Week 4 Lecture

Question 1

What did historical definitions of addiction define addiction as?

Answer 1

More as a definition of dependence:

“intense physical disturbances when administration of a drug is suspended”

Question 2

Because the initial definition of addiction only addressed physical affects, what did a second definition define addiction as?

Answer 2

“psychic drive that requires periodic or continuous administration of the drug to produce pleasure or avoid discomfort”

Question 3

What are some reasons as to why the word dependence should not be used to define addiction?

Answer 3

Any drug can produce dependence if it is defined as the withdrawal system.

Question 4

Addiction is much more than dependence, that is, much more of just a withdrawal syndrome. What is a better way to describe it?

Answer 4

Addiction refers to a recurrent patter of maladaptive behaviour that includes drug seeking despite negative consequences and, very often, relapse.

Question 5

What does the DSM 5 use to describe addiction?

Answer 5

“substance use disorders” -the term addiction is not mentioned

Question 6

How many seperate classes of drugs does the DSM 5 include to do with substance use disorders?

Answer 6

10 classes

Question 7

Substance disorders span a wide variety of problems arising from substance use, and cover how many criteria?

Answer 7

11 different criteria

Question 8

What are the first 5 criteria from substance use disorder in the DSM 5?

Answer 8

1. taking large amounts for longer than you’re meant to
2. wanting to cut down but not managing to
3. spending lot’s of tie getting and using the substance
4. cravings
5. not managing daily life

Question 9

What are the second half of the criteria that DSM defines as a substance use disorder?

Answer 9

6. continue to use even when problems are caused
7. giving up activities because of substance use
8. continuing substance use even when it is dangerous
9. continuing to use even when there is a physical or psych problem which could be made worse
10. needing more of the substance to get the effect you want
11. withdrawal symptoms

Question 10

For substance disorder to be diagnosed, what should be met in regards to criteria?

Answer 10

1. 2 or 3 symptoms indicated mild substance use disorder
2. 4 or 5 is a moderate disorder and
3. 6 or more is severe

Question 11

The DSM 5 uses the term substance induced disorder. Why is this?

Answer 11

Because mental problems are developed by substance use

Question 12

What are the 3 steps in defining the definition that Koob and Le Moal in 1997 define it as?

Answer 12

1. compulsion to seek and take the drug
2. loss of control in limiting intake
3. emergence of a negative emotional state

Question 13

What is one of the major objective of current research in terms of substance use disorders?

Answer 13

To understand the mechanisms that mediate the transition from the occasional and controlled use to the loss of controlled use

Question 14

From a psychiatric perspective, drug addiction has both impulse control disorders and compulsive disorders. Describe the key aspects about impulsivity:

Answer 14

The inability to withhold responding. Increasing sense of tension before engaging in a given behaviour. There may be or not be guilt after the act.

Question 15

From a psychiatric perspective, drug addiction has both impulse control disorders and compulsive disorders. Describe the key aspects about compulsion:

Answer 15

Characterised by anxiety and stress, followed by compulsive repetitive behaviour and relief from stress by performing the compulsive behaviour

Question 16

The search for positive reinforcement is more closely associated with what to do with substance use disorders?

Answer 16

Impulse control disorders

Question 17

Negative reinforcement in substance use disorder is more closely associated with what?

Answer 17

Compulsive disorders.

Question 18

How did George Koob define the transition between impulse to compulsion when it comes to substance use?

Answer 18

There is a shift from positive reinforcement driving the motivated behaviour to negative reinforcement driving the motivated behaviour.

Question 19

What is the incentive sensitisation theory?

Answer 19

When a drug is administered, its effects will not remain constant. Drug tolerance is a shift in the dose response curve. Thus, tolerant people with the same dose has less effect. In tolerant individuals, a greater dose is required to produce the same effect.

Question 20

Describe the separate processes for liking and wanting in the incentive sensitisation model:

Answer 20

The psych processes for pleasure is separate for the psych processes responsible for wanting (wanting increased, liking decreased)

Question 21

Describe George Koobs allostasis and negative reinforcement model in substance use:

Answer 21

The initial effect of the drug is believed to be opposed or counteracted by homeostatic changes in the systems that mediate primary drugs. (less euphoria, more tolerance)

Question 22

What is allostatic view on drug addition?

Then, what is Koob’s hypothesis?

Answer 22

The process of achieving stability through change

The process never returns to the original homeostatic level before drug taking is reinstated. Thus, creating a greater and greater allostatic state in the brain reward system.

Question 23

What is the habit learning theory developed by Robbins and Everett?

Answer 23

Addiction is an interaction between motivation and emotion, combined in learning (all of which have a biological basis).

Question 24

What is instrumental conditioning?

