Substance Related, Addictive & Impulse Control Disorders

Question 1

Impulse control disorders represent what?

Answer 1

A number of related problems that involve the inability to resist acting on a drive or temptation.

Question 2

What problems do impulse control disorders include?

Answer 2

Aggressive impulses
Stealing impulses
The impulse to set fires

Question 3

The term substance refers to?

Answer 3

Chemical compounds that are ingested to alter mood or behaviour.

Question 4

Psychoactive substances include?

Answer 4

Cocaine, heroine etc but also includes alcohol, nicotine, caffeine etc (anything that effects mood and behaviour)

Question 5

Substance use refers to?

Answer 5

The ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.
Like smoking the occasional joint or having a cup of coffee in the morning.

Question 6

Intoxication refers to?

Answer 6

Our physiological reaction to ingested substances-drunkenness or getting high

Question 7

The DSM-5 defines substance use disorders in terms of?

Answer 7

How significantly the use interferes with the user’s life.

Question 8

How many criteria must someone meet to meet criteria for substance use disorder?

Answer 8

For at least 2 symptoms in the past year that interfered with their life or bothered them a great deal.

Question 9

In regards to substance use disorders, someone with four or five symptoms are considered to fall in the ,,, range.

Answer 9

Moderate

Question 10

In regards to substance use disorders, someone with six or more symptoms are considered to have ?

Answer 10

A severe substance use disorder

Question 11

Substance use disorders: tolerance and withdrawal - withdrawal from many substances can bring on what?

Answer 11

Chills, diarrhoea, nausea, vomiting, aches and pains.

Question 12

Substance use disorders: tolerance and withdrawal - withdrawal from alcohol can cause alcohol withdrawal delirium which is an extreme example and is characterised by?

Answer 12

Frightening hallucinations and body tremors

Question 13

Cocaine withdrawal has a pattern that includes?

Answer 13

Anxiety, sleep changes , lack of motivation and boredom.

Question 14

Cannabis withdrawal includes symptoms such as?

Answer 14

Irritability, nervousness, appetite change, and sleep disturbances.

Question 15

Other symptoms that make up substance use disorder include “drug seeking behaviours”. Give examples.

Answer 15

A desperate need to ingest more of the substance, The repeated use of a drug )stealing money to buy drugs)

Question 16

In the DSM-5, substance-related disorders include how many symptoms, ranging from relatively mild (such as substance use results in failure to fulfill major role obligations ) to more severe (for example, occupational or recreational activities are given up or reduced because of substance use)

Answer 16

11 symptoms

Question 17

Researchers estimate that almost 3 quarters of the people in addiction treatment centers have an additional psychiatric disorder. What percentage of these people with mood disorders?

Answer 17

More than 40%

Question 18

Researchers estimate that almost 3 quarters of the people in addiction treatment centers have an additional psychiatric disorder. What percentage of these people with anxiety and posttraumatic stress disorder (PTSD)?

Answer 18

More than 25%

Question 19

Substance use might occur concurrently with other disorders due to chance etc. Drug intoxication can cause symptoms of anxiety, depression and psychosis, adding to the complicated nature of substance-related disorders and thus diagnosis. For someone to be diagnosed with a seperate disorder like schizophrenia or depression, how many weeks after they stopped taking substances would these symptoms need to persist?

Answer 19

6 weeks after

Question 20

Name the following general category of problematic behaviour:
These substances result in behaviour sedation and can induce relaxation. They include alcohol and the sedative and hypnotic drugs in the families of barbiturates (for example, Seconal) and benzodiazepines (for example, Valium and Xanax).

Answer 20

Depressants

Question 21

Name the following general category of problematic behaviour:
These substances cause us to be more active and alert and elevate mood. Included in this group are amphetamines, cocaine, nicotine, and caffeine.

Answer 21

Stimulants

Question 22

Name the following general category of problematic behaviour:
The major effect of these substances is to produce temporary analgesia (reduce pain) and euphoria. Heroin, Kratom, opium, codeine, and morphine and included in this group.

Answer 22

Opiates

Question 23

Name the following general category of problematic behaviour:
These substances alter sensory perception and can produce delusions, paranoia, and hallucinations. Cannabis and LSD are included in this group.

Answer 23

Hallucinogens

Question 24

Name the following general category of problematic behaviour:
Other substances that are misused but do not fit neatly into one of the categories here include inhalants (for example, airplane glue), anabolic steroids, and other over the counter and prescription medications (for example, nitrous oxide). These substances produce a variety of psychoactive effects that are characteristic of the substances described in previous categories.

