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Abnormal Psychology > EXAM 3 - Substance-Related, Addictive & Impulse-control Disorders > Flashcards

EXAM 3 - Substance-Related, Addictive & Impulse-control Disorders Flashcards

1
Q

Substance use

A

Taking moderate amounts of a substance in a way that doesn’t interfere with functioning

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2
Q

Substance intoxication

A

Physical reaction to a substance (e.g., being drunk)

Often involves impaired judgment, mood changes, and lowered motor ability

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3
Q

Substance abuse

A

Use in a way that is dangerous or causes substantial impairment in your life (e.g., affecting job or relationships)

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4
Q

Substance dependence

A

May be defined by tolerance and withdrawal

Sometimes defined by drug-seeking behavior (e.g., spending too much money on substance)

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5
Q

Tolerance

A

Needing more of a substance to get the same effect
Reduced effects from the same amount
A need for markedly increased amounts of the substance to achieve intoxication or desired effect
A markedly diminished effect with continued use of the same amount of the substance

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6
Q

Withdrawal

A

Physical symptom reaction when substance is discontinued after regular use
The characteristic withdrawal syndrome for the substance
Another substance is taken to relieve or to avoid withdrawal symptoms

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7
Q

Substance-Related Disorders in DSM-5: The 11 Criteria associated with substance use
There are no longer separate designations for intoxication, abuse, and dependence
Severity qualifiers are assigned:
Mild (2 or 3 of the 11 criteria are met)
Moderate (4 or 5 of the 11 criteria are met)
Severe (6 or more of the 11 criteria are met)

A

Taking more of the substance than intended or over a longer period of time than was intended
Persistent desire or unsuccessful efforts to cut down or to control use
Excessive time spent using substance, in activities to acquire substance or in recovering from the effects of the substance
Craving for or strong desire to use the substance
Failure to fulfill major role obligations at work, school, or home
Continued use despite persistent or recurrent social or Interpersonal problems caused by or exacerbated by substance use
Important social, occupational, or recreational activities are given up or reduced due to the substance use
Recurrent substance use in physically hazardous situations (e.g. driving)
Recurrent substance use despite knowing it is causing or exacerbating physical or psychological problems

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8
Q

Depressants

A

Behavioral sedation (e.g., alcohol, sedative, anxiolytic drugs)

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9
Q

Stimulants

A

Increase alertness and elevate mood (e.g., cocaine, nicotine)

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10
Q

Opiates

A

Produce analgesia and euphoria (e.g., heroin, morphine, codeine)

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11
Q

Hallucinogens

A

Alter sensory perception (e.g., marijuana, LSD)

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12
Q

Other drugs of abuse

A

Include inhalants, anabolic steroids, medications

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13
Q

The Brain’s Pleasure Centers - The Limbic System

A

Hippocampus (memories)
Amygdala (emotions)
The Striatum

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14
Q

Reward Circuits

A

Ventral Tegmental Area
Nucleus Accumbens
The Locus Coeruleus
The Prefrontal Cortex

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15
Q

How do drugs produce their effects and lead to addiction?

A

Some Stimulate GABA receptors, major inhibitory neurotransmitters, and causes dopamine to be released
Reduces tension (benzodiapines)
Some Increase levels of dopamine and/or endorphins
Pleasurable feelings
Some reduce levels of serotonin, Others increase serotonin
Some inhibit glutamate receptors
Cognitive effects, such as slurred speech, impaired decisions, and memory loss

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16
Q

Some Stimulate GABA receptors

A

major inhibitory neurotransmitters, and causes dopamine to be released
Reduces tension

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17
Q

Some Increase levels of dopamine and/or endorphins

A

Pleasurable feelings

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18
Q

Some reduce levels of serotonin, Others increase serotonin

Some inhibit glutamate receptors

A

Cognitive effects, such as slurred speech, impaired decisions, and memory loss

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19
Q

Alcoholism

A 
Jellinek’s (1946) sequence of behaviors associated with alcohol dependence:
Periodic, excessive drinking
Blackouts
Sneaking drinks
Loss of control over drinking (Key Sign)
Remorse and rationalization
Changing patterns
Morning Drinking
Benders
Defeat
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20
Q

