Abnormal Psych Chapter 12

rate at which alcohol absorption occurs in bloodstream depends on

- how much a person consumes and over what time period - whether food is present in the digestive system - drinker's metabolic rate

clinicians diagnose substance use disorders by assessing the individual in four categories of symptoms:

- impaired control - social impairment - risky use - pharmacological changes

tobacco withdrawal symptoms

- irritability - difficulties with concentration - strong cravings for nicotine

cannabis

- marijuana - hashish

to prevent heroin relapse, clinicians may use one or more of three different medications:

- methadone - buprenorphine - naltrexone

treatment to prevent heroin relapse

- methadone - buprenorphine - naltrexone

biological treatment of alcohol dependence

- naltrexone - disulfiram (ANTABUSE) - acamprosate

people with gambling disorder also have high rates of comorbidity:

- nicotine dependence (60%) - dependence on other substances (58%) - mood disorder (38%) - anxiety disorder (37%)

long term effects of alcohol

- permanent brain damage - dementia (wernicke's and korsakoff's) - harmful changes in liver, gastrointestinal system, bone density, muscles, and immune system - seizures, hallucinations, blackouts

heavy and continued use of marijuana

- produce effects on bodily functioning - lead to higher risk of heart attack - lead to impaired respiratory functioning

opioids

- psychoactive substances that relieve pain - among most abused prescription drugs (opiod crisis) - prescription opioids: oxycontin, hydrocodone, morphine, codeine - heroin

immediate effects of alcohol

- sedating - central nervous system - potentially fatal in excess potentiation compounds these effects

extent of substance intoxication depends on

- specific drug - speed with which it acts - duration of its effects intravenous or smokable drugs into the bloodstream lead to a more intense kind of intoxication than occurs with drugs taken in pill form

nonbenzodiazepine sleep medications

- zolpidem (ambien) - eszopiclone (Lunesta) - zalepon (sonata)

how much percentage of population are current users of illicit drugs?

8.9% - marijuana is most commonly used illicit drug

three routes to development of comorbid substance use

1. the similarity of risk factors in substance use and other psychological disorders 2. individuals with psychological disorders or symptoms may use drugs as a form of self-medication 3. people who use substances may subsequently develop a psychological disorder, due either to changes in brain activity produced by the substances or to changes in lifestyle that precipitate stress, which, in turn, leads to symptoms of depression and anxiety

four categories of inhalants

1. volatile solvents 2. aerosols 3. gases 4. nitriles

drug use in million, hallucinogens:

1.4

drug use in million, cocaine:

1.9

rate of drug use by race

15.7% - American Indian/alaska 12.5%- black 10.8%- white 9.2%- hispanic 4.1%- asian

mild

2 symptoms

drug use in million, marijuana:

24

drug use in million, illicit drugs:

28.6

moderate

4-5 symptoms

severe

6 or more symptoms

drug use in million, psychotherapeutics:

6.2

substance

a chemical that alters a person's mood or behavior when it is smoked, injected, drunk, inhaled, or swallowed in pill form

substance use disorders

a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using a substance even though it causes significant problems in his or her life

inhalants

a diverse group of substances that cause psychoactive effects by producing chemical vapors - inhalants have similar effects as alcohol, but short lived - slurring of speech, loss of coordination, euphoria, dizziness, and over time loss of inhibition and control

wernickes disease

a form of aphasia in which the individual is able to produce language but has lost the ability to comprehend, so that these verbal productions have no meaning - acute and potentially reversible - deficiency in vitamin b1 - delirium, eye movement disturbances, difficulties in movement and balance, deterioration of peripheral nerves to hands and feet

gambling disorder

a non-substance-related disorder involving the persistent urge to gamble shows many same behaviors as substance use disorders: - cravings - increasing needs to engage in the behavior - negative social consequences

stimulant

a psychoactive substance that has an activating effect on the central nervous system - amphetamine - methamphetamine

peyote

a small, spineless cactus whose principal active ingredient, mescaline, can also be produced artificially. Users chew the mescaline-containing crown of the cactus or soak it in water to produce a liquid; some prepare a tea by boiling the cactus in water to rid the drug of its bitter taste. Used as part of religious ceremonies by native peoples in northern Mexico and the southwestern United States, mescaline has long-term effects on these and recreational users that are not known. However, its effects on the body are similar to those of LSD, including increases in body temperature and heart rate, uncoordinated movements, extreme sweating, and flushing. In addition, mescaline may cause flashbacks, much like those associated with LSD

dual process theory

automatic processes that generate an impulse to drink alcohol and controlled effortful processing that regulates these impulses - two processes: 1. cognitive system that generates the impulses to drink and 2. the part of self that is inhibiting, trying to control it the first process triggers an automatic impulse to drink. The second process allows individuals to regulate and inhibit their drinking; to think it through and make more reasonable and thoughtful choices. The more someone can control the first process (automatic impulses to drink), the less likely it is that that person will consume alcohol.

