Study Guide Exam 4 Psychopathology 386

Substance Use Disorder

When a person uses moderate to high levels of substances that impacts their ability to function

What was Substance Use Disorder called in earlier DSM editions?

Substance Abuse Disorder and Substance Dependence Disorder

Symptoms of Substance Use Disorder

Taking the substance(s) in larger amounts than they intended to, a persistent desire to do the substance(s), and having a pattern of unsuccessful attempts to stop using the substance(s)

What does tolerance mean?

When the body adapts to the usual amount of substance use so now it takes a larger amount of the substance to feel the high

Psychoactive Drug

Drugs that impact thoughts, emotions, and behaviors by decreasing the blood flow to the brain (which also damages blood vessels)

What part of the brain gets stimulated when doing drugs?

The nucleus accumbent which is where dopamine is released

What substance is the most widely used?

Caffeine

Caffeine

Central nervous stimulant with symptoms that include increase of mood/energy, improvements in concentration, and increases the amount of stress hormones that are released

Is there a diagnosis for caffeine use?

No, because so many people can drink caffeine and it doesn't have any impact on them

Energy Drinks

Extremely dangerous because of high caffeine levels (240-250mg) and the high sugar levels

Is nicotine a stimulant or depressant and what chemical does it release when smoked?

Both a stimulant and depressant that releases Gabba, the calmness chemical.

What are some symptoms that come with smoking nicotine?

Some may feel more alert and have more energy when first smoking. Since it releases Gabba, people feel more calm too.

What happens chemically when smoking nicotine?

Besides releasing Gabba, nicotine is able to pass the blood brain barrier which can be dangerous. Also, nicotine leaves the body during stressful times which is why people tend to chain smoke when they're stressed

Marijuana

A plant whose leaves, buds, and flowers are usually smoked for their intoxicating effects

What tends to happen when smoking marijuana?

People are less impulsive and aggressive, their ability to think clearly and perform is impacted, and there is a chance of developing hallucinations and delusions (for regular users)

What are some statistics of people becoming dependent on marijuana?

1 in 10 chance of adults becoming dependent
1 in 6 chance of adolescents becoming dependent

What are some benefits to using marijuana?

Helps ease pain, gain help those with eating disorders as it increases appetite, it helps with nausea, glaucoma, and seizures

Amphetamines

Stimulant; increases energy, reduces the need to sleep, and decreases appetite

What are some side effects of amphetamines?

There's damage to the blood vessels in the brain, reduced amount of oxygen flow to the organs, and it destroys large parts of the pleasure center

Cocaine

Stimulant; has the same effects as amphetamines including increasing wakefulness, heart rate, and blood pressure

Benzodiazepines

Sedative; slows down/depresses the central nervous system which is the opposite of amphetamines

What chemical gets released when taking a sedative?

Gabba

What are some side effects of taking a sedative?

Heart rate slows down, in a slow/sleep-like state, more likely to lose balance, and it's highly addictive

Opioids

Sedative; works for about four hours and is usually prescribed to reduce pain that is negatively impacting the quality of life for the patient

What is the best way to use opioids?

Use them for three months or less under a doctor's care to check the level of addiction to the opioid.

OxyContin

The first opioid that claimed to provide pain relief for 12 hours instead of 4 but turns out it still only worked for 4 hours

What could increase a patient's perception of pain?

Stress and anxiety

What are some ways to help a patient with their pain distortions?

Guide them through deep breathing exercises, mindfulness activities, and also finding ways for them to regulate their emotions

Alcohol

Depressant since it releases Gabba; impairs the body's ability to utilize nutrients

How is alcohol metabolized?

Takes place in the liver; The alcohol is converted to acetaldehyde by being broken down by the enzyme alcohol dehydrogenase (ADH). Then the acetaldehyde is converted to acetic acid which is then broken down by the enzyme Aldehyde Dehydrogenase (AldDh).

What happens when alcohol and antidepressants are combined?

Since alcohol is a depressant, it counteracts the effectiveness of the antidepressant, meaning the person will continue to experience depression symptoms

Withdrawal Symptoms of Alcohol

Cirrhosis (the liver isn't able to detoxify of the liver the blood so it scars the liver), headaches, and balance impairments

Benzodiazepines and Alcohol

Mixing them is not good, can lead to significant impairment in cognition as well as impacting one's breathing

Alcohol Effects

Impairs the frontal lobe (judgement), cerebellum (balance), and medulla (heart rate/breathing)
Long term use included 10-12 years shaved off of life span, bleeding in stomach, and immune system is weakened

Wernicke Korsakoff's Disease

Short term memory problems that occur with long term drinking habits

Fetal Alcohol Syndrome

When a pregnant woman drinks alcohol during her pregnancy, which leads to brain abnormalities/problems in the fetus

Why do women metabolize alcohol less effectively?

They have less of the enzyme ADH which means they can't break down alcohol as effectively

What causes alcoholism from the genetics POV?

If parent(s) are alcoholics or have impulsive personality traits that the child can inherit, then there is a chance of the child becoming an alcoholic as well
(17% of one parent is alcoholic, 30% if both)

What causes alcoholism from the behavioral POV?

"What gets rewarded, gets repeated"
If people tend to like you more when you're drinking then you're more likely to drink

What causes alcoholism from the cognitive POV?

