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Addictive and compulsive disorders > Important lecture slides > Flashcards

Important lecture slides Flashcards

1
Q

Psychological symptoms of alcohol

A

Fear
Depressed mood
Confusion
Sleep problems
Mood swings

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2
Q

Withdrawal symptoms of alcohol within 8-12 hours

A

Nausea
Not eating
Headache
Light shaking
Fear
General sick feeling

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3
Q

Withdrawal symptoms of alcohol within 12-36 hours

A

Insomnia
Restless/agitation
Tremors
Sweat/palpitations

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4
Q

Withdrawal symptoms of alcohol within 48 hours

A

Withdrawal feeling / delirium
Tremor
Sweating
Agitation
Slight fever
Hypertension

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5
Q

Psychological symptoms of cannabis

A

Difficulty concentrating
Memory impairment
Fear
Suspicion/paranoia

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6
Q

Withdrawal symptoms of cannabis

A

Insomnia
Depressed mood
Agitation

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7
Q

Psychological symptoms of cocaine

A

Lack of energy
Depressed mood
Fear and panic
Suspicion and paranoia
Insomnia

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8
Q

Why does substance use co-occur with PTSD?

A

Substance use increases the risk of trauma
More substance use to cope with PTSD
No habituation when under the influence
Substance use can trigger symptoms
Other causal influences like genetic predisposition

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9
Q

Exceptions to waiting before making a diagnosis

A

Social anxiety disorder
OCD
Specific phobia
PTSD
GAD

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10
Q

Advice for dual-disorder treatment

A

Has no additional effect on addiction and there is no evidence-based integrated treatment. Just follow regular guidelines for the disorder and treat both separately

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11
Q

System 1- thinking fast

A
  • Unconscious
  • Evolved early
  • Shared with animals
  • Non-verbal
  • Rapid, parallel
  • High capacity
  • Domain specific
  • Pragmatic
  • Independent of working
    memory, IQ
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12
Q

System 2- thinking slow

A
  • Conscious
  • Evolved late
  • Uniquely human
  • Verbal
  • Slow, sequential
  • Low capacity
  • Logical, abstract
  • Hypothetical
  • Related of working memory
    capacity, IQ
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13
Q

Non reaction-time tasks related to memory

A
  • Outcome-behavior associations
    – Present outcome, assess spontaneously generated behaviors in a top-of-mind awareness test
    Having fun:________________
  • Cue-behavior associations
    – Present a word or picture cue or context, assess spontaneously generated behaviors
    Friday night:_______________
  • Word associations
    – First associations to ambiguous words which can be alcohol/drug related or not (e.g. “draft” “bottle” ….)
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14
Q

Experimental lab studies (POP)

A
  • not motivated to change
  • tests causality
  • not aware of what they are receiving and what is happening
  • goal is temporary change if bias is changed
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15
Q

RCTs

A
  • tests efficacy
  • motivated to change
  • aware of receiving treatment
  • reduction in online and consistent add on effects in face to face
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16
Q

Conclusion of CBM

A

CBM is effective as add-on in the treatment of
AUD when people are motivated to change (but have
problems succeeding in change due to cue-reactivity (C.E.
Wiers et al 2015), strong bias (Eberl et al 2013) strong impulsivity
Not in binge-drinkers not motivated to change (cf.
Lindgren et al PlosOne, 2015) nor in online training in people who want to reduce

17
Q

Improvement of CBM

A
  • gamification (but not found to be better)
  • more personalized goals
  • personalized learning
  • training based on more reliable assessment
  • training after reactivation
  • neurostimulation
18
Q

Phases during ABC

A
  1. Forced choice to learn consequences (continued in shamtraining)
  2. Open choice with consequences
  3. Speeded open choice with consequences, to foster
    automatization
19
Q

Compulsivity

A

Continued use of drugs/substances despite knowledge of negative consequences

20
Q

Transdiagnostic

A

Common underlying processes are believed to
play a role in the development and
maintenance of these various disorders. These
TD processes can serve as therapeutic targets.

21
Q

Endophenotype

A

biological or psychological phenomena of a disorder
believed to be in the causal chain between genetic contributions to a disorder and diagnosable symptoms of psychopathology

22
Q

Research Domain centre

A

It integrates many levels of information (from genomics and neurobiology to behavior and self-report) to explore basic
dimensions of functioning that span the full range
of human behavior from normal to abnormal. The
goal is to understand the nature of mental health
and illness in terms of varying degrees of
dysfunction in general psychological/biological
systems

23
Q

Goal-directed definition

A

Belief criterion- representation of causal relationship between action and outcome
Motivational criterion- representation of incentive value of outcome

24
Q

How are habits behaviourally autonomous?

A

Under external stimulus control (stimulus dependent) but independent of desirability of the outcome

25
Habit account
Aberrantly strong habits (together with impaired cognitive control) mediate the transition from goal-directed, recreational substance use towards compulsive substance abuse.
26
Brain areas related to drug use
Craving and goal-directed drug-seeking PFC, mesolimbic dopamine pathway Drug habits Nigrostriatal dopamine pathway (substantia nigra  posterior putamen) Drug abuse / addiction Compulsive behavior PFC dysfunction
27
3 dopamine pathways
* Mesolimbic – VTA -> NAcc * Nigrostriatal: – SN-> posterior putamen * Mesocortical – VTA -> PFC
28
Brain areas linked to habits and goal-directed actions in rats
Lesions to DMS and prelimbic cortex linked to habitual behaviour and lesions to DLS/infralimbic cortex are goal-directed in rats. Lesions to the nigrostriatal pathway disrupt habit formation so responding sensitive to outcome devaluation
29
Brain areas linked to habits and goal-directed actions
Ventromedial pre-frontal cortex and caudate have been linked to goal-directed action and motor cortex and putamen (over-training) has been linked to habits
30
Homeostatic account
Brain changes after chronic drug use to lower dopamine transmission. Down-regulation of D2 receptors, could also underlie decrease reward sensitivity in addiction and tolerance effects
31
Reward deficiency syndrome
Lower D2 receptors reflect individual differences in reward sensitivity. Less D2 receptors means lower reward sensitivity and higher vulnerability for addiction
32
How are drug-associated cues motivational magnets?
Through their association with past substance use, locations, situations, people and other stimuli may become “motivational magnets” that draw the user to them, thereby increasing the likelihood of more substance use. This has been studied with the conditioned place preference paradigm.
33
Reward prediction error
When the prediction of reward in that situation is not yet completely accurate, this leads to surprise and a reward prediction error occurs. Midbrain dopamine neurons encode this prediction error. This is a signal to cortico-striatal brain circuits that the current reward value does not match the expected value. So it functions as a teaching signal. Once the CS-US relationship has been learned, the predictive cue (CS) will evoke a dopamine response. Therefore, the DA neurons fire at the (unexpected) presentation of the CS (instead of the fully predicted US).
34
Phases in CBT
Taxation Intervention Relapse prevention Conclusion
35
What do CBT interventions aim to improve?
Coping skills Social skills Cognitive therapy Self-control
36
How to prepare for change?
Improve motivation through MI, make cost benefits analysis which includes short-term, long-term, disadvantages of using and advantages of not using. Aim is to provoke change language.
37
Self-control measures
Stimulus control (avoidance) Stimulus- response prevention (alternative behaviours) Response consequences (rewards and negative reinforcements)

Addictive and compulsive disorders (11 decks)

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