Substance Misuse, Eating Disorders, and Sexual Disorders Flashcards
(80 cards)
1
Q
Screen Time by Age
A
0-2 years: None
3-5 years: 1 hour of TV per day
6-12 years: 2 hours of TV per day
13-18 years: 2 hours per day of TV, handheld devices, and video games (limited to 30 min)
Never online violent video games or pornography
2
Q
Psychoactive substance
A
Affects your state of mind (i.e., caffeine), alters Central Nervous System
3
Q
Substance Use Disorders
A
Patterns of maladaptive behavior involving the use of psychoactive substances
4
Q
Substance Induced Disorders
A
Disorders caused by the use of psychoactive substances, including: intoxication, withdrawal symptoms, Mood Disorders, etc.
5
Q
Other Psychoactive Drugs
A
Anything that alters your mind
6
Q
Substance Dependence: Theory & Therapy
A
- Impaired control over the use of psychoactive drug
- Continued, or even increased, use despite knowing that the substance is having a negative effect
7
Q
What influences alcohol tolerance?
A
Exposure
8
Q
Marijuana
A
- Being smoked more than ever before
- Medical benefits: seizures, developmental disorders (autism spectrum), calming people down
- Lowers testosterone, decreases drive, affects cognitive functioning
- Legalized in some states but not federally
- Oil, food, lotion
- CBD: no THC to get you high, reduces anxiety
9
Q
Substances & Forensics
A
In 2002
- 68% of jail inmates reported symptoms in the year before going to jail that met substance dependence or abuse criteria
- 16% of convicted jail inmates said that they committed their offense to get money for drugs
- 63% of inmates who met substance dependence or abuse criteria had participated in substance treatment or other programs
10
Q
Substance Abuse & Violence
A
- Drug and alcohol addiction - more than any other mental illness - is associated with violence
- Nearly three quarters of male wife-abusers meet the criteria for alcohol depedence
- Disinhibition of CNS
11
Q
Substance Abuse and Mental Illness
A
- 50% of individuals with severe mental illnesses will develop a substance use disorder at some point in their lives
- Half will exhibit current substance abuse or dependence
12
Q
Substance Abuse vs. Dependence
A
Dependence - body can’t function without it, withdrawal and need for more
Abuse - affecting life
13
Q
Substance Use Disorder - General diagnostic criteria
A
- Impaired control
- Social impairment
- Risky Use - behavior, sexual behavior
- Pharmacological criteria
14
Q
What decreases risk for substance abuse in kids?
A
For every year a kid does not use substances at all, more likelihood they won’t have a problem with it
15
Q
Impaired Control
A
- Take more of the substance over time
- Time getting the substance
- Daily activities revolve around getting the substance
- Cravings
16
Q
Social Impairment
A
- Failure to fulfill major life obligations
- Continued use despite its impact on social, work, and recreational activities
- Important social, occupational, or recreational activities are given up because of use
17
Q
Risky Use
A
- Using in risky situations which may be physically dangerous
- More fentanyl (opioid) coming across the border than marijuana
18
Q
Pharmacological Criteria
A
- Tolerance: marked increase of the substance in order to achieve the desired effect
- Withdrawal: is a syndrome that occurs when blood or tissue concentration of a substance declines
19
Q
Harm Reduction
A
A set of practical strategies and ideas aimed at reducing negative consequences associated with drug use
20
Q
Societies number one drug problem is…
A
Alcohol
21
Q
Alcohol
A
- Social cost - 185 billion a year (med. exp., lost productivity)
- 1 in 4 children younger than 18 is exposed to alcohol abuse or dependence in the family
- 1995 - 52% of Americans aged 12 or older used alcohol
- 1995 - 6% were heavy drinkers. Had 5 or more drinks on the same occasion on at least 5 different days in a month
- Alcohol and Suicide (1/3rd of completed suicides)
- Related to violence towards self or others
22
Q
Blood Alcohol Level
A
BAC = amount of alcohol in relation to a specific volume of blood
.05 - lowered alertness; usually good feeling; release of inhibitions; impaired judgment
.08 (NY) - impaired driving, legally intoxicated
.10 - Less caution; impaired motor function
.15 - Large, consistent increases in reaction time
.20 - Marked depression in sensory and motor capability, decidedly intoxication
