General Information

Question 1

What are the characteristics of an addiction? (MILLER)

Answer 1

-Something done regularly, repeatedly, and habitually
- A compulsive quality that seems partially beyond the person’s control
- Persists despite potential or actual adverse consequences

Question 2

How is addiction defined according to the DISEASE model? (LEWIS)

Answer 2

Addiction as a brain disease (strongly biological)

Question 3

How is addiction defined according to the PERSONAL CHOICE model? (LEWIS)

Answer 3

Addiction as a problem with the decision-making system (strongly cognitive)

Question 4

How is addiction defined according to the SELF-MEDICATION model? (LEWIS)

Answer 4

Addiction as a result of attempts to manage distressing symptoms
(strongly developmental)

As children and adolescents develop, emotional problems can erode their sense of well-being and try different strategies until they find something that works (i.e., psychoactive drugs are found to relieve anxiety, interrupt rumination, or brighten one’s mood).

Question 5

What are the 5 models regarding the etiology of addiction?

Answer 5

PADSS Acronym

1. Personal Responsibility Model
2. Agent Models
3. Dispositional Models
4. Social Learning Models
5. Sociocultural Models

Question 6

What is the Personal Responsibility Model?

Answer 6

Addiction attributed at least partially to a failure of self-control, or a
violation of moral, ethical, or religious standards

Treated or prevented though legislation, education, repentance, punishment, and
social sanctions

Addiction as a choice

Question 7

What is the agent model?

Answer 7

Addiction attributed to the power / strength of the substance and its
effects

The drug itself is to blame, so remove it from society

Question 8

What is the dispositional model?

Answer 8

Addiction attributed at least partially to physical conditions of the addict,
though not to a lack of fortitude or willpower

Treatment through humane (often medicalized) routes, not punishment

Addiction as a (physical) disease

Question 9

What is the social learning model?

Answer 9

Addiction arises due to basic learning principles such as classical and
operant conditioning, and social learning

Treatment through behavior modification and manipulations of experience

Question 10

What is the sociocultural model?

Answer 10

Addiction attributed at least partially to social and cultural factors, such
as price / availability of alcohol or socioeconomic disparities

Treatment through alcohol/drug policy

Question 11

What is the public health perspective?

Answer 11

groups causal factors into three categories: those involving the agent (in this case, the drug itself), the host (personal characteristics of an individual), and the environment.

Question 12

What are the 5 stages of change?

Answer 12

PCPAM Acronym

1. Precontemplation: individuals are not especially aware of their problems and
   have no plans to change their behavior in the foreseeable future
2. Contemplation: individuals are aware of their problems but have not yet made a
   serious commitment to do anything about them
3. Preparation: individuals have begun to make small changes in their problematic
   behaviors with the intention of making more complete changes within 1 month
4. Action: successful (more complete) change has occurred for short time periods
5. Maintenance: goal is to maintain the behavioral and attitudinal changes

Question 13

Why is there a high rate of co-occuring disorders?

Answer 13

1. genetic vulnerability: People may have genetic vulnerabilities that increase the likelihood of developing both disorders
2. neurocognitive factors: For example, impairment in self-regulation, high impulsivity, cognitive control problems
3. developmental factors: Early exposure to a substance may increase risk of developing MH symptoms / disorders
4. environmental factors: Abuse, trauma, poverty, adverse childhood experiences

Question 14

What are some of the over-represented disorders that co-occur with SUDs?

Answer 14

MAPS

Mood Disorder
Anxiety Disorders
Personality Disorders (Antisocial and Borderline)
Schizophrenia Spectrum and other Psychotic Disorders

Question 15

What is the quadrant model?

Answer 15

offers a useful framework for conceptualizing subgroups of people with co-occurring conditions by understanding the severity of each disorder

Question 16

Quadrant 1

Answer 16

display low severity of both substance use and mental illness. They may not seek treatment at all, and if they do they are usually treated in nonspecialist settings, with specialist consultation as needed.

Question 17

Quadrant 2

Answer 17

display low substance use severity and high mental illness severity, and are usually seen in mental health settings. A collaborative or integrated model is preferred, in which substance use and mental health service providers collaborate, or where services are blended with a single team of providers.

Question 18

Quadrant 3:

Answer 18

These individuals have high substance use and low
psychological severity, and are most often seen in addiction service settings. Similar to Quadrant II, a collaborative model is preferable, offering integrated treatment of disorders.

Question 19

Quadrant 4:

Answer 19

People in this quadrant have severe substance use and
severe mental illness. They may be seen in mental health clinics or hospitals, correctional facilities, and emergency departments. They may also be bounced back and forth between mental health and addiction treatment facilities. It is for people in this quadrant that an integrated service model is most vital.

Question 20

What are the 7 dimensions of addiction?

Answer 20

1. Substance use: extent and pattern of the person’s use of psychoactive substances (i.e., how much, how often, and steady vs. periodic patterns of use).
2. Problems: extent to which substance use or other addictive behavior has resulted in adverse consequences for the individual and those around him or her.
3. Physical adaption: Drug tolerance, chronic tolerance, acute tolerance, physiological dependence
4. Behavioral dependence: A more general pattern of behavioral dependence is that the drug gradually assumes a more central place in the person’s life, displacing other activities, relationships, and social roles that once had greater priority
5. Cognitive impairment: Psychoactive drugs can also have acute (temporary) or chronic (long-term) effects on cognitive functioning, adaptive abilities, and intelligence
6. Medical harm: Many psychoactive drugs also have the potential to damage physical health. Some harm is due to the acute effects of intoxication such as risk taking, aggression, and overdose. Other forms of medical harm are related to chronic use (i.e., cancer, heart disease, etc.)
7. Motivation for change: Reluctance to recognize the need for change and take action is a common problem in addiction.

Question 21

What is the purpose of motivational interviewing?

Answer 21

having a conversation about change that strengthens people’s own motivations and commitment; person-centered

Question 22

What are the 4 themes of motivational interviewing?

Answer 22

1. Collaborative: partnership in which clients are recognized as experts on themselves
2. Evocative: calling forth people’s own insights, motivations and resources, rather than trying to install things that clients are presumed to lack
3. Acceptance  respecting and supporting clients’ autonomy (their right and power to make decisions about their own lives and behaviors)
4. Compassion  fundamental commitment to clients’ best interests and well-being as prime priority

Question 23

What are the 4 processes of motivational interviewing?

Answer 23

1. Engaging process: listening to and developing a working alliance with clients (Can we walk together?)
2. Focusing: developing shared goals for the journey (Where are we going?)
3. Evoking: person’s own motivation for change (Why do you want to go there?)
4. Planning: treatment plan (How will we get there?)