Answer 24

Other commonly misused substances

Question 25

Name the following general category of problematic behaviour: As with the ingestion of substances described, individuals who display gambling disorder are unable to resist the urge to gamble which, in turn, may result in negative personal consequences (such as divorce and loss of employment)

Answer 25

Gambling disorder

Question 26

Clinical description; apparent stimulation is the initial effect of alcohol, although it is a depressant. We generally experience a feeling of well being, our inhibitions are reduced, and we become more outgoing. Why is this?

Answer 26

Because the inhibitory centers in the brain are initially depressed - or slowed.

Question 27

Name 2 types of organic brain syndromes that can result from long term heavy alcohol use.

Answer 27

Dementia and Wernicke-Korsakoff syndrome

Question 28

Dementia (or neurocognitive disorder) involves what?

Answer 28

The general loss of intellectual abilities

Question 29

Wernicke-Korsakoff syndrome results in what symptoms?

Answer 29

Confusion, loss of muscle coordination, and unintelligible speech

Question 30

Dementia by way of excessive amounts of alcohol is a direct result of?

Answer 30

Neurotoxicity or poisoning of the brain

Question 31

Wernicke-Korsakoff syndrome is believed to be caused by a deficiency in?

Answer 31

Thiamine, a vitamin metabolised poorly by heavy drinkers

Question 32

What syndrome is now generally recognised as a combination of problems that can occur in a child whose mother drank while pregnant?

Answer 32

Fetal alcohol syndrome

Question 33

What are these symptoms associated with? Fetal growth retardation, cognitive deficits, behavioural problems and learning difficulties.

Answer 33

Fetal alcohol syndrome

Question 34

We metabolise alcohol with the help of an enzyme called ?

Answer 34

Alcohol dehydrogenase (ADH)

Question 35

Three different forms of the enzyme alcohol dehydrogenase have been discovered. Which form has been found to be prevalent among children with Fetal Alcohol Syndrome and among what group of people is this variant most commonly found?

Answer 35

Beta-3 ADH African Americans

Question 36

Jellinek analysed only 98 out of the 1600 surveys sent out by the newly formed self-help organisation Alcoholics Anonymous in 1945 and developed a four-stage model for the progression of alcoholism. Yet this faulty study appears to be inaccurate. Was was predictive of later alcoholic disorders in an Australian study of adolescents?

Answer 36

Early onset heavy drinking

Question 37

In another study, what age of starting to consume alcohol was predictive of higher risk for chronic and severe alcohol use disorders?

Answer 37

11 or earlier

Question 38

Research on the mechanisms responsible for the differences in early alcohol use suggests that a person’s response to the sedative effects of the substance affects later use. In other words, those who do not develop the slurred speech, staggering, and other sedative effects of alcohol are more likely to use it in the future. Why is this of particular concern?

Answer 38

Given the current trend to mix highly caffeinated drinks with alcohol which can reduce the sedative effects of alcohol, thus increasing the chances of later excessive use.

Question 39

The general group of depressants in addition to alcohol also includes sedative, hypnotic, and anxiolytic drugs. What effect does each have?

Answer 39

Sedative = calming Hypnotic = sleep inducing Anxiolytic = anxiety reducing

Question 40

For the group of depressants being sedative, hypnotic, and anxiolytic drugs. Name the 2 drug families associated.

Answer 40

Barbiturates and benzodiazepines

Question 41

Clinical description: at low doses, barbiturates?

Answer 41

Relax the muscles and can produce a mild feeling of wellbeing

Question 42

Clinical description: at larger doses, barbiturates?

Answer 42

Can have similar results to those of heavy drinking: slurred speech and problems walking, concentrating , and working.

Question 43

Clinical description: at extremely high doses, barbiturates?

Answer 43

Diaphragm muscles can relax so much that they cause death by suffocation

Question 44

Like barbiturates, benzodiazepines are used to calm an individual and induce sleep. In addition, drugs in this class are prescribed as muscle relaxants and anticonvulsants (anti seizure medications). People who use them for nonmedical reasons report first feeling?

Answer 44

A pleasant high and a reduction of inhibition, similar to the effects of alcohol.

Question 45

Like barbiturates, benzodiazepines are used to calm an individual and induce sleep. In addition, drugs in this class are prescribed as muscle relaxants and anticonvulsants (anti seizure medications). People who use them for nonmedical reasons will with continued use, however, possibly develop?

Answer 45

Tolerance and dependence

Question 46

Stimulant Related Disorders: Amphetamines at low doses can induce?

Answer 46

Feelings of elation and vigorous and can reduce fatigue.

Question 47

Amphetamines are prescribed for people with?

Answer 47

Narcolepsy

Question 48

DSM-5 criteria for intoxication in amphetamine use disorders include?

Answer 48

Significant behavioural symptoms such as; Euphoria or affective blunting (a lack of emotional expression), changes in sociability, interpersonal sensitivity, anxiety, tension, anger, stereotyped behaviours (repetitive motor movements), impaired judgment, and impaired social or occupational functioning.