.25 - Severe motor disturbance, staggering; sensory perceptions greatly impaired
.30 - Stuporous, but conscious - no comprehension of world around them
.35 - Equivalent to surgical anesthesia
.40 - Probable lethal dose
23
Q
Alcohol Dependence
A
The Personal Cost of Alcohol Problems:
- Vast majority of men killed in car accidents were drunk at the time. 73% were chronically heavy drinkers
- Most widely used anxiolytic
- “relieves tension” (individuals who are suffering in some way turn to alcohol to numb symptoms, PTSD - Vietnam)
- “social lubrication”
- Highly correlated with ASPD, depression, and anxiety
24
Q
Alcohol Physiologically
A
- Slows down brain functioning that control, organize, and inhibit mental processes
- Loss of self control
- Executive functioning
- Lots of substance abuse post 9/11 (FDNY)
- ANS (sympathetic nervous system) - fight or flight
25
Consequences of habitual use
- Stomach ulcers
- Hypertension
- Heart failure
- Cancer
- Brain damage - shrinking in frontal lobe
- Early onset of dementia
- Cirrhosis of the liver (resistant to damage, can rebuild)
- Delirium tremens - seizures
- Korsakoff's psychosis - deficiency in Thiamine (anterograde amnesia and confabulation)
26
Groups at Risk for Alcohol Abuse
1. Higher income = more likely to drink
2. College degree = 68% drink
3. Context = Alcohol use increased in NYC following 9/11
4. 60% of men vs 45% of women use
5. 32% of men vs. 11% of women use to excess
6. Women more often combine alcohol with other substances (e.g., tranquilizers)
7. Ethnic group at highest risk .- Native Americans
8. In 2010, Native Americans had the highest rate of drug-induced death (17.1%)
27
Treatment of Alcohol Dependence
Medical Detoxification
- Getting alcohol out of the person's system (dehydration - nutritional deficiency) --> IV, multivitamins
- Can be done outpatient - utilize a tranquilizer to prevent seizures (risky)
- 700,000 people in US receive treatment daily
- ANTABUSE: take voluntarily, makes you nauseous if you drink alcohol
28
Support Groups: Alcoholics Anonymous
- Once an alcoholic, always an alcoholic
- You can never go back to normal drinking
- Less than 10% who start, continue
- Sponsor
- "If you hang out in a barber shop long enough you are bound to get a haircut"
29
Relapse Prevention
- Narcan - in the nose, quick pump (3-4 times) for individuals high on opiates
- Relapse begins with high risk situations:
- Being in a situation that may make you lose control (e.g. running into an "x" at a party)
- Increasing confidence to protect from relapse
30
Control drinking
Only drinking X amount each time; doesn't work very well
31
Nicotine Dependence
A lot less people smoking than ever before
- Uptake of e-cigarettes
- Stimulates and relaxes you at same time
- One out of every four American adults is a smoker
- More have died from than all the wars and car accidents
- Withdrawal can lead to depression and anxiety
- Nicotine - paradoxical effect on nervous system
- The Antismoking Movement
- Learning or Addiction? No evidence of tolerance.
32
Other Psychoactive Drugs
- Marijuana
- Stimulants
- Cocaine
- Sedatives/tranquilizers
- Hallucinogens (including LSD)
- Opiates (including heroin)
- Any illegal drug
- Alcohol
- Cigarettes
33
Depressants
Act on CNS to reduce pain, tension, anxiety
34
Opiates
(9,000 years old)
- Induce relaxation and reverie
- Provide relief from anxiety and pain
- Opium, Morphine, Heroin
- "Imagine every cell in your body has a tongue and they are licking honey"
35
Methadone
- Theoretically less addictive
- Orally, long acting, tapers off slowly
- To crave opiates less
- Suboxone: pill form
36
Barbiturates
- Powerful sedative drugs
- Alleviate tension and bring about relaxation and sleep
- "sleeping pills"
- Drug of choice for suicide
- "red devils", "yellow jackets", "blue heavens", "Christmas trees", and "rainbows"
- Very addictive (e.g. Phenobarbital - seizures, anxiolytic)
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Tranquilizers
- Used in treatment of anxiety disorders and stress-related physical disorders
- Valium
- Addictive - creates tolerance
38
Stimulants
Amphetamines
- A group of synthetic stimulants which reduce feelings of boredom or weariness
- Users find themselves alert, confident, full of energy, and generally ready to take on the world
- Suppress hunger - Dexedrine (diet pills?)
