Alcohol Use Disorders
drunkorexics
college-age binge drinkers, typically women, who starve all day to offset the calories in the alcohol they consume
fetal alcohol syndrome FAS
combination of problems that can occur in a child whose mother drank while she was pregnant include fetal growth retardation,cognitive deficits, behavior problems and learning difficulties LEADING CAUSE OF MENTAL RETARDATION
why don't people just stop taking the drugs if they make them crash?
opponent process theory : increase in positive feelings will be followed shortly by an increase in negative feelings and vice versa so this mechanism is strengthened with use self medicating for other problems
substance intoxication
our physiological reaction to ingested substances - drunkenness or getting high
tiu lien
"loss of face" among Asians, that can lead
2 axes
1. engagement with alcohol 2. serous drinkings
path traveled by alcohol
1. ingeston 2. stomach 3. small intestine 4. heart and lungs (some of it is vaporized and exhaled : breathalyzer test) 5. live: broken down
four stage model of the progression of alcoholism
1. prealcoholic stage: drinking occasionally with few serious consquences 2. prodromal stage: drinking heavily but with a few outward signs of a problem 3. crucial stage: loss of control, with occasional binges 4. a chronic stage: the primary daily activities involve getting and drinking alcohol
what three aspects does the social learning theory focuses on?
1. social environmental 2. coping skills 3. cognitive factors
size of drink definied by alcohol content
12 oz glass of beer, 5 oz of win 1.5 oz of hard liquor
Which age group is at higher risk for lifetime alcohol abuse?
18-29 age group
binge drinking
5 drinks* in short period (e.g., within an hour highest prevalence among college students
heavy use drinking
5 drinks, 5 or more times in a 30-day period
behavior genetics of alcohol addiciton
50-50% heritable, some phenotypes heritable, no single gene likely to explain genetic liability
community support programs
AA and related groups, efficacy hard to test bc of anonymity, seem helpful and are strongly encouraged
incentive salience
Acquisition and sensitization of craving for alcohol produced by repeated ingestion and associated dopamine release After pathways sensitized, craving can be activated by the dopamine release initiated in response to alcohol cues or priming doses
what do they mean by alcohol has an anxiolytic effect?
Alcohol reduces anxietty
why did they combine substance abuse and substance dependence into general diagnosis of substance related disorder?
Bc evidence shows that the two can co-occur
antagonist
Drugs that block or counteract pleasurable drug effects - Examples include naltrexone for opiate and alcohol problems disadvantage: have to be clean and highly motivated
aversive treatment
Drugs that make use of drugs extremely unpleasant requires compliance
how is the GABA system influenced by alcohol?
GABA an inhibitory NT interferes with the firing of the neuron it is attached, and when it attaches to its receptor, chloride enters the cell and makes it less sensitive. Alvohol reinforces the movement of these Cl- ions and as a result, the neurons have difficulty firing GABA act on our feelings of anxiety --> alcohol antianxiety protperty may result
wet vs dry cultures
High consumption in , and Italy where consumption is widely accepted
allostatic model of dependence
Integrates neurobiology of rewarding effects of alcohol with mechanisms related to negative reinforcement Reward and stress circuits become dysregulated with repeated alcohol exposure
biological factors of alcohol use
NT systems, psychostimulant theory,
psychostimulant theory
Stimulant effects of addictive substances produce positive reinforcement Individuals who experience greater rewards from alcohol more likely to develop problems
agonist substitution
Substitute safer drug with a similar chemical composition -Examples include methadone and nicotine gum or patch disadvantage: heroin addicts may become addicted
proposed clinical subtypes for alcoholic personality
Type I and type II alcoholics Type A and Type B alcoholics
coping skills
ability to cope with stressful events without drinking
detoxification
Withdrawal from alcohol under medical supervision The therapeutic results of hospital treatment are not superior to those of outpatient treatment
withdrawal delirium or delirium tremens
a condition due to alcohol withdrawal that can produce frightening hallucinations and body tremors can occur when alcohol levels drop suddenly results in delriousness, tremulousness, hallucinations
alcohol use disorder
a problematic patern of alcohol use leading to clinically significant impairment or distress
unsteady gait
a symptom of instability while walking sign of alcohol intoxification
substance-related and addictive disorders
abuse of drugs and other substances people take to alter the way they think, feel, and behave
biological treatment of substance related disorders
agonist substitution , antagonist treatment aversive treatment
what is the name of the enzyme that allows us to metabolize alcohol?
