W3:

Question 1

Effects of substance use in pregnancy

Answer 1

harmful mental and fatal consequences

high rates of relapse postpartum

early dysfunctional maternal-infant relationship

Question 2

most frequent substance used in pregnancy

Answer 2

tobacco

then alcohol, cannabis

Question 3

Effects of alcohol use

Answer 3

• risk of miscarriage
• infant mortality
• congenital abomalies
• low birthweight
• reduced gestational age
• preterm delivery
• fetal alcohol spectrum disorders
• adverse neurodevelopment outcomes
• cognitive and behavioural challenges
• executive functioning deficits in children
• psychological consequences in adulthood

Question 4

Effects of smoking

Answer 4

• damage to the umbilical cord structure
• miscarriage
• ectopic pregnancy
• low birthweight
• placental abruption
• preterm
• infant mortality

Question 5

Effects of second-hand smoking

Answer 5

• respiratory and ear infections
• sudden infant death syndrome
• behavioural dysfunction
• cognitive impairment

Question 6

Coccaine

Answer 6

• premature rupture of membrane
• placental abruption
• preterm
• low birthweight
• small gestational age

Question 7

Opioids

Answer 7

• low birthweight
• respiratory problems
• third trimester bleeding
• toxemia
• mortality
• neonatal abstincence syndrome = postnatal withdrawal syndromes of the child

Question 8

Treatments in pregnancy

Answer 8

• motivational interviewing
• contigency management
• micronized progesterone
• methadone maintenance
• buprenorphine maintenance
• lactation

Question 9

Motivational interviewing

Answer 9

• patient centered
• collaborative
• help clients to explore and resolve ambivalence
• draws from the trans theoretical model of change
• improve treatment readiness and retention

Question 10

Contigency management

Answer 10

• positive reinforcement as means of operant conditioning
• usually monetary vouchers
• most successful for smoking cessation
• longer duration of cocaine abstinence
• addition to methadone or buprenorphine treatment

Question 11

Micronized progesterone

Answer 11

-for postpartum cocaine use

Question 12

Methadone maintenance

Answer 12

• medically controlled
• steady opiate dosing
• decreases maternal and neonatal morbidity
• greater relapse prevention

Question 13

Buprenorphine maintenance

Answer 13

• for opiods

- lower retention rates

Question 14

Breastfeeding

Answer 14

reduces HPA response to stress

-cognitive and motor development in the infant

Question 15

Brain development during adolescence

Answer 15

• decrease in grey matter -> synaptic pruning
• changes in extracellular matrix
• increases in white matter ->myelination of axons = more efficient communication between brain regions

Question 16

Neural changes occur well into

Answer 16

mid and late 20’s

Question 17

Mesolimbic and reward system mature before the

Answer 17

prefrontal and cognitive control

Question 18

Greater use of alcohol and marijuana by age 18 associated with

Answer 18

compromised inhibitory functioning

Question 19

Initiation of drinking by late adolescence predicted by

Answer 19

• smaller frontal grey matter and less cerebellar white matter volume
• less volume in regions involved in impulsivity, reward sensitivity, decision making

Question 20

Reward related subcortical structures are involved in

Answer 20

initiation of drinking in adolescents

Question 21

Smaller left nucleus accumbens predicts

Answer 21

greater substance use

Question 22

Markers of vulnerability to initiation

Answer 22

-alteration in neurocognitive performance and neural response patters during inhibition, working memory and reward processing

Question 23

Effects of substance use on developing brain

Answer 23

• dose dependent relationship with cognitive functioning
• heavy use = worse complex attention, memory, processing speed and visuospatial functioning
• early onset more harmful
• premature cortical grey matter decline

Question 24

Abstinence proves

Answer 24

improved verbal memory and psychomotor task performance

Question 25

Marijuana related changes in white matter microstructure confer risk for

Answer 25

psychological disorders like shizophrenia

Question 26

The emotional component of reward processing is affected by

Answer 26

binge drinking

Question 27

Heavy drinking is both predicted and preceded by

Answer 27

heavy drinking

Question 28

Cousin said that there is a natural resilience to

Answer 28

substance use disorder in adolescents -> something adaptive about the adolescent brain

Question 29

Thoughts on risky behaviour shifted from poor decision making to

Answer 29

adaptation

Question 30

Risky behaviour is biasing adolescents into

Answer 30

short term rewarding outcomes

Question 31

Single best predictor to engage in teen substance use is

Answer 31

social environment

Question 32

Teens perception of peer substance used is predicting

Answer 32

use even after 7 years after initiation

Question 33

Executive network

Answer 33

- cold executive control | - frontoparietal areas: PPC, DLPFC, inferior frontal gyrus, dorsal anterior cingulate cortex

Question 34

Salience network

Answer 34

- emotion regulation - salience attribution - integration of affective info into decision making ventral anterior cinculate cortex vACC Anterior Insula Orbitofrontal cortex Limbic areas:amygdala and striatum

Question 35

Medial prefrontal cortex and superior temporal brain areas

Answer 35

social cognitive functions - mature later than salience - sensitive to social and affective context

Question 36

Brain plasticity explains modulation of

Answer 36

neuronal connections through complex interaction between genes and environment

Question 37

Course from substance use to substance use disorder is a transition from

Answer 37

goal-oriented, voluntary use to compulsive use

Question 38

Motivation to use is explained by

Answer 38

salience networks becoming increasingly attentive and responsive to substance use and paired cues

Question 39

A decreased functioning of frontoparietal executive networks leads to

Answer 39

poor behavioural control over motivation -> more substance use -> disorder

Question 40

Neural factors that predispose teens to use

Answer 40

- increased emotional arousal, reward sensitivity and value of social info - valence and rewarding effects of use and cues

Question 41

Social plasticity hypothesis

Answer 41

same neurosocial mechanisms that place adolescents at initial risk of initiation and escalation of use underlie protective driving factors driving the natural resistance from substance use during adulthood

Question 42

Contemporary models of SUD in teens

Answer 42

- improv of top down executive control over salience network - > capacity to resist - >long term become important - > impulsive decision making decreases - >emotional control improves

Question 43

Key protective factors of social plasticity of normative teen resilience

Answer 43

- social attunement - heightened brain plasticity - role transitions and changes in motives - social context - durable network - salient role in social environment => social benefits of use decrease

Question 44

Social attunement alone is

Answer 44

insufficient to drive behavioural change -social + plasticity

Question 45

Regions paired with social attunement and learning

Answer 45

hippocampus and striatum medial PFC parahippocampal gyrus