PSYC 415 test three

What are some of the reasons that the 100:1 rule and the rise of mandatory minimum sentences lead to a disproportionate number of African Americans being incarcerated?

- 2005 data shows that 80% of prison population for cocaine is black despite 2/3 of users are white or Hispanic. This could have been due to sentencing disparity in regard to deciing 5g of crack is the same as 500g powder cocaine,behavioral and environmental vulnerability, Enhancement laws (school zones) socioeconomic factors, uneven enforcement.

What was the primary evidence cited to support the (erroneous) contention that only 1% of patients prescribed oxyxontin developed addiction?

- A one paragraph review or note to the journal editor reviewing a few of the studies in the journal, not actually an article

What is a reference group? What is a peer cluster? Which is most likely to influence whether we try a drug in adolescence? Why? How do family variables influence the types of peer clusters people develop?

- A peer reference group is a larger group of people that one generally associates with. A peer cluster is a very small cohesive group of peers, or ones close friends. A peer cluster is more likely to influence initiation of drug use due to how much individuals associate with one another. In general family and primary social influence, influence peer clusters through things such as family cohesion, religious identification, an participation

Why is the college environment particularly influential in the development of recreational drug use patterns?

- Adolescent and young adult tendencies to overestimate how normative it is for their peers to use and abuse drugs. - Party profile of the school - Peer modelling and socialization increases alcohol opportunities - College students that live at home are less likely to drink

Whose theory is associated with the concept of self-efficacy?

- Bandura's self-efficacy theory - Self-efficacy is the individuals confidence in maintaining behavioral change evn in situations that could trigger relapse

Describe several reasons that the idea of behavioral addictions have been more controversial than substance addictions?

- Behavioral addiction Is more controversial because the idea of substance use as an addiction became clear due to the fact that it is known that ingesting chemicals changes the chemistry of the brain leading to derailing brain circuitry but behaviors are viewed as more of a moral choice instead of a disease process

What is one reason described by Dr. Kolodny that African Americans and Latinos were protected from the high rates of opioid overdoses seen in whites?

- Doctors are more hesitant to prescribe drugs like this to minorities due to racial stigmas attached to these populations and perceived risk

What are the mechanisms through which peers influence drug use behavior?

- direct offers of drugs, modelling of drug use behaviors, conveying norms and expectancies about drug use

What are some of the secondary effects related to felony convictions for drug use? How do such convictions limit individual's lives after release? How does this continue to disadvantage them?

- Felons and families of the felons lose health and welfare benefits, they can no longer receive food stamps or TANF benefits. In some states you can lose insurance as well. - New laws restrict housing such as the one strike and you're out of `996 allowing properties to consider substance use in eviction cases. 2005, 5% denied housing and 6% evicted - Drug charges revoke eligibility for federal aid for a year and selling revokes it for up to two years. Eligibility can be reinstated upon rehab completion. - In many areas felons are barred from employment, including military and government jobs and cannot receive many licenses, this lack of employment can also lead to no health care benefits. - Incarceration removes users from the population for an average of 2 years but shows little to no positive impact on drug use after this period. Return to prison for drug use has high rates.

Be able to describe at least 4 similarities between behavioral and chemical addictions

- Gambling is commonly associated with similar life events that are also common with SUD such as divorce, joblessness, incarceration and impaired functioning. In addition gambling tends to begin in adolescence and early adulthood as well as following a similar trajectory to substance dependence showing long periods of abstinence and high relapse rate afterwards. It is also commonly co occurring with substance use disorder as well as anxiety and depression.

Why was gambling the first behavioral addiction to be formally included in the DSM 5?

- Gambling was introduced in the DSM because there is a growing agreement that there is a strong reinforcing nature due to gambling working on a variable ratio reinforcement schedule which stimulates the rewards center the same way as drug taking behaviors. In addition both tolerance and withdrawal symptoms are seen in this disorder similar to drug use.

At what stages of drug and alcohol use does genetics have its primary effect?

- Genetics play a primary role when use is initiated in adolescence because the development at this time period causes an overall increase in frequency of use as well as alters development making one less able to fight genetics.

Why are young people who become addicted to pain pills more likely to switch to heroin than older people according to Dr. Kolodny?

- Heroin is cheap and doctors readily stop prescribing pain pills to younger individuals whereas with an older individual it is easier to obtain prescription pills for ongoing chronic pain

How does high parental montoring limit genetic influences on substance use initiation?

