Clinical Psychology & Mental Health -- Unit 4

what is one of the most common mental health challenges worldwide?

substance use and addictive disorders

how do substances and addictions affect the brain?

affects its reward system, leading people to keep using them despite harmful consequences

is addiction just “weak willpower?”

no — it is a chronic, relapsing condition involving changes in brain chemistry, behavior, and environment

what is substance use?

the use of any alcohol, drugs, or other substances, legally or illegally (ex. drinking a glass of wine with dinner)

what is substance misuse/abuse?

using substances in ways that cause harm (ex. binge drinking every weekend, taking someone else’s prescription, etc.)

what is substance addiction?

the severe end of the spectrum, marked by a loss of control, compulsive use, and craving (drinking every day, experiencing withdrawal, losing your job due to addiction)

what groups does the dsm-5 use to categorize symptoms of substance use disorder?

impaired control, social impairment, risky use, pharmacological

what dsm-5 symptoms are in the ‘impaired control’ group for substance use disorder?

using more than intended, unsuccessful attempts to cut down, spending lots of time getting/using/recovering, cravings

what dsm-5 symptoms are in the ‘social impairment’ group for substance use disorder?

failing at work/school/home, relationship problems, giving up activities

what dsm-5 symptoms are in the ‘risky use’ group for substance use disorder?

using in dangerous situations (ex. drunk driving), continuing to use despite health issues

what dsm-5 symptoms are in the ‘pharmacological’ group for substance use disorder?

tolerance (needing more for the same effect), withdrawal (unpleasant symptoms when stopping)

what is the most widely used substance?

alcohol

what health risks are alcohol associated with?

liver disease, accidents, dependence

what are opioids?

a commonly misused substance that is highly addictive and provides a risk of overdose (ex. heroin, prescription painkillers, fentanyl)

what are stimulants?

a commonly misused substance that increases energy and alertness, but can cause paranoia and heart problems (cocaine, meth, ADHD medication)

what is cannabis?

a commonly misused substance that is legal in many places, but heavy use can impair memory, motivation, and mental health

what is nicotine?

a commonly misused substance that is extremely addictive and a major cause of preventable deaths worldwide

what are behavioral addictions?

addictions that are not caused by substances (ex. gambling disorder) but can cause similar symptoms

what is the biological and psychological mechanism of substances?

substances flood the brain with dopamine, which over time causes the brain to reduce natural dopamine production (why people feel bad without the substance), driving tolerance and withdrawal

how do genetic risk factors impact substance use and addictive disorders?

family history can increase vulnerability

how do environmental risk factors impact substance use and addictive disorders?

peer pressure, availability, stress

how do psychological risk factors impact substance use and addictive disorders?

depression, anxiety, and trauma can increase risk

what are the health consequences of substance use disorders?

liver disease, heart problems, overdosing

what are the psychological consequences of substance use disorders?

depression, paranoia, cognitive decline

what are the social consequences of substance use disorders?

relationship breakdowns, financial trouble, crime

what are the legal consequences of substance use disorders?

DUI, arrests, incarceration

what is the detoxification treatment approach for substance use and addictive disorders?

managing withdrawal safely

what is the medication-assisted treatment (MAT) approach for substance use and addictive disorders?

using methadone or buprenorphine for opioids, naltrexone for alcohol

what is the therapy treatment approach for substance use and addictive disorders?

using CBT to challenge thoughts/behaviors, motivational interviewing to strengthen motivation, and family therapy for a support system

what is the support groups treatment approach for substance use and addictive disorders?

ex. alcoholics anonymous

what is the relapse prevention treatment approach for substance use and addictive disorders?

providing ongoing support since relapse is common

how to reduce the occurrence of substance use and addictive disorders?

educating about risks (especially early), teaching coping skills for stress, limiting access to addictive substances, promoting healthy alternatives (sports, hobbies, etc.)

what is alcohol?

a depressant that slows the CNS for relaxation, lowered inhibitions, and impaired coordination — withdrawal symptoms include tremors, anxiety, seizures, and delirium

what is caffeine?

a stimulant that increases alertness and energy —withdrawal symptoms include headaches, fatigue, irritability, poor concentration

what are the long-term risks of drinking alcohol?

liver disease, brain damage, accidents, wernicke-korsakoff syndrome

what are the long-term risks of drinking caffeine?

sleep problems, heart palpitations, anxiety

what is cannibis?

a psychoactive that causes relaxation, altered perception, and impaired memory/attention — withdrawal symptoms include irritability, insomnia, loss of appetite, restlessness

what are the long-term risks of using cannibis?

cognitive impairment, motivational problems, possible psychosis

what are hallucinogens?

