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

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.

Substance-Induced Disorders

• Substance-Induced Delirium
• Substance-Induced Dementia
• Substance-Induced Amnesia
• Substance-Induced Psychotic Disorder
• Substance-Induced Mood Disorder
• Substance-Induced Anxiety Disorder
• Substance-Induced Sexual Dysfunction
• Substance-Induced Sleep Disorder
• Hallucinogen Persisting Perception Disorder

(flashbacks)

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

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

Substance Use Disorders

• Substance Dependence (DSM-IV-TR criteria contd.)
  • The substance is often taken in larger amounts or over a longer period than was intended
  • There is a persistent desire or unsuccessful efforts to cut down or control substance use
  • A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
  • Important social, occupational, or recreational activities are given up or reduced because of substance use

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)

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

Types of Substances (contd.)

• Hallucinogens

• Cause hallucinations, disorganized thinking, odd

perceptions, and delirium

• Examples: LSD, peyote
• Ecstasy: both stimulant and hallucinogen

Types of Substances (contd.)

• Marijuana (used to be classified as a mild hallucinogen)
  • Stimulates cannabinoid receptors throughout the brain.
  • Long-term use associated with infertility
  • Not physically addictive for everyone, but may be physically addictive for heavy users
• “Club Drugs” (aka, designer drugs)
  • Includes so-called “date rape” drugs (Ketamine, rophynol, and GHB) as well as other synthetic drugs
• Inhalants
• Steroids

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

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)

Environmental Risk Factors

• Stress
• Cognitive Distortions
• Learning
• Personality factors (no real research support for

the idea of an “addictive personality,” but things

like impulsivity are associated with substance-

related disorders)

• Family Factors
• Cultural Factors

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