- High parental monitoring is a frequent predictor of if an adolescent will initiate use because if a parent is involved in an adolescent's life and knows what is going on in ones life they show a highly reduced risk for initiating substance use. This does not refer to helicopter parenting but rather just general parental involvement that is appropriate for a given age. If an individual does not initiate use of a substance then genetics are unable to cause one to become addicted. The substance must be present for genetics to play a large role.

Why is Dr. Omar Abubaker working to change dental prescribing practices?

- His son died of an overdose

What are the similarities?

- Internet gaming is considered a behavioral disorder as well as gambling. In addition most of the criteria are almost identical to one another for the two disorders. Some of these similarities include lying about use, preoccupation or obsession with the behavior, withdrawal symptoms, tolerance to the condition, attempting to stop or curb playing time, lying about usage, using it as a way to relieve anxiety or guilt, and having lost and opportunity or a relationship as a result to gaming.

What are three factors discussed in class that are important in who we select as peers?

- Location - Availability - Perceived similarity - aspiration

What are mandatory minimum sentences and how does the 100:1 rule relate to them?

- Mandatory minimum sentencing is 5 years for 5 grams of crack and for 500 grams of powder cocaine. Minimum sentencing became popularized with drug use to allow for less judicial flexibility. - 100:1 rule relates to the amount of crack versus powder necessary to trigger a mandatory minimum prison sentencing.

According to Dr. Kolodny, people of what age are more likely to die of an opioid overdose?

- Middle aged individuals

What is the type of therapy often associated with the transtheoretical model?

- Motivational interviewing

What are the main insights of the transtheoretical model?

- Not everyone is ready to change, and in order to be helpful; need to meet people where they are and help them move to the next stage in the change process; Change isn't something that happens once and is over—is something that occurs over time; change isn't always linear—doesn't always go smoothly in one direction

Why are sex and food addictions particularly controversial?

- One of the large reason that sex and food addictions are so controversial is because they are deemed to be in the categories of the seven deadly sins particularly sexual deviancy and gluttony. In addition, food and sex are considered natural drivers of behavior and therefore people are resistant in labeling these as an addiction.

What is the difference between peer socialization and peer selection, and how do these interact in relation to drug use?

- Peer selection refers to choosing friends based on your perceived interest such as if you believe a group of people will use drugs as well an individual may seek out this friend group.

In adolescence, are peers more likely to influence drug use initiation or continued use? Why might this be true?

- Peers are more likely to influence the initiation of use because of perceived norms as bandura suggests in his social learning theory. The effects of the drugs themselves are what strongly contributes to long term problematic use

What does social learning theory (Bandura) suggest about peer influence on drug use behaviors?

- Peers influence individuals in adolescence by normalizing drug use for some individuals. Bandura suggests each peer group have norms and expectations about behaviors. This leads to initiation of use in adolescence

Are there differences in how peer influence vs. peer selection increase or decrease drug-related behaviors in adolescence, early adulthood, older adulthood?

- Peers influence initiation in adolescence as well as in emerging adulthood due to increase independence from familial influences. This is most likely if these behaviors are considered a norm. this has less of an effect in older adulthood.

Be able to write about one or more examples of industrial epidemics.

- Promotion of tobacco use and smoking in the first eight decades of the 20th century - Targeted young independent women, peer group segmentation - Gambling creates addiction by design - Works on an interval ratio pattern meaning there are random outputs keeping individuals in the game wanting more just so they can get that hit because the next one might be the one.

What were the Rand Corporation's conclusions related to the cost effectiveness of a variety of interventions in reducing drug use?

- RAND corporation made a preliminary synthesis in 2009 of the effects of these laws targeting drug offenders in terms of women and children. This pertains to: - Children and families being torn apart, loss of health care benefits, less housing availability, low access to higher education, loss of immigration status, no or few employment opportunities, low political representation. - In 2013 2.7 million had parents I prison,2/3 of this due to drugs, mostly black and Hispanic kids.

What are two arguments for and against the inclusion of social media addiction in the next version of the DSM?

- Some argue that this is the only behavior that is unique to the internet and It uses reinforcements in order to engage users. It uses notifications, as well as algorithms to present content picked just for you in order to keep one on a site. Some argue however that it is a means of social connection and there is simply not enough research or data on it in order to consider it an addiction. Some of the things that classify problematic use is loss of sleep, spending more than 2 hours a day, stalking old loves, ignoring work for social media, and accessing sites under dangerous conditions, simply not being able to ot respond.

What types of appeals did Purdue Pharma make to doctors to reduce their inhibitions about prescribing opioid pain medicines?

