Week 1 Flashcards
What is nomenclature and how is it important? (3)
How we pick and choose names for things or people
How we label things impacts the study of health and the mind because words can have severe consequences and serve as barriers to treatment
Changing the language we use to neutral, medically accurate terms can reduce stigma and have positive impacts on treatment and life
What is the difference between the words substance abuser and substance use disorder?
It is proven that, in the CJS, these labels impact how they are treated based on how it shifts responsibility and comes with stigma/assumptions about who people are and what they deserve, which impacts how we treat them and help them
What are the two types of stigma? What is the effect?
Public reactions from the general population to a certain group
Self-stigma, the tendency to internalize stigma and see oneself in more negative terms as a result of experiencing a psychological problem
Profound harmful effects come from being stigmatized because there are many different pathways to addiction and everyone is at some level of risk, stigma helps no one
What is addiction? (3)
The tendency to persist with an appetitive or rewarding behavior that produces pleasure states and desire, despite mounting negative consequences that outweigh the more positive effects
Includes loss of control
Negative consequences include preoccupation and compulsive engagement with the behavior, impairment of behavioral control, persistence with or relapse to the behavior, and craving and irritability in the absence of the behavior
Is addiction a continuum of use? (2)
Addiction is not binary, meaning you either have a problem or you don’t, but a continuum with many possible paths and levels of addiction
For example, experimental/recreational use to casual or situational use to intensive to compulsive to addiction
How did the DSM 4 Classify Addiction?
Either as substance abuse, where a drug is used in a manner that does not conform to social norms and is a precursor to substance dependence, which is more severe
How is substance abuse classified in the DSM 4? (HELP)
Someone who has drug use in Hazardous situations, neglecting External obligations, Legal problems, interpersonal Problems related to persistent drug use
How is substance dependence classified in the DSM 4? (7)
3 of 7 of the following symptoms over 12 months:
Tolerance
Withdrawal
Taken in larger amounts or a longer period than intended
Great deal of time spent in activities concerning the substance
Important social, occupational or recreational activities are given up or reduced
Use continued despite knowledge of having a persistent problem that is caused by the susbtance
How did addiction change in the DSM 5? (4)
2 categories from DSM4 combined into substance related and addictive disorders
The distinction was not helpful or useful as it did not provide guidance for treatment, didn’t cover those between categories and made abuse out to be less important
Also had Substance Use Disorder, where each specific substance is addressed as a separate use disorder
Nearly all substances are diagnosed on the same overarching criteria
What is the overarching DSM 5 criteria for SUDs? (11)
At least two of the following in a 12-month period
Taking in larger amount or for longer than intended
Wanting to cut down or stop using but not managing to
Spending a lot of time getting/using/recovering substances
Cravings
Not meeting major work/home/school obligations
Continuing to use even when it causes interpersonal problems
Giving up social/rec activities
Recurrent use in physically hazardous situations
Continued use even when you have a problem cause or worsened by use
Tolerance
Withdrawal
Describe prevalence of SUDs in Canada (2)
Numbers don’t shift that much unless something drastic in society happens
There are valid and reliable measures of symptoms of addiction that can reliably predict affliction and/or possible addiction
What is the overpathologizing of every day life? (4)
Studies show that the rate of publications on addiction is going up increasingly, which studies including Argentine tango, bubble tea, and studying
People are taking the addiction criteria (which are overarching and broad) and applying them to all sorts of behaviors without the research to back them up and acknowledging that bubble tea and alcohol are NOT the same
You already consider the target behavior an addiction, create a screening instrument and establish biopsychosocial correlates with new a behavioral addiction
Using this logic, anything can be classified as an addiction
What are the 6 components of the components model of addiction? (SMTWCR)
Salience (activity becomes the most important dominant activity in that persons life)
Mood modification (activity used to change one’s feelings/mood)
Tolerance (need increasingly more substance to achieve the same effects)
Withdrawal symptoms (unpleasant feelings/effects when the activity is reduced or stopped)
Conflict (interpersonal conflict)
Relapse (tendency to start again after long periods of control/stopping)
What are the two main reasons behind the overpathologizing of addiction?
The Components Model of Addiction
Analogistic reasoning in research
How is analogistic reasoning applied to the study of addiction? (3)
You compare two different behaviors to gain insights or understanding
You recognize and focus on similarities between known behaviors and lesser known behaviors
You make assumptions about the less known behaviors based on what we know about the known ones
What is a syndrome model of addiction? What are the three stages?
Suggests that people inherit, encounter and accumulate different life influences (biology, psych) and experiences (social), which interact and accumulate to form the syndrome of addiction
Distal antecedents of the addiction syndrome, premorbid addiction syndrome and expressions/manifestations/sequelae of addiction syndrome
What is a multidimensional BPS+ model of addiction? What are the 5 components?
Takes into account multiple biopsychosocial factors, and the ways that they interact, that play into the development of addictions to form a well-rounded and encompassing theory of addiction
Biology, psychology, social, cultural, spiritual
What is the cultural dimension? (2)
Takes into account cultural norms and how the lack of healthy ones can play into addiction
A healthy community has cultural norms that respects them, expects positive contributions with rewards for doing so and support/protection of those in need
What is the spiritual dimension? (3)
Acknowledges that trying to find meaning in life is challenging for many people caught in addictive behaviors
Spirituality (religious or not) is a protective factor for health and wellbeing (including avoiding addictive behavior)
Spirituality can help with healing, recovery and growth for those struggling with addiction
What is the biological dimension? (2)
Considers familial and genetic influences (heritability, chromosomes, etc.) and neurobiological influences (chemical imbalances, pleasure/reward system) when studying addiction
What is the social dimension? (4)
Considers the ways our bonds with those who matter to us impact our actions and decisions
The opposite of addiction is not sobriety but connection
The immediate interpersonal environment of a person can impact the development of an addictive disorder (social support friendships family)
Broader socio-structural properties of the environment also play a role (social disadvantage due to identity, globalization of addiction)
What does Johann Hari explain in his TedTalk?