naltrexone

blocks the effects of body's production of alcohol-induced opioids less likely to experience pleasurable effects of alcohol and even less likely to feel pleasure thinking about it.

Most drugs of abuse directly or indirectly target the reward center of the brain by flooding its circuits with

dopamine Over time, the neurons in these dopamine pathways "down-regulate" in response to these surges in dopamine, meaning they produce less dopamine themselves or reduce the number of dopamine receptors. Users then need to take the drugs to raise their dopamine levels back to normal. In order to experience the effects they experienced initially from the drugs, they also need to take higher and higher levels; in other words, they develop tolerance

psilocybin

are substances found in certain mushrooms. Users brew the mushrooms or add them to other foods to disguise their bitter taste. The active compounds in psilocybin-containing mushrooms, like LSD, alter the individual's autonomic functions, motor reflexes, behavior, and perception. Individuals may experience hallucinations, an altered sense of time, and an inability to differentiate between fantasy and reality. Large doses may cause flashbacks, memory impairments, and greater vulnerability to psychological disorders. In addition to the risk of poisoning if the individual incorrectly identifies the mushroom, the bodily effects can include muscle weakness, loss of motor control, nausea, vomiting, and drowsiness.

with larger ingestion of alcohol

drinkers may begin to feel more outgoing, self-confident, and uninhibited. Beyond that point, the depressant effects become apparent, leading users to experience sleepiness, lack of physical coordination, dysphoria, and irritability.

hallucinogens

drugs that cause people to experience profound distortions in their perception of reality in the form of illusions or hallucinations, usually visual in nature - LSD - Peyote - Psilocybin - PCP - MDMA *use and intoxication but not withdrawal

LSD

emotions. They may feel several emotions at once or swing rapidly from one emotion to another. With larger doses, users can experience delusions and visual hallucinations. In addition, they may feel an altered sense of time and self - LSD does not seem to produce compulsive drug-seeking behavior, and most users choose to decrease or stop using it without withdrawal

alcohol myopia theory

as individuals consume more alcohol, more likely to make dangerous choices, risky behavior that has consequences, immediate temptation of moment overcomes the consequences of behavior

biological treatment for substance use disorder

except in the case of alcohol dependence, weak evidence exists for the efficacy of pharmacotherapies

hallucinogen persisting perception disorder

experience flashbacks or spontaneous hallucinations, delusions, or disturbances in mood similar to the changes that took place while they were intoxicated with the drug

when people abruptly stop alcohol after period of usage what happens?

experience sleep disturbances, profound anxiety, tremors, hyperactivity of the sympathetic nervous system, psychosis, seizures, or death

tolerance

extent to which the individual requires larger and larger amounts of a substance in order to achieve its desired effects, or the extent to which the individual feels less of its effects after using the same amount of the substance

heroin

form of opioid, synthesized from morphine, extracted from the seed pod of the Asian opium poppy plant high potential for addiction serious health consequences of heroin use: - fatal overdoses - infectious diseases - damage to the cardiovascular system, abscesses, and liver or kidney disease

caffeine

found in coffee, tea, chocolate, energy drinks, diet pills, and headache remedies - By activating the sympathetic nervous system through increasing the production of adrenaline, caffeine increases an individual's perceived level of energy and alertness. It also increases blood pressure and may lead to increases in body's production of cortisol * addiction and withdrawal but no caffeine use disorder

biological theory of drug disorder

genetic abnormalities - opioid receptor on chromosome 1 (OPRM1) - chromosome 15 in a cluster of nicotine receptor subunits (CHRNA-3, -5, -4) - catechol-o-methyltransferase (COMT)

biological theory of alcohol dependence

genetic factors - associations with genes involved in alcohol metabolism and neural transmission

other neurotransmitter influence by drugs

glutamate Long-term drug abuse can lower the individual's level of glutamate and lead to memory impairments

abstinence syndrome

hangover - nausea and vomiting - tremors - extreme thirst - headache - tiredness - irritability - depression - dizziness

synesthesia

hear colors and see sounds

long term user of marjiuana can cause

higher risk of heart attack and impaired respiratory functioning. In addition to developing psychological dependence on marijuana, long-term users may experience lower educational and occupational achievement, psychosis, and persistent cognitive impairment.

