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Psychopathology > Task 9: Substance Use Disorders > Flashcards

Task 9: Substance Use Disorders Flashcards

1
Q

substance use disorders

A

chronic difficulties in resisting the desire to drink alcohol or take drugs

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2
Q

gambling disorder

A

inability to resist the impulse to gamble because the behavioral patterns and causes of this disorder appear to be similar to the behavioral patterns and causes of the substance use disorders

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3
Q

substance

A

any natural or synthesized product that has psychoactive effects - it changes perceptions, thoughts, emotions, and behaviors

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4
Q

substance intoxication

A

= a set of behavioral and psychological changes that occur as a result of the physiological effects of a substance on the central nervous system

  • people become intoxicated soon after they ingest a substance, and the more they ingest, the more intoxicated they become
  • the diagnosis of intoxication with a substance is given only when the behavioral and psychological changes the person experiences are significantly maladaptive
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5
Q

substance withdrawal

A

= a set of physiological and behavioral symptoms that result when people who have been using substances heavily for prolonged periods of time stop or greatly reduce their use

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6
Q

substance abuse (IV)

A

= a person’s recurrent use of a substance results in significant harmful consequences comprising four categories
1. the individual fails to fulfill important obligations at work, school, or home
2. the individual repeatedly uses the substance in situations in which it is physically hazardous to do so, such as while driving
3. the individual repeatedly has legal problems as a result of substance use
4. the individual continues to use the substance despite repeated social or legal problems as a result of use

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7
Q

substance dependence (IV)

A

= people who are dependent on, or addicted to, a substance often show tolerance – they experience diminished effects from the same dose of a substance and need more and more of it to achieve intoxication

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8
Q

DSM-5 Criteria Substance Use Disorder

A

Impaired Control
1. The substance is taken in increasingly larger amounts over a longer period of time than originally intended
2. The substance user craves the substance
3. The substance user feels an ongoing desire to cut down or control substance abuse, or has made unsuccessful attempts to do so
4. Much time is spent in obtaining, using, or recovering from the substance

Social Impairment
5. The ongoing use of the substance often results in an inability to meet responsibilities at home, work, or school
6. Important social, work-related, or recreational activities are abandoned or cut back because of substance use
7. Ongoing substance use despite recurring social or relationship difficulties caused or made worse by the effects of the substance

Risky Use
8. Ongoing substance use in physically dangerous situations such as driving a car or operating machinery
9. Substance use continues despite the awareness of ongoing physical or psychological problems that have likely arisen or been made worse by the substance

Pharmacological
10. Tolerance: the need for increased amounts of the substance to achieve the desired effect or by a diminished experience of intoxication over time with the same amount of the substance
11. Withdrawal: the substance user experiences the characteristic withdrawal syndrome of the substance and/or takes the same or similar substance to relieve withdrawal symptoms

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9
Q

Depressants

A
  • slow the CNS
  • moderate doses: relaxed, sleepy, reduced concentration, impaired thinking, judgement, motor skills
  • heavy doses: stupor or even death
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10
Q

Alcohol

A
  • low dose: self-confidence, relaxed, euphoric
  • increasing dose: depressive symptoms
  • intoxication: slurred words, walking unsteadily, attentional and memory problems, acting inappropriately, aggression, mood swings
  • women get intoxicated faster than men
  • 600.000 deaths due to unintentional alcohol-related injuries
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11
Q

Alcohol Withdrawal

A
  1. within a few hours, there is tremulousness, weakness, profuse perspiration
  2. convulsive seizure: begin as soon as 12 hours after drinking stops, usually, 2/3 days after
  3. delirium tremens (DTs) = auditory/visual/tactile hallucinations; little sleep, delusion, disorientation
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12
Q

Alcohol Misuse

A
  • heavy drinking: 2+ (men)/1+ (women) drinks per day
  • binge drinking: 5+ (men)/4+ (women) drinks within a couple of hours –> especially in college fraternities and sororities
  • men are more likely to drink alcohol (heavily) and binge drink
  • decline with age
  • starts earlier in youth
  • higher rates in cultures with excessive rate of poverty and unemployment
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13
Q

Long-term effects of alcohol misuse

A
  • malnourishment
  • vitamin B1 deficiency
  • risk for dementia
  • negative effects on the brain development
  • increased heart-disease risk
  • risk of cancer
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14
Q

Benzodiazepines and Barbiturates

A
  • depress the CNS
  • sedatives
  • intoxication and withdrawal similar to Alcohol
  • decrease in blood pressure, respiratory rate, and heart rate
  • feelings of euphoria and disinhibition
  • depressed moods, perceptual distortions, loss of cordiantion
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15
Q

