substance use and addictive disorders. ch 5 pg 118-131

Question 1

definitions of drug addiction usually state 2 facts:

Answer 1

1. the addicted individual has impaired control over the use of the drug
2. the drug use has harmful consequences

Question 2

what is one problem with the control aspect of the def. of addiction
–> what is the real questions that needs to be asked

Answer 2

there is no way to tell the difference between behaviour that is controlled or not controlled
–> can the person stop if he or she wanted to

Question 3

craving and control are subjective states that ultimately depend on the?

Answer 3

self -report of the user

Question 4

is a person ever cured fro addiction?

Answer 4

no they are just in remission of symptoms. (addiction is a chronic disorder)

Question 5

hedonia means?

Answer 5

pleasure

Question 6

can stimuli act as reinforcers without the sensation of pleasure

Answer 6

yes

Question 7

activation of the mesolimbic dopamine system occurs in response to the stimuli that precede or anticipate a stimulus as opposed to?

Answer 7

the actual stimulus itself.

Question 8

where are hedonic hotspots

Answer 8

nucleus accumbens and ventral portion of the pallidum

Question 9

increases of “liking” reactions results from activation of?

Answer 9

the hedonic hotspots by opioids

Question 10

are the hedonic hotspots and “liking” dependent on dopamine

Answer 10

no

Question 11

what are the nucleus accumbens and mesolimbic dopamine systems role in reinforcement

Answer 11

wanting

• -> general activation (pushing) ex, hungry
• -> directing the behaviour towards the goal

Question 12

directing a behaviour towards a goal is done by ?

Answer 12

incentive salience

Question 13

various stimuli in the environment have or acquire special motivational properties that cause us to notice

Answer 13

incentive salience

Question 14

what brain structure is responsible for incentive salience and what is a crucial element in the process

Answer 14

nucleus accumbens, dopamine

Question 15

the nucleus accumbens turns a neutral stimulus into?

Answer 15

a stimulus that we WANT

Question 16

if dopamine is taken away what happens?

Answer 16

you still “like” the stimulus but your drive to obtain it (want) it lessons

Question 17

what is the “do it again” system

Answer 17

“wanting” system

Question 18

what is one of the most important differences between natural and drug related reinforcers?

Answer 18

under normal conditions, natural reinforcers have a satiation mechanism that terminates their reinforcing effect. (ex, after we eat and are full food loses its reinforcing effect)

Question 19

what reinforcement is more immediate and why?

Answer 19

drug reinforcement (over natural) because drugs are able to get the brain immediately

Question 20

the fast, high surges in dopamine that correspond with drug taking are not what cause the feelings of euphoria
–> could be what?

Answer 20

• could be opioids and endocannabinoids (liking)

Question 21

the heightened surge in dopamine ensures?

Answer 21

we are motivated to seek them again

Question 22

Stress can increase the strength of a reinforcing stimulus. this is due to increased levels of?

Answer 22

glucocorticoid hormones causing the release of dopamine

Question 23

repeated exposure to a stressful stimuli will do what?

Answer 23

cause sensitization to that stimulus

Question 24

in addiction there is sensitization to both the sensation of the drug as well as the motivation circuitry. the incentive becomes a?
- in other words there is a sensitization of?

Answer 24

motivational magnet

- incentive motivation

Question 25

the ? uses the change in motivational sensitivity to explain addictive behaviours

Answer 25

- incentive sensitization theory

Question 26

a strong de- sire or urge to use a specific substance

Answer 26

craving

Question 27

The incentive motivational effects of drugs and their cues become stronger (sensitized) with repeated exposure due to increased activity of the

Answer 27

meso- limbic dopamine system and neuroadaptations of brain circuits that mediate classical conditioning of incentive motivational processes

Question 28

2 characteristics of incentive salience

Answer 28

1. The stimulus is easily noticed and attended to by the organism 2. the stimulus motivates behavior that is directed toward it

Question 29

what happens when a recovering alcoholic see a picture of alcohol

Answer 29

it induces a craving and increased activity in the pre frontal and anterior cingulate cortices and the mesolimbic dopamine system becomes active

Question 30

the dysfunction of dopamine in the ventral striatum my lead alcoholics to?

Answer 30

attribute increased amounts of attention to alcohol related cues

Question 31

can internal memories induce cravings?

Answer 31

yes

Question 32

According to incentive sensitization theory, the subjective consequence of activation of this system (craving) is ?, and the subjective experience of a sensitized system is intense wanting or ?

Answer 32

- wanting | - craving

Question 33

the more a drug is used the more it gains control over?

Answer 33

the motivational circuitry and the more it can control a large amount of your behaviour --> addiction

Question 34

people often crave drugs even though they report that, at the same time, they are miserable and get little or no pleasure from the drug--> this explains the difference b/w ?

Answer 34

liking and wanting

Question 35

hedonic, neurobiological/psychological dependence model of addiction based on a continually shifting balance between the activity of?

