Psych of Substance Abuse TEST 3

How might drug addiction be explained using an operant conditioning paradigm?

(Reinforcers): Positive - adds something good example: take alcohol or drug = feel good Negative - Takes away something bad example: take a drug during withdrawal = feel better.

What factors sustain denial?

1. Denial protects the ego from the concept of inadequacy 2. Denial protects the option to continue to use i.e. It is tough to admit one is an alcoholic or an addict

What are three potential reasons why findings from twin studies don't always agree?

1. Different study designs 2. Different participants 3. Different cultures

The medical community points to the significance of biological factors in alcoholism and drug abuse. Name five biological factors that the medical community can point to that support their contention.

1. Emphasize role of genetic susceptibility 2. Increased tolerance 3. Withdrawal signs after stopping usage 4. Liver disease with chronic alcohol abuse 5. Brain abnormalities

McAuliffe and Gordon talk about three classes of reinforcers. What are they?

1. Euphoria 2. Social variables 3. Elimination of withdrawal sickness

From a sociological perspective, what are 4 functions of substance abuse?

1. Facilitation of social interaction 2. Provide a release from normal social obligations 3. Promote cohesion and solidarity among the members of a social or ethnic group 4. Denial of middle-class or establishment values. Hedonistic pursuits, spontaneity, and freedom

Name three reasons punishment as it is currently used may be ineffective in diminishing drug addiction.

1. Following first offense few people get arrested 2. If people do get arrested, punishment is usually mild 3. Punishment if often delayed before real consequence

What is the purpose of dream interpretation when using the psychoanalytic approach?

The purpose of dream interpretation is to uncover unconscious material, which the analysand typically represses.

What is the main thesis of the Susceptibility Model of addiction?

There are both genetic and psychological pathways to a substance abuse disorder.

How is denial a central factor in the disease model?

There is an inability to perceive an unacceptable reality: that of being an alcoholic or an addict

According to modern psychoanalytic formulations there are two general factors in the development of substance abuse. What are they? Explain what they mean.

1. Addictive Search - The internal urge is a psychological hunger or craving for an entire group of activities (e.g. compulsive gambling, overeating, indiscriminate sexual activity, violence). 2. Adventitious Entrance of Chemicals. The random introduction (in terms of accessibility and seductiveness) of alcohol or drugs into a person's life perhaps by peers or drug dealers.

Name four behaviors that are conducive to the maintenance of recovery.

1. Attending AA or NA 2. Calling one's spouse 3. Reading self-help literature 4. Getting to work on time

What are four factors leading to alcohol or drug abuse with reference to conditioning models?

1. Availability of alcohol or drugs 2. Lack of reinforcement for alternative behavior 3. Reinforcement for alcohol and drug use 4. Lack of punishment for experimenting with alcohol or drugs

What are four factors that are important in the reinstatement of drug taking after quitting?

1. Availability of drug 2. Presence of drug related environmental cues 3. Presence of stress 4. Lack of reinforcements for competing behaviors

There are two major types of conditioning models. What are they?

1. Classical Conditioning (Ivan Pavlov), also called respondent conditioning 2. Operant Conditioning (B.F. Skinner) Behavior is controlled by contingencies, i.e. rewards and punishments control behavior

Name 5 defense mechanisms in the addicted and be able to tell their applicability to addicted persons.

1. Compensation, i.e. overindulgence in something else (gambling, sex, work) 2. Denial (person denies he is an alcoholic while hiding bottles of booze) 3. Displacement - directing pent-up feeling toward others 4. Fantasy 5. Isolation - withdrawal into a passive state

What statements can be made to summarize the genetic risk with respect to alcohol and drug addiction?

1. Genes and the environment jointly determine alcohol and drug addictions. 2. The inherited characteristics are not reflective of a disease, but rather a predisposition. 3. Among persons with addiction problems, there is heterogeneity to the contribution of genes and environment. 4. Recognizing the role of genetic risk factors does not require that alcoholism and other drug dependencies be defined as disease states. 5. Research on the genetics of addiction is important because it may lead to more effective ways to prevent and treat problems. 6. In the future, genetic testing will likely gain acceptance in the general population, but individuals will need help in interpreting the results of genetic tests.

