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Addiction FSWP4029K > W3: > Flashcards

W3: Flashcards

1
Q

Effects of substance use in pregnancy

A

harmful mental and fatal consequences

high rates of relapse postpartum

early dysfunctional maternal-infant relationship

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2
Q

most frequent substance used in pregnancy

A

tobacco

then alcohol, cannabis

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3
Q

Effects of alcohol use

A
  • 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
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4
Q

Effects of smoking

A
  • damage to the umbilical cord structure
  • miscarriage
  • ectopic pregnancy
  • low birthweight
  • placental abruption
  • preterm
  • infant mortality
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5
Q

Effects of second-hand smoking

A
  • respiratory and ear infections
  • sudden infant death syndrome
  • behavioural dysfunction
  • cognitive impairment
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6
Q

Coccaine

A
  • premature rupture of membrane
  • placental abruption
  • preterm
  • low birthweight
  • small gestational age
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7
Q

Opioids

A
  • low birthweight
  • respiratory problems
  • third trimester bleeding
  • toxemia
  • mortality
  • neonatal abstincence syndrome = postnatal withdrawal syndromes of the child
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8
Q

Treatments in pregnancy

A
  • motivational interviewing
  • contigency management
  • micronized progesterone
  • methadone maintenance
  • buprenorphine maintenance
  • lactation
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9
Q

Motivational interviewing

A
  • patient centered
  • collaborative
  • help clients to explore and resolve ambivalence
  • draws from the trans theoretical model of change
  • improve treatment readiness and retention
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10
Q

Contigency management

A
  • 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
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11
Q

Micronized progesterone

A

-for postpartum cocaine use

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12
Q

Methadone maintenance

A
  • medically controlled
  • steady opiate dosing
  • decreases maternal and neonatal morbidity
  • greater relapse prevention
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13
Q

Buprenorphine maintenance

A
  • for opiods

- lower retention rates

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14
Q

Breastfeeding

A

reduces HPA response to stress

-cognitive and motor development in the infant

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15
Q

Brain development during adolescence

A
  • decrease in grey matter -> synaptic pruning
  • changes in extracellular matrix
  • increases in white matter ->myelination of axons = more efficient communication between brain regions
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16
Q

Neural changes occur well into

A

mid and late 20’s

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17
Q

Mesolimbic and reward system mature before the

A

prefrontal and cognitive control

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18
Q

Greater use of alcohol and marijuana by age 18 associated with

A

compromised inhibitory functioning

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19
Q

Initiation of drinking by late adolescence predicted by

A
  • smaller frontal grey matter and less cerebellar white matter volume
  • less volume in regions involved in impulsivity, reward sensitivity, decision making
20
Q

Reward related subcortical structures are involved in

A

initiation of drinking in adolescents

21
Q

Smaller left nucleus accumbens predicts

A

greater substance use

22
Q

Markers of vulnerability to initiation

A

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

23
Q

Effects of substance use on developing brain

A
  • 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
24
Q

Abstinence proves

A

improved verbal memory and psychomotor task performance

25
Q

Marijuana related changes in white matter microstructure confer risk for

A

psychological disorders like shizophrenia

26
Q

The emotional component of reward processing is affected by

A

binge drinking

27
Q

Heavy drinking is both predicted and preceded by

A

heavy drinking

28
Q

Cousin said that there is a natural resilience to

A

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

29
Q

Thoughts on risky behaviour shifted from poor decision making to

A

adaptation

30
Q

Risky behaviour is biasing adolescents into

A

short term rewarding outcomes

31
Q

Single best predictor to engage in teen substance use is

A

social environment

32
Q

Teens perception of peer substance used is predicting

A

use even after 7 years after initiation

33
Q

Executive network

A
  • cold executive control

- frontoparietal areas: PPC, DLPFC, inferior frontal gyrus, dorsal anterior cingulate cortex

34
Q

Salience network

A
  • 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

35
Q

Medial prefrontal cortex and superior temporal brain areas

A

social cognitive functions

  • mature later than salience
  • sensitive to social and affective context
36
Q

Brain plasticity explains modulation of

A

neuronal connections through complex interaction between genes and environment

37
Q

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

A

goal-oriented, voluntary use to compulsive use

38
Q

Motivation to use is explained by

A

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

39
Q

A decreased functioning of frontoparietal executive networks leads to

A

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

40
Q

Neural factors that predispose teens to use

A
  • increased emotional arousal, reward sensitivity and value of social info
  • valence and rewarding effects of use and cues
41
Q

Social plasticity hypothesis

A

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

42
Q

Contemporary models of SUD in teens

A
  • improv of top down executive control over salience network
  • > capacity to resist
  • > long term become important
  • > impulsive decision making decreases
  • > emotional control improves
43
Q

Key protective factors of social plasticity of normative teen resilience

A
  • 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
44
Q

Social attunement alone is

A

insufficient to drive behavioural change

-social + plasticity

45
Q

Regions paired with social attunement and learning

A

hippocampus and striatum
medial PFC
parahippocampal gyrus

Addiction FSWP4029K (5 decks)

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