39
Ketamine
"Special K"
- Popular anesthetic with vets
- Research for mood related issues
- Acid originally intended to treat alcohol addiction, psychoanalysis on trips
- Horse tranquilizer, party drug (ecstasy, molly)
- creates the effects of euphoria and sedentary lethargy
40
Cocaine
- From leaves of the coca plant
- A stimulant
- Suppresses appetite
- Freud??
- Coca-Cola??
41
Crack Cocaine
- It is a solid state
- Smokable form of cocaine
- Highly addictive
- Freebase form of cocaine that is made using baking soda in a process to convert powder cocaine into freebase cocaine
- Cheap, quick high - huge in 80s
42
Crystal Methamphetamine
- Highly addictive synthetic (man-made) stimulant
- Resembles small fragments of glass or shiny blue white "rocks" of various sizes
- Typically has a high purity level and produces long-lasting and intense physiological effects
- Mainly in midwest - need a lot of room to cook
43
Hallucinogens
- LSD: Interfere with the processing of information in the nervous system, causing hallucinations
- PCP: Cheap, easily available, and often mixed with other substances (Cannabis); "Angel Dust"
44
Cannabis
Marijuana (leaves) and Hashish (the resin)
- Similar, but milder, effects as other hallucinogens
Is marijuana dangerous?
- Reduces testosterone
- Suppresses immune reaction
- Lung cancer
- Psychologically - apathy, poor judgment
Marijuana as a Medical Treatment (chemotherapy)
45
K2
- Synthetic Marijuana
- These products are sold for recreational drug use
- There are several psychoactive artificial cannabinoid families that are sold under brand names like K2 and Spice, both of which are now used as generic terms used for any synthetic cannabinoid product
- Although most synthetic cannabinoids exhibit only the typical cannabinoid effects when used in appropriate doses, they are potent drugs capable of causing clinical intoxication and death (probably due to CNS depression and hypothermia) when used inappropriately
- Keep changing contents
- Goes across blood brain barrier quickly --> a lot of death
- A lot in Mexico and Chine
46
Hypoactive Sexual Desire Disorder
Absence of desire
47
Sexual Aversion Disorder
Disgusted/frightened by sex
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Female Sexual Arousal Disorder
Insufficient vaginal lubrication
49
Male Erectile Disorder
Impotence
| - Put line of stamps on penis to test
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Dyspareunia
Pain during sexual activity
51
Vaginismus
Muscles surrounding the vagina contract involuntarily
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Groups at Risk for Sexual Dysfunction
Women > pain/lack of interest/pleasure
| Men > anxiety, climax too early (most common complaint)
53
Sexual Dysfunction: The Psychodynamic Perspective
- Unresolved Oedipal/Electra conflicts
- A fixation at pre-genital stage
- Castration anxiety and penis envy
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Sexual Dysfunction: The Behavioral and Cognitive Perspectives
- Learned anxiety and the spectator role (watching and judging ones own performance instead of enjoying)
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Sexual Dysfunction: Treatment
- Medical Evaluation
- Interventions:
- Retraining of the experience
- Sensate focus exercises
- PARADOXICAL INSTRUCTION
- Relaxation techniques
- Exercise (endorphin-producing) - staying healthy - enhances arousal
- The more sex you have at a younger age indicates how much you’ll have later in life
56
Gender Dysphoria (Formerly Gender Identity Disorder)
Refers to an individual's affective/cognitive discontent with the assigned gender
57
Transgender
Refers to the broad spectrum of individuals who transiently or persistently identify with a gender different from the original gender
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Transsexual
Individual who seeks or has undergone a social transition from one gender to another. Sex reassignment surgery may have occurred.
