Abnormal Test #3 Review Ch. 9, 10, 11, 12, 16 Flashcards
(148 cards)
1
Q
What is psychology in law?
A
Clinical practitioners and researchers operating within the legal system.
2
Q
What do forensic psychologists do?
A
May testify in trials, research reliability of eyewitness testimony, or help police profile killers
3
Q
What is criminal commitment?
A
People accused of crimes who are deemed mentally unstable and are sent to a mental institution for treatment
4
Q
What is the M’Naghten Test?
A
Stated that experiencing a mental disorder at the time of a crime does not itself mean that the person was insane; defendant had to be unable to know right from wrong.
5
Q
Stats for those who plead insanity?
A
50% White, 86% male, mean age 32, less than 1% of cases plead insanity
6
Q
What is the guilty but mentally ill verdict?
A
Defendants are found to have had a mental illness at the time of the crime, but was not fully related to or responsible for the crime. Usually given prison term with added treatment afterwards (in 14 states)
7
Q
Who are considered mentally disordered offenders?
A
Those who repeatedly are found guilty of sex crimes; committed to mental health institutions.
Must be found “sexually dangerous beyond a reasonable doubt”
Must be good candidate for treatment.
Whites 2X more likely to get this classification than Latinos/Blacks
8
Q
What is the sexually violent predator law?
A
17 States; Call for certain sex offenders to be committed to mental institution after prison sentence, against their will if a judge deems them likely to engage in further predatory acts.
9
Q
What is civil commitment?
A
Legal process by which an individual can be forced to undergo mental health treatment if the person is deemed dangerous to themselves or others.
Most have family members involved in committing the person.
10
Q
What is minimum standard of proof?
A
Must be clear and convincing proof that he/she is mentally ill and has met the states’ criteria for involuntary commitment.
Suicidal patients can be involuntarily committed with 2 physicians certificates.
11
Q
Which mentally ill patients are most dangerous?
A
Those with schizophrenia, major depression, or bipolar disorder
12
Q
Problems with civil commitment?
A
- Difficulty in assessing a person’s dangerousness
- Legal definition of “mental illness” and “dangerous” are too vague
- Questionable therapeutic value for those committed involuntarily
- Potential for misuse: asylums for women when men divorced them in the 1960s; former Soviet Union; today in China
13
Q
What is Right to Treatment?
A
Legal right of patients, particularly those involuntarily committed, to receive adequate treatment:
-More therapists, better living conditions, more privacy, more social interactions, more use of proper restraint and medication
14
Q
What is Right to Refuse Treatment?
A
Legal right of patients to refuse certain forms of treatment, such as psycho-surgery, ECT, some psychotropic drugs
15
Q
What are some other patient rights?
A
Right to aftercare and to an appropriate community residence, such as a group home.
Right to receive treatment in least restrictive facility available.
16
Q
What can Psychologists vs Psychiatrists do?
A
Psychologists in some states can now commit patients to state hospital.
Psychologists CANNOT prescribe medication.
17
Q
What is a code of ethics?
A
Body of principles and rules for ethical behavior, designed to guide decisions and actions by members of a profession.
18
Q
What is Psychologists code of ethics?
A
- Offer advice in any form as long as its based on appropriate research/practice.
- Cannot conduct fake research, plagiarize, publish false data.
- Recognize limitations w/ regards to patients who are disabled or whose gender, ethnicity, language, status, or sexual orientation differs from the therapist.
- In legal cases, must base assessments on sufficient info
- May not take advantage of clients/students sexually or otherwise
19
Q
What is the principle of Confidentiality?
A
Certain professionals won’t divulge the info they obtain from the client.
20
Q
What’s the Duty to Protect?
A
Responsibility to break confidentiality even w/o consent when necessary to protect the client and others from harm.
