Overview of Substance Use and Personality Disorders

Stimulants

Effects: Increased energy, alertness; dopamine agonists.

Stimulants Withdrawal

Fatigue, depression.

Depressants

Effects: Relaxation, sedation; GABA agonists.

Depressants Withdrawal

Tremors, seizures (DTs for alcohol).

Opioids

Effects: Pain relief, euphoria; endorphin agonists.

Opioids Withdrawal

Muscle pain, nausea.

Opioids Treatments

Methadone, Suboxone, Naloxone (for overdose).

Hallucinogens

Effects: Altered perceptions; serotonin agonists.

Cannabis Effects

Relaxation, altered time perception; CB1/CB2 receptors.

Cannabis Syndromes

Amotivation, memory issues (chronic use).

Dabbing

Concentrated THC.

K2/Spice

Synthetic cannabinoids, unpredictable effects.

Reward Circuit

VTA, nucleus accumbens, prefrontal cortex; dopamine-driven.

Polysubstance Use

Multiple substances.

Dual Diagnosis

SUD + mental illness.

Tolerance

Needing more for the same effect.

Withdrawal

Symptoms from stopping use.

SUD Prevalence

8-10% U.S. adults.

Alcohol Addiction

71-74% of SUD cases.

Co-Morbidity

1 in 5 with mental illness has SUD.

Treatment

Only 18% get professional help.

Risk Groups

Males, 16-25 years, trauma survivors, low SES.

MAT

Medication-Assisted Therapy.

Alcohol MAT

Antidepressants, naltrexone.

Opioids MAT

Methadone, Suboxone.

DTs

Hallucinations, tremors, disorientation.

Korsakoff's Syndrome

Memory loss from thiamine deficiency.

BAL Symptoms

Progress by range (e.g., 0.08% = impaired motor control).

Gambling Disorder

Compulsive gambling.

Internet Gaming Disorder

Problematic gaming.

Paraphilic Disorders

Persistent sexual interests involving unusual objects, activities, or situations causing distress/impairment or harm to others.

Fetishistic Disorder

Intense sexual focus on non-living objects/body parts.

Transvestic Disorder

Sexual arousal from cross-dressing.

Voyeuristic Disorder

Arousal from observing non-consenting individuals.

Exhibitionistic Disorder

Arousal from exposing genitals to non-consenting individuals.

Frotteuristic Disorder

Arousal from touching/rubbing against a non-consenting person.

Pedophilic Disorder

Sexual attraction to prepubescent children.

Sexual Masochism Disorder

Arousal from being humiliated, beaten, or bound.

Sexual Sadism Disorder

Arousal from causing physical/psychological suffering to others.

Gender Dysphoria

Distress related to incongruence between assigned gender and experienced gender.

Transgender

Identity differing from assigned gender.

Gender Nonconformity

Not a disorder; cultural/gender expression.

Personality Disorders

Enduring patterns of inner experience and behavior that deviate from cultural norms, are pervasive, inflexible, and lead to distress or impairment.

Cluster A Personality Disorders

Odd/Eccentric: Paranoid, Schizoid, Schizotypal.

Cluster B Personality Disorders

Dramatic/Erratic: Antisocial, Borderline, Histrionic, Narcissistic.

Cluster C

Anxious/Fearful personality disorders: Avoidant, Dependent, OCPD.

Paranoid PD

Pervasive distrust and suspiciousness of others.

Schizoid PD

Social detachment with limited emotional expression.

Schizotypal PD

Eccentric behavior with cognitive distortions present.

Antisocial PD (ASPD)

Disregard for others, impulsivity, and lack of remorse.

ASPD Gender Ratio

More common in men, ratio 4:1.

Borderline PD (BPD)

Instability in mood, relationships, and self-image.

BPD Gender Ratio

More common in women, ratio 2:1.

Dialectical Behavior Therapy (DBT)

Effective treatment for BPD focusing on mindfulness.

Avoidant PD

Social inhibition and fear of rejection.

Dependent PD

Excessive need for care and fear of separation.

Obsessive-Compulsive PD (OCPD)

Preoccupation with order and perfectionism.

Difference OCPD vs. OCD

OCPD lacks intrusive thoughts and rituals.

Positive Symptoms of Schizophrenia

Hallucinations and delusions experienced by patients.

Negative Symptoms of Schizophrenia

Flat affect, avolition, and alogia present.

Cognitive Symptoms of Schizophrenia

Impaired executive function and memory deficits.

Genetic Risk for Schizophrenia

High concordance in monozygotic twins.

Neurochemical Theories

Dopamine hypothesis: hyperactivity in mesolimbic pathways.

First-Generation Antipsychotics

Treat positive symptoms, risk for tardive dyskinesia.

Second-Generation Antipsychotics

Treat both positive and negative symptoms effectively.

Schizoaffective Disorder

Features of schizophrenia plus mood disorder symptoms.

30/40/30 Rule

30% significant improvement, 40% moderate, 30% minimal.

Environmental Factors in Schizophrenia

High expressed emotion and prenatal complications.

Iatrogenic Effects

Side effects from treatment like weight gain.