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Abnormal Psychology > Substance Abuse > Flashcards

Substance Abuse Flashcards

1
Q

Good case study for substance abuse?

A

Elvis Presley - destructive habits (abuse of prescription drugs). Father spetn 3 years in prison when he was 4 – distant reltaionship. Mother = v close, protective of him. Died in the year when she woudln’t speak to him- just joined army. Married. Famous. Became promiscuous, eating badly. Wife left, drug use increased. RElied on range of doctors and pharmacologists to fulfil needs - ‘tooth’ problems
Post mortem - huge range of pharmaceutical drugs found in body

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2
Q

How man people = classified with substance dpendence or abuse in past year based on DSM diagnositc criteria?

A

22.2 milllion people. 18.9% of population over 12

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3
Q

What is the life span of someone with alochol depenence?

A

About 12 years shorter than that of average person without this disorder

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4
Q

What brain impairment (physical) occurs in peole with alcohol dependence?

A

Gazdinski et al, 2005 – organic impairment, including brain shrinkage, occurs in a high proportion of people with alcohol dep

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5
Q

How many emergency room visits associtated with drug misuse winvolved alcohol?

A

USDHHS 2010 – of the 1.3 million emergenyc room visits associated with drug misuse/abuse = 7% incolved alochol abuse in patietns under 21

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6
Q

State on car accidents and alcohol?

A

Chou et al 2006 – alcohol abuse = associated with over 40% of the deaths suffered in automobile accidents each year and with about 40-50% of murders (Bennett and LEhman 1998)

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7
Q

How many alcohol abusers suffer from at least one other co-existsing mental disorder?

A

Lapham et al 2001 – over 37% of them

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8
Q

How many in the US = abstainers?

A

28% of men, 50 % of women

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9
Q

What do lower levels of alcohol do?

A

Braun, 1996 – stimulate certain brain cells and activate brain’s pleasure areas – release opium like endegenous opioids stored in the body

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10
Q

What do higher levels of alochol do?

A

Depresses brain functioning, inhibiting one of the brain’s excitatory neurotransmitters glutatmate – in turn slows down actiivty in parts of the brain (Koob et al 2002)

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11
Q

What does the inhibition of glutamate in the brain do ?

A

Impairs organism’s ability to learn adn affect the higher brain cortex, impairing judgement and other retrieval processes, lowering self control

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12
Q

What did Turnet et al 2006 conclude?

A

For indivdiauls who drink to excess, the clinical picture is highly unfavourable

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13
Q

Can mild to moderate drinking have cogntive effects?

A

Yes Gordis, 2001 – even mild to moderate drinking can adversely affect memory and problem solving

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14
Q

Is damage from alcohol reversible?

A

Wobrock et al 2009 – fMrI study. Damage is partially reversible if the person abstains from alcohol use

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15
Q

Which neurotransmitter systems does alcohol influence?

A

GABA system. Anti-anxiety properties of alcohol result from interaction with the GABA stystem
Dopamine system
Serotonin system – sensitive – affects mood, agitation, insomnia

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16
Q

What is the centre of pscyhoactive drug activation in the brain?

A

Mesocorticolimbic dopamine pathway (MCLP)

Alcohol produces euphoria by producing this area

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17
Q

Who stimulated the MCLP?

A

Littrell, 2001 – direct electrical stimulation of the MCLP produces great pleasure and has strong reinforcing properties

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18
Q

Two examples of genetics effect on alcoholism?

A

Cotton, 1979

Goodwin et al 1973

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19
Q

What did Cotton 1979 do?

A

Review of 39 studies over 40 years. Almost 1/3 of alcoholics had at least one parent with an alcohol problem

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20
Q

What did Goodwin et al 1973 find in terms of genetics?

A

Children of alcoholic parents who had been adopted by non-alcoholic foster parents = nearly twice as likely to have alcoholic problems by late 20s as control group of adopted children whose parents were non=alcoholic

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21
Q

Which experiment questions role of genetics in substance abuse?

A

Merikangas & Swendsen (1997) – genetics appear to play a stronger role in men than eomen – questions role of genetics as explanotry factor in substance abuse

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22
Q

What are important moudling infulences for children?