Must protect people who are close to a client’s intended victim, such as children. (Tarasoff case-murdered intended victim)
Protection of minors, elders, and vulnerable populations
21
Q
DSM5 Criteria of Anorexia Nervosa
A
- Doesn’t maintain more than 85% body weight.
- Restricted net intake of nourishment=low weight
- Intense fear of gaining weight, even though very underweight.
- Disturbed body perception/ persistent denial of seriousness of current low weight
- Stops menstruating
22
Q
What are 2 types of anorexia?
A
- Restricting-type anorexia-restricts intake; first starts with sweets then increasingly cut out all other foods
- Binge-Eating/Purging-type anorexia- force themselves to vomit after meals or use diuretics
23
Q
Prevalence of anorexia in females?
A
90-95%
.5-2% will develop it at some point in their lives
24
Q
Age of onset in anorexia?
A
14-18 years old
25
Goal of anorexia? Driving motivation? Co-morbid illnesses?
1. Become thin
2. Fear (of becoming obese, giving in to food, losing control
3. Depression, substance abuse, insomnia, low self-esteem, OCD, anxiety
26
Problems caused by anorexia?
Low BP, Bone mass decline, brittle nails, ammenorhea, seizures, anemia, hair loss, electrolyte imbalance, low WBC, irreg. heart rate, dry/yellow skin, lanugo
27
DSM5 criteria for Bulimia Nervosa
1. Recurrent episodes of binge-eating (rapid consumption under 2 hours eating high cal over 1000cal meals), sense of lack of control over eating.
2. Recurrent inappropriate compensating behavior to prevent weight gain (vomiting/fasting, laxative use, excessive exercise)
3. Must binge/compensate at least once a week for 3 months
4. Self-eval unduly influenced by body shape and weight
28
What are the 2 types of bulimia?
1. Purging-type bulimia=use laxatives, diuretics, vomiting
| 2. Non-purging type= fast, excessive exercising
29
Prevalence of bulimia?
1. 5% of females will have at some point
2. 90-95% cases female
3. Mostly normal or slightly overweight individuals
4. Often from chaotic family lifes
30
Onset of bulimia?
15-21 typically
31
Co-morbidities with bulimia?
BPD, depression, impulsivity w/sex and substance abuse
32
Medical issues associated with bulimia?
Potassium depletion, laxatives cause diarrhea, problems w/ electrolytes, vomiting damages esophagus, dental enamel, swollen salivary glands, inability to feel satiated after meal
33
What is Binge-Eating Disorder? (DSM5)
1. Recurrent episodes of binges
2. Binge at least 1X a week for 3 months
3. Eat unusually rapid, large amounts w/o physical hunger, eating until uncomfortably full, eating alone due to embarrassment, self-disgust, depression, guilt
34
Etiology of eating disorders?
```
Multi-dimensional risk perspective=identify several key factors that place individuals at risk for these disorders.
Combines:
-Biological
-Psychological
-Sociocultural
influences.
```
35
Biological etiology of EDs?
1. Genetics-identical twins 70% likely to have same disorder
2. Lateral hypothalamus, ventromedial hypothalamus, CCK and GLP-1 form the "weight thermostat" that keeps person at a "weight set point"
3. Low serotonin causes carb cravings
36
What happens if weight thermostat isn't working properly?
When people diet and fall below "weight set point", brain tries to restore the weight=preoccupation with food and binging
37
Sociocultural etiology of EDs?
1. EDs more prevalent in Western cultures-shifts towards thin frame (Becker;Fiji study)
2. Professions such as actors, models, dancers, athletes are more prone..models dying over this.
3. Over the last 3 decades, the "ideal" female weight has dropped=increase in EDs
38
What happened in Fiji in 1995?
```
TV shows (soaps) came to Fiji-few years later research found that Fijian teen girls that watched TV at least 3X a week were more likely than others to feel "too fat"
-In addition, almost 2/3 had dieted in the previous month and 15% had vomited to control weight within the previous year (compared to 3% before TV)
```
39
Family theory with EDs?