cocaine

highly addictive CNS that an individual snorts, injects, or smokes effects: feelings of euphoria, heightened mental alertness, reduced fatigue, and heightened energy intense high is short, so likely to do binge - stimulates dopamine receptors - increase body temp, blood pressure, heart rate Cocaine's risks include heart attack, respiratory failure, stroke, seizures, abdominal pain, and nausea

marijuana bad side effects

impaired short-term memory, slowed reaction time, impaired physical coordination, altered judgement and poor decision making

relapse prevention

individuals are encouraged not to view lapses from abstinence as signs of certain failure

hypnotics

induce sleep

antabuse (disulfiram)

inhibits aldehyde dehydrogenase (ALDH) and causes severe physical reactions when combined with alcohol -if they slip and do drink alcohol, will vomit or nauseous very sick so now classical conditioning alcohol with bad effects

MDMA

known as ecstasy of increased energy, euphoria, emotional warmth, distorted perceptions and sense of time, and unusual tactile experiences. Taken as a capsule or tablet, MDMA was once most popular among white teens and young adults at weekend-long dances known as "raves." - neurotransmitter affected is serotonin, MDMA (labeled "ecstasy") binds to the serotonin transporter responsible for removing serotonin from the synapse. As a result, MDMA extends the effects of serotonin

spectrum of symptoms

mild, moderate, severe

comorbidity with substance use disorders

mood disorder high numbers, anxiety disorders high with any drug comorbidities with marijuana is highest

tobacco

nicotine is the psychoactive substance found in cigarettes - stimulates the release of adrenaline (norepinephrine) - increases blood pressure, heart rate, and respiration *tobacco withdrawal and disorder, not intoxication

withdrawal

physiological and psychological changes that occur when an individual stops taking a substance

mood and anxiety disorders are more likely to _____ rather than ____, the onset of gambling disorder

precede, follow

marijuana

psychoactive substance derived from the hemp plant whose primary active ingredient is delta-9-tetrahydrocannabinol (THC ) - most commonly used illicit drug in the US - many first time drug users chose marijuana - legal in several states - marijuana also has the highest levels of past year dependence - to alter their bodily sensations and perceptions of their environment. The effects they seek include euphoria, a heightened sense of sensuality and sexuality, and an increased awareness of internal and external stimuli

methamphetamine

related to amphetamine but provokes more intense central nervous system effect rush or feeling of euphoria and becomes addictive very quickly Methamphetamine overdose can cause overheating of the body and convulsions, and if not treated immediately, it can result in death. Long-term use of methamphetamine can lead users to develop mood disturbances, violent behavior, anxiety, confusion, insomnia, severe dental problems ("meth mouth"), and a heightened risk of infectious diseases including hepatitis and HIV/AIDS.

Korsakoff's syndrome

retrograde (loss of memory of past events) and anterograde (inability to remember new info) amnesia, inability to remember recent events or learn new information - thiamine deficient really really long term you can remember

thc produces effects on body how

specific sites in the brain, called cannabinoid receptors. The brain regions with the highest density of cannabinoid receptors are the areas that influence pleasure but also are active in memory, thinking and concentration, perception of time, sensory responses, and ability to carry out coordinated movement

how does cocaine stimulate dopamine receptors

specifically targets an area in the midbrain called the ventral tegmental area (VTA)

biopsychosocial perspective

used for: - understanding substance dependence - approaches to treatment - genetics - action of substances on the central nervous system

gamblers fallacy distortion

when events generated by a random process have deviated from the population average in a short run, such as roulette ball falling on red four times in a row, individuals may erroneously believe that the opposite deviation (ex: ball falls on black) becomes more likely

caffeine withdrawal symptoms include:

