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Flashcards in Task 9 drug use disorder Deck (35)
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1

DSM-5

o Impaired centre control:
 The substance is taken in increasingly larger amounts or over a longer period of time than originally intended.
 The substance user craves the use of the substance
 The substance user feels an ongoing desire to cut down or control substance abuse
 Much time is spent in obtaining, using, or recovering from the substance
o Social impairment:
 The ongoing use of the substance often results in an inability to meet responsibilities at home, work, or school
 Important social, work-related, or recreational activities are abandoned or cut back because of substance use
 Ongoing substance use despite recurring social or relationship difficulties caused or made worse by the effects of the substance
o Risky use:
 Ongoing substance use in physically dangerous situations such as driving a car or operating machinery
 Substance use continues despite the awareness of ongoing physical or psychological problems that have likely arisen or been made worse by the substance
o Pharmacological criteria:
 Changes in the substances user’s tolerance of the substance is indicated by the need for increased amounts of the substance to achieve the desired effect or by a diminished experience of intoxication over time with the same amount of the substance.
 Withdrawal is demonstrated by the characteristic withdrawal syndrome of the substance and/or taking the same or similar substance to relieve withdrawal symptoms

2

Severity of DUD

• Mild: 2-3
• Moderate: 4-5
• Severe: 6+
o for over a year

3

Prevalence (general)

2,5-5% (USA)

4

Synaesthesia

overflow from one sensory modality to another, mood shifts, can produce psychosis

5

Drug treatments for druf use disorder LOL

o Benzodiazepines: used to decrease withdraw symptoms of alcohol
o Antidepressants: decrease depressive symptoms but not relay proved efficiency
o Antagonistic drugs: block or change effects of drug, thereby reducing desire
 Can cause extreme withdraw symptoms in some people
 Disulfarm: makes people sick when they drink
 Replacement for nicotine: plasters etc.
o Methadone maintenance programs:
 Achieves gradual withdraw
 Block receptors and withdraw

6

Behavioural therapies

 With disulfarm negative conditioned response to alcohol is created
• Then learn to avoid through operant conditioning

7

Covert sensitization therapies

uses imagery to create associations between thoughts of alcohol use and thoughts of highly unpleasant consequences

8

Contingency management programs

provide reinforcers such as vouchers (controlled with urine test)

9

Cognitive treatments

o Helps identifying situations in which drinking occurs most likely, as well as maladaptive expectations

10

Motivational Interviewing

o Elicits and solidifies clients motivation and commitment to changing their substance use.
 Taking the side of the participants and support his will to stop

11

Relapse prevention

o Teaches people to see slips as temporary and situational caused
 By e.g. avoiding risky situations or develop coping situations for them
Counteracting abstinence violation effect

12

Abstinence violation effect

 Sense of guilt when breaking abstinence and continuous drinking to supress conflict

13

Prevention programmes

o Target younger people as onset predominantly during adolescent risk period (brain still developing, esp. prefrontal cortical regions that cannot yet regulate emotions properly)
o Focus education on immediate risk of excess & payoffs of moderation
o Harm reduction model – drink safe like you drive safe
 Learn to be aware of drinking habits & thought to calculate alcohol blood level .

14

Biological factors

o Individuals whose reward network overpowers their control network may be more like to use substances
o After continuous usage of drugs brain decreases dopamine production which creates craving when no drug is used
o Stress and conditioned stimuli trigger craving
o Repeated exposure to drugs impairs impulse control
o Heredity: 0,5
o Genes controlling GABA and Dopamine systems mediate the experienced pleasure
s

15

Social learning theory

suggest that children may learn substance use behaviours from the modelling of their parents and others
 Because children prefer similarity it might run through male family members

16

Cognitive theories

focused on people’s expectation of alcohols effects and their beliefs about the appropriateness of using it to cope with stress
 No other coping mechanisms facilitate that

17

Behavioural undercontrol

take drugs at an earlier age, ingest more, higher likelihood of diagnoses
 Might be influenced by genes

18

Sociocultural factors

People living in stressful environment use drugs as relief and think they have little to lose.

19

Cultures

Attitude about drugs mediates prevalence
Religion-> big factor

20

Gender differences in risk

 In the past drinking was less accepted
 Carry less risk factors than men (personality)
 Suffer alcohol related illness at lower levels of exposure than men
 May notice intoxication sooner
 More likely to be drawn into addiction by family or lovers

21

Alcohol-induced place conditioning in moderate social drinkers (childs article)

• Conditioned place preference: rewarding drugs become associated with context by the mean of classical conditioning
• Method:
o Paired group: always receives alc in one room but not in the other
oUnpaired group: receives alc and non alc in both rooms
• Results:
o Participants styed longer in the alcohol conditioned room
o Subjective responses to alcohol predicted preferences for the alcohol-paired room
o Participants who reported the greatest sedative effects from alcohol exhibited the strongest place preference
o Conditioning is mediated by sedative-like component of alcohol experiences rather than the exciting effects
o Behaviour may be influenced by drug cues before individuals are aware of drug: cue contingencies

22

Choice model

rejects disease model because possibility of voluntary stopping violates disease criteria
o Immediate rewards take precedence over long-term gains
 Repeatedly choosing immediate rewards sets both immediate and long-term rewards to lower and lower values
o Ignore brain
o Cues are driving part of drug addiction

23

Criticism on choice model (Lewis)

o Motivation and emotion influence behaviour by narrowing appraisals and urging actions that address them
o Choosing to not take a drug is extremely difficult, increases with time

24

Dopamine

o Responsible for wanting rather than liking
o Role in addiction: the motivation and urge results from excessive dopamine release that is highly enormously exciting or pleasurable
o Activating the power of cues
o Shuts down intertemporal flexibility

25

Craving and the power of now

o Self-reports of craving and their striatal and orbitofrontal activity both peaked just before the moment of drug administration and declined immediately after
o Craving and its foundation in “now”, may be the byproduct of a brain designed to be maximally responsive to immediate rewards

26

Utility theory

Describes the idea that delayed reward discounts with increasing intervals

27

Incentive-sensitization hypothesis

increased activity in VTA to drugs and decreased activity to other stimuli

28

Decrease of acethylcholine as a result of exposure

leaving dopamine to dominate effortful behaviour
o Causes shift from exploration, alertness and volition to single minded desperate pursuit

29

Orbitofrontal cortex and ACC

become dysfunctional both during addiction and withdrawal
o OFC: assigning value
o ACC: judging option and selecting among them

30

Dual process model

decision making abilities result from interactions between two systems
o Reflective system: involved in cognitive evaluation of the stimuli by means of memory and executive functions, responsible for controlled-deliberate responses
 Impaired prefrontal network (could be cause or effect for binge drinking)
 Inhibited, leading to an inability to voluntarily inhibit the consumption
o Affective automatic system: involved in the emotional evaluation of the stimuli, initiating automatic-appetitive responses
 Limbic network
 Over activated by emotional or alcohol related stimuli leading to impulsive behaviour
o Cycle continuous