* Minuchin
- Child phsyiological vulnerability and family characteristics determines if child will form ED or not
- Family characteristics for anorexia=enmeshment, over-protectiveness, rigidity
- Family characteristics for bulimia=chaotic, role confusion, explosive
40
Psychodynamic etiology of EDs?
* Bruch
- Parents misread child's cues and overfeed/deprived
- Child learned to ignore internal hunger/satiation cutes and became overly dependent on others to meet needs
- Ergo, lack of: labeling feelings, self-soothing, independence, impulse control
- Thought disturbance=what others think; lack of control over life
41
Experiential (Client-centered, Gestalt, etc) etiology of EDs?
1. Client centered (Rogers) "conditions of worth" from parents and media (valued for what I do..being a size 2..etc)
2. Gestalt=Goal to experience, express, behave as a whole rather than displacement of feelings/pleasing others
3. Existentialism (Yalom)=Avoidance of existential dilemma of freedom
42
Cognitive/Behavioral etiology of EDs?
1. Inaccurate perception of internal cues (hunger, fullness)
2. Cognitive distortions
- behaviors negatively reinforced by reducing anxiety-->operant conditioning
- distorted perception of weight, shape, size
- distorted relationship between weight and self-worth
- distorted perception of being "perfect"
43
Eclectic approach of treatment of EDs?
Combines biological, behavioral, dynamic, socio-cultural, and cognitive methods
44
Biological interventions?
1. Weight stabilization
2. Anti-depressants to increase serotonin levels
3. Psycho-education
45
Behavioral interventions?
1. Eating behavior triggers
2. Exposure with response prevention
3. Operant conditioning
4. Assertiveness/ Social skills
46
Dynamic interventions?
1. Developmental cues
2. Ego strength: Affects regulation
3. Pleasing others, self-worth
47
Socio-cultural interventions?
1. Family patterns
| 2. Cultural messages
48
Cognitive interventions?
1. Body size distortion
2. Distortions @ eating (all or nothing)
3. Criterion for self-worth
49
Medical treatment of Anorexia?
1. Initial goal= immediate weight gain; stabilize body weight
2. Hospitalization or intensive outpatient (force feeding) with ultimate goal of gaining 1-2 lbs a week
3. Rewards for eating
4. Anti-depressants for serotonin levels
5. Second goal=weight maintenance, psycho-education with nutritionist
50
Medical treatment of Bulimia?
1. Initial goal=stop binge/purge cycle and stabilize body's systems.
2. Anti-depressants
3. Hospitalization or intensive outpatient
- eat with response prevention
- psycho-education with nutritionist
51
Family therapy goals for both EDs?
1. For those with anorexia:
- high parental involvement
- "food police", need to change communication strategy
- independence after weight gain
- teach conflict resolution
2. For those with bulimia:
- stabilize chaos
- change role of patient vs. parents
- teach conflict resolution
52
DSM5 criteria for substance abuse disorder?
1. Maladaptive pattern of substance abuse leading to significant impairment or distress.
2. Presence of 2 or more within 12 months:
- taken often/in larger amounts/longer time than intended
- persistent desire or unsuccesful attempts to decrease
- excessive amounts of time to obtain/use/recover
- failure to fulfill work/school/home obligations
- cont' use despite problems caused by it
- stopping/reducing social/work/rec activity
- recurrent use despite physical hazzards
53
What is tolerance?
The need to use more and more of a drug to reach the same high/effect
54
What is tolerance affected by?
dose size, intradose interval, how quickly it enters the bloodstream, and individual differences
55
What is withdrawal?
opposite symptoms of drug's effect; varies by substance
| -causes clinically significant distress or dysfunction in social, occupational, or other important areas of functioning
56
What are some types of depressants?
Alcohol, opiods, sedative-hypnotics
57
Types of Opiods?
Heroin, morphine, methadone
58
Types of sedative-hypnotics?