Incidence rates for Alcohol Dependence

A

men is over 20% and for women is over 8%

Native American youth have highest rates

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21
Q

Alcohol Use: The Effects - Acts on multiple neurotransmitter systems

A

Major effects on GABA, an inhibitory neurotransmitter; inhibits firing of other neurons (e.g. anti-anxiety)
Effects glutamate system, excitatory (e.g. learning/memory)
Effects serotonin (e.g., mood, sleep, eating. Cravings)

At low blood alcohol levels (.03 to .06)
Disinhibitory Effect (ex., boisterous, aggressive, depressed)
Impaired Judgment
At higher blood concentrations (.06 up)
Psychomotor Incoordination 
More impaired Judgment
22
Q

At low blood alcohol levels (.03 to .06)

A 
Disinhibitory Effect (ex., boisterous, aggressive, depressed)
Impaired Judgment
23
Q

At higher blood concentrations (.06 up)

A

Psychomotor Incoordination

More impaired Judgment

24
Q

Effects of Alcohol:

Hangovers

A

From the conginers added to alcohol to enhance the taste; These can be added chemicals or byproducts of the fermentation process.
Only ¼ to 1/3 of alcohol is metabolized in 1 hour

25
Q

Negative Physiological Effects of Alcohol Dependence

A

Hepatitis (Inflammation of the Liver)
Treatable

Cirrhosis of the Liver (Fat buildup along with fibrous tissue replacing liver cells)
Nonreversable; eventually toxins destroy the liver

Wernicke-Korsakoff’s Syndrome (Dementia)
Memory impairment
Flat Affect
Blackouts

Delirium Tremens
After sudden cessation of drinking, when dependent for many years
Can be fatal (Seizures, Hallucinations)

26
Q

Social Factors of Alcoholism

A

The more available, the higher the rates of alcoholism (ex., bartenders, liquor store owners)
Alcohol use by parents increases risk of drinking in children
Risk increases with Psychiatric problems, marital problems, lack of emotional support from parents, lack of parental monitoring of children’s behavior, or legal problems
Media influences problems (Countries that ban alcohol ads had 16% less consumption)
Cost of alcohol

27
Q

Psychological Factors

of Alcoholism

A

Alcohol abuse can be reinforced by altering mood states

Alcohol-> Stress->Alcohol

While alcohol is reported to reduce stress, it is not really a very potent stress reducer for most people

The Exception: People with Anxiety Problems may find it more tension reducing

28
Q

Biological Factors

of Alcoholism

A

Concordance rates are higher in identical than fraternal twins
The diathesis may be an inherited higher tolerance for alcohol
Risk is low among Asians
3/4 of Asians have an inherited deficiency in an enzyme that metabolizes alcohol and drinking causes noxious effects

29
Q

Schuckit (1994, 1996) found 2 variables that predicted the development of alcohol abuse in a 10 year follow-up study of men

A

1)Self-report of low level of intoxication after a dose of alcohol
2)Less body sway after drinking
Women with these indicators tend to have a positive family history of alcoholism (but not men)

30
Q

Swedish Adoption Studies

A

Offspring of alcoholic parents reared by nonalcoholic adoptive parents are more likely to develop alcoholism than people in general

31
Q

Treatment of Alcoholism

A 
Alcoholics Anonymous
12 Step Program
Abstinence
Inpatient Treatment
Detox (just the first step in treatment)
Doesn’t appear superior to outpatient treatment, unless they have few sources of social support or if they have comorbid psychiatric disorders
32
Q

Treatment of Alcoholism: Controlled Drinking (Sobell & Sobell, 1993) (Now called “Guided Self-Change”)