Studies by Tsuang et al, 1998 in males suggested that vulnerability to addiction to drugs was influenced by three factors. What are they?

1. Genetic factors 2. Family environment factors 3. Non-family environmental factors

Some would argue that the use of labels for certain behaviors has some advantages. Name three of these advantages.

1. Gives credibility to physicians' and mental health professionals' efforts to control, manage, and supervise the care given to persons with substance abuse problems. 2. It makes legitimate such potentially lucrative endeavors as hospital admissions, insurance company billings, expansion of the client pool, consulting fees, and so forth. 3. Serves to restrict the number and type of practitioners who are permitted to assist persons with these problems.

What are three positive attributes of contingency management approaches to addiction?

1. Grounded in science 2. Procedures rely on incentives to motivate clients 3. Has good outcomes

What are the general conclusions about the origins of alcoholism that can be drawn from twin studies?

1. Heredity and environment interact in complex ways to spur the development of alcoholism. Genetics seems to set the stage for vulnerability. 2. Other studies suggest that genetics play a role in early onset alcoholism, but not later onset.

What are the four principles underlying behavioral counseling?

1. Humans are viewed as being neither intrinsically good nor bad, but have the potential for all kinds of behavior 2. Humans are able to conceptualize and control their own behaviors 3. Humans are able to acquire new behaviors 4. Humans are able to influence others' behavior as well as to be influenced by others

Name three advantages of controlled drinking.

1. In our society, abstinence from alcohol is deviant behavior 2. Abstinence may lead to overwhelming anxiety 3. Abstinence during treatment rules out the possibility for changes in drinking behavior

What are 2 limitations of the sociocultural concept of substance abuse?

1. Many of these concepts lack precision and do not seem relevant to contemporary helping strategies. For example: social boundaries, subcultures, conduct norms, time out. 2. There is a general inability of prevention and treatment practitioners to significantly alter the social, cultural, and environmental factors that cause substance use and abuse.

What are the three phases of contingency contracting?

1. Problem specification - identify the problem in behavioral terms 2. Helping clients to make a commitment to change. The use of incentives to generate and maintain motivation for change is crucial 3. Specify goals- counselor and client should work together to specify goals

Name three weaknesses of the disease model.

1. Propositions of the model are not well supported by science since environmental factors other than drugs are clearly important 2. Gives too little emphasis on the impact of psychosocial variables and particularly the role of learning as an etiological basis of addiction 3. Doesn't provide guidance to skill based relapse prevention strategies

Name four strengths of the disease model.

1. Removes alcohol and the other drug addictions from the moral realm 2. Has helped shift resources toward treatment and research 3. Has increased research on molecular mechanisms which can provide greater understanding and perhaps lead to better treatments 4. Abstinence as a goal is the best way to go if it can be accomplished

What are the three main tenants of the Alcoholics Anonymous Model?

1. Stresses the importance of spirituality in the cause of, and recovery from alcoholism. 2. See alcoholism LIKE a disease rather than as a disease. 3. AA encourages members to find a "Higher Power" and turn to their life over to that power.

Give three examples of alcohol as a boundary marker.

1. The Temperance movement 2. Alcohol use in some Indian tribes 3. Jewish moderation of drinking

What are four common assumptions in the psychoanalytic formulation of addiction?

1. The act of drug use is a symptom of some type of underlying psychological disorder 2. The psychological problems precede and cause the substance abuse 3. Addiction is seen as a uniform disorder across all drugs, courses of severity, and disorder subtypes 4. The presence of addiction indicates severe psychopathology

What are some consequences of applying a label?

1. The diagnosis may motivate the client to seek help. 2. The diagnosis may lead to overly intrusive treatment, social stigma, estrangement from family members, loss of employment, feelings of worthlessness and humiliation, or exacerbation of the problem.

What are two insights as to compulsive drug use according to psychoanalytic theory?

1. The id is oriented toward death instincts rather than constructive (e.g. sexual) instincts. 2. Substance abuse is seen as a symptom of a deficient ego.

What are four of the recommended treatments today with respect to psychoanalytic formulations?