alcohol dehydrogenase
what are alcohol related disorders?
alcohol use disorder alcohol intoxification alcohol withdrawal other alcohol-induced disorders unspecified alcohol-related disorder
hallucinogens
alter sensory perception and can produce delusions, paranoia and hallucinations cannabis and LSD
what is the first initial effect of alcohol
apparent stimulation: feeling of well-being, our inhibitions are reduced, we become more outgoing. This is because the inhibitory centers in the brain are initially depressed (or slowed)
disease model of dependence
assumes that drug dependence is caused by an underlying physiological disorder seeking treatment for a medical problem
stimulants
cause us to be more active and alert and can elevate mood. amphetamines, cocaine, nicotine, caffeine
alcohol withdrawal
cessation or reduction in alcohol use that has been heavy and prolonged
substance
chemical compounds that are ingested to alter mood or behavior
Wernicke-Korsakoff syndrome
confusion, loss of muscle coordination, unintelligible speech, believed to be caused by a deficiency of thiamine B1, a vitamin metabolized poorly by heavy drinkers
controlled use vs complete abstinence as p
controlled drinking may be as effective as abstinence but neither approach is successful in the long run
cognitive processing model
craving predicts within session drinking behavior
temperance culture
culture where there is a social movement against the consumption of alcoholic beverages
depressants
decrease CNS activity, reduce psychological arousal, result in behavior sedation and can induce relaxation ex: alcohol, sedative and hypnotic drugs of barbiturates and benzodiazepines
what are two types of organic brain syndrome that may result from alcohol drinking
dementia and Wernicke-Korsakoff syndrome
six general categories of substances
depressants, stimulants, opiates, hallucinogens. other drugs of abuse, gambling disorder
what are continued drinking effects on the brain?
depresses other brain areas that interfere with functioning and include e.g. impaired motor coordination, slowed reaction time
phenotypic complexity of alcoholism
diverse symptom pesentation
moral weakness model of chemical dependence
drug use is seen as a failure of self-control in the face of temptation
what are some psychological dependence manifestations?
drug-seeking dependence the repeated use of a drug, a desperate need to ingest more of the substance, the likelihood that use will resume after a period of abstinence
marianismo
female Latin role of motherly nurturance and identifying with the Virgin Mary
ALDH2 gene
flushing effect : reddening and burning of the face after drinking alcohol. Protective value was diminished by the change in cultural norms
How is the glutamate system influence by alcohol
glutamate is excitatory , helps neurons fire. is the avenue through which alcohol affects out cognitive abilities loss of memory or blackout
efficacy of biological treatment
high relapse, ineffective when used alone (without CBT)
sex ratio of alcohol use
higher prevalence of dependence among male
substance abuse
how significantly it interferes with the user's life
acculturation
how well people adapt to new cultures, , can either be a source of strength or a stress that can impact drug use
impatient vs outpatient care
impatient care is very costly,
specific personality traits relevant to risk for alcoholism
impulsivity/disinhibtion
three broad-based personality traits that are of relevance to understanding Greek affiliation
impulsivity/novelty seeking extraversion neuroticism
how has alcohol diagnosis changed over the past decade or so?