Barbiturates, Benzos (xanax, ativan, valium, etc)
59
What are some types of stimulants?
Cocaine, amphetamines, meth, crank, ritalin, adderall, nicotine, caffeine
60
With alcohol, what are levels of impairment related to?
Concentration of ethyl alcohol in blood
61
BAC's?
```
BAC=.02 Drunk driver under 21
BAC=.04 Drunk driver commercial
BAC=.06 relaxation/comfort
BAC=.08 Drunk driver over 21
BAC=.09 Intoxication
BAC= over .55 Death (most people lose consciousness before they can drink this much)
```
62
Rate at which alcohol is metabolized?
25% of an ounce per hour
63
What is a binge drinker?
Someone who has over 5 drinks in a night
64
What constitutes someone as a heavy drinker?
5 binges or more a month
7% of people heavy drinkers
-males 8%, females 4%
65
Short term effect of alcohol?
- Binds to GABA which increases GABA's inhibitory messages to relax
- CNS: judgement, speech, motor, reaction time, vision, hearing
- cause of 1/3 suicides, homicides, assaults, rapes, and accidental deaths
- Cause of 30% of all fatal car crashes
66
Long term effect of alcohol?
- Malnutrition
- Cirrhosis of liver
- Damage to brain (frontal lobe), short term memory, speed of thinking, attention, and balance
- Hypertension, heart failure, increased risk of stroke
- Korsakoff's syndrome
- With sudden cessation of drinking: delirium tremens and withdrawal
67
Symptoms of Fetal Alcohol Syndrome?
- intellectual development disorder
- facial abnormalities
- slowed growth, heart defects
- many psychiatric problems
68
Which narcotics are used for pain?
Morphine, codeine=legal with prescription
69
Which narcotic is illegal?
heroin in all forms
70
Which narcotic is used in clinics for treatment of heroin addictions?
methadone
71
What do narcotics do?
-Attach to receptor sites of endorphins which relieve pain and reduce emotional tension
72
How fast does one form tolerance/withdrawal from narcotics?
quickly, after only a few weeks.
73
Symptoms of narcotic withdrawal?
anxiety, restlessness, sweating, rapid breath, twitching, aches, fever, vomiting, high BP, loss of appetite
-Peaks on 3rd day, usually gone by 8th day
74
Biggest concerns with narcotics?
- Quick physical dependency=quick dysfunction
| - Return to use, taking previous dose could cause overdose (death)
75
What are sedative-hypnotics used for/how do they work?
- Used for calming
| - Binds to GABA receptor sites and increases GABA activity which inhibits anxiety symptoms
76
Problem with sedative-hypnotics?
- Only meant for short term use
- Lethal dose remains the same, even though tolerance continues to build
- Withdrawal can cause dangerous convulsions, need MD
- Can die from respiratory failure; often combined with fatal alcohol use
77
Characteristics of Nicotine?
- Stimulant
- Nicotine receptors in CNS for Ach
- Tobacco causes: cancer, emphysema, cardiovascular damage, stroke
78
Symptoms of nicotine withdrawal?
Irritability, cravings, sleep trouble, low metabolism, cognitive difficulties
79
How does cocaine work?
Causes euphoria from flood of dopamine which then increases serotonin and norepinephrine levels-->then huge crash
80
Symptoms of intoxication from cocaine?
Poor coordination, grandiosity, bad judgement, anger, aggression, compulsive behavior, anxiety, confusion, hallucinations, delusions
81
Concerns with cocaine?
- Cheaper versions available (such as crack) means increased use.
- Overdose: 20% of all male suicides; respiratory failure; heart failure
82
Other names for methamphetamine?
Crank, glass, ice, meth
83
What is meth?
- An amphetamine derivative (methedrine)
- Psychostimulant
- Highly psychologically addictive
84
Effects of meth?
Euphoria, intense energy, sleeplessness, then very intense crashing, depression
85
Types of hallucinogens?