LSD, psilocybin, PCP, etc. that causes sensory distortions, distorted perceptions, and mood swings — withdrawal symptoms include (maybe) psychological distress

what are the long-term risks of taking hallucinogens?

flashbacks, anxiety, paranoia

what are inhalants?

toxic household/industrial chemicals (glue, gasoline, paint, etc.) that cause euphoria, dizziness, and slurred speech — withdrawal symptoms are few (craving is possible)

what are opioids?

pain relievers that cause intense euphoria and drowsiness — withdrawal symptoms include flu-like symptoms (aches, sweating, nausea, diarrhea)

what are the long-term risks of smelling inhalants?

brain/liver/kidney damage, sudden death

what are the long-term risks of taking opioids?

overdosing, collapsed veins, HIV/hepatitis, death

what are sedatives/hypnotics/anxiolytics?

depressants that calm anxiety (relaxation) and aid sleep (drowsiness) — withdrawal symptoms include anxiety, insomnia, seizures

what are the long-term risks of using sedatives/hypnotics/anxiolytics?

memory impairment, accidents, dangerous overdose

what are stimulants?

cause an increase in energy, alertness, euphoria, increased heart rate — withdrawal symptoms include fatigue, depression, irritability  

what are the long-term risks of using stimulants?

cardiovascular disease, paranoia, aggression, cognitive decline

what is tobacco/nicotine?

a legal stimulant (cigarettes, vapes) that causes mild stimulation and relaxation — withdrawal symptoms include irritability, anxiety, strong cravings

what are the long-term risks of using tobacco/nicotine?

cancer, heart disease, lung disease (COPD), high mortality

what are designer drugs?

synthetic substances that mimic other drugs (spice, bath salts) that can cause agitation, hallucinations, aggression, and other unpredictable effects — withdrawal symptoms include cravings and mood problems

what are the long-term risks of taking designer drugs?

psychosis, organ damage, seizures, unpredictable toxicity

what does gambling disorder cause?

excitement, adrenaline rush — withdrawal symptoms include irritability, restlessness  

what are the long-term risks of gambling?

financial ruin, relationship breakdown, depression, suicide risk

what are sexual disorders?

conditions where a person’s sexual response, functioning, or interests cause significant distress or impairment

what are sexual dysfunctions?

problems in desire, arousal, orgasm, or sexual pain

what are paraphilic disorders?

atypical sexual interests that cause distress or harm or involve non-consenting individuals

what is gender dysphoria?

distress when one’s experienced gender does not align with assigned biological sex

what is male hypoactive sexual desire disorder?

when a male has a persistent lack of sexual thoughts, fantasies, or interests (may be linked to low testosterone), leading to stress, depression, or relationship issues

what is female sexual interest/arousal disorder?

a disorder of desire for females with low sexual drive, little initiation, and reduced arousal/pleasure (could be caused by trauma, depression, or hormonal changes)

what is erectile disorder?

a disorder of excitement when there is an ongoing difficulty in obtaining or maintaining erections (can be caused by vascular disease, diabetes, performance anxiety, guilt)

what is female orgasmic disorder?

a disorder of orgasm where a female experiences difficulty in reaching an orgasm or reduced intensity

what is premature ejaculation?

a disorder of orgasm where ejaculation persistently occurs within a minute of penetration (specific timing can depend on age)

what is delayed ejaculation?

a disorder of orgasm where there is a significant delay or inability to ejaculate

what is genito-pelvic pain/penetration disorder?

a disorder of sexual pain where there is pain during intercourse, the involuntary tightening of vaginal muscles, or fear of pain (can be caused by physical or psychological factors)

what is fetishistic disorder?

a paraphilic disorder where one experiences sexual arousal from nonliving objects or specific body partsw

when does fetishistic disorder become a disorder?

if the fetish is required for arousal or causes distress

what is exhibitionistic disorder?

a paraphilic disorder where one experiences arousal from exposing their genitals to unsuspecting strangers — arousal is fueled by the shock/surprise reaction

what is voyeuristic disorder?

a paraphilic disorder where one experiences arousal from secretly observing others undressing or having sex

at what age can voyeuristic disorder be diagnosed?

