Week 7 - Feeding & Eating Disorder; Sleep-Wake Disorders, and Substance Use Disorders Flashcards
1
Q
What are ‘feeding and eating disorders?’
A
Psychological disorders involving disrupted eating patterns and maladaptive ways of controlling body weight.
2
Q
What is ‘Anorexia Nervosa?’
A
An eating disorder primarily affecting young women, characterized by the maintenance of abnormally low body weight, distortions of body image, and intense fears of gaining weight.
3
Q
What does ‘prevalence mean?’
A
The measure of a condition in a population at a given point in time (in this document referred to as point prevalence ); can also be measured over a period of time (e.g. a year).
4
Q
What does ‘period prevalence’ mean?
A
Porportion of a population that has the characteristic at any point during a given time period of interest. “Past 12 months” is a commonly used period.
5
Q
What is the prevalence of ‘Anorexia Nervosa?’
A
0.4% 12-month prevalence; meaning .10 times more
prevalent in females.
6
Q
What are the essential features of ‘Anorexia Nervosa?’
A
Energy intake restriction, fear of gaining weight or becoming fat, distorted self-perceptions.
7
Q
What are the common symptoms of ‘Anorexia Nervosa?’
A
Amenorrhea, lanugo, dry skin, brittle nails, intolerance/sensitivity to cold temperatures, cardiovascular and gastrointestinal problems.
8
Q
What is ‘amenorrhea?’
A
Absence of menstruation - a possible sign of anorexia nervosa.
9
Q
What is ‘Osteoporosis?’
A
A physical disorder caused by a calcium deficiency that is characterized by extreme brittleness of the bones (from the Greek osteon, meaning “bone,” and the Latin porus, meaning “pore”).
10
Q
What is ‘lanugo?’
A
Is fine, soft, unpigmented hair that is often present in fetuses, newborns, and certain disease states. While IT is a normal finding in fetuses, its presence in an older person might be an indication of underlying pathology
11
Q
What are the specifiers of ‘Anorexia Nervosa?’
A
Restricting type, and the binge-eating/purging type.
12
Q
What is the major distinction between the subtypes of anorexia?
A
The distinction between the subtypes is supported by differences in personality patterns. Those with eating/purging type tend to have problems related to impulse control (binge eating habits, substance abuse, stealing); they tend to alternate because of periods of rigid control and impulsive behaviour. Those with restrictive type tend to be rigidly and obsessively controlled about their diet and appearance.
13
Q
What is the ‘Restricting Type/specifier’ of Anorexia Nervosa?
A
During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting,
and/or excessive exercise.
14
Q
What is the ‘Binge-eating/purging type/specifier’ of Anorexia Nervosa?
A
During the last three months, the individual has engaged in recurrent episodes of binge-eating or purging behaviour (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
15
Q
What is ‘bulimia nervosa?’
A
An eating disorder is characterized by a recurrent pattern of binge eating followed by inappropriate compensatory behaviours to prevent weight gain and accompanied by persistent overconcern with body weight and shape.
16
Q
What are the common symptoms of ‘Bulimia Nervosa?’
A
*Irritations of skin about mouth and hand (due to contact with stomach acid)
* Blockage of salivary ducts
* Decay of tooth enamel and dental cavities
* Stomach acid may damage taste receptors in the mouth (decreased sensitivity to the aversive taste of vomit)
* Abdominal complaints; stress on the pancreas (development of pancreatitis)
* Muscular weakness, cardiac irregularities, sudden death, lost of menstruation
17
Q
How does the ‘binge-eating/purging type” specifier in anorexia differ from bulimia?
A
Although repeated binge eating and purging cycles occur in bulimia, bulimic individuals do not reduce their weight to anorexic levels.
18
Q
What is an example of a ‘systems perspective?’
A
In terms of eating disorders, families are organization systems that are meant to resist overt change; within this perspective, an anorexic girl may be seen as maintaining dysfunctionality by displacing attention from family conflicts and marital tensions onto themselves. The girl might be identified as the problem when it is actually a dysfunctional family unit.
19
Q
What is a ‘systems perspective?’
A
View that problems reflect the systems (family, social, school, ecological, etc.) in which they are embedded.
20
Q
In terms of “losing weight,” which diagnosis is more “successful,” Anorexia Nervosa or Bulima Nervosa?
A
Anorexia, primarily because while both include purging, bulimia involves eating large amounts of food and using compensatory measures like purging. Purging only reduces caloric intake by approx. 50%. Generally, those with bulimia, generally, remain within 10% of their normal weight.
21
Q
What are some examples of “compensatory measures?”
A
Self-induced vomiting, using laxatives and/or diuretics, fasting, exercise.
22
Q
What are the cultural considerations regarding eating disorders?