LSD, mescaline, shrooms, ecstasy( MDA, MDMA)=both stimulant and hallucinogen
86
Intoxication of hallucinogen?
- Hallucinations (usually visual)
- Increased emotionality
- Altered perception
- Synesthesia
- Flashbacks that can occur hours, days, even months after ingestion
- Increased risk of developing psychosis and mood disorders (diathesis-stress model)
87
Some bad effects of cannabis?
- May cause panic reactions (ends 3-6 hours)
- Sensorimotor effects linked to accidents
- Memory problems with new information
88
How much more potent is Cannabis since the 70s?
4X
89
Long term heavy use of cannabis risks?
- Withdrawal:flu-like symptoms, restlessness, irritability
- Poor concentration/impaired memory (under 24) that can cause school/work problems
- May cause respiratory problems/cancer
- May affect reproduction
- Amotivational syndrome
- If family has history of psychiatric disorders=increased emergence of disorders
- 30% develop substance abuse disorder
90
What is caused by combining substances?
- Synergistic effects=one kind of synergistic effect occurs when 2+ drugs have similar(agonistic) actions
* ex: alcohol, barbiturates, benzos, and opoids (all depressants, may severely depress CNS and could lead to death)
91
Another kind of synergistic effect?
When two or more drugs have opposite (antagonistic) effects
| *ex:stimulants with alcohol-->may build up lethal levels because of metabolic issues
92
Biological etiology?
-Individual differences (7% of population has alcoholism)
93
Sociocultural etiology?
- Most likely to develop substance abuse when living under stressful situations
- lower socioeconomic status=more alcoholism and substance abuse rates
- 18.5% of unemployed use an illegal drug, 9.4% part-time workers do, and 8.8% full time workers do
94
Psychodynamic etiology?
- People who abuse substances have powerful dependency needs that can be traced to early years
- Parents fail to nurture=depend excessively on others for help/comfort
- If no help/comfort found=turn to drugs
95
What is substance abuse personality?
- More prone to drug use
| - Tend to be more dependant, antisocial, impulsive, novelty-seeking, depressive than others
96
Cog/Behvaioral etiology?
- Operant conditioning may play a role in substance abuse
- Temporary reduction of tension/raising spirits from drug use has rewarding effects, thus increasing likelihood of re-using
- Develop expectancy that substances will be rewarding (may lead to using higher doses)
- People "medicate" themselves when feeling tense (over 22% of all adults who suffer from psychological disorders have been dependent on or abused alcohol/other substances)
- 1/4 of those severely depressed depend on/abuse drugs
97
Biological etiology?
- Genetic disposition for it (alcoholism in family)
- Alcoholism concordance rate of 54% in identical twins, fraternal only 28%
- One study found an abnormal form of dopamine-2 receptor gene in majority of people w/ alcohol, nicotine, or cocaine dependency, but gene in less than 20% of non-dependent participants
98
Biochemical factors in substance abuse?
-Once drug is ingested, increases activity of certain neurotransmitters that normally calm, reduce pain, lift mood, or increase alertness in people. Brain makes adjustment and reduces own production of these neurotransmitters, which causes need for more of the drug for same effect
99
What is the reward center?
- The pleasure pathway in the brain that all drugs eventually activate
- Key neurotransmitter involved=dopamine
- Cocaine, amphetamines, caffeine all directly increase dopamine activity
100
What is reward deficiency syndrome?
- The reward center isn't readily activated by usual revents in lives, so they turn to drugs to stimulate this pleasure pathway
- Abnormal genes such as abnormal D2 receptor genes have been cited as a cause of this
101
What is tolerance?
The need to use more and more of a drug to reach the same high/effect
102
What is tolerance affected by?
dose size, intradose interval, how quickly it enters the bloodstream, and individual differences
103
What is withdrawal?
opposite symptoms of drug's effect; varies by substance
| -causes clinically significant distress or dysfunction in social, occupational, or other important areas of functioning
104
What are some types of depressants?