- That we are needlessly allowing patients to suffer with chronic pain - Doctors were mistaking addiction for dependence - Less than 1% become addicted - Pain as the 5th vital sign

What does the it mean that the genetic influence on substance related disorders is shared with other behavioral disorders like Antisocial personality disorder -what is the underlying genetic trait that is shared (behavioral disinhibition)

- The common characteristic is behavioral disinhibition, this is referring to the lack of concern or regard for social and behavioral norms making an individual more likely to engage in a behavior.

What other factors interact with genetics in limiting or increasing the risk for substance use?

- The core factors discussed in lecture that interact with genetics making substance use more likely is low parental monitoring, high peer deviance, and various neighborhood characteristics such as being in a transitory neighborhood, being around more slightly older young adults or being in an area with higher alcohol sales.

What are primary differences between gambling and gaming?

- The criteria are both different and similar for videogaming. One primary reason that video game disorder is not in the DSM is because a large amount of research for this DSM is prior to 2012 and also because videogaming is a very new technology. Gambling does however make one more at risk for bankruptcy and reliance upon others for money. In addition to qualify for this diagnosis 5 criteria must be met of the nine and players must use these internet games to the point that it leads to significant problems with functioning

When was the second war on drugs? What were some of the major precipitating events? (Len Bias, rise of crack cocaine)

- The second war on drugs is said to have occurred between 1986 and 2008. - Crack cocaine was seen as a glamour drug used by celebrities in the 70s and early eighties but became more popular when a powder form of crack cocaine became available, it was smokeable intense and cheap. It was also highly addictive making it the street drug of choice. - Len Bias was the 2nd round draft pick of the Celtics in 1986, he died two nights after his draft from cocaine. - Cardiac arrest killed him drawing attention to the issue.

What is heritability?

- the proportion of phenotypic variance that can be accounted for by genes Does heritability measure INDIVIDUAL genetic influence? NO! Is a population level measure.

What prevention efforts at VCU are designed to increase awareness of actual frequency of drug-use behaviors? Why are these same types of strategies controversial in younger age groups?

- The stall seat journal from the well is used to educate at VCU. This is more difficult to achieve with younger individuals - Norms may be gender specific

What is "the zone"? What is TOD?

- The zone is described as a trance like state in which an individual is just completely sucked into playing a game generally seen with slots. This is why hitting a jackpot can cause irritation because it takes them out of the trance

What are the major symptoms that differentiate gambling disorder from gambling more generally

- There is a set of criteria in the DSM that set apart gambling disorder from more general gambling those criteria are as follows. o Needs to gamble with increasing amounts of money (tolerance) o Restless or irritable when trying to cut down (withdrawal) o Repeated unsuccessful efforts to stop o Is frequently preoccupied with gambling o Often gambles when feeling distressed o Chasing ones losses or after losing money returning to gamble even more o Lies to conceal the gambling o Has jeopardized or lost a relationship, job, or educational opportunity due to gambling. o Relies on others to provide money to relieve desperate financial situations. The individual must meet at least 4 of 9 criteria in order to be diagnosed.

In what year did the US Sentencing commission first identify the disparities? How long was it until changes were made in the 100:1 rule?

- These disparities were first notices in 1991 but changes were not made until 2010

Name 2 or 3 reasons that these industries have become more prominent in the late 20th and early 21st century. What were earlier constraints?

- These industries used to be illegal or severely limited, some did not exists o Gambling was illegal or limited o Eating outside the home was rare o Strong condemnation of sex industry o Gaming, and social media didn't exist o Drug dealing is considered for gangsters or hustlers not pharmacists

What are strategies that casinos and other gambling venues use to keep you "in the zone?"

- They use very bright lights as well as make it so that an individual never has to move their hand from resting position at slots machines, they serve free alcohol to players and work on an interval ratio schedule.

Why would a gambler be annoyed by winning a jackpot?

- This causes an individual to come out of the zone, jackpots last for several seconds to minutes and the typical gambling addict wants to keep playing not just for the money and hitting the jackpot prevents them from doing this

In what parts of the world is internet gaming disorder most common?

- This disorder is most common in the far eastern side of the world in countries such as korea and japan.

Why is it called "transtheoretical"?

- This is called transtheoretical because it includes and integrates key ideas from othe theories into a comprehensive theory of change.

How do twin studies that compare pairs of MZ vs DZ twins help us understand the degree to which behaviors like substance abuse are genetically influenced?

- This is determined through comparing groups. If Monozygotic twins are greater than dizygotic twins there is a greater genetic influence. If dizygotic and monozygotic are equal then there is a greater environmental influence. If monozygotic is shown to be less than one, however, it is assumed there is a unique environmental influence, such as friend group differences between the twins.

What does the statement P = A + C + E mean?