A
Found overwhelmingly in Western cultures/influence. Some studies have shown African American adolescents to have less body dissatisfaction, few weight concerns, and a more positive self-image.
23
Q
What are the psychological influences of eating disorders?
A
Women with anorexia often have significantly higher perfectionistic attitudes compared to healthy controls. Bulimia women tend to be both perfectionist and dichotomous (“black or white”) in their thinking patterns. Bulimic women also tend to struggle with interpersonal relationships.
* A diminished sense of control,
* Tendency toward perfectionism
* Black or white thinking
* High self-judgment
* Struggles with independence
24
Q
What are the cognitive influences of bulimia nervosa?
A
Women with bulimic tendencies tend to have a dysfunctional cognitive style that may lead to exaggerated beliefs.
25
What are the biological influences of eating disorders?
There is some evidence of a genetic link; the hypothalamus (as it regulates eating) and serotonin (a decrease in production may be a factor in bingeing and impulsivity, it is also involved in regulating mood and appetite, especially for carbs).
26
Binge-Eating Disorder (BED)
Eating disorders characterized by repeated episodes in which binge eating occurs but is not followed by purging.
* Associated with severe obesity
* Have similar concerns about shape and weight
* Later onset; more common in males
* Tends to occur later in life
27
Pica
Eating one or more nonnutritive, nonfood substances on a persistent basis over a period of at least 1 month.
* Could be paper, cloth, hair, soil, chalk, gum, metal, ash
28
What are the sociocultural influences of eating disorders?
Parental and societal influences. Have close but troubled relationships
* Families can be successful, but hard
driving, concerned about external
appearances, and eager to maintain
harmony (Attie et. al., 1985)
* Mothers tend to demonstrate
perfectionism may have low levels
of nurturance and empathy
* Standards of the ideal female body
are often unrealistic
* Increase in diets and exercise trends
* Link between chronic dieting and
bingeing and food preoccupation
29
Multimodal Treatment includes:
CBT – target eating behaviours, attitudes
around body weight and shape
* Interpersonal therapy – target interpersonal
functioning (helping with their ability to create healthy relationships)
* Family therapy – focus on relationships and
communication (aiding a dysfunctional family)
30
What is 'Sleep Efficiency (SE)?'
Commonly defined as the ratio of total sleep time (TST) to time in bed (TIB), plays a central role in insomnia research and practice. The significance of SE is understandable because it captures a core problem for those suffering from insomnia—spending too much time in bed trying to sleep.
31
What are the 'Sleep Stages?' How do they differ?
* Stage 1: low amplitude, high-frequency waves
* Stage 2: sleep spindles (batch of high-frequency waves) & k-complexes (a biphasic wave that stands out from the rest of the wave)
* Stage 1 &2 = "light sleep"
* Stage 3: "slow wave sleep" or "deep sleep." there are high amplitude delta waves that make up about 20% of the brain active - overall restfulness
*REM Sleep: resembles waking activity, most vivid dreams
32
How long is a sleep cycle? How many do we typically cycle through in a night?
Sleep cycles repeat 4-5 times per night, each cycle lasts around 90-110 minutes.
* Order: 1-2-3-2-1-REM-1-2-3-2-1-REM-1-2-3-2-1-REM
33
What is 'REM Sleep?'
REM (rapid eye movement) sleep is the sleep stage associated with dreaming characterized by the appearance of rapid eye movements under closed eyelids. Hypocretin neurotransmitter is involved in arousal and wakefulness.
34
What is a 'neuropeptide?'
An amino acid found in cerebrospinal fluid that plays a role in neuronal transmission and the modulation of brain circuits or regions.
35
What is 'breathing-related sleep disorders?'
Sleep disorders in which sleeping is repeatedly disrupted due to difficulties breathing normally.
36
What is 'Insomnia Disorder?'
Dissatisfaction with sleep quality
or quantity associated with:
* Difficulty initiating sleep
* Difficulty maintaining sleep
* Early-morning awakening with
inability to return to sleep
* Occurs at least 3 nights per week
* Present for at least 3 months
37
How prevalent is 'Insomnia Disorder?'
25% of Canadians report symptoms of insomnia
38
What is 'Hypersomnolence Disorder?'
Excessive sleepiness during the
day; may sleep a lot but never feel
refreshed. Daytime sleep with intended or
unintended naps.
* Sleep-wake disorder involving a persistent pattern of excessive sleepiness during the day.
39
What is 'Narcolepsy?'
Sleep attacks in when a person suddenly falls asleep without warning. Sometimes paired with cataplexy.
* Can occur multiple times per day
* Sleep for an average of 15 minutes
* Sudden irresistible episodes of sleep (sleep attacks)
40
What is 'cataplexy?'
