Week 2 Flashcards
What are concurrent disorders? (4)
Someone has a substance use disorder as well as at least one other co-occurring mental or psychiatric disorder
People who have concurrent disorders make up less of the population than those with just one or the other
They are not dependent on gender but are more prevalent among 15-24 year olds
People with concurrent disorders have more problems and therefore need more help
What does the Lai et al. meta-analysis say about anxiety and mood disorders in people with SUD? (3)
Examined cooccurence of SUD with different disorders
Found that there is a high prevalence of people having substance use disorder among people with any diagnosed anxiety or mood disorders
People with depression are more likely to be alcoholics
Does not indicate causation because it is not a longitudinal study so it cannot tell what came first
What does the Swendsen et al. study on transitions from mental disorders to SUDs demonstrate? (3)
Longitudinal study (10 years) that examined the associations of mental disorders with transitions to substance use disorders
Linked depressive, bipolar, anxiety disorders and PTSD to preceding the initial onset of nicotine, alcohol and drug dependence
Confirmed that mental disorders are risk factors because they precede SUDs
What are the two main feelings of anxiety disorders? How do they differ? How are they similar?
Fear, a negative emotional state in response to a real or perceived imminent threat to the self; present focused on immediate danger
Anxiety, a negative emotional state that stems from anticipation of future threats; future focused on what if
Both are adaptive and essential for survival, keeping us alive in the olden days?
What are the 3 components of anxiety?
Physiological: heightened level of arousal and physiological activation
Cognitive: subjective perception of anxious arousal and associated cognitive processes like worry and rumination (can be good but not when disproportionate and frequent)
Behavioral: safety behaviors like avoidance (which is bad)
When does anxiety become bad? (3)
When it is chronic, relatively intense, associated with role impairment and causing significant distress for self or others
They perceive threats when there is no objective threat or the situation is ambiguous, it is disproportionate
How we interpret daily situations and react to situational factors is key
What are three common expressions of anxiety?
Catastrophizing: thinking it is the end of the world if/when something happens
Overgeneralizing: one thing goes wrong/happens and letting it affect every other part of your life
Selective abstraction: only seeing specific details (usually negative ones) of the situation while missing others (usually positive ones)
According to the DSM, what is a specific phobia? (7)
Marked fear or anxiety about a specific object or situation
The phobic object/situation almost always provokes fear/anxiety,
Is actively avoided or endured with intense fear/anxiety
Is out of proportion to the actual danger posed
Is persistent
Causes clinically significant distress or impairment in important areas of functioning
Cannot be better explained by another mental disorder
What is social anxiety disorder (SAD)? (3)
Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
The individual fears they will act in a way or show anxiety symptoms that will be negatively evaluated
They are preoccupied with a need to seem perfect and not make mistakes, view themselves negatively even when they’ve done well and have excessive self-criticism
What are the cognitive theory’s of specific phobias and SAD? (4)
People who experience these are more likely to attend to negative stimuli, perceive ambiguous information as threatening, believe that negative events are more likely than positive ones to re-occur, and keep rehashing the negative event in their mind
What is a biopsychosocial model of SAD and substance use comorbidity?
Social anxiety compounded with risky biopsychosocial factors lead to substance use as a way of coping with social anxiety
What does the Walukevich-Dienst et al. study on substances to cope with anxiety demonstrate? (4)
A study on using substances to cope with social anxiety where they tracked people for 2 weeks
High risk days were days in which young adults used substances to cope with social anxiety, and found these days were linked to heavier alcohol use
On high risk cannabis use days, there was more social avoidance
On high risk alcohol/co-use days, there was greater perceived positive alcohol consequences (less worried, more sociable)
What are panic attacks? (3) What are the two kinds?
Not a mental disorder but they can occur in the context of any anxiety disorders or mineral health disorders/medical conditions
Panic attacks are indicators for a more serious disorder
Someone having a panic attack may also experience depersonalization (out of body experience) and derealization (not real, loss of control, dying)
Unexpected (no obvious trigger) and expected (in response to a situational trigger)
What is panic disorder? (3)
Recurrent unexpected panic attacks/intense surges of fear/discomfort
Symptoms of a panic attack include palpitations, sweating, shaking, shortness of breath, choking, chest pain, nausea, dizziness, chills, numbing/tingling, fear of going crazy/dying, etc.