Stimulants

A
  • activate the CNS
  • feelings of energy, happiness, power, decreased desire for sleep, diminished appetite
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16
Q

Cocaine

A
  • crack: a form of freebase cocaine –> euphoria, heightened self-esteem, alertness, energy, feelings of competence, and creativity
  • effects: grandiosity, impulsiveness, hypersexuality, compulsive behavior, agitation, anxiety
  • activates brain areas related to reward and pleasure
  • causes dopamine release and blocks its reuptake
  • medical complications: heart rhythm disturbances, heart attacks, respiratory failure
    neurological effects: stroked, seizures, headaches
  • physical symptoms: chest pain, blurred vision. fever, muscle spasms, convulsions, coma
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17
Q

Amphetamines

A

= prescribed for the treatment of attention problems, narcolepsy, and chronic fatigue
- release dopamine and norepinephrine and block their reuptake
- similar intoxication symptoms as in cocaine
- can cause perceptual illusions
- speed run: inject amphetamines frequently over several days without eating or sleeping –> then they crash into a devastating depression
- withdrawal: instability, memory loss, confusion, paranoid thinking, perceptual abnormalities
- medical issues: cardiovascular problems, increased blood pressure, stroke , HIV, hepatitis

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18
Q

Nicotine

A

= an alkaloid in tobacco
- 28% are smokers
- begins in the early teens
- operates on CNS and PNS –> releases dopamine, norepinephrine, serotonin, and endogenous opioids into the brain
- resembles the fight-or-flight response
- cancer, bronchitis, coronary heart disease
- 70% higher mortality rate
- withdrawal: depression, irritability, anger, anxiety, frustration, restlessness, hungry, concentration issue

19
Q

Caffeine

A

= most heavily used stimulant (75%)
- stimulates the CNS –> increases levels of dopamine, norepinephrine, and serotonin
- restlessness, nervousness, hand tremors, upset stomach, sleeping problems

20
Q

Opioids

A

= used to relieve pain
- morphine: highly addictive
- intoxication: behavioral change, constriction of pupils, drowsiness, attention/memory problems
- sensations in the abdomen
- can suppress respiratory and cardiovascular systems to point of death
- withdrawal: achy feelings, increased sensitivity to pain, craving, nausea, sweating, fever

21
Q

Hallucinogens and PCP

A

hallucinogens = produce perceptual changes
- synaesthesia: overflow from one sensory modality to another –> time passes slowly, mood shifts, detachment
- bad trips: severe anxiety, paranoia, loss of control

phencyclidine (PCP) = manufactured as a powder to be snorted or smoked
- lower doses: intoxication, euphoria, talkativeness, loss of concern, slowed reaction
- intermediate doses: disorganized thinking, depersonalizations, hostility, violence
- higher doses: amnesia, coma, seizures, hyperthermia

22
Q

Cannabis

A
  • intoxication: begins with “high” feeling of well-being, relaxation, tranquility, dizziness, dreamy, sleepy, grandiose, funny, aware, anxiety, distortions
  • impairs cognitive and motor functioning
  • physiological symptoms: increased/irregular heartbeat, increased appetite, risk of cancer
23
Q

Inhalants

A

= volatile substances producing chemical vapors that can be inhaled and depress the CNS
- respiratory irritations, rashes
- permanent damage to CNS: cognitive deficits, hepatitis, liver/kidney disease
- sudden sniffing death –> acute heartbeat irregularities or loss of oxygens, suffocating when falling unconscious

24
Q

Causes: Biological

A
  • dopamine-rich pleasure pathway
  • VTA –> nucleus accumbens –> frontal cortex
  • some drugs increase dopamine
  • GABA neurons inhibit the VTA
  • frontal cortex controls the urge to use drugs
  • dopamine becomes less sensitive
  • enhancing the activity of GABA
  • affects on serotonin system –> changes in mood
  • conditioned response to cues and tress
  • 50% heritability
25
Q

Causes: Brain Disease Model of Addiction

A
  • during intoxication, drug-induced activation of the brain’s reward regions is enhanced by conditioned cues in areas of increased sensitization
  • during withdrawal, the activation of brain regions involved in emotions results in a negative mood and enhances sensitivity to stress
  • during preoccupation, decreased function of the prefrontal cortex leads to an inability to balance the strong desire for the drug with the will to abstain, which triggers a relapse
26
Q

Causes: Psychological

A

Social Learning Theories: modeling parents and important others (mostly in males)

Cognitive Theories: People who expect alcohol to reduce distress and have no more adaptive means of coping are more likely to drink when upset and to have social problems related to drinking

Personality Trait: Behavioral under control, sensation-seeking, antisocial behaviors