A

Hasin & KAtz, 2010 – family relationship sand parental guidance = important moudling influences for children

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23
Q

Personality traits assoc with those who are more high risk for developing alcohol related problems?

A

Morey et al 1984 – people at high risk for developing alcohol related problems = sig more impulsive and aggressive than those at low risk

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24
Q

Two experiments indentifying relationship between alcohol use with stress?

A

Schaefer & Majavits (2007)

Hussong et al (2001)

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25
Q

What did Schaefer & Majavits (2007) show?

A

about 25-50% of PTSD patients also have substance abuse problems

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26
Q

WHat did Hussong et al (2001) show?

A

high degree of association between alcohol consumption and negative affectivity such as anxiety and somatic complaints
Adults with less intimate and supportive relatinoships show greater drinking following sadness/hostility than those with close peers and more positive relationships

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27
Q

What preventative measures should be taken for children?

A

Smith et al (1995) – prevention efforts should be targeted at children before they begin to drink so that the positive feedback cycle of reciporocal reinforcement between expectancy and drinking will never be established

28
Q

What did DiClemente (1993) refer to these sorts of addictions as?

A

‘diseases of denial’

29
Q

What is the most effective treatment of drinking problems?

A

Margolis & Zweben 1998 – a multi disciplinary approach to the treatment of drinking problems = most effective because problems = often complex, requiring flexibility and indidiualisation of treatment procedures

30
Q

Two examples of medication being used to treat alcoholism?

A

Grossman & Ruiz, 2004 – disulifram = drug causes vomiting when followed by alcohol ingestion – prevents immediate return to drinking. LT = not effective
Lee et al 2010 – naltrexone = opiate antagonist -r educes craving by blocking pleasure producing effects of alcohol

31
Q

Facts about AA

A

52000 groups in US. Person-person and group relationships = emphasised. Lifts burden of personal responsibility . Taught to see themselves as not weak willed but as having an ‘affliction’
12 steps. Reliance on spirtituality and adoption of alcoholism as a ‘disease’

32
Q

Dropout rate at AA?

A

4 months = 50%. 12 months = 75%

33
Q

Compairson of AA programme with other alcoholic treatments

A

Brandsma et al (1980) – PPs assigned to AA group = subsequently encountered more life diffulcities and drank more than people in other treatment groups

34
Q

Who are more likely to have a postive outcome from AA?

A

Emrick et al (1993) – those who regularly participate and follow guidelines

35
Q

Heroin overdose stat

A

2005 - heroin overdose accounted for 10% of all drug realted emergency room admission

36
Q

What do opioids do?

A

Induce euphoria, drowsiness, slow breathing. High doses - death if respiration = completely depressed
Users - secretive. PRevalance estimates = hard

37
Q

How long till withdrawal symptoms for those addicted to opioids kick in?

A

8 hours.

Some can withdraw very easily. Some = too hard.

38
Q

What werer the most frequntly cited reasosn for beginning to take herion?

A

Fulmer & Lapidus, 1980 – pleasure, curiosity and peer pressure

39
Q

What did Zuckerman (2007) say?

A

substance abuse = related to perosnlaity characteristics he refers to as ‘sensation seeking’

40
Q

What are opiod addicts like?

A

Meyer & Mirin (1979) – opioid addicts = highly impulsive and unable to delay gratification

41
Q

What is treatment for opidoi addiction like?

A

Similar to alcoholism in that it involves building up an addict both physically and psychologyically and providing thelp through withdrawwl period

42
Q

What do amphetamines do ?

A

In contrast to narcotics (depress action of CNS), amphetamines stimulate it.
Induce elation and viguour. Reduce fatigue.
Come down. Reduce appetite

43
Q

What is associated with cocaine use?

A

Mann, 2004 – cognitive impairment is associated with cocian = likely to be an imporatnt consideration in LT effects of the drug

44
Q

FActs about amphetamines?