Attacks are also followed by persistent worry or concern and a maladaptive change in behavior
What is agoraphobia? (4)
From the Greek word agora meaning marketplace
A cluster of fears surrounding public spaces and being unable to escape or find help should one become incapacitated
Anxiety in public transportation, open spaces, enclosed spaces, lines/crowds, and being out of the house alone
Often co-occurs with panic disorder
What are four psychological theories of panic disorder?
The fear-of-fear hypothesis suggests that agoraphobia is not a fear of public places but a fear of having a panic attack in public
The misinterpretation of physiological arousal symptoms suggests that people who have an autonomic nervous system predisposed to be overly active is coupled with a tendency to become very upset by these sensations
The role of vicious circles in panic disorder of overthinking and fear
The role of anxiety sensitivity in panic disorder, where physiological responses prompt more anxiety
What is generalized anxiety disorder? (6)
Excessive anxiety and worry occurring frequently and consistently about a number of events and activities (from work to school performance)
Difficult to control the worry
Associated with restlessness, fatigue, difficulty concentrating, irritability, muscle tension and sleep disturbance
Do not typically seek treatment even thought it typically starts as early as the early teens
It is hard to treat
Highly comorbid with other anxiety and mood disorders
What is the role of the intolerance of uncertainty theory in GAD? (3)
Related to control, predication events produce less anxiety than do unpredictable events
Research shows that intolerance of uncertainty plays a large role in the experience of chronic worry and GAD
Particularly relevant when assessing ambiguous situations, with appraisals mediating uncertainty and worry
What is the role of approach-avoidance conflicts in GAD? (3)
There is a two-factor model of approach-avoidance: intolerance of uncertainty and fear of anxiety
GAD-prone people have a desire to engage in approach behaviors to reduce their feelings of uncertainty, to know the unknown
But they also simultaneously fear anxiety which promotes the use of avoidance strategies to limit the experience of anxiousness
What are the general characteristics of depression disorders? (4)
Much more serious than typical emotional states that everyone feels
Involves significant disturbances in emotion, including extreme sadness or elation/irritability
Are disabling and interfere with daily functioning
Are often associated with other serious psychological problems (panic attacks, substance abuse, personality disorders, sexual dysfunction)
What are the 3 helplessness theories of depression?
Learned helplessness, where uncontrollable aversive events leads to a sense of helplessness which leads to depression
Attributional reformulation, where aversive events are attributed to global and stable factors and leads to a sense of helplessness with no possible resolution (as global stable factors are out of your control), leading to depression
Learned hopelessness, where aversive events are attributed to global and stable factors or cognitive factors, leading to a sense of hopelessness due to lack of resolutions and an expectation of an undesirable outcome, leading to depression
What is major depressive disorder? (2)
Consistent and frequent depressed mood and markedly diminished interest of pleasure in activities
Often combined with weight, sleep concentration and energy issues as well as feelings of worthlessness, guilt and death
What is persistent depressive disorder (dysthymia)? (3)
Consistent and frequent depressed mood for at least 2 years
Presence of poor appetite, in/hypersomnia, low energy and self-esteem, concentration problems and feelings of hopelessness
May also be experienced with episodes of major depressive disorder
What are the three kinds of bipolar/mood disorders?
Bipolar I disorder: requires the present of at least 1 manic episode and may be followed by hypomanic or depressive episodes
Bipolar II disorder: requires the presence of at least 1 hypomanic episode and at least 1 major depressive episode and never a manic episode
Cyclothymic disorder: a less debilitating mood disorder with a lower threshold; periods of at least 2 years with moods cycling between variations from our baseline that do not meet criteria for episodes and frequently cooccurs with anxiety disorders
What is mania? (3)
An emotional state or mood of intense but unfounded elation accompanied by irritability, hyperactivity, talkativeness, flight of ideas, distractability and impractical grandiose plans
Noticed by others who know them due to loudness, poor planning and annoyingness
Treatment is mood stabilizing medication
What is a manic episode? (3)
A distinct period of abnormally and persistently elevated, expansive or irritable mood and increased activity or energy
Lasting at least 1 week for most of every day
Symptoms include inflated self-esteem/grandiosity, decreased need for sleep, talkative, racing thoughts/ideas, distractability, increase in goal-directed activities and involvement in activities with high potential for painful consequences
What is a hypomanic episode? (3)
A distinct period of abnormally and persistently elevated, expansive or irritable mood and increased activity or energy
Lasting at least 4 consecutive days for most of the day
Symptoms include inflated self-esteem/grandiosity, decreased need for sleep, talkative, racing thoughts/ideas, distractability, increase in goal-directed activities and involvement in activities with high potential for painful consequences
What is a major depressive episode? (2)
Depressed mood and/or loss of interest or pleasure present during the same 2-week period and represent a change from the norm
Often combined with weight, sleep concentration and energy issues as well as feelings of worthlessness, guilt and death
What is a mixed episode? (3)
Can occur during any of the episodes
Symptoms occur during the majority of days of the episode
The individual experiences rapidly alternating mood (sadness, irritability, euphoria) accompanied by symptoms of mania and depression
What are the 3 mechanism seen across conditions that might explain why people with concurrent disorders turn to substance use?