27
Q

Causes: Sociocultural

A
  • reinforcing effects more attractive for chronic stress –> poverty, women in abusive relationships, adolescents with fighting parents
  • in societies discouraging the use of alcohol, abuse and dependence, and excessive drinking –> problems less common
28
Q

Causes: Gender Differences

A
  • substance use is more acceptable for men
  • women tend to carry fewer risk factors
29
Q

Dual-Process Model

A
  1. Reflective system: involved in the cognitive evaluation of the stimuli by means of memory, and executive functions, responsible for controlled-deliberate responses –> prefrontal network
    - impaired, leading to an inability to voluntarily inhibit the consumption
  2. Affective-automatic system: involved in the emotional evaluation of the stimuli, initiating automatic-appetitive responses –> limbic network
    - over-activated by emotional or alcohol-related stimuli, leading to impulsive prepotent behaviors
30
Q

Affective-Automatic System in Binge Drinking

A
  • repeated alteration of intoxication and withdrawal
  • emotional disturbances
31
Q

Reflective System in Binge Drinking

A
  • rapid appearance of cognitive consequences among binge drinkers
  • impaired perceptive-motor and attentional abilities
  • altered higher-level functions –> working and episodic memory
  • impairments for planning, updating, flexibility, or inhibition
32
Q

Disease Model

A

= emphasized the physiological changes that go with addiction, including changes in the function and structure of the nervous system

  • addictive behavior is involuntary as it is primarily driven by involuntary behavior/cues (classical conditioning)
  • increased dopamine –> reward-seeking
  • striatal changes involving dopamine correspond with the feeling of craving –> “wanting” not liking”
  • classical conditioning —> involuntary behavior/cues
33
Q

Choice Model

A

= addiction works like other choices whereby immediate rewards take precedence over long-term gains

  • addiction is a voluntary act
  • focusing on immediate rather than long-term rewards
  • operant conditioning—> voluntary behavior/consequences
34
Q

Treatment: Anxiety Drugs, Antidepressants, and Drug Antagonists

A
  • benzodiazepines have depressant effects –> reduce anxiety
  • antidepressants treat substance dependence along with depression
  • antagonist drugs block/change effects of addictive drugs –> reducing desire
  • nicotine replacement therapy: nicotine gum, patch, and inhaler to prevent withdrawal effects
  • prescription medication to reduce craving for nicotine
35
Q

Treatment: Methadone Maintenance Programs

A
  • gradual withdrawal from heroin
  • methadone = opioid, less potent, long-lasting
36
Q

Treatment: Behavioral

A
  • aversion therapy based on classical conditioning –> pairing favored drug with an unpleasant reaction
  • operant conditioning –> learning to avoid the drug to avoid an aversive response
  • covert sensitization therapy –> imagery to create associations between thoughts of use and also highly unpleasant consequences
  • contingency management programs –> aims to help individuals identify environmental stimuli and situations that have come to control the symptoms
37
Q

Treatment: Cognitive

A

= helps identify situations most likely to induce drinking

–> challenge these by reviewing negative effects

38
Q

Treatment: Motivational Interviewing

A

= elicits and solidifies motivation and commitment to change substance use

39
Q

Treatment: Relapse Prevention

A
  • abstinence violation effect: a sense of conflict/guilt when having a drink
  • mindfulness = non-judgmental acceptance of emotional/physical state
  • reduction in craving and relapse
40
Q

Treatment: Alcoholics Anonymous

A
  • 12 steps to recovery
  • encourages to seek help from higher power, admit weakness, and ask forgiveness
  • goal: complete abstinence
41
Q

Treatment: Classic Psychedelics

A
  • ‘classic psychedelics’ act primarily on the serotonin system as agonists at the serotonin 2A (5-HT2A) receptor
  • classic psychedelics could be beneficial in treating various psychiatric disorders, including SUDs across a wide variety of substances including tobacco, alcohol, opioids, and cocaine
  • the ultimate goal of AA/TSF programs is to elicit a “spiritual” awakening that will help lift individuals out of their addiction, and classic psychedelics appear to often do just that by reliably and systematically eliciting self-transcendent experiences that participants sometimes call ‘spiritual’, and potentially substantive changes in worldview and behavior as well as insights
42
Q

Prevention Programs

A
  • focus education on immediate risks of excess, payoffs of moderations

Harm reduction model - Alcohol Skills Training Program (ASTP): targets heavy-drinking in college students

43
Q

Place Preference

A

= based upon rewarding drug effects that become associated with the context through Pavlovian processes —> conditioning

  • individuals spent significantly more time in a context paired with alcohol
  • behavior may be influenced by drug cues before individuals are ware of the drug

Psychopathology (10 decks)

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