Substance Use Disorders - Abnormal Psychology - Lecture Slides, Slides of Abnormal Psychology

Download Substance Use Disorders - Abnormal Psychology - Lecture Slides and more Slides Abnormal Psychology in PDF only on Docsity! Substance-Related Disorders Docsity.com Substance-Induced Disorders • Substance Intoxication (diagnostic criteria from DSM-IV-TR) – Development of a reversible substance-specific syndrome due to recent ingestion of (or exposure to) a substance. Note: Different substances may produce similar or identical symptoms. – Clinically significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system (e.g., belligerence, mood lability, cognitive impairment, impaired judgment, impaired social or occupational functioning) and develop during or shortly after the use of the substance. – Symptoms not due to a general medical (i.e., non-psychiatric) condition, and are not better accounted for by another mental disorder. Docsity.com Substance Use Disorders • Substance Abuse (DSM-IV-TR criteria) – Maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occuring within a 12-month period: • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home. Examples include: – Repeated absences or poor work performance – Substance-related absences, suspensions, or expulsions from school – Neglect of children or household Docsity.com Substance Use Disorders • Substance Abuse (DSM-IV-TR criteria contd.) • Recurrent substance use in situations in which it is physically hazardous. (e.g., driving an automobile or operating heavy machinery • Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct) • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) – The symptoms have never met the criteria for Substance Dependence for this class of substance. Docsity.com Substance Use Disorders • Substance Dependence (DSM-IV-TR criteria) – A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by THREE (or more) of the following, occurring at any time in the same 12-month period: • Tolerance, as defined by either of the following – A need for markedly increased amounts of the substance to achieve intoxication or the desired effect. – Markedly diminished effect with continued use of the same amount of the substance • Withdrawal, as manifested by either of the following: – The characteristic withdrawal syndrome for the substance – The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms Docsity.com Types of Substances • Depressants: Inhibit aspects of the central nervous system – Alcohol: (initially, disinhibition effect that produces feelings of euphoria, but as intoxication increases, excitatory areas of the brain become depressed or inhibited – Anesthetics – Antiseizure medications – Barbiturates (mostly replaced by anxiolytics) – Anxiolytics (anti-anxiety drugs) – Hypnotics (sleep medications) Docsity.com Types of Substances (contd.) • Stimulants: activate or stimulate the central nervous system – Bronchodilators – Methylphenidate (ritalin) – Caffeine: helps release epinephrine and norepinephrine. Mood, alertness, and cardiovascular activity become elevated. – Nicotine: effects similar to caffeine, increased cardiovascular activity. But also increases serotonin levels, so may promote a feeling of relaxation. (This may also be from staving off withdrawal symptoms). 25% of college students smoke cigarettes. – Cocaine: stimulates dopamine, norepinephrine and serotonin systems. – Amphetamines (90% of this is consumed in the form of meth) increases norepinephrine and dopamine activity Docsity.com Types of Substances (contd.) • Opiates (Opioids) – Codeine – Morphine – Heroin is a derivative of morphine – Opiates work by stimulating opiate receptors in the brain (in hippocampus, amygdala, thalamus, and locus coeruleus) – Painkillers such as OxyContin, Vicodin are also included in this group. Docsity.com Rates of Substance Use • Lifetime prevalence: most common is alcohol, followed by: – Tobacco – Marijuana – Unauthorized use of prescription drugs (including pain relievers, tranquilizers, stimulants, and sedatives) – Cocaine (including crack) – Hallucinogens Docsity.com Risk Factors for Substance-Related Disorders • Biological Risk Factors – Genetics: • Family studies found high heritability rates (40-60%); however, family studies include environmental as well as genetic factors. • Review of genetic studies found 20-26% heritability for general population and 30-36% for males with severe alcohol dependence. • Alcoholism is likely polygenic (many genes working together) • Variables related to alcoholism (metabolism of alcohol, sensitivity to alcohol, craving for alcohol) • Other substances: evidence for heritability is strongest for cocaine and opiates Docsity.com Risk Factors for Substance-Related Disorders (contd.) • Brain Features – Brain changes related to priming, drug cues, cravings, and stress – Major system associated with these changes: mesolimbic system, major dopamine pathway associated with pleasure and reward. – Mesolimbic system links to other brain areas. • Amygdala (emotion) • Anterior Cingulate (involved in self-control and problem- solving) • Pre-frontal cortex (judgment, decision-making—can be highly stimulated by cues that predict drug availability) Docsity.com Treatment of Substance-Related Disorders • Biological treatments – Agonists—mimic the abused drug (e.g., methodone, LAAM) – Antagonists—block pleasurable effects of the drug – Partial agonists (subutex)—mimics abused drug at some opioid sites but not others. – Aversives—(antabuse) make ingestion of drug uncomfortable Docsity.com Treatment of Substance-Related Disorders • Psychological Treatment (often combined with biological) – Inpatient/Residential (medically supervised detox, and rehabilitation) – Cognitive Behavioral Therapy (skill building) – Family and/or Marital Therapy – Group Therapy – Self-Help Groups (such as 12-step models—AA, NA) Docsity.com