difficulties can not stop substance intake
Name the Symptoms of Risky use according to the DSM :
- Use of substance in physical dangerous situation
2. Awarnes of connection between physical/psychological problems and substance does not stop the intake
Name the Symptoms of Pharmacological criteria according to the DSM :
- When tolerance goes up
2. Withdrawal symptoms are present
What are the 3 forms of substance abuse disorder ?
- Mild 2-3 criteria
- moderate 4-5 critria
- Severe 6+ criteria out of 12
What are the prevalance of substance abuse disorder ?
- 2.5-5.0%
What are the comorbidities of substance disorder ?
- anxiety derpession and mood disorder
What is the main function of depressants psycholeptics ? And name some examples also opiods
- slow the CNS
- Alcohol, barbiturates, benzodiazepines, inhalants
- Opioids: heroin, morphine
- work on gaba ! (inhibitory)
What is the main function of stimulants Psychoanalatics ? And name some examples:
- activate CNS
- Cocaine, amphetamines, nicotine, caffeine
- > increase Dopamine (relaxed)
Descripe the effect of alcohol regarding the stage of intoxication, withdrawal and long term effects:
- While intoxication: inappropriate sexual/aggressive behaviour, mood lability, impaired judgement, blackouts
- Withdrawal:
1. Hyperactivity, puking,headache
2. Cramps
3. Extreme boily reaction + delirium tremens(confusion) - long term effects: cognitive/personality changes and increase risk of heart and cancer also hypertension and high cholestrol
Define heavy drinking:
- Drinking every day more then two beers
Define binge drinking:
- 5 drinks within an hour
What is meant by malnurished ?
- tend to drink their meals as high in calories, however, low in nutrition
What is the prevalance for a drinking disorder ?
- More in men
- The earlier the onset the more sever
- higher in countries with high unemployemnt and low lvl of education
Descripe the effect of caffeine regarding the stage of intoxication, withdrawal and long term effects:
- during intoxication: exitment and hyperactiity/ restlesness
- during withdrawal: depression and low lvl of energy
- long term effects: cause extreme excitement, cramps, heart problems, respiration failure
How does caffeine work ?
- Increases levels of dopamine, norepinephrine, serotonin
Descripe the effect of nicotine regarding the stage of intoxication, withdrawal and long term effects:
- during intoxication: stress reduction and similar to fight of flight repspond
- druing withdrawal: depressed, scared angry, restless, hungry, can’t concentrate
- long term effects: lung cancer, bronchitis, coronary heart diseas
How does nicotine work ?
- Release of dopamine, norepinephrine, serotonin,
Wha t is the main function of opioids ?
- relieve pain
How does canabis work ? Name also side effects:
- Calming and stimulant effects
- Side effects: short-term memory deficit and motor performance impaired leads also less concentartion
How do biological theories expalin substance abuse disorder ?
- the dopamine pathway is changed
- VTA (ventral tegmental area) -> NAC (nucleus accumbens) -> PFC (frontal cortex)
- reward system overules the control system
- Heritable (general rather than specific)
- also enhancing of gaba can lead to dative effect
How do psychological theories explain subastance abuse disorder ?
- via social learning (modeling)
- > learned that alcohol reduces stress
- Certain personality types are more vulnerable
Which personality type is more vulnerable towards substance abuse disorder according to the psycholgical theory ?
-behavioural under-control, impulsiveness, sensation-seeking, prone to antisocial behaviours
How do sociocultural theories explain substance abuse ?
- more likely if you are under chronic stress
- more comman in enviormental areas where alcohol is not restricted
What are the gender differences regarding alcohol ?
- Women less likely to carry risk factors like personality traits
- Women suffer from alcohol earlier & may notice that sooner
- Men tend to start in socialising context, women in family/partner/lover context
Do only dependent drinkers show places of prefeered alcohol intake ? (Some facts about the induced pace conditioning)
- no also non dependant drinkes show preferred
- Which is called CPP (conditioned place prefference)-> meassured by time
- > Due to relaxing and sedative preference people stay longer in bars if they show relaxation effects (CPP)
- > cue pairing can happen unconsciously
- > So you have to go to bars without bariing
What is so special about CPP ?
- Conditioning happened without explicit knowledge of the drug context contigency
- behaviour influenced by drug before being aware of it
Explain the dieseas model ?
- Explains substance disorder as a true disease rather then a decision making task
- via 3 stages
1. Binge and; intoxication
2. Withdrawal & negative affect
3. Preoccupation & anticipation
What happens according to the disease model in the satge of binge and intoxication with the patient ?
- Drug activate reward system -> more dopamine
- repeated experience of reward become associated with stimuli
- After repeated exposure dopamine stops firing towards reward instead start firing regarding and anticipatory repsonse (priming)
- only cue triggers craving drug-seeking behaviour
What happens according to the disease model in the satge of withdrawal and negative effect with the patient ?
