TASK 9 - SUBSTANCE-USE DISORDER Flashcards

Question

theories | - gender roles

Answer 1

- men + alcoholism: more likely because “masculine”; tend to start in socialising context - societal acceptance of drinking in women went up, so did drinking in women - women: less likely to carry risk (personality traits); suffer from alcohol earlier + may notice that sooner + may find effects scarier thus --> limit consumption; start in family/partner/lover context

Answer 2

= whether non-dependent drinkers show place preference for a location paired with alcohol + whether time spent in those places is related to subjective alcohol effects - -> non-dependant consumers develop a preference for locations paired with alcohol consumption - conditioning happened without explicit knowledge of the drug --> cue contingencies: behaviour influenced by drug before we’re even aware of it

Answer 3

= chronic disease, with underlying mechanisms seen in the brain - reward system (= mesolimbic dopamine system) as centre - depressed reward system = dopamine receptors decrease in availability --> decreased activation of PFC --> impaired control/ inhibition - three recurring stages of addiction

Answer 4

- pavlovian learning: repeated experience of reward becomes associated with environmental stimuli that precede them - dopamine cells start firing anticipatory to conditioned stimuli (drug intoxication) --> cue triggers craving + motivates drug-seeking behaviour - drugs, unlike natural rewards (e.g. food), avoid satiation + continue to increase dopamine levels --> after abuse drug is the only reward strong enough to trigger response

Answer 5

- addicted = drug triggers much smaller increases in dopamine levels --> less sensitive to drug + other rewards (= less motivated by everyday stimuli) - -> conditioned pull toward reward - amygdala over-activated - anti-reward system becomes overactive = repeated exposure leads to adaptation in circuit of extended amygdala + the basal forebrain --> increased reactivity to stress --> emergence of negative emotions/withdrawal - -> emotional push to escape withdrawal - addiction changes: wanting euphoria to preventing dysphoria - -> don’t see drug as pleasurable anymore; only take drug to escape distress/withdrawal

Answer 6

- changes in function of involved PFCs (executive functioning especially) - prefrontal region changes: impaired signalling of dopamine + glutamate in prefrontal regions - down-regulation of signalling = impairment of executive processes --> weakened ability to resist strong urges + follow through on decision to stop taking the drug

Answer 7

- differ in vulnerability to various genetic, environmental, developmental factors = unique susceptibility (for initial drug use, sustaining drug use, progressive changes in brain) - increasing vulnerability: 1. family history: heritability + modelling 2. early exposure to drug use: adolescence greatest vulnerability 3. exposure to high-risk environments: socially stressful environments 4. certain mental illnesses: mood disorders, psychoses, anxiety…

Answer 8

- adolescent brain is still developing, period of enhance neuroplasticity --> sensitive to effects of drugs - -> eave drinking and raise legal smoking age to 21 - medical treatment can help to restore healthy function in affected brain circuitry + assist in preventing relapse - behavioural interventions to help restore balance in brain circuitry 1. mitigate person’s stress reactivity and emotional states --> help manage strong urges 2. improve executive function and self-regulation --> help recovering patients plan ahead to avoid vulnerable situations 3. help patients to avoid environmental cues (circle of friends) --> reduce likelihood of conditioned craving

Answer 9

A. chronic diagnosis cause demoralisation for treatment - think they will relapse anyway, there is no recovery B. many actually do recover naturally - brain change ≠ malfunction --> might be normal plasticity + change back some time

Answer 10

= addictions work like other choices in which immediate rewards take precedence over long-term gains - drug addicts can + do recover --> decision to take drugs or to quit are executed voluntarily - addicts choose “locally” rather than “globally” - trick is to acquire strategies for seeing overall summation of rewards over time & ignoring the attraction of immediate goal - -> neither disease nor full on choice but something in-between: momentary states of dopamine enhancement triggered by cues shut down intertemporal flexibility (disease model) --> can’t consider moments other than “now” - with recurrence of this cycle: this gets worse + it gets much harder to make the choice

Answer 11

= can explain why people start but not maintenance/persistence of addiction 1. positive reinforcement: drug high, pleasurable effect 2. negative reinforcement: reduce withdrawal effects

Answer 12

- addicts always choose more attractive local option (= take drug --> more reward than not taking it) - no pleasure without drug - treatment implications: adapt global view (contingency management)

Answer 13

- hyperactive impulsive system (1) + dysfunctional reflective system (2) - continuum hypothesis = assumes similar deficits across different alcohol related disorders: binge drinkers would show qualitatively similar but quantitatively less impairments than alcohol-dependent

Answer 14

= emotional evaluation (limbic) - impulsive prepotent behaviours - strong impulse to take drug - -> shown in craving, attention bias, approach bias

Answer 15

= cognitive evaluation (prefrontal) - inability to voluntarily inhibit the consumption - have more difficulties controlling urges - -> shoes in worse WM, decision making + response inhibition

Answer 16

- have increase in reward seeking + compulsion in common - -> dopamine system, impulsivity, local decisions - have loss in control in common - -> PFC deficits, loss of control, lack of global view

Answer 17

- detoxification = drugs used to dampen withdrawal symptoms but dosages are decreased slowly --> patient doesn’t become dependent (= help prevent relapse while brain is healing) - drug replacement/maintenance therapy = substituting drug that has fewer damaging effects a. antagonist drugs = block/ change effect of addictive drug, reducing the desire for it BUT cause severe withdrawal - alcohol: antabuse/disulfiram = makes alcohol punishing but only as long as they continue to take it - nicotine: patches/gums or antidepressant bupropion - heroin: opioid methadone, which has less severe effects

Answer 18

- alcohol: aversive classical conditioning with Antabuse then through operant conditioning they learn to avoid alcohol in order to avoid the aversive response - covert sensitisation therapy: imagine unpleasant associations between drug + consequences to create conditional aversive response - contingency management programmes: reinforcing abstinence

Answer 19

- identify situation in which they’re most likely to take drug - identify expectations about drug taking + challenge those by reviewing negative effects - motivational interviewing: elicit + solidify motivation + commitment to changing substance use - mindfulness + meditation

Answer 20

- abstinence violation effect: when they violate their abstinence, they tend to attribute it to lack of will power and self-control rather than situation-factors --> violate it even more to suppress conflict + guilt (dietary-slip) - relapse prevention programmes: teach people to see slip as situational and identify high risk situations to come up with coping/avoiding strategies

Answer 21

- by/ for people with alcohol related problems - 12 steps - -> 1. admit dependence - group members provide moral + social support - believe that people are never completely cured and will always be “recovering alcoholics"

Answer 22

- target younger people as onset predominantly during adolescent risk period - focus education on immediate risk of excess + payoffs of moderation - harm reduction model: drink safe like you drive safe - learn to be aware of drinking habits + thought to calculate alcohol blood level