A

Cognitive-Behavioral Approach
Emphasizes personal responsibility & control
Identify negative aspects of drinking (cost, behavior)
Narrowing where drinking occurs
Sipping instead of gulping
Reinforce resisting the urge to drink
Alternative coping skills developed

33
Q

Medications for Alcoholism

A

Disulfiram (Antabuse):
Causes violent vomiting if ingested with alcohol
Blocks the metabolism of alcohol
Very high drop out rates

Opiate Antagonists:
Naltrexone (Revia)
Blocks activity of endorphins stimulated by alcohol, reducing cravings
Reduced relapse compared to placebo when combined with counseling

Acamprosate (Campral) is the most recent medication approved by the FDA
Used by individuals who are already abstaining from alcohol use to maintain sobriety
People are 3 times more likely to abstain from alcohol use compared to a placebo
Acts on the glutamate system to reduce withdrawal symptoms

SSRI anti-depressants
Improve treatment when depression is a comorbid diagnosis

34
Q

Narcotics

A

Sedative and analgesic-painreducing effects

35
Q

Barbiturates

A

Powerful sedatives and anticonvulsants

36
Q

Tranquilizers

A

Benodiazepines: Valium, Xanex; Rohypnol (“Roofies”)
Can die of withdrawal
Extremely addictive

37
Q

Effects of Narcotics:

A

Similar to the effects of alcohol (so very dangerous to take with alcohol
Act on GABA, inhibitory neurotransmitter
CNS depressants

38
Q

Stimulant Drugs

A

Amphetamines
Nicotine
Caffeine
Cocaine

39
Q

Stimulant Drugs

A

Effect dopamine by blocking its reuptake in the synapse by binding to their sites on the dendrites; thus, stimulating the dopamine sites in the pleasure pathways of the brain
Can be very addictive

40
Q

Opiates

A

Opium
Morphine
Heroin
Oxycodone (other pain killers)

41
Q

The Opiates

A

Effects natural opioids in the brain: enkephalins and endorphins that produce narcotic effects
Can be very addictive

42
Q

Hallucinogens

A

Distortions in Sensory Perception

43
Q

Hallucinogens

A 
LSD
Psilocybin (mushrooms)
Mescoline (from peyote)
PCP (Angel Dust)
Ecstasy (also has properties of amphetamines)
44
Q

LSD

A

Seeds of the morning glory plant)and psilocybin certain mushrooms likely effect serotonin

45
Q

Mescoline

A

found in the peyote cactus plant) likely affects norepinephrine

46
Q

Ecstasy

A

likely affects serotonin and dopamine mixed hallucinogen/amphetamine
Some may affect acetylcholine

47
Q

Cannabis (from the hemp plant)

A

Marijuana (leaves)

Hashish (dried resin)

Active ingredient is THC

THC activates the same cannaboid receptors in the brain as the neurotransmitter, Anadamide, and has a pain relieving effect (in the limbic system, cortex, and cerebellum), but interferes with their normal functioning

THC also effects dopamine

Long-term use reduces hippocampal activity (Memory)

Rarely can trigger psychosis that may be irreversible

About 10% of people who use marijuana become dependent on it.

It is the most commonly abused drug, except for alcohol and nicotine

48
Q

Principles of Effective Treatment for Substance Use Disorders (NIH, 2009)

A

pic

slide38

49
Q

Gambling Disorder

A

New disorder in
DSM-5
Classified under “Addictive Disorders”

Recurrent gambling leading to clinically significant distress or impairment

50
Q

DSM 5 Gambling Disorder Criteria

A

pic slide 47

51
Q

Gambling Disorder: Treatment

A

Psychosocial treatment similar to substance abuse
Treatment is often ineffective
Motivation to get better is critical; dropout is high
Research is limited, but multipart CBT interventions are under investigation
Scheduling alternative activities, setting financial limits, relapse prevention

Abnormal Psychology (18 decks)

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