* brief, sudden loss of muscular control
* Can last from seconds to 2 minutes
* Often preceded by a strong emotion
41
What is 'Sleep Paralysis?'
The brief period after awakening when the person can’t move or speak.
42
What is 'Hypnogogic Hallucinations?'
* Vivid experiences that begin at
the start of the sleep and are
generally very realistic
* Often involve visual, touch,
hearing, and even the sensation
of body movements
43
What is 'apnea?'
Temporary cessation of breathing.
44
What is 'Obstructive sleep apnea-hypopnea (OSA)?'
Type of breathing-related disorder involving repeated episodes of either complete or partial obstruction of breathing during sleep.
45
What is 'Circadian Rhythm Sleep-Wake Disorders?'
Disruptions of sleep are caused by a mismatch in sleep schedules between the body’s internal sleep-wake cycle and the demands of the environment.
* Can lead to insomnia or hypersomnia
* Light and melatonin influence our sleep rhythms
46
What is 'Parasomnias?'
Disruptive sleep-related disorders. Abnormal movements, talk, emotions and actions happen while you're sleeping, although your bed partner might think you're awake. Examples include sleep terrors, sleepwalking, nightmare disorder, sleep-related eating disorder and sleep paralysis.
47
What is 'Nightmare Disorder?'
* Recurrent awakenings from sleep
because of frightening dreams
* Dreams are recalled vividly upon
wakening
* Occur during REM sleep
48
What is 'Non-REM Sleep Arousal Disorder?'
Sleep-wake disorders involviing recurrent episodes of incomplete arousal during sleep that are accompanied by sleep terrors or sleepwalking. Comprised of Sleep terrors and sleepwalking.
* Sleep terrors: piercing screams, awake suddenly, don’t remember the dream
* Sleepwalking: walks around while fully asleep
49
What are 'Anxiolytics?'
Drugs, such as sedatives and anesthetics, that induce partial or complete unconsciousness and are commonly used in the treatment of sleep-wake disorders. A class of medications used to prevent or treat anxiety symptoms or disorders. They're sometimes called anti-anxiety medications or minor tranquillizers. Helpful for falling asleep faster, increasing the total length of sleep. and reducing nightly awakening.
These types of medications are habit-forming and can lead to dependency or a substance use disorder. Problems may arise, like the hangover effect, rebound insomnia, reduced effect over time, and dependence.
50
What are the treatment(s) for 'apnea?'
CPAPs surgery.
51
What are the characteristics for psychological treatment for sleep disorders?
CBT for Insomnia, which includes:
* Relaxation training
* Cognitive strategies (e.g., thought-stopping)
* Stimulus control, which includes: strengthening the connection between the bed and sleep, limiting time spent trying to fall asleep, starting with shorter amounts of total sleep and working up to more hours (while waking up at the same time every day with no napping)
52
What does 'use' mean?
Any consumption of a substance.
53
What does 'intoxication' mean?
A substance-induced disorder characterized by clinically significant problematic behavioural or psychological changes caused by the recent ingestion of a substance (state of drunkenness or "being high").
A reversible syndrome caused by a substance that affects one or moe of the functions:
*memory
*orientation
*mood
*judgement
*behavioural, social, or occupational functioning
54
What does 'abuse' mean?
Use of a substance that deviates from social or medical patterns.
55
What does 'misuse' mean?
Use of a prescribed medication that deviates from recommended usage.
56
What does tolerance' mean?
* Phenomenon when, after repeated administration, an increase in the dosage is required for the same effect
57
What is "delirium?"
State of mental confusion, disorientation, and extreme difficulty in focusing attention.
58
What is "delirium tremens (DTs)?"
Withdrawal syndrome that often occurs following a sudden decrease or cessation of drinking in chronic alcoholics that is characterized by extreme restlessness, sweating, disorientation, and hallucinations.
59
What is "tachycardia?"
Abnormally rapid heartbeat.
60
What does 'withdrawal syndrome' mean?
A characteristic cluster of withdrawal symptoms following the sudden reduction or abrupt cessation of use of a psychoactive substance after physiological dependence has developed.
* A substance-specific syndrome that occurs after stopping or reducing the amount of the drug or substance that has been used regularly over a prolonged period.
61
What does 'dependence' mean?
* Physiological – body changes due to repeated consumption and then comes to depend on the substance.
* Psychological – reliance on a substance, regardless of physiologically dependence.
62
What does 'addiction' mean?
Impaired control over the use of a chemical substance accompanied by physiological dependence. Habitual or compulsive use of a drug/behaviour accompanied by distress when not using as well as an irresistible urge to use again
63
What does 'physiological dependence' mean?
State of physical dependence on a drug in which the user's body comes to depend on a steady supply.
64
What does 'psychological dependence' mean?
Reliance as on a substance, although one may not be physiologically dependent.