Alcohol, opiods, sedative-hypnotics
105
Types of Opiods?
Heroin, morphine, methadone
106
Types of sedative-hypnotics?
Barbiturates, Benzos (xanax, ativan, valium, etc)
107
What are some types of stimulants?
Cocaine, amphetamines, meth, crank, ritalin, adderall, nicotine, caffeine
108
With alcohol, what are levels of impairment related to?
Concentration of ethyl alcohol in blood
109
BAC's?
```
BAC=.02 Drunk driver under 21
BAC=.04 Drunk driver commercial
BAC=.06 relaxation/comfort
BAC=.08 Drunk driver over 21
BAC=.09 Intoxication
BAC= over .55 Death (most people lose consciousness before they can drink this much)
```
110
Rate at which alcohol is metabolized?
25% of an ounce per hour
111
What is a binge drinker?
Someone who has over 5 drinks in a night
112
What constitutes someone as a heavy drinker?
5 binges or more a month
7% of people heavy drinkers
-males 8%, females 4%
113
Short term effect of alcohol?
- Binds to GABA which increases GABA's inhibitory messages to relax
- CNS: judgement, speech, motor, reaction time, vision, hearing
- cause of 1/3 suicides, homicides, assaults, rapes, and accidental deaths
- Cause of 30% of all fatal car crashes
114
Long term effect of alcohol?
- Malnutrition
- Cirrhosis of liver
- Damage to brain (frontal lobe), short term memory, speed of thinking, attention, and balance
- Hypertension, heart failure, increased risk of stroke
- Korsakoff's syndrome
- With sudden cessation of drinking: delirium tremens and withdrawal
115
Symptoms of Fetal Alcohol Syndrome?
- intellectual development disorder
- facial abnormalities
- slowed growth, heart defects
- many psychiatric problems
116
Which narcotics are used for pain?
Morphine, codeine=legal with prescription
117
Which narcotic is illegal?
heroin in all forms
118
Which narcotic is used in clinics for treatment of heroin addictions?
methadone
119
What do narcotics do?
-Attach to receptor sites of endorphins which relieve pain and reduce emotional tension
120
How fast does one form tolerance/withdrawal from narcotics?
quickly, after only a few weeks.
121
Symptoms of narcotic withdrawal?
anxiety, restlessness, sweating, rapid breath, twitching, aches, fever, vomiting, high BP, loss of appetite
-Peaks on 3rd day, usually gone by 8th day
122
Biggest concerns with narcotics?
- Quick physical dependency=quick dysfunction
| - Return to use, taking previous dose could cause overdose (death)
123
What are sedative-hypnotics used for/how do they work?
- Used for calming
| - Binds to GABA receptor sites and increases GABA activity which inhibits anxiety symptoms
124
Problem with sedative-hypnotics?
- Only meant for short term use
- Lethal dose remains the same, even though tolerance continues to build
- Withdrawal can cause dangerous convulsions, need MD
- Can die from respiratory failure; often combined with fatal alcohol use
125
Characteristics of Nicotine?
- Stimulant
- Nicotine receptors in CNS for Ach
- Tobacco causes: cancer, emphysema, cardiovascular damage, stroke
126
Symptoms of nicotine withdrawal?
Irritability, cravings, sleep trouble, low metabolism, cognitive difficulties
127
How does cocaine work?
Causes euphoria from flood of dopamine which then increases serotonin and norepinephrine levels-->then huge crash
128
Symptoms of intoxication from cocaine?
Poor coordination, grandiosity, bad judgement, anger, aggression, compulsive behavior, anxiety, confusion, hallucinations, delusions
129
Concerns with cocaine?
- Cheaper versions available (such as crack) means increased use.
- Overdose: 20% of all male suicides; respiratory failure; heart failure
130
Other names for methamphetamine?