Question 49

In addition, physiological symptoms occur during or shortly after amphetamine or related substances are ingested and can include?

Answer 49

Heart rate or blood pressure changes, perforation or chills, nausea or vomiting, weight loss, muscular weakness, respiratory depression, chest pains, seizures, or coma.

Question 50

Amphetamines stimulate the central nervous system by …?

Answer 50

Enhancing the activity of norepinephrine and dopamine. Specifically, amphetamines help the release of these neurotransmitters and block their reuptake, thereby making more of them available throughout the system.

Question 51

Too much amphetamine, and therefore too much norepinephrine and dopamine can lead to hallucinations and delusions. This effect has sparked theories on the causes of which disorder?

Answer 51

Schizophrenia

Question 52

Clinical description: like amphetamines, in small amounts cocaine increases?

Answer 52

Alertness, produced euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite.

Question 53

Cocaine is in the same group of stimulants as amphetamines because?

Answer 53

It has similar effects on the brain.

Question 54

The cocaine experience of being “up” seems to come primarily from the effects of cocaine on the?

Answer 54

Dopamine system

Question 55

Cocaine enters the bloodstream and is carried to the brain where the cocaine molecules act to?

Answer 55

Block the reuptake of dopamine

Question 56

Few negative effects are noticed at first, but with continued cocaine use?

Answer 56

Sleep is disrupted, increased tolerance causes a need for higher doses, paranoia and other negative symptoms set in, and the user gradually becomes socially isolated. Chronic use may result in premature aging of the brain.

Question 57

Cocaine withdrawal produces

Answer 57

pronounced feelings of apathy and boredom. You are bored with everything and find little pleasure from everyday activities.

Question 58

The DSM-5 does not describe an intoxication pattern for tobacco (nicotine ) related disorders, rather it lists withdrawal symptoms, which include what?

Answer 58

Depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness, and increased appetite and weight gain

Question 59

Nicotine in small doses stimulates the central nervous system and can?

Answer 59

Relieve stress and improve mood. However, it can also cause high blood pressure, can increase the risk of heart disease and death worldwide.

Question 60

High doses of nicotine can?

Answer 60

Blur vision, cause confusion, lead to convulsions, and sometimes even cause death

Question 61

The high or “rush” experienced by opioid users comes from activation of the body’s natural opioid system. In other words, the brain already has its own opioids that provide narcotic effect. These are called?

Answer 61

Enkephalins and endorphins

Question 62

The DSM-5 diagnostic criteria for hallucinogen intoxication are similar to those for cannabis. They include?

Answer 62

Perceptual changes such as subjective intensification of perceptions, depersonalisation, and hallucinations. Physical symptoms include, pupillary dilation, rapid heartbeat, sweating, and blurred vision.

Question 63

Hallucinogens seem to affect the brain in diverse snd nonspecific ways, meaning by affecting multiple different receptors at one time in opposing ways. It is thought that this broad impact on brain receptors may lead to?

Answer 63

Consciousness expanding experienced by some.

Question 64

Most of these hallucinogen drugs bear some resemblance to neurotransmitters: LSD, psilocybin, lysergic acid amide, and DMT are chemically similar to?

Answer 64

Serotonin

Question 65

Mescaline (hallucinogen) chemically resembles?

Answer 65

Norepinephrine

Question 66

Inhalant use is highest in what age group and in what environments?

Answer 66

Ages 13 to 14, especially in those in correctional or psychiatric institutions.

Question 67

Additionally, higher rates of inhalant use are found among Native Americans and white persons, as well as those who live in rural or small towns, come from disadvantaged backgrounds, have higher levels of anxiety and depression, and show…?

Answer 67

More impulsive and fearless temperaments

Question 68

The high associated with the use of inhalants resembles that of alcohol intoxication and usually includes…?

Answer 68

Dizziness, slurred speech, lack of coordination, euphoria, and lethargy.

Question 69

Withdrawal from inhalants which involves sleep disturbance, tremors, irritability and nausea can last from ..

Answer 69

2 to 5 days

Question 70

Long term use of inhalants includes ..?

Answer 70

Damage to bone marrow, kidneys, liver, lungs, nervous system, and the brain

Question 71

Research on the long term effects of steroid use seems to suggest that mood disturbances are common, for example.?

Answer 71

Depression, anxiety, and panic attacks

Question 72

In terms of familial and genetic influences, what is the field of research that looks to answer the question oh how genes function when it comes to addiction?

Answer 72

Functional genomics

Question 73

What are the psychological dimensions of substance use?

Answer 73

Positive reinforcement (pleasurable feelings) Negative reinforcement (to escape from unpleasantness)

Question 74

Causes of substance-related disorders (p 424): what are the 2 biological dimensions?

