Adult Psychopathology: Chapter 8

Substance use disorders

characterized by significant impairment of a person’s occupational, social, or daily functioning, or causes personal distress

Alcohol is often disregarded bc it is so widely used; normalized

• Made of same substance in rocket fuel, solvents, perfume, paint

• Problem remains after effect wears off

Our culture promotes alcoholism; this time in our lives, we are expected to/supposed to drink excessively

Positive reinforcement + negative reinforcement (reduces emotional pain)

_____ can get addicted

ANYONE.

psychological/physical dependence → not two distinct things

• Use increases as connection between drug and relief is reinforced

tolerance

need more to get the same effect, the problem continues to exist

withdrawal syndrome

negative feelings experienced after decreased usage or total abstinence

• Significantly reduce after a week or two without use

• Applicable to ANY addition

common pathway to addiction

1. Experimentation

2. Routine use

3. Addiction or dependence

____ increases one’s desire to drink alcohol

boredom

depressants

drugs that slow down or curb the activity of the central nervous system:

• reduces feelings of tension and anxiety

• slows movement

• impairs cognitive processes 

• can cause death in high doses

barbiturates

sedative drugs used to ease anxiety, reduce pain and treat epilepsy and high blood pressure. Sedative, anti-convulsant, anesthetics properties

• Highly addictive

• Relaxing and can produce mild state of euphoria

• Popular as street drugs

• Deadly in high doses – especially when mixed with alcohol

opioids

narcotics, have pain-relieving and sleep-inducing properties

• morphine, heroin, Percocet, OxyContin, Fentanyl, Opana)

  • Highly addictive

  • Produce rush, an intense feeling of pleasure

  • Stimulate brain’s pleasure circuit

• Includes naturally occurring opiates derived from the juice of the poppy plant and synthetic drugs that have opiate-like effects 

• Brain produces its own opiate-like substance – endorphins

stimulants

increase the activity of the central nervous system

• Enhance state of alertness.

• Produce pleasure or even euphoric highs. 

• Effects vary with the particular type of stimulant drug

• includes

  • amphetamines

  • ecstasy

  • cocaine

  • nicotine

amphetamines

a class of synthetic stimulants

• Used in high doses for euphoric rush.

• The most potent form is methamphetamine, injected directly into veins.

Can cause amphetamine psychosis: psychotic state characterized by hallucinations and delusions, induced by ingestion of amphetamines.

ecstasy (mdma)

a designer drug, a chemical knockoff similar in chemical structure to amphetamine

• Produces mild euphoria and hallucinations

• Popular on college campuses and in clubs

• Can produce adverse psychological effects, including depression, anxiety, insomnia, and even paranoia and psychosis

cocaine

a natural stimulant derived from the leaves of the coca plant.

• Second most widely used illicit drug in the United States (after marijuana).

• Directly stimulates the brain’s reward or pleasure circuits. 

• Produces a sudden rise in blood pressure and an accelerated heart rate.

nicotine

a stimulant found in tobacco products.

• Claims more than 480,000 lives annually in the United States and more than 3 million worldwide.

• Smoking rates have declined dramatically in the last several decades.

hallucinogens

a class of drugs that produce sensory distortions or hallucinations. 

• May also have additional effects, such as relaxation and euphoria or, in some cases, panic.

• LSD

• PCP

• Marijuana

LSD

a  synthetic hallucinogenic drug.

• effects vary by amount taken and the user's expectation, personality, mood, and surroundings.

PCP

Classified as a deliriant – a drug capable of producing states of delirium.

Marijuana

a hallucinogenic drug derived from the leaves and stems of the plant Cannabis sativa.

• Classified as a hallucinogen because in high doses it can produce perceptual distortions or mild hallucinations.

• In low doses, produces relaxed feelings.

• Use is on the rise among high school students and adults.

• Can produce perceptual distortions or mild hallucinations.

learning theory perspectives

Propose that substance-related behaviors are largely learned and can therefore be unlearned.

operant conditioning view of substance use disorders

drugs produce reinforcing effects such as feelings of pleasure and reductions in anxiety or depression.

• Can also produce relief from tension (tension reduction theory).

• Can provide social reinforcers such as approval from others. 

• Relief from unpleasant withdrawal symptoms is a negative reinforcer to resuming drug use.

classical conditioning view of substance use disorders

classical conditioning may explain some aspects of drug cravings.

• Cravings is a conditioned response to environmental cues associated with prior use of the substance.

• Negative emotional states that have been paired with the use of drugs in the past may also elicit cravings.

observational learning view of substance use disorders

modeling plays an important role in determining risk of drug-related problems.

• Adolescents with a parent who smokes are much more likely to smoke compared to those in families where neither parent smokes.

sociocultural perspectives of substance use disorders

Drinking is determined, in part, by:

• Where we live

• Social or cultural norms that regulate our behavior 

Important influences in determining substance use among adolescents and young adults:

• Peer pressure 

• Exposure to a drug subculture

  • Cultural attitudes can encourage or discourage problem drinking.

  • Rates of alcohol abuse vary across ethnic and religious groups.

treatment of substance use disorders

• Biological

• Psychological

• Nonprofessional support groups

  • Promote abstinence and provide an opportunity to discuss feelings and experiences in a supportive group setting. 

  • Examples include:

    • Alcoholics Anonymous

    • Narcotics Anonymous

    • Cocaine Anonymous

residential approaches

requires a stay in a hospital or therapeutic residence.

• Hospitalization is recommended when substance abusers:

  • Are not able to exercise self-control in usual environments

  • Behave self-destructively or dangerously

• Most inpatient programs use an extended 28-day detoxification period, which includes:

  • Treatment for withdrawal symptoms

  • Counseling

• Drawbacks: unforgiving, doesn’t teach how to live within the environment.

behavioral approaches

focus on modifying abusive and dependent behavior patterns.

• “ABC” model of substance abuse: A (antecedent cues), B (abusive behavior), and C (consequences)

• Self-control training – Helps abusers develop skills they can use to change their behavior.

• Contingency management (CM) programs – Provide reinforcements (rewards) contingent on performing desirable behaviors.

relapse prevention training

identify high-risk situations and learn effective coping skills for handling these situations.

• High-risk situations may include:

  • Negative mood states

  • Interpersonal conflict

  • Socially conductive situations

• Relapse-prevention training

  • Importance of interpretation of any lapse or slip

• Relapse-prevention training also focuses on preventing lapses from turning into full-blown relapses.

compulsive gambling treatment

challenging because they have little insight into causes of their problems and are reluctant to enter treatment

• It is an addiction

• Almost winning → want to play more

• Position of consequential choice between 2, distills risk choices and only win or lose

• Keep playing until nothing left (only certainty is when things end)