1. The initial stage of treatment should be supportive and didactic 2. Sessions should be held once or twice a week 3. The "couch" should not be used 4. Interpretation should be minimized

What two assumptions must be made in the studies comparing twins and the relationship to addiction?

1. The mating of parents is random, i.e. alcoholics don't marry each other. 2. The with-in pair environment between dizygotic and monozygotic environment is similar.

Name three emphases of the Youth Culture.

1. The person must be loyal to friends and attempt to maintain group association 2. Social interaction with the peer group should occur in locations where adult controls are relatively absent 3. Within such peer groups, a veiled competition exists for status and prestige among group participants and leads to new forms of behavior or operating innovations.

What are three consequences of modifications of the mesolimbic dopamine systems by drug addiction?

1. Things that previously gave people pleasure do so in a lesser fashion because of the intense pleasure from drugs 2. The organism relies more and more on rewards from drugs 3. Addiction leads to loss of control and drug seeking predominates

What are the three main advantages of the disease model?

1. Treating addiction as a disease has lessened the stigma previously associated with addiction. 2. Has made insurance money available for treatment. 3. Reduces feeling of failure on the part of the addict.

What is contingency contracting?

A positive intervention that specifies the behavioral, social, or academic expectations to be completed in order to access reinforcement.

Main idea underlying the disease model of addiction?

Addiction is a disease like other diseases, thus can be diagnosed, treated, and possibly cured.

What is meant by addiction as a primary disease?

Addiction is not caused by heavy drinking or drug use, stress, or psychiatric disorders. Rather, the disease causes these.

According to modern psychoanalytic thinking substance abuse is seen as a defense mechanism. Explain the thinking about this.

Addicts use alcohol or drugs to protect themselves from overwhelming anxiety, depression, boredom, guilt, shame , and other negative emotions.

Give four examples of drug subcultures.

Alcohol Abuse Marijuana Abuse Polydrug Abuse Herion Injection

From a sociological perspective, the problems of excessive drinking have become "medicalized". What is meant by the term "medicalized"?

Because of vested interests, the medical and mental health communities have redefined the problem as one of "illness" or "disease". i.e. labels for the behavior have been given.

Give three examples of neuroplasticity.

Changes in receptor number, NT release, and dendritic spine length

Where do clinical diagnostic criteria come from in the general sense? (don't say DSMV)

Cultural norms- "alcoholic" and "addict" deviate from socially acceptable standards.

Give an example of a label.

Diagnosis - a formal label of problem behaviors created by the helping professionals

What is their conclusion as to the importance of each of the three classes of reinforcers in drug addiction?

Drugs (particularly narcotics) are powerfully reinforcing-even irresistible-to the individual.

What is the Achievement Anxiety Theory of addiction?

Drugs are initially used to seek relief from the pressures of achievement and productivity. They provide a quick "chemical vacation". However, continued use reduces the difference between "work life" and leisure-time activities, such as drug taking. Drug taking becomes more and more a full-time pursuit.

In order to help individuals the ____________________ (part of personality subsystems) needs to be strengthened.

Ego

What is the general conclusion about the sociocultural approach to understanding addiction?

The lack of practicality is likely to prevent sociocultural perspectives from gaining more prominent status among theories.

Behavioral Self-Control Training has been found to be effective in reducing some measures of alcohol addiction. It has been found to be effective on ALL clients.

False

Many psychoanalysts today recognize that traditional analytic methods are largely effective.

False

Marijuana abuse appeared to be influence by

Genetic factors Family environment factors Nonfamily environment factors

How might the development of tolerance be explained using a classical conditioning paradigm? (think Seigel, 1982).

He demonstrated that drug tolerance can become partially conditioned to the environment, i.e. use the same drug in the same environment, effect of drug will diminish over time.

Genetic factors seemed to play the greatest role in the addiction to (what drug?)

Heroin

There are three personality subsystems according to the psychoanalytic model. What are the three subsystems and what is the role of each?

ID-Orginal source of personality, contains instinctual drives, present from birth EGO-The ego arises from the Id in order to satisfy the needs of the individual that require transactions with the external world. (i.e. reality) SUPEREGO-is the moral component and is referred to as the "conscience" It emerges from learning the moral values and social taboos Concerned with right and wrong

What is extinction in the operant conditioning paradigm?