65
How does the DSM describe substance use disorders?
Substance use disorders involve a pattern of recurrent use of a substance that repeatedly leads to damaging consequences and impaired control over the use of a substance and often includes features of physiological dependence on the substance, as manifested by the development of tolerance or abstinence syndrome.
* Recurrent use
*Damaging consequences
* Impaired control over substance use
* Dependence
66
What does 'Substance Use Disorder' mean?
Patterns of maladaptive behaviour involving the use of a psychoactive substance.
67
What are 'substance-induced disorders?'
Disorders induced by the use of psychoactive substances include intoxication, withdrawal, syndromes, mood disorders, delirium, and amnesia, psychotic disorders, anxiety disorders, sexual dysfunctions, and sleep disorders. Includes:
* Substance intoxication
* Substance withdrawal
* Substance/Medication - Induced Mental Disorders
68
What is 'substance use disorder?'
Patterns of maladaptive behaviour involving the use of the psychoactive substance; leads to damaging consequences.
69
What are the specifiers in Substance Use Disorders?
Early remission, sustained remission, controlled environment.
70
What are the class of substances?
Depressants, opiates, stimulants, and hallucingens.
71
What is characteristic of the 'depressant' class?
A drug that lowers the level of activity of the central nervous system; results in behavioural sedation.
* Induces relaxation
* Alcohol
* Sedatives & hypnotics (barbiturates, benzodiazepines)
72
What are the risk factors for alcoholism?
* Gender (more common in men, occurs more rapidly in women)
* Age (young adulthood, adolescence)
* Antisocial personality disorder (increased risk)
* Family history (predisposition, "bad example."
* Sociodemographic factors
73
What is characteristic of the 'opiates' class?
Types of depressant drugs with storng additive properties that are derived from the opium poppy; provide feelings of euphoria and relief from pain.
74
What are 'narcotics?'
Drugs, such as opiates, are used for pain relief and treatment of insomnia., but which have a strong additive property.
75
What is characteristic of the 'hallucinogens' class?
Substances that give rise to sensory distortions or hallucinations
* Intoxicants that induce sensory distortions or hallucinations
* Also known as psychedelics
* Natural substances (psilocybin - mushrooms, mescaline - peyote)
* Synthetic substances (LSD, PCP)
* Acts on the serotonin system
* Not typically associated with long-term tolerance, withdrawal, or dependence
* Can be taken orally or smoked
76
What are the effects of alcohol?
* Alcohol is absorbed into the bloodstream and then distributed to all body tissues
* Seems to heighten the sensitivity of GABA (reduces communication between neurons)
* Affects serotonin, dopamine, and endogenous opioids
* Thought, judgment, and restraint are loosened
* Although it can ease falling asleep, have adverse effects (decreased REM and stage 4 sleep, increased awakenings)
77
Characteristics of Alcohol intoxication:
Slurred speech, incoordination, unsteady gait, nystagmus, impairment in attention and
memory, stupor or coma. Mild intoxication can start after two drinks (your lid gets flipped, drastic decrease in cognitive ability).
78
Characteristics of Alcohol withdrawal:
Autonomic hyperactivity, hand tremors, insomnia, nausea or vomiting, transient hallucinations, psychomotor agitation, anxiety, seizures. It can develop a few hours to days after cessation of alcohol.
79
What is 'withdrawal delirium?'
* Also known as DTs (delirium tremens)
* Usually occurs for heavy drinkers after years of
use
* Extreme restlessness, sweating, disorientation, and hallucinations
* May be assaultive or act on their hallucinations
* Is a medical emergency
* Untreated, it has a mortality rate of 20%
* Best treatment is prevention – supervised detoxification
80
What are the long-term effects of alcohol?
* High comorbidity with other psychiatric illnesses
* Liver damage (alcohol hepatitis, cirrhosis)
* Higher risk of cancer
* Malnourishment
* Korsakoff's syndrome
* Pregnancy complications
81
What is 'Korsakoff's Syndrom?'
Form of brain damage associated with chronic thiamine deficiency. The syndrome is associated with chronic alcoholism and is characterized by memory loss, disorientation, and the tendency to invent memories to replace lost ones (confabulation)
82
What is the prevalence of 'Alcohol Use Disorder (AUD)?'
* 30-45% of adults met the criteria for an episode of an alcohol-related problem
* 3-5% of women and 10% of men meet the criteria for AUD
* Increasing of women
83
What is the onset of 'Alcohol Use Disorder (AUD)?'
* First episode of intoxication, usually during mid-teens
* Meeting criteria for AUD usually during late teens to early-mid ’20s
84
What is a 'hypnotic?'
Sleep-inducing drugs.
85
What is an 'anxiolytic?'
Anxiety-reducing drugs.