Answer 74

Familial and genetic influences Neurobiological influences (the activation of the brain’s pleasure pathway)

Question 75

Social dimensions of substance use (p 428); Two views of substance related disorders characterise contemporary thought being?

Answer 75

The moral weakness model of chemical dependence The disease model of physiological dependence

Question 76

The moral weakness model of chemical dependence - drug use is seen as a failure of self control in the face of temptation. This type of perspective is this?

Answer 76

Psychological perspective

Question 77

The disease model of physiological dependence assumes that drug use disorders are caused by an underlying physiological cause. What type of perspective is this?

Answer 77

Biological perspective

Question 78

As per the moral weakness model of chemical dependence acts to punish those afflicted with the disorder. Whereas a disease model includes seeking treatment for a medical problem, sending messages that …?

Answer 78

The disorder is out of their control

Question 79

Treatment for substance related disorders focuses on multiple areas. The national institute on drug abuse (p 431) recommends how many principles based on more than 35 years of research?

Answer 79

13

Question 80

Antagonist drugs act to?

Answer 80

Block or counteract the effects of psychoactive substances.

Question 81

Or

Question 82

What is aversive treatment?

Answer 82

Clinicians may prescribe drugs that make ingesting the misused substances extremely unpleasant

Question 83

Controlled use studies for alcohol as opposed to abstinence indicates (p 434)?

Answer 83

Controlled drinking is at least as effective as abstinence but neither treatment is successful for 70% to 80% of patients over the long term.

Question 84

Component treatment: (p 435) Aversion treatment uses what type of model?

Answer 84

A conditioning model

Question 85

Component treatment (p 435): What is covert sensitisation?

Answer 85

It follows the conditioning model for treatment aversion and involves imaging unpleasant scenes, picturing yourself having a drink to then being interrupted with visions of becoming violently ill

Question 86

Component treatment p 435: name the below component that seems to be a valuable part of therapy for substance use. The clinician and client together select the behaviours that the client needs to change and decide on the reinforcers that will reward reaching certain goals (like money or small retail items).

Answer 86

Contingency management

Question 87

Component treatment p 435: name the following package of treatments. First, a friend or relative who is not a substance user is recruited to participate in relationship therapy. Second, clients are taught how to identify the antecedents and consequences that influence their drug taking. This includes recognising relationships with whom for example they use cocaine with, and thus to avoid these relationships. Third, clients assisted with employment, education and finances, or other services aimed at minimising stress. Fourth, new recreational options help replace substance use with new activities.

Answer 87

Community reinforcement approach Strong empirical evidence that this approach is effective for alcohol and cocaine use

Question 88

Component treatment p 435: Name the below increasingly common intervention approach . Aimed at building an awareness that the user has a problem and helping the user be willing to change. Reminds the client of what they cherish most and that any change will be beneficial.

Answer 88

Motivational enhancement therapy (MET)

Question 89

Component treatment p 435: name the below approach. Is an effective treatment approach for many psychological disorders and is one of the best designed and best studied approaches for treating substance dependence. This treatment addresses multiple aspects of the disorder, including a person’s reactions to cues that lead to substance use (like being among certain friends), and thoughts and behaviours to resist use. Also addressed the problem of relapse.

Answer 89

Cognitive behavioural therapy (CBT)

Question 90

Heroin and methadone are … which means they affect the same neurotransmitter receptors.

Answer 90

Cross tolerant

Question 91

The ….. model involves therapy that helps individuals remove ambivalence about stopping their drug use by examining their beliefs about the positive and negative aspects of drug use.

Answer 91

Relapse prevention P 435 Another target of CBT

Question 92

P 438 Research shows strong similarities in the biological origins of gambling disorder and what disorders?

Answer 92

Substance abuse disorders

Question 93

The following is characteristic of what disorder? Poor impulse control and risky decisions are both processes that involve ventromedial prefrontal cortex, and individuals with higher problems in these areas also show poorer response to treatment and higher relapse rates. P 438

Answer 93

Gambling disorder

Question 94

Gambling disorder p 438 Evidence of effectiveness for gamblers anonymous (that incorporates the 12 step program ) suggests that 70% to 90% drop out of these programs and that the desire to quite …. ?

Answer 94

Must be present before intervention

Question 95

Name 2 addictive disorders listed in the DSM-5

Answer 95

Gambling disorder Internet gaming disorder

Question 96

P 438 name 3 impulse control disorders as per the DSM-5

Answer 96

Intermittent explosive disorder Kleptomania Pyromania

Question 97

Intermittent explosive disorder: recent studies have proposed that there is a diary of the orbital frontal cortex’s role ( the executive part of the brain) in inhibiting amygdala activation ( emotional part of the brain), combined with changes in the ….? P 439

Answer 97

Serotonin system