PSY240 5. Substance Abuse Flashcards

Question

Substance-Related Conditions (DSM-IV)

Answer 1

1+ symptoms occurs during a 12-month period: 1. Failure to fulfill important obligations 2. Repeated use in hazardous situations 3. Repeated legal problems 4. Use despite social problems • Causes significant impairment or distress

Answer 2

Maladaptive pattern of substance use (3+): 1. Tolerance 2. Withdrawal 3. Substance taken in more/longer than intended 4. Persistent desire/unsuccessful efforts to cut back/control 5. Substance use is time-consuming 6. Important activities are reduced because of substance use 7. Use continued despite persistent problems

Answer 3

Diagnostic Thresholds

Answer 4

• Severity is based on the number of criteria endorsed: – Mild disorder: 2–3 criteria – Moderate disorder: 4–5 criteria – Severe disorder: 6+ criteria

Answer 5

DSM-IV | DSM-5

Answer 6

* Mood | * Behaviour • Physiology • Cognition

Answer 7

* 80% Engaged in daily or weekly heavily drinking • 70% Consumed 1/5 (26er) of liquor in one day • 62% Family objects * 59% Perceives self as an "excessive drinker" * 31% Was arrested while drinking * 21% Wanted to stop drinking but couldn't • 14% Continued to drink with serious illness

Answer 8

* Low-grade hypertension * Paranoia * Deficits in memory and cognition * Wernicke-Korsakoff ’s syndrome * Alcohol-induced dementia * Alcohol-induced persisting amnesic disorder * Fetal alcohol syndrome

Answer 9

• Benzodiazepines: Xanax, Valium, Halcion, Librium • Barbiturates: Quaaludes – Legally manufactured – Sold by prescription

Answer 10

Signs of use/intoxication • Mild euphoria • Relief of tension, anxiety • Slurred speech • Poor motor coordination • Impaired judgment • Poor concentration • Sleepiness

Answer 11

Long-term effects • Chronic tiredness • Breathing disorders • Vision Problems

Answer 12

Patterns of problematic use: | 1. Adolescents’ recreational use 2. Increasing prescription dosage

Answer 13

* Solvents | * Anesthetic gases and nitrates

Answer 14

Signs of use/intoxication • paintorstainsonbodyorclothing • spotsorsoresaroundthemouth • redorrunnyeyesornose • chemicalbreathodor • drunk,dazedordizzyappearance • nausea, loss of appetite • anxiety,excitability,irritability

Answer 15

``` Harmful Effects • Brain damage, memory loss • Hearing loss, Slurred speech • Nose bleeds, loss of smell • Suffocation, sudden death • Irregular heart beat, heart attack • Nausea, vomiting • Liver damage, kidney damage • Etc… ```

Answer 16

``` Chronic use • Respiratory irritations, rashes • Permanent CNS damage, organ failure, death At-risk populations • Prepubescent and early teen boys • Aboriginal youth ```

Answer 17

``` Affective/Cognitive symptoms: • Euphoria • Affective blunting • Impaired judgment Somatic Symptoms: • Fight-or-flight response • GI symptoms • Seizures, coma ```

Answer 18

``` Uses: • Combat depression, fatigue • Boost energy and self-confidence • Appetite suppressant • Symptoms similar to cocaine intoxication ```

Answer 19

• Affects CNS & PNS • Releases DA, NE, 5-HT, endogenous opioids • Withdrawal symptoms: – https://www.youtube.com/watch?v=a7MIpyUpEcE • No DSM-IV-TR diagnosis Æ new to DSM-5

Answer 20

``` • Most heavily used stimulant – ~2 cups / day (U.S.) – 1 cup = 100 mg caffeine • Affects CNS • Increases DA, NE, & 5-HT ```

Answer 21

``` Derived from the opiate poppy: – Morphine – Heroin – Codeine – Methadone • Derived naturally from the body: – Endorphins – Enkaphalins ```

