Module4 Flashcards
(21 cards)
Co-morbidity associated with worse prognosis:
Higher drop out
More severe symptoms
Lower treatment compliance
Worse treatment outcome
Higher probability of relapse
Explanatory models of co-morbidity
- susceptibility hypothesis/ high risk hypothesis
- self-medication hypothesis
- third factor hypothesis
- bidirectional hypothesis
Susceptibility hypothesis
The substance renders one more susceptible to developing certain disorders through biological processes
High risk hypothesis
The substance use leads to behaviour that increases one‘s risk to be exposed to situation (trauma exposure) that can result in other mental disorders
Third factor hypothesis
Idea that there is no direct relationship between substance use and co-morbid disorders but that the association occurs because the disorders share some common cuases
=> stressful events, genetic vulnerability, preexisting neurobiological alteration
Bidirectional hypothesis
Idea that substance use and other mental disorder bidirectionally influence each other -> makes it hard to pinpoint which causes which
Characteristic withdrawal symptoms cannabis
Insomnia
Somber mood
Agitation
Symptoms while and after using cocaine
Lack of energy
Somber mood
Insomnia
Fear and panic
Suspicion
Paranoia
Integrated treatment model
Idea that a simultaneous + coordinated treatment of both the addictive and affective disorders is needed to maximise adherence and outcome
Al-Anon/Nar-Anon
Instructs CSOs to accept that they are powerless + helps them detach with love from the substance abusers + to resist any effort to influence their behaviour
Johnson Intervention
Promotes active CSO role in attempting to set up a family group confrontation with goal of getting addict to enter treatment through new insights into the negative impact of their behaviour
= radical, direct, confronting
Behavioural Couple Therapy (BCT)
Actively involves addict‘s partner in treatment + aims to teach
1. couple to cope with substance-related situations
2. partner to support/reinforce behavioural change
3. improve relationship satisfaction + reduce stress
!! Large effect on satisfaction but weak-moderate effect on substance abuse
Community Reinforcement and Family Training (CRAFT)
Protocolized treatment in which close relatives are supported by a practitioner to adjust their behaviour in order to motivate the patient to start treatment
CRAFT based on CBT + MI and involves several important elements
- functional analysis
- emergency plan
- communication training
- reinforcement
Relevance of comorbidity
More severe symptoms
Lower treatment compliance
Higher drop-out
Worse treatment outcome
Higher probability of relapse
Alcohol: influence on psychological symptoms
Depressed mood
Fear
Confusion
Mood swings
Sleep problems
Cannabis: influence on psychological symptoms
Concentration issues
Memory issues
Memory impairment
Fear
Suspicion/paranoia/psychosis
Withdrawal
- insomnia
- depressed mood
- agitation
Influence of cocaine on psychological symptoms
Lack of energy
Depressed mood
Insomnia
Fear and panic
Suspicion/paranoia
For which 2 disorders do you not need complete substance abstinence for a diagnosis
PTSD
ADHD
Substance use and anxiety
- symptoms can be result of SA: intoxication + withdrawal
- SU may also have masked AD
- AD can maintain SU and cause relapse
- anxiety decreases after alcohol abstinence, returns after relapse
Substance use and psychotic symptoms
Cannabis use -> psychosis/schizophrenia ONLY IF YOU ARE VULNERABLE FOR PSYCHOSIS