Using examples of rats in rat park and veterans coming back from the Vietnam war to demonstrate that addiction isn’t just about biology but also very reliant on social factors in an addict’s life
What is the psychological dimension? (4)
Feelings, learning patterns, cognition and personality can form protective or risk factors for addiction
Positive and negative reinforcement related to the substance use
Beliefs, perceptions and expectancies of performing the addiction (gambling expecting to win big)
Neuroticism and attachment styles impact susceptibility to addiction
What is self-determination theory? (3)
We need autonomy, relatedness and self-efficacy in order to live a happy, healthy and satisfied life
When our needs are met, we are satisfied and have positive growth/wellbeing
When our needs are frustrated, it can lead to ill-being (absence of self-esteem and happiness), the need for substitutes and extrinsic goals to find the satisfaction we are missing, and compensatory behavior (addiction due to loss of control, perfectionism, oppositional defiance)
Why is addiction engulfing the globalizing world? (4 parts)
Bruce Alexander’s macro-social theory
States that societies impacted by globalization and a free-market society (which encourages an open-season, every man for himself, individualist mentality) erodes social bonds, creating mass dislocation as people are no longer connecting with others, leading to mass addiction as a coping method
How does stress relate to addiction? What are the 3 research focuses on stress?
Stress is extremely common from early to late life and addiction can be used as a way of coping with stress
The environment (stress as a response to stimulus/stressors, like natural disasters), reaction to stress (stress as a response to distress), and stress as a process that includes stressors and strains but includes a relationship between the person and the environment (coping)
Define stressor, strain and stress
Stressor: any event that triggers coping adjustment
Strain: the physical and emotional wear and tear reaction of a person attempting to cope with a stressor
Stress: the process by which we perceive and respond to events
How does biology pertain to stress? (2)
We have biological reactions to stress, like a fight or flight response
The hypothalamic pituitary adrenal axis
What is the HPA axis? (4)
The hypothalamus is a small structure in the brain that perceives something as stressful
That releases hormones to send a message to the pituitary gland
That releases more hormones to send a message to the adrenal cortex, which releases hormones that prompt the body to react (sweating, accelerated heartbeat)
Some people have active axes that are constantly triggered, which exhausts the body and takes a toll on vital organs (in addiction to a psychological toll)
What is the general process of a stressor turning to stress? (4)
When confronted with a stressor, you have to decide whether that stressor is a threat that could lead to harm, loss or negative consequences with a primary appraisal
If it is, you do a secondary appraisal where you consider if you have the biopsychosocial resources to meet the demands of the situation
If you do, you do problem-focused coping (finding resolutions to the problem) to moderate the stress
If you don’t, you do emotion-focused coping (substance use) which creates high stress
What are the psychological aspects of stress? (2)
Stress can affect cognitive performance due to rumination and worry
It can also affect our emotions, creating fear and anxiety
What is a cognitive model of anxiety? (4)
Acknowledges that how we appraise and perceive events is really important
A triggering situation prompts anxious appraisal, which informs the anxious feelings
This appraisal involves the calculation of two questions: how likely is harm? How severe would the harm be?
High anxiety results from high threat probability/severity (in combination with low coping and safety resources) while low anxiety results from low threat probability/severity (with high coping and safety resources)
What is the difference between acute and chronic stress?
Acute is a sudden, short-lived threatening event (like seeing a bear in the woods or giving a speech)
Chronic results from ongoing environmental demand (marital conflict, work stress)
What are daily hassles and uplifts?
Hassles are experiences and conditions of daily living that have been appraised as salient and harmful/threatening (concerns about weight, inflation, taxes, crime)
Uplifts are experiences and conditions in daily living that have been appraised as salient and positive/favourable (completing tasks, enough sleep, spending time with friends/family)
What is environmental stress? (2)
Traumatic events that pose a great risk to someone’s life, like natural disasters, terrorism, war, etc.
Can lead to PTSD
What is PTSD? (3)
Results when someone is threatened with death/serious injury/sexual violence and response involves fear and helplessness
Symptoms include distressing memories, flashbacks, dreams, and triggers associated with the event
Studies show that substance use to cope with PTSD worsens symptoms over time and makes them more intrusive
What are Adverse Childhood Experiences (ACEs)? (3)
Early life stress that occurs before the age of 18 and could be caused by a number of issues, including abuse, neglect and household dysfunction
Measurements of ACEs ask about these three factors
Outcomes of ACEs include behavior problems (addiction, substance use, missed work, lack of activity) and physical and mental health problems (depression, suicide, STDs, cancer, heart problems)
What does ACEs have to do with addiction? (2)
A retrospective cohort study by Dube et al. had adults complete a survey about childhood abuse, neglect, household dysfunction, drug use and other health issues
Found that the more ACEs someone had, the more likely someone was to have severe and earlier drug use problems and addiction