Answer 22

Intoxication • Mood • Cognition • Physiology Withdrawal • Mood • Physiology

Answer 23

``` Hallucinogens • e.g., LSD, MDMA (ecstasy), and peyote. PCP (angel dust) • Snorted or smoked • Not technically a hallucinogen, but has similar effects ```

Answer 24

* Intoxication * Mood * Cognition * Physiology * Moderate to high dose may cause * hallucinations * depersonalization * paranoia

Answer 25

Examples: gambling, sex, exercise, | video games, work, shopping, etc.

Answer 26

* A pattern of gambling behaviour that causes harm * 12 month Canadian prevalence = ~ 2% (Cox et al., 2005) * DSM Classification * DSM-IV-TR: “Impulse-control disorders NOS” * DSM-5: Non-substance-related disorder

Answer 27

Hypersexual Disorder: • A pattern of sexual behaviour that is initially pleasurable but that becomes unfulfilling and self-destructive Internet Gaming Disorder: • Persistent and recurrent use of the Internet to engage in games, often with other players

Answer 28

Comorbid mental health and substance use problems • Complex and difficult to treat Substance Use Treatment Seekers Psychiatric Treatment Seekers

Answer 29

``` Impact influenced by • Stressor • Individual differences • Gender • Age • Genes ```

Answer 30

``` Stress/Trauma => Negative Affect / Somatic Symptoms => Poor Coping Skills => Substance Use =>Stress Proliferation => ```

Answer 31

``` Anxiety • Risk of substance problems 2-5X higher • In 75% of cases, anxiety came first Bipolar Disorder • Possible overlapping predispositions • A “disorder-inducing disorder” ```

Answer 32

• Substance use can: – Hasten onset of psychotic disorders – Worsen symptoms and the course of illness – Exacerbate negative consequences

Answer 33

* Some cultures impose strict sanctions on all drugs * Some cultures view it as a medical problem * Some distinguish soft vs. hard drugs * Some cultures normalize it

Answer 34

• Costs ~$14 billion CAD / year

Answer 35

• Desire for Mood Alteration – Negative Affect Reduction (Emotionally vulnerable) – Euphoria/Excitement Induction (Antisocial/Impulsive)

Answer 36

``` Manufactured in • Ventral Tegmental Area (VTA) Released to • Nucleus Accumbens • Prefrontal Cortex ```

Answer 37

``` • Connected via GABA-sensitive neurons • ↑ GABA reduces anxiety • ↓ GABA – increases anxiety – increased sensitivity to pain – panic attacks, seizures • Self-medicate with substances ```

Answer 38

Behavioural Genetics Studies • Moderate-to-high heritability • Phenotypes (e.g., impulsivity) also heritable Molecular Genetics Studies • The role of specific genes is unclear • Implicates gene variants linked to DA deficiency

Answer 39

Behavioural • Positive & Negative Reinforcement (self-medication) • Modelling (parents, peers, culture, media) • Maladaptive coping (comorbid social phobia)

Answer 40

``` Dispositional • Trait vulnerabilities • Impulsivity • Tendency to act without planning or restraint • Strongest predictor of substance use • Diathesis for substance use disorders ```

Answer 41

``` Adolescent Alcohol Use • Experimentation • Adolescents with alcoholic parents • Stress in family home • Opposite-sex friends ```

Answer 42

* Chronic stress + support/promotion of use * Advertising and media * Gender differences

Answer 43

Alcoholics/Narcotics Anonymous • “12-step” programs • Total abstinence • 27% AA members sober after 1 year

Answer 44

Biological Treatments: • Antidepressants & Antianxiety agents • Antagonists (block reinforcing effects) • Agonists (e.g., Methadone)

Answer 45

``` Behavioural • Aversive classical conditioning • Covert sensitization therapy • Cue exposure and response prevention • Controlled Drinking (controversial) ```

Answer 46

Cognitive • Identify and gain control in risk situations Motivational Interviewing (MI) • Therapists express empathy, support self-efficacy • Help clients explore and resolve ambivalence

PSY240 5. Substance Abuse Flashcards

(248 cards)