86
Why are the withdrawals and intoxication symptoms for sedatives, hypnotics, and anxiolytics similar to that of alcohol?
They are all depressants, while low doses produce relaxation and mild feelings of well-being.
87
What are 'barbiturates?'
Types of depressant drugs are sometimes used to relieve anxiety or induce sleep, but they are highly addictive.
88
What are 'sedatives?'
Calming drugs. Types of depressant drugs that reduce states of tension and restlessness and induce sleep.
89
What are 'benzodiazepines?'
A type of sedative medication. This means they slow down the body and brain's functions. They can be used to help with anxiety and insomnia (difficult getting to sleep or staying asleep).
* Came in the 1960s
* Safer than barbiturates with less risk of abuse and dependence
* Yet, risk remains, and these are often overprescribed and misused
* E.g., diazepam (Valium), Xanax, Ativan, Rohypnol (illegal)
90
What are the natural forms of opiates?
* Brains "natural opiate system" = labelled endorphins, which is short for endogenous morphine (morphine coming from within).
* Derived from the poppy plant: Morphine, heroin, and codeine.
91
What are the artificial forms of opiates?
* Synthetic opiates include Demerol, Percodan, and fentanyl
92
What are the intoxication effects of opioids?
* Powerful rush (5-15 mins)
* State of satisfaction, euphoria, and welling being (3-5 hours)
* All positive drives are satisfied, all negative feelings of guilt, tension, and anxiety disappear
* A depressant, chemical effects do not directly stimulate cimrinal or aggressive behaviour
* Experience drowainess, slurred speech, impairment in memory or attention
93
What are the withdrawal effects of opioids?
* Flu-like symptoms, accompanied by anxiety, feelings of restlessness, irritability, and cravings for the drug. It can be severe; begin within 4-6 hours after the last dose
* Progression of symptoms after few days: rapid pulse, high blood pressure, cramps, tremors, hot and cold flashes, fever, vomiting, insomnia, diarrhea
* Uncomfortable, but not devastating
* Can last 1-3 days and is usually over within a week
94
What are the overdose effects of opioids?
Usually from respiratory arrest from the depressant effect of the drug
95
Where does the term "cold turkey" come from?
A quick-fix method to quitting tobacco, alcohol, or other drugs. Rather than gradually tapering off the substance, you stop taking it immediately. The term comes from the goosebumps people sometimes get in the days after they quit.
96
What are the long-term effects of opiods?
* 90% of individuals with OUD (Opioid use disorder) develop another psychiatric disorder, such as major depressive disorder, alcohol use disorder, antisocial personality disorder
* 15 % attempt suicide
97
What are the intoxication effects of stimulants?
* Heart races, pupils dilate, changes in blood
pressure, sweating or chills, nausea,
psychomotor agitation
* Euphoria – talkativeness, grandiosity,
alertness, gregariousness, repetitive
behaviour, anger, anxiety
98
What are the withdrawal effects of stimulants?
Fatigue, vivid, unpleasant dreams, insomnia, increased appetite, psychomotor, agitation or retardation
* Seen as a “crash”
* Develops within a few hours to days after
cessation and resolve in a week
99
What is the 'pleasure pathway?'
A surrgence of dopamine.
100
What are the characteristics of "cocaine?"
* Natural stimulant derived from leaves of the coca plant
* Historically and culturally used medicinally
* Then introduced in Coca-Cola and then synthetically
* Increase use through the 1980’s, when it was not viewed to be addictive
*Adverse effects: nasal problems, seizures, cardiac problems, death
101
What is 'crack?'
Hardened, smokable form of cocaine.
* Contains more than 75% pure cocain
102
What is 'freebasing?'
Method of ingesting cocaine by means of heating the drug with ether to separate its most potent component (it's "free base") and then smoking the extract
103
Craving difference between stimulants and depressants
Stimulant withdrawal symptoms typically include:
* Fatigue or mental and physical exhaustion
* Depression or suicidal thoughts
* Sleep problems
Irritability, agitation, or anxiety
* Intense hunger
* Inability to feel pleasure
While depressant withdrawal symptoms typically include:
* Shakiness and overactive reflexes
* Agitation and anxiety
* Nausea or vomiting
* Insomnia or sleep problems
* Increased heart rate, blood pressure and temperature with excessive sweating
* Hallucinations
* Seizures
104
What are the characteristics of "amphetamines?"
Types of synthetic stimulants, such as Dexedrine and Benzedrine. Abuse can trigger an amphetamine psychosis that mimics an acute episode of schizophrenia.
* Synthetic stimulant
* Sometimes used to get a boost or increase energy
* Dependence on the drug is associated with violent behaviour
105
What are some examples of amphetamines?