Emotion (dys)regulation, impulsivity and perfectionism
What is emotional (dys)regulation? What are the 6 factors of the DERS? (3)
Emotional regulation refers to the use of health strategies to adapts to the demands of the environment and diffuse tough negative emotions
Emotional dysregulation refers to the inability to use healthy strategies to diffuse or moderate negative emotions and instead turning to substance use to cope with strong negative emotions
Difficulties in emotion regulation scale (DERS) include factors like non-acceptance of negative emotions, difficulty engaging in goal-directed behavior, limited access to strategies, impulse control difficulties, lack of emotional awareness, and lack of emotional clarity
What does the Stellern et al study on emotional regulation in SUDs show? (2)
Found people with SUDs were more likely to score higher on DERS
Shows a statistically significant correlation between substance use and the ability to regulate emotions
What is impulsivity? (3)
Behavior without adequate thought, the tendency to act without thinking ahead or a predisposition toward rapid unplanned reactions to stimuli without regard to the negative consequences
Urgency, both for positive and negative stimuli
Many different maladaptive behaviors are linked to impulsivity, like problems with self-control of emotions and behaviors and the violation of the rights of others/social norms
What is the 5 factor model of impulsivity?
Found 4 distinct personality facets associated with impulsivity from self-report measure
Lack of premeditation (careful and purposeful thinking)
Lack of perseverance (seeing things through to the end)
Sensation seeking
Urgency
What 2 tasks measure behaviors of impulsivity?
The go/no-go task, which measures patience and the ability to wait
The delay discounting task, which measures the ability to delay gratification for greater reward
How does impulsivity relate to addiction? (3)
Trait measures of impulsivity predict experimenting with substances and SUDs
Tasks show people with SUDs value smaller immediate rewards over delayed larger rewards, showing impulsive decision making
Addiction can also lead to cognitive defects that increase impulsivity which in turn increases engagement in risky behaviors like addiction (a cycle)
What does the ADHD and SUD initiation study show? (3)
Men with ADHD were more likely to initiate various illicit drug uses over a period of 5 years
They were also more likely to binge drink and have AUD
ADHD predicted these outcomes
What is perfectionism? (5)
A personality trait characterized by an overarching desire to meet high standards and self-criticism in response to failing to meet those standards
Often set excessively high standards for themselves and constantly strive for excellence in everything they do
Common in mental disorders associated with SUD (depression, anxiety, eating disorders)
This cycle of constantly raising the bar is exhausting because if you meet them, it is just raised higher until you can’t meet them and if you don’t, it’s devastating
Results in the use of substances to cope
What is Hewitt and Flett’s multidimensional perfectionism scale? (3)
Perfectionism comes from and it directed toward many different directions
Self-directed perfectionism from oneself towards oneself
Other-oriented perfection from oneself towards others
Social prescribed perfectionism from others towards oneself
What is Shafran et al Clinical Perfectionism theory? (2)
Overvaluing the importance of striving to meet standards and reacting to perceived failure to meet standard with self-criticism
Includes overvaluation of striving/ability and concerns over mistakes
What does the Rice and Van Arsdale study on perfectionism and SUDs demonstrate?
The path of perceived stress to drinking to cope to AUD is stronger for participants who were classified has having maladaptive perfectionism than those with adaptive perfectionism (meeting those high standards) and non perfectionism