- This is in reference to heritability. This is defined as the proportion of phenotypic variance that can be accounted for by genetic affects.

What is an "industrial epidemic?" How does this concept relate to the concept of limbic capitalism?

- This is the idea that industries that sell good fitting this model that lead to health and social problems can promote epidemics - This is related to limbic capitalism because the industry itself creates a need for addictive products thereby creating the epidemic by the very nature of limbic capitalism

What are some ways in which approach of the transtheoretical model different from other models of addiction we have covered?

- This model is not a theory of what causes addiction as other theories are that we have discussed but rather is a theory that attempts to explain why somebody with addictive behavioral problems maintains these behaviors.

What did the Fair Sentencing Act of 2010 do to the 100:1 rule? What was the original intention of the Act? What were the political reasons that was it impossible to meet the original goal?

- This was to make legal action with powder cocaine and crack cocaine equal (1:1) ultimately ended up reducing the disparity to 18:1 meaning 28g of crack was needed for the minimum sentencing, this was met with heavy resistance and many states repealed these laws with support of law enforcement

Be able to provide examples of industries that might fall under this model, and some examples of the ways that they alter and market their products to make them more alluring and addictive.

- Tobacco - Alcohol - Gambling - Gaming - Social media - Fast food - Sex industry - The deny or minimize the harm - Report only research encouraging use - Place blame on the user when harm occurs - Promote responsible use - Support good works in the community - Targets vulnerable populations (segmentation)

What efforts are being made at VCU hopsital centers to reduce opioid-related problems and overdoses?

- VCU hospital centers are among the first to integrate continued education courses for doctors using the 2016 CDC guidelines for opioid prescribing - VCU has had federal funding for 45 years for those studying drug dependence - VCU teaches courses for upcoming doctors on safe prescribing of opioids

What is the proposed disorder called general internet addiction, and how is it different from internet gaming addiction or social media addiction?

-general internet addiction is something that should be measured by total time spent engaged in all internet activities. Internet gaming is specific to gaming just as social networking is only in relation to networking. Some argue that the internet should not be included as a disorder as it is only a mechanism for facilitating doing other addictive behaviors such as internet gaming, or internet shopping.

What is the status of internet gaming disorder in the DSM 5?

-internet gaming disorder is under consideration in the DSM 5

Difference between monozygotic (MZ or identical) twins and dizygotic (DZ or fraternal) twins

-traditionally monozygotic twins share a 100% home environment and also always share 100% of genetic variation. The home environment is similar for dizygotic twins but they only share 50% of genetic variation.

-cognitive and affective:

1. Consciousness rising 2. Dramatic relief 3. Environmental reevaluation 4. Self-reevaluation 5. Social liberation

- Behavioral:

1. Self-liberation 2. Counter conditioning 3. Helping relationships 4. Reinforcement management 5. Stimulus control

What is molecular genetics?

Molecular genetics is the use of genes to look for significant markers that might indicate an increased risk for substance use. This is done for various other disorders as well such as schizophrenia.

What do the initials stand for?

P=Phenotype; A=Additive Genetic Influence; C= Common Environmental Influences; E= Unique Environmental influences

Action:

Stage where people have made changes to lifestyle in the last 6 months Not all behavior changes count as action Pros outweigh the cons As self-efficacy and temptation disparity closes one moves to this phase

What is range of heritability estimates for substance related disorders?

What is range of heritability estimates for substance related disorders?

What are the two general types of change processes?

cognitive and affective VS behavioral

Precontemplation

not ready to take action at that time, usually measured as the next 6 months Can have previous failed attempts, or be uninformed of consequences of actions Traditionally characterized as resistant Pros are outweighed by the relative cons Temptation outweighs self-efficacy to abstain

Contemplation

stage in which people are intending to change in the next 6 months Aware of both pros and cons of stopping This pro-con relationship can cause one to stay in this stage for a long time Not ready for traditional action oriented programs yet Pros and cons carry the same weight leaving the individual ambivalent toward change Temptation outweighs self-efficacy

Maintenance

stage where people have made specific overt changes in their lifestyle and are working to prevent relapse Pros of maintaining behavior change should outweigh cons of maintenance Less tempted to relapse Average maintenance lasts 6 months to 5 years After 5 years risk of relapse drops to 7% based on the 1990 surgeon generals report Self-efficacy outweighs temptation Relapse occurs when temptation trumps ones sense of self-efficacy to maintain desired behavior

Preperation

stage where people intend to take action in the immediate future, usually in the next month Normally already taken some significant action These people have a plan of action Pros outweigh the cons As self-efficacy and temptation disparity closes one moves to this phase