* Prescription: Dexedrine, Ritalin
* Illegal: speed, uppers, (crystal) meth, MDMA, Ecstasy, ice
* People are known to use it for OCD, and hysteria-related disorders
106
What are the intoxication effects of amphetamines?
* Euphoric intense rush
107
What are the withdrawal effects of amphetamines?
* "Crash" and fall into a deep sleep or depression, and may suffer from brain damage
* Suicide
* Restlessness, irritability, hallucinations, paranoid delusion, loss of appetite, and insomnia
108
Amphetamine Psychosis
Psychotic state induced by ingestion of amphetamines; mimics the features of schizophrenia (hallucinations, delusions)
109
What are the intoxication effects of hallucinogens?
Produce sensory distortions or hallucinations involving major alterations in colour perception and hearing.
* Relaxation and euphoria, panic
* Perceptual changes, psychological changes (e.g., paranoia, anxiety), racing heart, dilated pupils, sweating, tremors, blurry vision
* Thought to expand consciousness
* Effects can be variable, depending on user’s mood, expectations, surroundings
110
What are the adverse effects of hallucinogens?
* Ill-advised behaviours (e.g., injuries from thinking one can fly)
* Persisting Perception Disorder
111
What is 'persisting perception disorder?'
Rare clinical condition in which patients who have had previous exposure to a hallucinogenic substance continue to experience perceptual distortions months to years after complete cessation of the initial substance use.
* Usually associated with LSD.
112
What are some examples of hallocinogens?
* Lysergic acid diethylamide (LSD)
* Psilocybin
* Mescaline
* Marijuana (cannabis)
* Phencyclidine (PCP)
113
What are the characteristics of marijuana/cannabis?
A mild or minor hallucinogen derived from the Cannabis sativa plant.
114
What are the intoxication effects of cannabis?
* Low doses helped to relieve anxiety
* High doses lead users to withdraw into themselves and perceive time passing more slowly (a few mins seems to last an hour)
* Reports on increased insight and creativity
* Heavy intoxication = perception of time changes, a few mins feels like an hour
* Awareness of bodily sensations; heightens sexual sensations.
* Visual hallucinations
115
What are the withdrawal effects of cannabis?
Sleep problems, anger, irritability, loss of appetite, nightmares.
116
What are the adverse effects of cannabis?
Impair cognitive abilities, increase experiences of paranoia as well as psychotic symptoms.
* Associated with patterns of compulsive use or psychological dependence rather than physiological dependence.
117
What are "Inhalants?"
Volatile substances that produce chemical vapours that can be inhaled to induce a psychoactive, or mind-altering, effect; also known as "solvents."
* Interact with GABA and dopamine systems
* 4 classes: solvents for glues & adhesives, propellants (aerosols, hair sprays), thinners (paint products, nail polish), fuels (gasoline, propane).
* Highest prevalence in young males; often seen in Indigenous communities.
118
What are the effects of "Inhalants?"
* Intoxication: Dizziness, nystagmus, incoordination, slurred speech, lethargy, tremor, stupor, euphoria.
* Apathy, diminished social and occupational functioning, impaired judgment, and impulsive or aggressive behaviour
* Reinforcing effects of inhalants occur mainly through their effects on GABA and dopamine.
119
What are the biological perspectives of addiction?
* Evidence for a genetic vulnerability (especially for AUD)
* Pleasure pathway - dopaminergic system
* Rates of metabolisms
* Sensitivities to certain drugs
120
What are the learning perspectives of addiction?
* Classical: triggers that induce cravings (association with visuals and aromas)
* Positive reinforcement: chase the high
* Negative reinforcement: take away the stress and pain; tension-reduction (self-medicating)
* Observational: parental or peer modelling
121
What is a 'stimulus smoker?'
An examing of 'the conditing model of cravings' where someone will reach for a cigarette in the presence of smoking-related stimuli like seeing someone else smoke or smelling smoke.
* Smoking can become a strongly conditioned habit when paired repeatedly with situational cues: finishing dinner, driving, drinking or socializing with friends, sex, etc.
122
What are "Seemingly Irrelevant Decisions (SIDs)?
Those decisions which directly contribute to making lapse and relapse a more likely outcome and can be anticipated and acted on to prevent or reduce the risk of lapse and relapse.
123
What are the cognitive perspectives of addiction?
* Attitudes toward substances & peer attitudes
* Self-efficacy expectations: beliefs in our abilities to accomplish tasks directly or indirectly; people may rely on drugs to protect their self-efficacy
* Expectancy Effect: When someone expects a given result, that expectation unconsciously affects the outcome or report of the expected result.
* Seemingly Irrelevant Decsiiosn (SIDs)
*Self-fulfilling prophecy & absolutist thinking/black-white thinking (Beck): if people believe one drink will cause a loss of control, they perceive the outcome as predetermined when they drink.
