Brain Disease Arguments Flashcards
What are the arguments for and against the brain disease model statement of “Addiction if a disorder of fronto-striatal circuitries”? (3 and 1, respectively)
Pro:
- All substances (of abuse) affect dopamine pathways involved in cravings and havits
- Substance abuse is associated with altered function and gray matter loss (PFC, insula and Cingulate Cortex- regions involved in top-down cognitive control)
- In line with a chronic disease, these changes are long-lasting and persist after abstinence
Opp:
- Some brain functions do show recovery (thus “chronic disease/long-lasting” can be debated)
Opponents of the brain disease model argue that brain lesions/dysfunction are not sufficiently specific to support diagnosis. What are the counterarguments (2) of proponents of the model?
- Neuroimaging as the ultimate diagnostic tool is not realistic. Other neuropsychiatric disorders can also not be diagnosed on the basis of brain scans
- Neuroimaging helps reveal underlying mechanisms (identify targets for behavioural/pharmo. treatment)
Right, but other neurpsychiatric disorders are also not considered chronic brain disorders, so like, wtf is that first argument
What is a problem with neuroimaging studies (BD model) and what is the counterargument of proponents of the BD model?
Opp:
- Neuroimaging offers correlational evidence (not causal)
Pro:
- Agrees with above, thus convergence with findings from experimental animal models
There are a lot of arguments against animal findings as well (other flashcards) + generalization from animal studies to humans is questionable
“That is not an argument against the brain disease model, as these factors ultimately exert their influences on behaviour by impacting neural processes.” This is a counterargument from proponents, what is it a counterargument against?
Social influences, environment, policies, availability, costs and socioecenomic factors also play an important role in the risk for addiction
How does the cost/availability affect neural processes- that makes 0 sense to me tf. Also you cannot technically say that environment/social shit impact neural processes because it is an interactive effect (it goes both ways). It is inherently an argument for both sides simultaneously??
Genetic predisposition does not equate addiction, why do proponents not think this an argument against the BD model?
- Genetic risk is probabilistic, not deterministic (that is what the statement implies, yes)
- Heritability of alcohol addiction is around 50%, thus DNA sequence variation accounts for 50% of the risk (which is, all in all, really not that high??)
- Polygenic risk factors are shared across different substances
Proponents of the BD model note that complete abstinence is relatively rare as a treatment outcome & that test-retest reliability is likely low in people with only mild SUD(???). People at the severe end do tend to shot a chronic relapsing course.
What is the counterargument by opponents?
Just note that the argument is for the chroning relapsing part of BDM
That of spontaneous remission (which is seen in large proportions)
Although it is unclear if this happens in severe cases
Regarding stigmatization of addiction, what do the pros of the BD model argue and what counterarguments to the opps have?
Pro:
- “Chronic illness sufferer view” as opposed to moralistic “bad person” view helps people to get the treatment that they deserve
- Biology-based definition of addiction aims to alleviate moral judgement/discrimination/stigma
Opp:
- Evidence suggest BD model does not alleviate stigma (and sometimes even worsens it)
- There are other alternatives to the moral model than the BD model