- headache - tiredness and fatigue - dysphoric mood - difficulty concentrating - depression - irritability - nausea

sociocultural theory of alcohol dependence

- family, community, cultural stressors - children of alcoholics at greater risk

representativeness distortions

- gamblers fallacy - overconfidence - trends in number picking

combined behavioral intervention project

*most comprehensive protocol enhancing reinforcement and social support for abstinence receive up to 20 sessions, according to their needs, beginning semiweekly and then eventually biweekly or less, for up to 16 weeks - coping skills, ways to refuse drinks and avoid social pressure to drink, communication skills, assertiveness skills, management of moods, social and recreational counseling, social support for sobriety, and job seeking skills

psychological treatment of alcohol dependence

- Cognitive behavioral interventions - motivational approaches - expectancy manipulation (breaking down classical conditioning) - relapse prevention - combined behavioral intervention

biopsychosocial pathways model

- an approach to gambling disorder that predicts that there are three main paths leading to three subtypes - genetic vulnerability interacts with the poor coping and problem-solving skills of the person with gambling disorder (this makes the individual particularly susceptible to early gambling experiences)

psychological treatment for substance use disorders

- cognitive behavioral therapy (CBT) is now widely understood to be a crucial component of successful treatment - clinicians may combine CBT with motivational therapies, as well as with behavioral interventions that focus on contingency management

alcohol

- depressant - psychoactive substance that causes the depression of central nervous system activity

tobacco use disorder

- difficulty cutting down usage, despite physiological or psychological problems - withdrawal - tolerance

psychological theory of alcohol dependence

- dual process theory - alcohol expectancies: the potential for alcohol to reduce tension or help them cope with social challenges, feel better or sexier, etc. - alcohol myopia theory

factor for higher risk of substance use disorder later on

- early drug use - high genetic vulnerability - physically or emotionally traumatized individuals

sociocultural, alcohol dependent individuals showed a variety of behaviors:

- early neural dysfunction - nervousness and fretfulness as infants - hyperactivity as children - poor physical coordination

drug use in million, heroin:

0.5

drug use in million, inhalants:

0.6

gambling disorder is estimated to be diagnosable in

0.6 percent of population

effectiveness of CBI

CBI alone was not as effective in producing abstinent days as was CBI plus medication and management immediately after treatment, 1 year after treatment ended, the CBI-only group did not differ significantly from those receiving medication

stimulant examples

adderall and ritalin

new diagnostic term has fewer negative connotations than the term

addiction

amphetamine

affects the central and autonomic nervous system waking or speeding up the central nervous system, it also causes elevated blood pressure and heart rate, and decreased appetite and physical activity

acamprostae

amino acid derivative that moderates glutamate receptors reduces the risk of relapse by reducing the individual's urge to drink and thereby reducing the drive to use alcohol as a way of reducing anxiety and other negative psychological states

anxiolytics

anti-anxiety medications - benzodiazepines - barbiturates

sedatives

calming effects on the central nervous system increase gaba

potentiation

combination of effects of two or more psychoactive substances so that the total effect is greater than the effect of either substance alone ex: wine with cocaine

hashish

contains a more concentrated form of THC, comes from the resins of the plant's flower

rate of drug use age

declines with age peak at 18 to 25

pcp

symptoms that mimic schizophrenia, mood disturbance, memory loss, difficulties with speech and thinking, weight loss, and depression. Although these negative effects led to its diminished popularity as a street drug, PCP appeals to those who still use it because they feel that it makes them stronger, more powerful, and invulnerable. Despite its adverse effects, users can develop strong cravings and compulsive PCP-seeking behavior - Low to moderate doses produce increases in breathing rate, a rise in blood pressure and pulse, general numbness of the extremities, and loss of muscular coordination, as well as flushing and profuse sweating - At high doses, users experience a drop in blood pressure, pulse rate, and respiration, which may be accompanied by nausea, vomiting, blurred vision, abnormal eye movements, drooling, loss of balance, and dizziness. They may become violent or suicidal. In addition, at high doses users may experience seizures, coma, and death

methadone

synthetic opioid that produces a safer and more controlled reaction than heroin and is used in treating heroin addiction

substance intoxication

temporary maladaptive experience of behavioral or psychological changes that are due to the accumulation of substance in the body - experience a drug's effects on their physiological functioning and show signs of significant impairment

overstimulation of the reward system produces

the euphoric effects that abusers seek and leads them to repeat the behavior in order to repeat the experience