124
What are the sociocultural perspectives of addiction?
In order:
1. Experimentation
2. Social Use
3. Habitual Use
4. Abuse
5. Dependency
125
What are the different forms of (biological) treatment?
Detoxification, agonist substitution, antagonistic treatment, aversive treatment.
126
What is 'detoxification?'
Process of ridding the system of alcohol or drugs under supervised conditions in which withdrawal symptoms can be monitored and controlled.
* Medical supervision that helps control the withdrawal process
127
What is 'agonist substitution?'
Providing the person with safer drugs that are similar to the harmful drug.
* Methadone, suboxone, nicotine patch or gum
128
What is 'antagonist treatment?'
Blocks/counteract the effects of the drugs.
* Naltrexone and naloxone for opiates.
129
What is 'aversive treatment?'
* A form of classical conditioning
* Makes using the substance unpleasant, allows for other treatments
* Disulfiram (antabuse)
130
What is 'Relapse Prevention Training?'
* Developed by Alan Marlatt
* Cognitive-behavioural technique used in the treatment o addictive behaviours that involves the use of behavioural and cognitive strategies to resist temptations and prevent lapses from becoming relapeses.
131
What is the difference between a 'lapse' and a 'relapse?'
A lapse is a momentary slip, whereas relapse is a reoccurrence of a problem.
132
What is the 'Abstinence Violation Effect?'
An overreaction to a lapse which leads to a full-on relapse.
133
What are 'Self-control' strategies?
* Antecedent cues or stimuli that trigger the use
* Abusive behaviours
* Reinforcing or punishing consequences
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What is 'Motivational Interviewing?'
* Works with ambivalent clients about changing (any form of behavioural change).
* Motivation and change come and go, and the client-therapist sits with it through all the stages; there are no contradictions and no challenges for the patient.
* Non-accusatory questions are asked.
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What are Prochaska & DiClemente's Stages of Change; how do they differ?
* Pre-contemplation (ppl don't think they need to change)
* Contemplation (aware that they need to change, considering what to do)
* Preparation (attempts are made to change behaviour)
* Action (committed to changing behaviour)
* Maintenance
* An unofficial 6th stage, relapse, is popularly included because occasional slips are inevitable in the change process.
136
What are the characteristics of AA/NS/CA?
View alcoholism as a disease
* Use the term addicts
* Use religion to overcome the power of the substance
137
What is 'Harm Reduction?'
An evidence-based, client-centred approach seeks to reduce the health and social harms associated with addiction and substance use without requiring people who use substances to abstain or stop.
* Understands that substance use will occur in society
* Seeks to minimize the harm associated with the substance as its primary goal
* Goal: build relationships and offer additional support when the individual is ready
* Safe injection sites: education on safe use, needle swap programs
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What is 'Person-centered language?'
Examples of person-first language include “people with disability,” “person with multiple sclerosis,” “person with chronic pain,” or “people who have epilepsy.”
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What does 'prevalence mean?'
The measure of a condition in a population at a given point in time (in this document referred to as point prevalence ); can also be measured over a period of time (e.g. a year).
140
How does the 'binge-eating/purging type" specifier in anorexia differ from bulimia?
Although repeated binge eating and purging cycles occur in bulimia, bulimic individuals do not reduce their weight to anorexic levels.
141
How do findings suggest that serotonin plays a role in binge eating and bulimia?
Serotonin is involved in regulating mood and appetite, and when individuals take antidepressants (SSRIs) which increase serotonin activity, it can decrease binge-eating episodes in bulimic women.
* A correlation is found between depressed individuals and those with eating disorders.
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How did bulimic individuals fare in the "Simon Spatial Incompatabiloity Task?" What did the findings reveal?
* Individuals with bulimia were more impulsive than others during testing.
* Group differences and patterns (in brain activity) suggest that individuals with bulimia do not activate frontostriatal circuits, perhaps contributing to impulsive responses that require activation of those circuits and self-regulatory control to generate a correct response.
* The inability to engage the frontostriatal systems may contribute to their inability to regulate binge eating and other impulsive behaviours.
143
What is the 'diathesis-stress model?'
The model suggests that a mental disorder develops when an individual has a vulnerability or predisposition combined with exposure to stressful life events.
144
Using the 'diathesis-stress model,' what might contribute to the development of eating disorders?
A genetic predisposition involving dysfunction of neurotransmitter activity interacts with family, social, cultural, and environmental pressures, thereby leading to the development o of eating disorders.
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What proves to be the best methods for treatment regarding feeding and eating disorders?
CBT should be the first treatment choice, followed by the use of antidepressant medication if psychological treatment is not successful.
* The multimodal treatment!
146
What is 'family group psychoeducation (FGP)?'
The aim is to provide information about mental illnesses and help consumers and families enhance their problem-solving, communication, and coping skills.