A

DSM-IV-TR critersia for intoxication include behavioural symptoms of euphoria, changes in sociability and physiological symptoms = heart rate or blood pressure cahnges, perspiration or chills
Severe intoxication = halluncination, panic
Tolerance builds quickly. Withdrawal = apathy, prolonged periods of sleep
Stimulates the cNS by enhancing dopamine and noradrenalin

45
Q

Crack cocain and sexual behaiour>

A

Kim et al 1992 – most crack cocaine users lose interest in sex and develop sexual dysfunction with prolonged use

46
Q

What does methadone do?

A

Weinstock et al 2010 – it’s effective in promoting abstinence among those with less sever cocaine use

47
Q

What did Chang et al 2007 find?

A

Methamphetamine operates by increased level of dopamine in brain
Prolonged use = structural changes in the brain

48
Q

Negative LT outcomes of cannabis?

A

Imapried memory and concentration

Pope et al 2001 - marijuana induces memory dysfunction and a slowing of information processing

49
Q

Main cause of substance abuse?

A

Pleasure - thought to include dopaminergic system and its opioid releasing neurons

50
Q

What is the opponent process theoyr?

A

Solomon and Corbit – crash after being high. Need more of it next time to acheive same results. Negative feelings that follow also intesnify. BEst remedy - hare of dog

51
Q

Smelling task wtih children and alcohol?

A

Noll et al 1990 – children aged 3-6. smelling task. 9 substances. More than 1/2 children recognised beer, wine and whiskey. 20% of the youngest children identified alcohol

52
Q

Alcohol attidues across eupope kinda experiment?

A

Osterberg 1986 – alcohol consumption in Poland = low, yet arests for drunkenness = high compared to Holland

53
Q

What is the idea behind agonist substitution?

A

using a safe drug with a similar chemical make up. Methadone = synthetic narcotic developed in Germany in WW2 when morphinew asn’t available

54
Q

What did Ball and Ross (1991) suggest?

A

When addicts combine methadone with cousnselling, many reduce drug use and engage in less criminal activity

55
Q

What about becoming dependent on methadone?

A

O’Brien et al 1996 - some who use methaodne benefit significantly, but may be dependent for rest of their lives

56
Q

Wary about AA ?

A

Ferri et al (2006) - lack of experimental evidence on effectiveness of AA programs

57
Q

What did Moos & Moos (2006) do>

A

Longer AA attendance = associated with less drinking at 8 and 16 years

58
Q

Who did a meta-analysis involving AA?

A

Kownacki et al (1999) – attending AA led to worse outocmes than no treatment at all

59
Q

What did Bufel (1991) think about AA?

A

A cult that relies on God as hte mechanism of action

60
Q

Definition of addcition

A

A chronic disease of the CNS characterised by loss of control over takiing additive substances that leads to compulsive drug seeking and drug taking behaviour
ASsociated with distortion of hte reward system

61
Q

What do the US Food and Drug Administration think about nicotine replacement>

A

Approved nicotine replacement strategy – gum etc for treatment of nicotine dependence

62
Q

What did Degenhardt et al 2007 say?

A

Epidemological studies suggest that cannabis use has a negative impact on the expression and casuse of shiz

63
Q

Waht can cannbis do in healthy indivdiuals and those with schiz?

A

Can produce transient shiz-like symptoms in healthy indivdiuals and exarcerberate symptoms in schiz patients (D’souza et al 2009)

64
Q

Who did a review of longitudinal studies of cannabis and pscyhotic outcomes?

A

Moore (2007) – 40% increased risk of psychotic outcomes in indidivuals who had ever used cannabis

65
Q

What is heavy and prolonged cannbis use associated with?

A

Gonzalez et al 2002 – heavy and prolonged cannabis exposure may be associated with deficits in memory, sustained attention and executive functioning

66
Q

Pre-natal exposure to cannabis?

A

Fried et al 2003 – pre-natal exposure to cannabinoids has been associated with long lasting cognitive, motro and social deficits

67
Q

In 2005 how much cost and how many deaths could bea ttributed to alcohol consumption?

A

£3 billion and 31000

Accounted for 5% of all deaths in 2005

Abnormal Psychology (3 decks)

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