If you think people like you while you're drinking then you're going to do it, even if people aren't confirming it

Treatment for Alcoholism

Detoxification, Rehab center, and Alcoholics Anonymous

Abstinence

When one stops drinking all together which allows them to create new neural pathways in the brain

Controlled Drinking

Reducing how much person drinks

Antabuse

Makes a person throw up if they drink alcohol within 7 days of taking it
Can cause liver damage and not usually prescribed for the elderly

Naltrexone

Reduces the amount of dopamine released when drinking so it doesn't give them the usual high

Aversion Therapy

Creating a connection between a negative outcome and the substance

Covert Sensitization

Asking the patient to think of the worse case scenario by slowly going through the steps and having each step get progressively worse

Relapse

When someone goes back to using a substance after previously not using the substance

Who is more likely to relapse?

A person who started drinking young, if a person has dual diagnosis, or if a person has antisocial behaviors

When is a person most likely to relapse?

In the first three months of sobriety

Gender Dysphoria Disorder

Having consistent discomfort with one's biological sex traits for 6 months

What is Gender Dysphoria Disorder listed at in the DSM 5?

"Gender Dysphoria", having it in the DSM 5 allows the person to see a therapist and have their insurance cover the therapy

What does the DSM 5 list?

The disorders, symptoms/how many symptoms the person needs to have to be diagnosed and how long these symptoms last

Gender Dysphoria in Children

Symptoms: Has a strong desire to be the other gender, strong preference for cross gender roles/games, and a desire to be treated as the other gender
Ages 7-13 for diagnosis

Gender Dysphoria in Adolescence/Adults

Symptoms: Similar to children, strong conviction/desire to be treated as the opposite gender

What causes gender discomfort/dysphoria?

Genetics/biology (imbalance in sex hormones), psychologically could be that people don't like being pigeonholed into gender stereotypes

Treatment for Gender Dysphoria

Starts with psychotherapy, then can move to hormone blockers, and then possibly sex reassignment surgery

Homosexuality

Was taken out of the DSM 2 and all future editions because there is no difference in intelligence between a homosexual person and a heterosexual person

Prejudice

A negative judgement/attitude about people

Selective Attention

People watch certain shows/other medias the reinforce their views

Discrimination

Negative action taken against a person because their apart of a specific group

Sexual Dysfunctions

When a person has a low/high sex drive, has a desire for sex but cannot get aroused, or they cannot achieve orgasms

Sexual Response Cycle: Desire

Person's thoughts/fantasies for sexual activities

Sex drive/desire

Motivation to engage in sexual behaviors
Related to testosterone levels

Sexual Response Cycle: Arousal Phase

Occurs after direct sexual stimulation

Sexual Response Cycle: Orgasm

The release from sexual tension

Phase/Refractory Period

When men are unresponsive to sexual stimulation, women don't generally have one

Sexual Response Cycle: Resolution Phase

Everything returns to normal

Sexual Desire Disorders

Refers to people who have a diminished/reduced desire for sex

Hypoactive

Having a low/very low sex drive

Sexual Aversion

A repulsion to the idea of having sex

Love Languages

Different ways that people feel cared for in their relationships

1. Words of Affirmation

When the partner gives verbal compliments, encouraging comments, and conveys appreciation

2. Quality Time

Giving someone your undivided attention/time

3. Receiving Gifts

When the partner gives them something

4. Acts of Service

When the partner does things without asking

5. Physical Touch

Holding hands, hugging, etc.

Divorce

When a marriage ends, around 50% of marriages end in divorce.

Treatment for Sexual Dysfunctions

Explore the client's sexual history or see if they're on medication that could have side effects

International Professional Surrogate Association

Organization that works with adults with sexual dysfunctions disorders

Arousal Disorder

When someone does have sex drive and wants to be sexual but they cannot experience arousal

Primary Erectile Dysfunction

When a man hasn't had an erection before
Can be caused by physical issues or emotional trauma

Secondary Erectile Dysfunction

When a man previously had erections but now he can't
Could be caused by trauma, medication, age, or performance anxiety

Treatment for Arousal Disorders

Sensate focus

Sensate Focus

A non sexual mutual massage which lowers the pressure of having sex since it's just about giving a massage

Orgasmic Disorders

A person who has a high enough sex drive and the ability to get aroused but cannot achieve orgasm

Premature Ejaculation

When a man cannot control when he ejaculates
Diagnosis occurs when he cannot control ejaculation 98% of the time for 6 months and it impacts the patient's life

Treatment for Premature Ejaculation

Start/Stop method
Edging

Delayed Ejaculation

a male dysfunction characterized by persistent inability to ejaculate or very delayed ejaculations during sexual activity with a partner

Female Orgasmic Disorder

A dysfunction in which a woman persistently fails to reach orgasm, experiences orgasms of very low intensity, or has very delayed orgasms.

Hyper sexuality

High sex drive/excitability

How do you diagnose someone with hyper sexuality?

There is no diagnosis in the DSM 5, instead would use two categories called "Other Specified Sexual Dysfunction" and "Impulsive Control Disorder"

Infidelity

When a person cheats on their partner

What's one way to help heal a relationship when a partner cheats?

Making sure the partner who was cheated on gets a chance to ask all of the questions they need/want to ask

Genito-Pelvic Pain/Penetration

People (usually women) who have consistent pain before, during, or after penetration in intercourse

Paraphilia

Sexual deviations from normal sexual behaviors

Fetishism

Something that a person requires to be there in order to be aroused/stay aroused

Transvestite Fetishism

When a person enjoys/gets aroused by dressing in the opposite gender's clothing

Voyeurism

Observing other people/strangers undressing/having sex

Pedophilia

Only way to get aroused is by imagining having sex/having sex with children