147
What is 'sleep-wake disorder?'
Diagnostic category representing persistent or recurrent sleep-related problems that cause significant personal distress or impaired functioning.
148
What is 'polysomnographic (PSG) recording?'
The simultaneous measurement of multiple physiological responses during sleep or attempted sleep.
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What does 'psychoactive' mean?
Describing chemical substances or drugs that have psychological effects.
150
What does "disorientation" mean?
State of mental confusion or lack of awareness with respect to time, place, or the identity of oneself or others.
151
What is meant by 'early remission?'
3 months to 1 year with no presence of DSM-5 criteria symptoms.
152
What is meant by 'sustained remission?'
1 year or more with no presence of DSM-5 criteria symptoms.
153
What is meant by 'controlled environment?'
If individual is in an environment where access to substances are.
154
What is 'analgesia?'
States of relief from pain without loss of consciousness.
155
What are the recommendations for drinking alcohol?
*10 drinks a week for women, with no more than 2 drinks a day most days
*15 drinks a week for men, with no more than 3 drinks a day most days
* Plan non-drinking days every week to avoid developing a hab
156
What neurotransmitter (NT) does cocaine "play with"?
Dopamine, thereby producing pleasurable intoxication effects.
* The drug produces a sudden rise in blood pressure, constrains blood vessels, and accelerates the heart rate.
157
What are some complications associated with nicotine usage?
* Causes cancer in the larynx, oral cavity, esophagus, and lungs; may contribute to bladder, pancreas, and kidney cancer.
* Pregnant women risk miscarriage, premature birth, and birth defects
* 2x more risk in developing Alzheimers & other forms of demirta
158
What are the withdrawal effects of cocaine?
It consists of depression, inability to experience pleasure, and intense cravings for the drug.
* Usually brief and involve a "crash," it period of intense depression and exhaustion following a binge.
159
What are the effects of cocaine usage in utero?
Infants exposed showed impaired auditory information processing, which may lead to subsequent language deficits.
160
What are the intoxication effects of nicotine?
* Increases alertness, cold, clammy skin, nausea, vomiting, dizziness, faintness, diarrhea
* Stimulates the release of epinephrine, a hormone that generates a rush of autonomic activity, including rapid heartbeat and release of stores of sugar
* Quells appetite, and provides a psychological "kick."
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What are the withdrawal effects of nicotine?
Lack of energy, depressed mood, irritability, frustration, nervousness, impaired concentration, light0headness, dizziness, drowsiness, headaches, fatigue, irregular bowels, insomnia, cramps, lowered heart rate, heart palpitations, increased appetite, weight gain, sweating, tremors, craving
162
What is 'persisting perception disorder?'
Rare clinical condition in which patients who have had previous exposure to a hallucinogenic substance continue to experience perceptual distortions months to years after complete cessation of the initial substance use.
163
What are 'flashbacks?'
* Vivid re-experiencing of a past event, which may be difficult to distinguish from current reality
* Experiences of sensory distortions or hallucinations occurring days or weeks after the use of LSD or another hallucinogenic drug that mimic the drug's effects
164
What is "delta-9-tetrahydrocannabinol?"
The major active ingredient in marijuana (abbreviated THC)
165
What is 'hashish?'
Drug derived from the resin of the marijuana plant; Cannabis sativa.
166
What is 'methasone?'
Artificial narcotic that lacks the rush associated with heroin and is used to help people addicted to heroin abstain without incurring an abstinence syndrome.
167
What is 'naloxone?'
A drug that prevents users from becoming high if they subsequently take heroin. Some people are placed on naloxone after being withdrawn from heroin to prevent a return to heroin.
168
What is 'naltrexone?'
The Chemical cousin of naloxone the blocks the high from alcohol as well as opiates and is now approved for use in treating alcoholism.
169
What is 'Al-Anon?'
The organization that sponsors support groups for family members of people wth alcoholism.
170
What is 'cue-exposing training?'
The treatment used for people with substance-related disorders; it involves exposure to cues associated with the ingestion of drugs or alcoholic beverages in a controlled situation in which the person is prevented from using the drug.
171
What is 'relapse-prevention training?'
The cognitive-behavioural technique used in the treatment of addictive behaviours that involves the use of behavioural and cognitive strategies to resist temptations and prevent lapses from being relapses.
172
What is the 'abstinence-violation effect (AVE)?'
The tendency in people trying to maintain abstinence from a substance, such as alcohol or cigarettes,m to overrate to a lapse of feelings of guilt and a sense of resignation that may then trigger a full-blown relapse.
173
What is 'controlled social drinking?'
A controversial approach to treating problem drinkers in which the goal of treatment is the maintenance of controlled social drinking in moderate amounts, rather than total abstinence.
