Chapter 12: Substance Use Disorders

Question 1

What are the categories of symptoms in substance use disorders?

Answer 1

• Impaired control
• Social impairment
• Rising use
• Pharmacological criteria

Question 2

What is compensatory response?

Answer 2

Equal and opposite physical response to counteract the effects of a substance to maintain homeostasis

Question 3

What is the severity rating of drug use disorders?

Answer 3

• Mild: 2-3 criteria
• Moderate: 4-5 criteria
• Severe: 6+ criteria

Question 4

What is the difference between dependence and abuse?

Answer 4

• Abuse: psychological and behavioral symptoms

* Dependence: tolerance, withdrawal, compulsive use

Question 5

Why was the DSM-IV distinction between dependence and abuse removed in the DSM-5 and instead calling it “substance use disorder”?

Answer 5

Due to confusion surrounding “dependence” - defining addiction as a substance use disorder is more inclusive way to ID people who need help. Also that there is not much real distinction between abuse and dependence

Question 6

What are substance-induced disorders?

Answer 6

When ingestion of a substance results in serious behavioral, psychological, and physiological signs and symptoms

Question 7

Diagnostic criteria for substance-induced disorders?

Answer 7

Specifies that the associated symptoms are reversible and there is physical evidence that it was recently ingested

Question 8

What is substance intoxication?

Answer 8

• Symptoms vary greatly depending on the substance
• Symptoms often resemble other disorders - you don’t know if person is intoxicated or actually going through a psychological disorder

Question 9

Prevalence of alcohol related disorders

Answer 9

• Prevalence rate highest between 21-34 years old
• Males have higher rates than females
• High rate of co-morbidity with other disorders - using alcohol as self-medication

Question 10

What is dual diagnosis?

Answer 10

Substance use disorder in addition to another disorder

Question 11

What is pharmacological dependence?

Answer 11

More typical at the more severe end of the spectrum - tolerance, withdrawal

Question 12

What constitutes abuse of alcohol?

Answer 12

• Failure to complete committed tasks - usually due to intoxication or hangover
• May also involve legal problems - disorderly conduct, DUI’s, etc

Question 13

Diagnosis of alcohol abuse

Answer 13

• Recent ingestion of alcohol
• Clinically significant maladaptive behavior or psychological changes (aggressive behavior, mood lability (swings), impaired functioning)
• Slurred speech, incoordination, unsteady gait, nystagmus, impairment in attention/memory, stupor, coma

Question 14

Biological causes of alcohol behavior

Answer 14

• Genetically inherited

* Differences in metabolism of alcohol

Question 15

Psychosocial causes of alcohol behavior

Answer 15

• Emphasis on oral dependency

* Problems during oral stage of development

Question 16

Behavioral causes of alcohol behavior

Answer 16

• Positively or negatively reinforced from previous drinking - operant conditioning
• Multiple regulation theory - classical conditioning

Question 17

What is multiple regulation theory?

Answer 17

Classical conditioning - person pairs ingestion of alcohol with “good” feelings, pairs not drinking with neutral or “bad” feelings, used to describe alcohol, cigarette smoking, etc

Question 18

Cognitive causes of alcohol behavior

Answer 18

Cognitive expectancies - expect experience to be fun/positive, and by virtue of expectancies it is fun

Question 19

What are delirium tremens?

Answer 19

Occurs during alcoholism treatment - person may develop hallucinations/delusions which require monitoring and inpatient care

Question 20

What is the AA-disease model?

Answer 20

Alcoholism is a disease so alcohol triggers onset of alcoholism. Thus, the key is complete abstinence from alcohol

Question 21

What is the learned behavior model?

Answer 21

• Says that problem drinking is a learned behavior, so behavior can be modified.
• Uses “harm reduction” program - does not prescribe abstinence
• What can we do to help you drink and have it remain a positive experience, not go into a negative experience
• Assumes people will drink - teaches them to drink at a level that reduces harm

Question 22

What is the only non-substance addiction in the DSM?

Answer 22

• Gambling - has signs of tolerance and withdrawal
• Life is centered around gambling, it is used as coping
• Behavior continues after significant loss

Question 23

What is internet use addiction?

Answer 23

Under DSM-5 as “conditions that require further research”

Question 24

What are diagnostic criteria for internet use addiction?

Answer 24

• How often you lose sleep, try to cut down time but fail
• Tolerance and withdrawal, starts off and spends more and more time
• Take person off internet, get extreme reaction