If one performs the behavior and doesn't get reinforced then the behavior will diminish.

How might one explain overdosing in a new environment using the classical conditioning paradigm?

If one takes the same amount of drug in a different environment, then the environmental component is not there. Without the environmental component of tolerance, the drug effect will be greater. It is possible that this situation will lead to over dosing.

Social and cultural foundations of addiction are about the macroenvironment of substance use and abuse. What is considered the macroenviroment?

In general, the social values, beliefs, and norms that influence drug use.

What three character traits seem to be associated with future drug use?

Independence Nonconformity Impulsivity

What are defense mechanisms?

Irrational protective measures such as denial and rationalization.

What conclusion can be drawn about the primary disease model of addiction?

It doesn't hold true, because for each alcoholic there is probably a relatively unique combination of forces that led to development of the drinking problem.

How might one utilize their knowledge of extinction to help in treatment of addicted individuals?

It is important to work with the addict and their particular cues that they associate with their drug use. Hopefully the craving responses will eventually diminish after reinforcement has been eliminated completely.

How does the concept of "loss of control" fit into addictive processes?

It is the central premise of the traditional disease model of addiction. Powerlessness comes from some unknown defect or abnormality.

Which neuronal pathway in the brain would most people expect to be modified with respect to addiction?

Mesolimbic Dopamine Pathway (the brain's reward center)

What is the main idea underlying learning models of addiction?

Most or all of human behavior is learned including adaptive and maladaptive (addiction) behavior.

Does research support the self-medication hypothesis?

No

Name four problems with the primary disease model of addiction.

One size does not fit all. 1. Some sensitive to genetic factors 2. Some influenced by environmental factors, e.g. stress, marital and family problems, depression 3. Some may reflect severe antisocial life problems 4. Personality traits may predispose some

What is the distinction between the two competing cultures of "parent culture" and " youth culture" with respect to values and experimentation?

Parent culture which attempts to defend traditional values. Youth culture which encourages experimentation with new or novel form of expression.

What is the main controversy about the disease model and addiction?

People still argue that addiction is a moral failing or results from lack of self-restraint and self-discipline.

What is the self-medication hypothesis with respect to addiction?

People use drugs to medicate themselves for underlying affective states.

A major tenant of the exposure model is that there is neuroplasticity. What is neuroplasticity?

Plasticity, or neuroplasticity, describes how experiences including aging reorganize neural pathways in the brain.

What are the identified social contexts by Thombs and Beck? Pick all that apply

School defiance Social facilitation Stress control Peer acceptance Parental control

What person is primarily associated with Psychoanalysis?

Sigmund Frued

Give an example that would illustrate the role of classical conditioning in addictive processes.

Taking a drug (US) makes you feel good (UR). If you pair a stimulus (crack house, CS) with the US (drug), you will feel good (UR). After enough pairings of the crack house (CS) with the drug (US), the CS (crack house) alone will make you feel good (CR).

What is the exposure model of addiction?

The exposure model suggests that chemicals and their actions on the brain are the primary causes of addiction. Since the brain demonstrates plasticity, alcohol and drugs have the ability to modify brain function in such a way that a person becomes addicted.

What is the misperceived norms hypothesis?

The model maintains that excessive drinking among young people is maintained by misperceptions of peers' drinking practices.

According to Thombs & Beck (1994), there are three sources of drinking motivation for adolescents. These are Psychological, Situational, and Temporal.

True

Chemical dependency is seen as an outward manifestation of deeper personality problems.

True

Modern Psychoanalytic formulations of addiction view chemical dependency as a symptom of a deficient ego.

True

Psychoanalysis relies heavily on the analyst's interpretation of the analysand's concerns.

True

What is the logic in using both identical and fraternal twins in studies on addiction?

Twin studies compare a specific characteristic or a specific trait between the two types of twins.

What is a drug subculture?

Values are shared ideas about what the subgroup believes to be true or what it wants. The group has the intention or desire to alter consciousness, or to get "high".

What are two problems with contingency management approaches to addiction?

a. Costly b. Limited Time and Dollars to Implement

What four areas of a client's life does the community reinforcement approach to treating addiction focus on?

a. Vocational b. Recreational c. Social d. Familial