Answer 35

the reward system and the anti-reward system

Question 36

with repeated use of a drug the REWARD system become? and the ANTI-REWARD system become? --what kind of process is this?

Answer 36

- dysfunctional/dysregulated - don return to normal level - increasingly recruited and level of activity increases - allostatic process

Question 37

a contrast to homeostasis

Answer 37

allostasis

Question 38

situations where the set point is not constant but changes in response to changes in the animal’s environment

Answer 38

allostasis

Question 39

what does allostasis mean in regards to dosage

Answer 39

new allostatic set point means that a person must take larger and larger doses of the drug to achieve the same degree of euphoria or pleasure as he or she did from the first dose.but at the same time the person does not get the same feelings when on the drug and gets worse and worse depression when not on it

Question 40

changes take place in the neurocircuitry and neurochemistry that drive the stress response

Answer 40

between system

Question 41

eventually sensitization is overcome by the processes of? the term they use to describe the lowering of the mood set point.

Answer 41

hedonic dysregulation,

Question 42

dysphoria

Answer 42

depression or unhappiness

Question 43

dysphoria can be thought of as? that can only be alleviated by taking more drugs

Answer 43

psychological withdrawal syndrome

Question 44

drug addiction involves a dysfunction in information processing and integration among multiple brain regions that comprise four interrelated circuits. these circuits are?

Answer 44

1. reward saliency 2. motivation/drive 3. memory/ conditioning 4. inhibitory control/ executive function

Question 45

all circuits receive direct input from?

Answer 45

dopamine

Question 46

dysfunction of brain areas (orbitofrontal cortex, anterior cingulate gyrus, dorsolateral prefrontal cortex, and insular cortex) involved in motivation and attentional control, LEADS TO

Answer 46

compulsion and impulsivity

Question 47

long term dug use leads to dysfunctional prefrontal cortex so it cannot properly regulate dopamine which means the ? and ? are left uninhibited, resulting in?

Answer 47

the motivational drive and memory conditioning circuits | - compulsive drug intake

Question 48

researchers think denial may be due to?

Answer 48

dysfunctional cortical circuits that mediate insight and self-awareness

Question 49

the most affective treatments for drug addiction are those that focus on?

Answer 49

all aspects of functioning that have been disrupted by drug use

Question 50

process by which the body clears itself of drugs and is often ac- companied by unpleasant and sometimes even fatal side effects.

Answer 50

detoxification

Question 51

medically managed with drawal.

Answer 51

medications that help lesson the effects of withdrawal

Question 52

provide intensive but relatively brief treatment based on a modified 12-step approach

Answer 52

short term residential treatment

Question 53

often is more suitable for people with jobs or extensive social supports

Answer 53

out patient treatment program

Question 54

provides 24-hour a day care with planned lengths of stay between 6 and 12 months

Answer 54

therapeutic community (type of long term residential treatment)

Question 55

focus on the resocialization of the individual

Answer 55

therapeutic community

Question 56

designed to engage people in treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug use, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and relapse.

Answer 56

behavioural treatments

Question 57

individuals learn to identify and correct problematic behaviors through techniques intended to enhance self-control by exploring the positive and negative consequences of continued use, self-monitoring to recognize drug cravings early on and to identify high- risk situations for use

Answer 57

cognitive behavioural theory

Question 58

based on operant conditioning principles of reinforcing drug-free urine samples with low-cost incentives such as prizes or vouchers exchange- able for food items, movie passes, and other personal goods

Answer 58

contingency management interventions

Question 59

aimed at helping individuals resolve ambivalence about engaging in treatment

Answer 59

motivational enhancement theory

Question 60

Alcoholics Anonymous and Narcotics Anonymous, are some of the most well-known behavioral treatments for addiction - these are an example of?

Answer 60

12 step facilitation therapy

Question 61

3 key aspects of 12 step facilitation therapy

Answer 61

1. acceptance 2. surrender 3. active involvement

Question 62

for drug addicts with partners as an add-on to individual and group therapy

Answer 62

behavioural couples therapy

Question 63

what is a very important part of therapy for youth/adolecense

Answer 63

family involvement

Question 64

outpatient approach that views adolescent drug use in terms of a network of influences

Answer 64

Multidimensional Family Therapy (MDFT

Question 65

targets family interactions that are thought to maintain or exacerbate adolescent drug abuse and other co-occurring problem behaviors such as oppositional behavior, delinquency, associating with antisocial peers, aggressive and violent behavior, and risky sexual behavior.

Answer 65

Brief Strategic Family Therapy (BSFT

Question 66

addresses the factors associated with serious antisocial behavior of adolescents who abuse drugs

Answer 66

multi systemic therapy

Question 67

substitution or replacement therapies

Answer 67

drug of abuse could be replaced with a gradually decreasing dose of a pharmacologically similar, longer-acting medication until the individual was drug free. (ex, nicotine patch)