Module 1

Question 1

Risk factors SUD

Answer 1

younger age
Gender: men greater risk
Living alone
Being unemployed
Very high degree of urbaniyation
(Unrelated to income)
(Unrelated to country of origin)

Question 2

Individual risk factors

Answer 2

Early aggressive behaviour in childhood
Early drug use ->importance of prevention

Question 3

Individual Protective factors against SUD

Answer 3

Self-efficacy (belief in self control)
Academic performance

Question 4

Family risk factors SUD

Answer 4

Lack of parental supervision
Substance abuse by caregivers

Question 5

Protective family factors SUD

Answer 5

Parental monitoring and support

Question 6

Peer risk factors SUD

Answer 6

Low refusal skills
Poor social skills

Question 7

Protective peer factors

Answer 7

Positive relationships

Question 8

School risk factors SUD

Answer 8

Drug availability at school

Question 9

Protective school factors SUD

Answer 9

School anti-drug policies

Question 10

Community risk factors SUD

Answer 10

Community poverty

Question 11

Community protective factors

Answer 11

Neighbourhood resources

Question 12

Risk addictive potential drugs

Answer 12

Differs between drug + administration through ingesting or injecting

Question 13

Moral model of addiction

Answer 13

A sign of moral weakness: drug abuse and drug seeking behaviour is immoral and in conflict with social norms and values

Question 14

Pharmacological model (mid 19th century)

Answer 14

Addicts are not to blame: highly addictive substance is
->prohibitions: prevent people from getting involved with the substances

Question 15

Symptomatic model (1930-1950)

Answer 15

Not a condition in itself, but rather a symptom of an underlying neurotic character or personality disorder
-> long-term, insight-oriented psychotherapeutic treatment

Question 16

Disease model (1940-1960)

Answer 16

There are fundamental biological and psychological differences between addicts and non-addicts, making the former unable to use substances in moderation
-> complete abstinence from substance

Question 17

Learning theory (1960-1970)

Answer 17

A form of maladaptive learned behaviour that can be unlearned again
->behavioural therapeutic interventions

Question 18

Bio-psycho-social model (1970-1990)

Answer 18

Both the onset and termination are the result of continuous interaction between biological, psychological and social factors
->multi-modal interventions in which attention is on many factors

Question 19

Brain disease model (1990 - onwards)

Answer 19

Innate vulnerability forms the basis of repeated use and this repeated use leads to important, difficult to reverse, brain changes leading to impaired cognitive control functions and craving habits
-> pharmacological and behavioural therapeutic interventions

Question 20

Criticism on the brain disease model

Answer 20

• most people beat addiction by very hard effort. We cannot say this about medical diseases
• people take substances out of choice and also have to make a choice to stop taking them. They are not blameless victims of some illness they have no control over.

Question 21

Homeostatic account (theory of structural changes)

Answer 21

Structural changes are a CONSEQUENCE of addiction:
->chronic overstimulation of dopamine D2 receptors > brain compensate by downregulating these receptors (explains anhedonia/dysphoria)

Question 22

Reward deficiency syndrome (RDS) account (theories of structural changes)

Answer 22

Addiction is the RESULT of structural differences
-> individuals with less receptors (chronic dopamine deficiency) have lower reward sensitivity > vulnerable for addiction because they look for stronger stimuli to activate the reward system

Question 23

2 notable differences in how the dopamine system reacts towards (unexpected) natural vs drug rewards

Answer 23

1. the reaction of the dopamine system is much stronger for drug rewards
2. the response to the CS is stronger for drug rewards than for natural rewards: the peak is higher. > central to temporal difference account

Question 24

Temporal difference account

Answer 24

Idea that, because the dopamine response to the CS is stronger for drug rewards, drug-related cues and actions would continue to be reinforced too pathological levels

Question 25

Incentive -sensitisation theory

Answer 25

Idea that the core feature of addiction is pathological motivation for drugs (wanting/craving), together with impaired cognitive control, which results from incentive sensitisation

Question 26

Conditioned opponent theories to the withdrawal-based hypotheses

Answer 26

Associated conditioning causes predictive drug cues to elicit conditioned tolerance and conditioned withdrawal symptoms

Question 27

2 types of wanting in drug addiction

Answer 27

1.COGNITIVE WANTING: conscious, explicit desire for a specific reward 2. INCENTIVE SALIENCE ‘WANTING‘: cue triggered wanting that does not involve explicit goals or rewards that one is aware of

Question 28

aberrant learning theory of addiction

Answer 28

Idea that drugs alter learning processes, promoting abnormal learning, which causes the transition to addiction -> compulsivity in addiction arises because drugs facilitate the learning of automatic S-R habits which confer compulsivity into actual behaviour

Question 29

Incentive salience of drug-associated stimuli can be recognised in different ways

Answer 29

1. motivational magnet 2. reinforcing 3. reinstatement 4. wanted

Question 30

Incentive-sensitisation: research methods to recognise the different ways of drug-associated stimuli

Answer 30

- Motivational magnet: pavlovian conditioning paradigm - reinforcing: conditioned reinforcement paradigm (instrumental/operant conditioning) - reinstatement: reinstatement paradigm - wanted: progressive ratio experiments

Question 31

3 phases of reinstatement experiments

Answer 31

1. acquisition 2. extinction 3. reinstatement test (of cue/stimulus, e.g. light, not the drug itself)

Question 32

3 types of reinstatement

Answer 32

1. cue induced reinstatement 2. prime-induced reinstatement (by drug itself) 3. stress induced reinstatement

Question 33

barriers to seeking treatment

Answer 33

1. attitudinal 2. readiness for change 3. stigma 4. financial/cost 5. structural

Question 34

'Reward deficiency syndrome' theor

Answer 34

number of D2 receptors relates to individual differences in reward sensitivity: less receptors means lower reward sensitivity and higher vulnerabilitz for addiction (natural rewards such as food are not sufficient)

Question 35

neural sensitization

Answer 35

increase in the ability of drugs to elevate dopamine transmission in brain regions that receive dopamine inputs, such as the nucleus accumbens

Question 36

3 behavioural ways in which IS is expressed

Answer 36

1. drug-associated stimuli elicit attention + approach towards the, acting as "motivational magnets" 2. drug-associated stimuli become reinforcers in their own right 3. drug-associated stimuli and drugs can induce relapse