18 — may be part of development

what is frotteuristic disorder?

a paraphilic disorder where one experiences arousal from rubbing or touching non-consenting people (often in crowded areas)

what is pedophilic disorder?

a paraphilic disorder where one experiences sexual attraction to prepubescent children (generally <13 years)

at what age can pedophilic disorder be diagnosed?

the patient must be at least 16 years old and five years older than the child

what is sexual masochism disorder?

a paraphilic disorder where one experiences arousal from being humiliated, beaten, bound, or otherwise made to suffer

when does sexual masochism/sadism become a disorder?

when it causes distress or required non-consenting partners

what is sexual sadism disorder?

a paraphilic disorder where one experiences arousal from inflicting suffering or humiliation on others

what is transvestic disorder?

a paraphilic disorder where one experiences sexual arousal from cross-dressing (typically involves heterosexual males wearing female clothing)

when does transvestic disorder become a disorder?

when it causes significant distress or impairment in functioning

what is the dsm-5’s criteria for gender dysphoria?

a strong desire to be another gender, dislike of sex characteristics, preference for roles/clothing of another gender, or desire for physical transition (>6 months)

what is modern sex therapy?

a short-term, integrative, and focused therapy for both partners — includes assessment and education, cognitive and emotional work, performance anxiety reduction, communication training, behavioral techniques, medical interventions, addressing comorbidities, and a holistic approach

what is the assessment and education phase of modern sex therapy?

thorough evaluation of medical, psychological, and relationship factors, correcting myths about sexuality

what is the cognitive and emotional work phase of modern sex therapy?

addressing guilt, shame, trauma, or unrealistic expectations, using CBT to reframe negative sexual beliefs

what is the performance anxiety reduction phase of modern sex therapy?

using techniques like sensate focus (non-demand touching, no pressure for intercourse) to relearn intimacy without pressure

what is the communication training phase of modern sex therapy?

teaching couples to express sexual needs, set boundaries, and negotiate differences to reduce secrecy and enhance intimacy

what is the behavioral techniques phase of modern sex therapy?

reducing “spectatoring” to focus on physical sensations (erectile disorder), stop-start and squeeze techniques (premature ejaculation), directed masturbation training (female orgasmic disorder), gradual vaginal dilation and relaxation training (genito-pelvic pain disorder)

what is the medical intervention phase of modern sex therapy?

PDE-5 inhibitors (ex. viagra) for erectile disorders, hormonal treatments when indicated, surgical/medical treatments for gender dysphoria when appropriate

what is the addressing comorbities phase of modern sex therapy?

addressing depression, anxiety, trauma and relationship conflict (often underlie sexual problems) by integrating therapy for these issues

what is the holistic, couple-oriented approach phase of modern sex therapy?

focusing not only on the identified patient, but also on the couple’s dynamic to improve intimacy, trust, and satisfaction — involving both partners

what are the biological causes of sexual disorders and gender variations?

hormonal imbalances, neurological issues, chronic illness

what are the psychological causes of sexual disorders and gender variations?

conditioning, trauma, performance anxiety, attachment issues

what are the sociocultural causes of sexual disorders and gender variations?

stigma, restrictive gender roles, cultural taboo around sexuality

what are schizophrenia and related disorders?

severe mental illnesses marked by psychosis, which involves a loss of contact with reality — impact thinking, emotion, perception, and behavior, interfering with work, relationships, and daily functioning

what are the key features of schizophrenia and related disorders?

hallucinations, delusions, disorganized thinking and behavior, negative symptoms

what are hallucinations?

perceiving things that are not real (ex. hearing voices, seeing things, other false sensory perceptions)

what are delusions?

strongly held false beliefs not grounded in reality and resistant to reason (ex. believing someone is plotting against you)

what is disorganized thinking and behavior?

difficulty organizing thoughts, following conversations, or completing tasks 

what are negative symptoms?

reduction or loss of normal functions (ex. affective flattening, alogia, avolition, anhedonia, asociality)

what are positive symptoms?

“added” experiences not seen in healthy individuals (ex. delusions, hallucinations, disorganized speech/thought, catatonic behavior)

what are persecutory delusions?

the false belief that others are out to harm you

what are grandiose delusions?

an inflated sense of importance