Crank, glass, ice, meth
131
What is meth?
- An amphetamine derivative (methedrine)
- Psychostimulant
- Highly psychologically addictive
132
Effects of meth?
Euphoria, intense energy, sleeplessness, then very intense crashing, depression
133
Types of hallucinogens?
LSD, mescaline, shrooms, ecstasy( MDA, MDMA)=both stimulant and hallucinogen
134
Intoxication of hallucinogen?
- Hallucinations (usually visual)
- Increased emotionality
- Altered perception
- Synesthesia
- Flashbacks that can occur hours, days, even months after ingestion
- Increased risk of developing psychosis and mood disorders (diathesis-stress model)
135
Some bad effects of cannabis?
- May cause panic reactions (ends 3-6 hours)
- Sensorimotor effects linked to accidents
- Memory problems with new information
136
How much more potent is Cannabis since the 70s?
4X
137
Long term heavy use of cannabis risks?
- Withdrawal:flu-like symptoms, restlessness, irritability
- Poor concentration/impaired memory (under 24) that can cause school/work problems
- May cause respiratory problems/cancer
- May affect reproduction
- Amotivational syndrome
- If family has history of psychiatric disorders=increased emergence of disorders
- 30% develop substance abuse disorder
138
What is caused by combining substances?
- Synergistic effects=one kind of synergistic effect occurs when 2+ drugs have similar(agonistic) actions
* ex: alcohol, barbiturates, benzos, and opoids (all depressants, may severely depress CNS and could lead to death)
139
Another kind of synergistic effect?
When two or more drugs have opposite (antagonistic) effects
| *ex:stimulants with alcohol-->may build up lethal levels because of metabolic issues
140
Biological etiology?
-Individual differences (7% of population has alcoholism)
141
Sociocultural etiology?
- Most likely to develop substance abuse when living under stressful situations
- lower socioeconomic status=more alcoholism and substance abuse rates
- 18.5% of unemployed use an illegal drug, 9.4% part-time workers do, and 8.8% full time workers do
142
Psychodynamic etiology?
- People who abuse substances have powerful dependency needs that can be traced to early years
- Parents fail to nurture=depend excessively on others for help/comfort
- If no help/comfort found=turn to drugs
143
What is substance abuse personality?
- More prone to drug use
| - Tend to be more dependant, antisocial, impulsive, novelty-seeking, depressive than others
144
Cog/Behvaioral etiology?
- Operant conditioning may play a role in substance abuse
- Temporary reduction of tension/raising spirits from drug use has rewarding effects, thus increasing likelihood of re-using
- Develop expectancy that substances will be rewarding (may lead to using higher doses)
- People "medicate" themselves when feeling tense (over 22% of all adults who suffer from psychological disorders have been dependent on or abused alcohol/other substances)
- 1/4 of those severely depressed depend on/abuse drugs
145
Biological etiology?
- Genetic disposition for it (alcoholism in family)
- Alcoholism concordance rate of 54% in identical twins, fraternal only 28%
- One study found an abnormal form of dopamine-2 receptor gene in majority of people w/ alcohol, nicotine, or cocaine dependency, but gene in less than 20% of non-dependent participants
146
Biochemical factors in substance abuse?
-Once drug is ingested, increases activity of certain neurotransmitters that normally calm, reduce pain, lift mood, or increase alertness in people. Brain makes adjustment and reduces own production of these neurotransmitters, which causes need for more of the drug for same effect
147
What is the reward center?
- The pleasure pathway in the brain that all drugs eventually activate
- Key neurotransmitter involved=dopamine
- Cocaine, amphetamines, caffeine all directly increase dopamine activity
148
What is reward deficiency syndrome?
- The reward center isn't readily activated by usual revents in lives, so they turn to drugs to stimulate this pleasure pathway
- Abnormal genes such as abnormal D2 receptor genes have been cited as a cause of this