in early editions of the DSM alcoholism and drug abuse were categorized as sociopathic personality disrturbances (forerunner of antisocial personality disorder), substance use was seen as a symptom DSM III: furst time specific diagnostic criteria, abuse vsdependence distinction DSM IV: tolerance and w/drawal are sufficient buut not necessary DSM V: 11 symptoms ranging from mild to severe, craving/strong desire to use the substance was added
tension-reduction theory/stress-response dampening model
individuals drink alcohol bc of its ability to reduce tension increase positive feelings, decrease negative feelings
expectancy theory
information reflecting alcohol's reinforcement value stored as memory tempates --> when templates activated effective experience triggered --> can influence behavior " If I drink I will be a more fun person"
substance use
ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning
other drugs of abuse
inhalants, anabolic steroids, nitrous oxide, produce a variety of psychoactive effect
extraversion
interest and energy toward outside the self
nystagmus
is a vision condition in which the eyes make repetitive, uncontrolled movements, often resulting in reduced vision sign of alcohol intoxification
SLT applied to relapse process
lapses from poor coping skills in high risk situations --> low self efficacy regarding ability to cope --> expectancies that drinking is an effective coping strategy in future situations
distal risk factors of relapse
less active coping efforts lower self efficacy, higher craving, less self-help group and treatment participation
neuroticism
liability to experience negative emotions
machismo
male dominance in Latin cultures
what are some other psychiatric disorders associated with substance abuse?
mood disorders 40%, anxiety disorders and posttraumatic stress more than 25%
psychological treatment of substance-related disorder
needed for bio treatmentto work
dementia
neurocognitive disorder, involved the general loss of intellectual abilities and can be a direct result of neuotoxicity or poisoning of the brain
what is p300 amplitude and how is it among those with a family history of alcoholism
p300 is a particular brin pattern that emerges after a tone is resented, it is lower in those with a family history of alcoholism but also lower in people with other substance abuse disorderss
risk factors for drinking in adolescence
peer and family contexts
proximal risk factors of relapse
personal characteristics and experiences
personality theory
personality traits account for some of variance in vulnerability to AUDs but no support for alcoholic personality
what are the effects of dopamine and serotonin while drinking?
pleasurable effects
psychological influences
positive reinforcement negative reinforcement cognitive influences
how have the prevalence of dependence and prevalence of abuse changed in the past decade?
prevalence of dependence have declined and the prevalence of abuse has increased
opiates
produce analgesia temporarily (reduce paine), and euphoria heroin, opium, codeine, morphine
tolerance
requires increasingly grater amounts of the drug to experience the same effect
withdrawal
respond physically in a negative way when the substance
cognitive factors
self-efficacy and alcohol expectations
biological influences on alcohol abuse
sensitivity to drug rate of metabolism base levels of arousal dsorders of mood or anxiety
How is the serotonin system affected by alcohol?
serotonin affects mood. sleep and eating behavior and is responsible for alcohol cravings
social environmental
situational factors paired with drinking (triggers)
clinical neuroscience of addition
still need more research
functional genomics
studying the function of genes
impulsivity
tendency to act rahly while little self-regulation and heightened levels of sensation
neuroplasticity
the brain's tendecu to reorganize itself by forming new neural connections
impulse-control disorders
the inability to resist acting on a drive or temptation
T or F alcohol kills brain cells
this may not be true ,brain damage comes from the experiences of people who are alcohol dependent and experience blackouts, seizures and hallucinations
what are physiological reactions to chemicals being ingested
tolerance and withdrawal
gambling disorders
unable to resist the urge of gambling, results in negative personal consequences
what is the key to the diagnosis of alcohol use disorder
use of heavy doses of alcohol with resulting repeated and significant distress or impaired functioning.
polysubstance use
using multiple substances
expectancy effect
what people expect t experience when they use drugs influences how they react to them, increase your likelihood to take certain drugs because you believe hey will have positive effects
long term effects of alcohol abuse
withdrawal , malnutrition, cirrhosis of the liver (liver cells engorged with fat),
can you use drugs and not abuse them?
yes
Can you depend on a drug without abusing it?
yes ca