Psychopathology Exam 4 Notes

Drug

any substance other than food that influences our body and mine

substance

a term that includes alcohol, tobacco, and caffeine

• sounds more inclusive and is preferred to be used instead of drug

substance use disorder

pattern of long-term maladaptive behaviors and reactions brought about by the repeated use of a substance

• more emphasis on behaviors while on substance

• more severe patterns include tolerance and withdrawal 

• on a continuum (none ←→ severe)

criteria for a diagnosis of substance use disorder 

• tolerance 

• withdrawal 

• taken in larger amounts or over longer period of time than intended 

• unsuccessful efforts to cut back if they would try to scale back 

• significant time spent getting, using, or being intoxicated 

• continued use despite causing or leaving physical, psychological, or social problems 

prevalence

46 million U.S. adults and teens display a substance use disorder

• 16.5 of population of age 12 or older

• highest rate among native Americans and lowest among asian Americans

how many people with substance use disorder receive treatment

18.4% of people with substance use disorder

comorbidity of mental health and drug dependance

those with a mood or anxiety disorders are about twice as likely to also suffer from a drug disorder

categories of substances 

depressants, stimulates, opiates, hallucinogens, cannabis 

depressants

slow the activity of the central nervous system producing relaxation and tension reduction

• includes alcohol, sedative hypnotics, and benzodiazepines

alcohol (depressant)

• GABA binds to neurons in the brain to slow them down

• judgment, inhibition, memory, motor control, and action time are effected

• extent of the effects id determined by the concentration in the blood which is influenced by size and gender

40% of college students

at least once every two weeks college students participate in binge drinking (40%)

opiates

collectively known as narcotics

• includes both natural and synthetic substances

natural opiates

opium, heroin, and morphine

synthetic opiates

methadone

what makes opiates additive 

these substances are highly additive due to their instant rush and short half-life 

• this causes tolerance to build quickly

opioid overdoses

in the past decade there as in a 400% increase in the number od deaths due to opioids

stimulants

increase the activity of the central nervous system with emphasis on dopamine, norepinephrine, and serotonin

• in small doses it increases energy and alertness as well as reduces appetite

• cocaine, caffeine, nicotine and amphetamines

cocaine

proceeds mania, paranoia, psychotic symptoms

• most powerful natural stimulant

amphetamines (Adderall and Speed)

developed in 1930s for asthma treatment

• special focus: methaphetamine

hallucinogens

produce changes in sensory perceptions

• also known as psychedelics

• natural and synthetic

natural hallucinogens

mescaline and psilocybin

synthetic hallucinogens 

LSD and ecsety 

LSD

most powerful hallucinogens and is derived from ergot alkaloids

• can induce synthesia (“tasting colors etc)

hallucinogen effects

effects are due to serotonin receptor binding

• tolerance and withdrawal are rare

Cannabis

Active ingredient: THC

• at low doses may produce mild euphoria and relaxation, although at high doses nah produce anxiety, paranoia, and irritation

Cannabis dependency

Contrary to past beliefs, dependence is possible with short and long term consequences

• increasing rates of cannabis use disorder related to increase in THC content

Legalization of marijuana

23 states plus D.C. have legalized the recreational use of marijuana

• generally 21+ able to buy 1 oz, not to be consumed in public

• Most other states allow for the use of medical marijuana under certain circumstances

Marijuana and the federal government

Highly controlled substance federally

Sociocultural view and substance related disorders

• Higher rates of substance use disorders related to stress economic conditions

• More likely in family and social environments where substance use is valued or at least accepted

Psychodynamic perspective and substance related disorders

• dependency is traced to a lack of parental nurturing in childhood

• Substance abuse personality

Substance abuse personality

Leaves an individual vulnerable to substance use disorder

No one personality type in substance related disorders

Several personality characteristics are associated with substance abuse such as impulsiveness, sensation seeking, dependency, being antisocial and depressive

• why substance abuse personality isn’t valid

Cognitive behavioral (behaviorist) and substance related disorders

Look at operant conditioning

• negative reinforcement properties of substance use

Cognitive-behavioral (cognitive) and substance related disorders

Add the notion of expectancies to behavioral therapy

• behavioral rewards produce an expectancy that substances will be rewarding which increases motivation to use

• Drinking and you expect to feel the effects

Self medication hypothesis

consistent with high rates of substance use disorders in individuals with psychological disorders

Classical conditioning and substance related disorders

Objects presented at the time drugs are taken may become classically conditioned stimuli and come to produce the same response as the substance itself

• UCS: cocaine UCR: increased body temperature CS: paraphilia CR: lower body temp

• UCS: substance UCR: euphoria CS:pipe CR: euphoria

Genetic predisposition

Family: higher conformance rates for alcohol use disorder in identical twines compared to fraternal twins

Adoption: adopted individuals show alcohol use disorder more consistent with biological parents rather than adopted parents

Biochemical factors and substance related disorders

Many drugs activate a single reward center or pleasure pathway in the brain

• down pine implicated as well as the ventral tegmental area, nucleus accumbens and the frontal cortex of the brain

Incentive sensitization theory

With drug use reward center become hypersensitive to the substance and fires more readily/easily

• works more readily as time goes on

• Wanting a drug

Reward deficiency syndrome

Typical life events do not activate the reward center so it leads individuals to substance use

Behavioral therapies

Contingency management

• based on operant conditioning principles

• Incentives are provided following drug free urine screens

• Token economies

• Positive reinforcement due to reward

• Most effective for stimulants

Relapse prevention training (cognitive behavioral therapy)

Manage substance use behavior, clients focus on identifying high risk situations, decision-making, changing maladaptive behaviors, and learning from lapses

Relapse prevention training strategies (cognitive behavioral therapy)

• self monitoring

• Implementing coping strategies

• Planning ahead

biological treatments for substance related disorders

• may be used to help individuals withdraw from substances, abstain or maintain levels of use without further increases

• limited success is achieved long term when used alone

detoxification in substance related disorders

systemic and medically supervised withdrawal from a drug

1. gradual withdrawal by tapering doses of the substance (better than doing a cold turkey)

2. additional medication is given to reduce symptoms of withdrawal

3. release rates are Hugh without follow up treatment

antagonist drugs 

designed to reduce the likelihood of future use, antagonist drugs block or change the effects of the addictive substance 

• disulfiram for alcohol

disulfiram for alcohol

take medication → person drinks → drinking while on the medication causes undesirable symptoms

• positive punishment

drug maintenance therapy

• methadone maintenance is defined to provide a safe alternative to heroin use

• laboratory opioid with a ling half life and without the rush

• criticized as “submitting addictions”