59
Paraphilias
- Recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving
1. Nonhuman objects
2. Suffering of oneself or one's partner
3. Children or a non-consenting partner
60
Fetishism
Reliance on inanimate objects or on a body part for sexual gratification
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Transvestic Disorder (cross dresser)
Sexual gratification through dressing in the clothes of the opposite sex
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Exhibitionism
Sexual gratification through display of one's genitals to an involuntary observer
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Voyeurism
Sexual gratification through clandestine observation of other people's sexual activities or sexual anatomy
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Sexual Sadism Disorder
Sexual gratification through infliction of pain and/or humiliation of others
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Sexual Masochism Disorder
Sexual gratification through pain and/or humiliation inflicted on oneself
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Frotteurism
- French word meaning to "rub"
| - Sexual gratification through touching and rubbing against a non-consenting person
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Pedophilia
Sexual gratification, on the part of the adult, through sexual contect with prepubescent children (5 year difference)
- Hebephilia for post-pubescent children
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Rape (Criminal Matter)
Sexual intercourse with a non-consenting partner
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Kansas v. Hendricks (1997)
- Statue is not punitive
- Mental abnormality is not confined to mental health definition
- States have a right to protect themselves from dangerous persons with mental abnormalities
- The legislative intent may be more important than the implementation of the law
70
Motivation for Sexual Offending
- Power/control
- Intimacy
- Vent anger
- Feeling competent
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Sex Offender Instruments
- STATIC-99
- Minnesota Sex Offender Screening Tool (MnSost)
- Sex Offender Need Assessment (SONAR)
- Abel Screen
- SVR - 20 which is now the RSVP
- Penile Plethysmography (PPG)
- SORAG
72
Sexual Offender Treatment
What we know:
- Treatment can reduce re-offense rates
- Treatment is not effective for all sex offenders
- About one-third of sex offenders are NOT motivated to stop committing sex offenses
- However, the treatment process does give us much more insight about offender modus operandi, strategies, triggers, level of risk to the community
73
Components of treatment (SO)
Relapse Prevention model
- sexual offending similar to an addiction
- stress "abstinence" not "cure"
- cognitive-behavioral: focuses on feelings, beliefs (cognitive distortions), stimuli and behaviors
- identify triggers for elevated risk, details of offense cycle, effective safety plan
- enhance empathy for victims
- enhance motivation for remaining abstinent
- individual and group therapy recommended, psychopharmacology
74
Anorexia Nervosa
- Refusal to maintain normal body weight (85% less than normal for age and height)
- Intense fear of obesity, even though underweight
- Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
- Amenorrhea, in post-menarcheal females
75
Amenorrhea
The absence of at least 3 consecutive menstrual cycles
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Anorexia Stats
85-90% female
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Types of Anorexia
Binge Eating/Purge Type
- Regular binge eating or purging behavior
- Self-induced vomiting, misuse of laxatives, diuretics, or enemas
Restricting Type
- Refuse to eat
- No regular binge eating or purging behavior
78
Bulimia Nervosa
- Recurrent episodes of binge eating
- Eating large amount of food in discrete time period (2 hours)
- A sense of lack of control over eating
- Recurrent inappropriate compensatory behavior in order to prevent weight gain
- Self-induced vomiting (90%)
- Misuse of laxatives, diuretics, or enemas
- Fasting or excessive exercise
- Both occur at least 2 times per week for 3 months
- Self-evaluation unduly influenced by body shape/weight
More common than Anorexia
79
Types of Bulimia
Purging Type
- Regular self-induced vomiting or misuse or laxatives, diuretics, or enema
Non-Purging Type
- Other inappropriate compensatory behaviors
- Fasting or excessive exercise
80
Childhood Obesity
- Often results in low self-esteem
- 15 percent of children and adolescents are obese
- Over 50% of the population
- Who is to blame?
- Culture
- Fashion
- Advertising
- Parents