- drug consumption triggers much smaller increases in dopamine levels
- less sensitive to drug and non-drug related rewards
- also lead to less motivated by everyday stimuli (dysphoria)
- Anti-reward system becomes overactive-> basel forebrain and amygdala gets more activated
- > dopamine cell less active !!
- > increase reaction to stress and higher negative emotion
What happens according to the disease model in the satge of preoccupationa and anticipation with the patient ?
- Prefrontal region changes (caused by down regulation of glutamate and dopamine)
- That leads to weakened ability to resist strong urges -> CAN NOT STOP anymore
How does the dual process model explain alcohol dependence ?
- imbalance Two systems:
1. Reflective sytems: cognitive evaluation controlled response (prefrontal)
2. Affective system: emotional evaluation automatic respons (limbic) - > Alcohol dependence is caused by an imbalance
- Affective system = overactivity -> impulsive behaviours (short term decision)
- Reflective system = impaired -> can not stop actively
- > SUBSTANCE ABUSE IS NOT A choice
What is meant by the continuum hypothesis ?
- assumes similar deficits across different alcohol related disorders
How does the dual process model explain binge drinking ?
- only impairment in reflective system
- showed by reduce cortical thickness
- Affective system in binge drinking must be more explored
What does the choice model of heyman states ?
- u can stop an addiction by your own power and decision
- recovery is possible
- It explains decison making process based on locally and gloablly decisions
- in relaity this model does not apply
How can an addiction problem being solved by regarding the choice model ? (Heyman’s Message)
- choose globally (so long term run benefits)
- seeing overall summation of rewards over time & and ignoring the attraction of immediate goal
What are the limitations of the choice model ?
- addictive behaviour is involuntary because it is primarily driven by cues and not by consequences
- locally decision making is not overcome in matter of a second
- dismisses the importance of structural and functional brain changes
What are some biological treatments ?
- Detoxification
- Drug replacement/maintenance therapy
- Antagonist drugs
- Antabuse/disulfiram
How does detoxification work ?
- drugs used to weaken withdrawal symptoms and dosaage will decrease
How does Drug replacement/maintenance therapy work ?
- treat severe substance abuse with by substituting a drug that has fewer damaging effects
How does Antagonist drug therapy work ?
- block/change effect of addictive drug, reducing the desire for it BUT cause severe withdrawal
How does Antabuse/disulfiram work ?
- makes alcohol punishing but only as long as they continue to take it -> make drug unpleasant
How do prevention programm work ?
- target young people cause brain is still developing
- use education over immediate risk of excess & payoffs of moderation
- Skills for resisting peer pressure
- learn to be aware of addiction and maybe try to calculate proportion
How do Community Programmes (AA= Alcoholics anonymous) work ?
- By and for people with alcohol related problems
- follows a 12 step program
- 1 first step is the admitting
- Group members provide moral and social support
- never fully cured
What is meant by the abstinence violation effect ?
- when they violate their abstinence, they tend to attribute it to lack of will power and self-control rather than sitch-factors
How can the Abstinence violation effect being treated ?
- via relapse prevention programmes -> teach peopel that slip is based on situational factor and not based on will also teach them to identify high risk stich
How does cognitive theory treat substance abuse ?
- identify stitch where substance is most likly to be taken
- challange expectations of drug taking by showing negative effect
- use mindfulness and mediation + motivational interviewing
How does motivational interviewing work ?
- straigthen motivation and commitment to changing their substance use
- find arguments for change
How does behavioural therapy treat substance abuse ?
- >
- via
1. Aversive classical conditioning
2. Covert sensitisation therapy
3. Contingency management programmes
- via
How does Aversive classical conditioning work ? Rework!
- Pair drug with another operant conditioning
- so they do not want to be attached to the aversive condition !
- condition could be something realy discusting !
How does Covert sensitisation therapy work ?
imagine unpleasant associations between drug & consequences to create -> reduce assumption of what drug does for u
How does Contingency management programmes work ?
- provide reinforcements (like employment) for individuals who stop taking substance
What fits into the category of Hallucinogens ? (what do they do in the brain)
- Cannabis and LSD
- leads to hallucinations
- inhibit gaba and less dopamine
Name the timeline of prevalance ?
- Tobacco
- Alcohol
- Cannabis
- Cocaine and heroin
What is meant by the behavioural under control theory ?
- the tendency to be impulsive is correlated to drinking or substance abuse
Can binge drinking lead to alcohol dependence ?
- Yes
What are the 2 types of motivation to engage in a substane absued behaviour ?
- Pull factors: experience euphoira
- Push factors: escape withdrawl
What is lewis opinion on the heymann message ?
- it is a choice but very hard because of biological reasons