Answer 24

The organisms’s behaviour produces the stimulus. The behaviour occurs because of the consequences that it produces. Often referred to as “goal directed behaviour”.

Question 25

What are the three main categories of instrumental conditioning?

Answer 25

1. positive reinforcement
2. negative reinforcement
3. punishment

Question 26

Can different forms of learning actually occur concurrently?

Answer 26

Yes

Question 27

What are three points as an example that different forms of learning are used simultaneously?

Answer 27

1. Goal directed behaviour: We learn to associate the response and the outcome. This is instrumental conditioning
2. we associate the stimulus with the reinforcing outcome (classical conditioning)
3. the stimulus begins to elicit the response directly (habit learning)

Question 28

What is the learning hypothesis of addiction developed by Everett and Robbins?

Answer 28

Postulates that addiction involves a transit from response outcome to habit like (stimulus response) behaviour. This is mediated by information transfer from the ventral striatum to the dorsal striatum.

Question 29

Compulsive drug-taking persists despite what?

Answer 29

negative consequences

Question 30

When shown a cocaine cue video, what did cocaine addicted subjects show?

Answer 30

Increased dopamine levels in the dorsal striatum, which correlated to self-reported craving.

Question 31

What is a heterogenous phenotype?

Answer 31

Abusers represent a highly heterogenous group, and patterns leading to drug dependence are diverse.

Question 32

What are personality traits in association to addiction?

Answer 32

Factors of vulnerability include disinhibition novelty, sensation seeking, anxiety and especially impulsiveness.

Question 33

How are comorbid psychiatric associations associated to drug use disorders?

Answer 33

mood disorders, antisocial personality and anxiety disorders are all associated.

Question 34

How do developmental factors influence drug use?

Answer 34

adolescent exposure to alcohol, drug use and tobacco leads to significant vulnerability during adulthood.

Question 35

Describe the association between use of legal drugs and substance abuse?

Answer 35

There is support that initiation often begins with legal drugs early in life often lead to a lifetime dependence problem of illegal drugs.

Question 36

How do genetic factors influence drug use disorders?

Answer 36

Studies have used twins raised together or apart to determine if there is a correlation between drug use and genetics. The results showed that there is an estimate of heritability. Also demonstrates how important environment is.

Question 37

In cocaine addicted patients and other familiar drugs, what affect does it have on their dopamine receptor?

Answer 37

Reduced dopamine receptor availiabiity in their brain.

Question 38

What, as well as drugs, activate common reward circuitry in the brain?

Answer 38

Food.

Question 39

In Australia, what continues to cause more ill health and premature death than alcohol and other drug use combined?

Answer 39

Tobacco smoking

Question 40

How many Australians have used an illicit drug in their lifetime?

Answer 40

More than 2 in 5

Question 41

Compared with people their age in 2001, today’s young people are less likely to what?

Answer 41

smoke, drink and use illicit drugs

Question 42

What was the most commonly used illicit drug in 2019?

Answer 42

Cannabis, followed by cocaine, ecstasy and non-medical use of pain killers and opioids.

Question 43

Between 2010 and 2019, how did the proportion of Aboriginal and Torres Strait islander people’s smoking and drinking habits change?

Answer 43

Fell from 35% to 25% as did drinking at a risky level

Question 44

While smoking rates have fallen in all socioeconomic areas, where has the improvement been greatest, and what is the downfall of these areas?

Answer 44

Smoking rates have improved most among those living in advantaged areas. However in these areas, illicit drug use has increased the most.

Question 45

What is the four stages of substance use, as defined by the health psychology perspective?

Answer 45

1. initiation
2. maintenance
3. cessation
4. relapse

Question 46

In stages 1 and 2 (initiation and maintenance) of the health psychology perspective, what is the main focus?

Answer 46

Cognitions and social norms. Also, peer group pressure.

Question 47

Outline stage 3 of the health psychology model, cessation of an addictive behaviour.

Answer 47

social cognition models have been used to examine the predictors and intentions to stop addiction. the best predictors were perceived behavioural control and perceived susceptibility.

Question 48

What are some of the many factors which contribute to relapse?

Answer 48

After many years of drug abuse, drug addiction becomes a chronic illness, and has a relapse rate similar to other chronic illnesses. Stress, conditioned cues, exposure to the drug are all relapse factors.

Question 49

Does the brain process wanting and liking in the same way?

Answer 49

no

Question 50

For a drug addicts dopamine response to say stable, what must happen?

Answer 50

They must take more and more of the drug

Question 51

Instead of punishing drug addicts, what does Dr. Mark Tyndall suggest that we do?

Answer 51

Promote safe injection sights, which will lead to safer recovery