Chapter 11 – Substance-Related, Addictive, and Impulse-Control Disorders

A comprehensive set of question-and-answer flashcards covering key terms, mechanisms, clinical features, biological and psychosocial influences, and treatment approaches presented in Chapter 11 of Barlow & Durand’s “Psychopathology: An Integrative Approach” (9th ed.).

What is a psychoactive substance?

A chemical that alters mood, behavior, or cognition.

Define "substance use."

Taking moderate amounts of a substance in a way that does not interfere with functioning.

What is substance intoxication?

A reversible, substance-specific physical and psychological reaction to recent ingestion of a drug.

Which two physiological processes define substance dependence?

Tolerance and withdrawal.

What is tolerance?

Needing more of a substance to achieve the same effect or experiencing reduced effects from the same amount.

Define withdrawal.

A set of physical and psychological symptoms that occur when regular use of a substance is discontinued.

How many DSM-5 criteria (and within what time frame) are required to diagnose a substance use disorder?

At least 2 symptoms within a 12-month period.

Name three DSM-5 symptoms of substance use disorder other than tolerance and withdrawal.

Taking more than intended, persistent desire/unsuccessful efforts to cut down, excessive time spent obtaining/using/recovering, craving, role failure, interpersonal problems, giving up activities, hazardous use, continued use despite problems.

List the five main substance categories.

Depressants, stimulants, opiates, hallucinogens, and other drugs of abuse (e.g., inhalants, steroids).

What general effect do depressants have on behavior?

Behavioral sedation and relaxation.

Which neurotransmitter system is enhanced by alcohol to produce its depressant effects?

GABA (gamma-aminobutyric acid).

Outline the metabolic pathway of alcohol in the body.

Ethanol → acetaldehyde (via alcohol dehydrogenase) → acetic acid + water (via acetaldehyde dehydrogenase) → CO₂ + water.

Name two serious long-term neurological complications of chronic alcohol use related to thiamine (vitamin B1) deficiency.

Wernicke’s disease and Korsakoff’s syndrome.

What percentage of U.S. adults currently drink alcohol?

About 50 percent.

Starting to drink at or before what age markedly increases risk for severe alcohol use disorder?

Age 11.

Give two examples of barbiturates.

Luminal, Nembutal, Seconal, or Amytal (any two).

What class of drugs includes diazepam and alprazolam?

Benzodiazepines (anxiolytics/hypnotics).

Which receptor complex do benzodiazepines act on?

The GABA-A receptor.

State two common acute effects of amphetamines.

Elation/vigor and reduced fatigue (followed by crash of extreme fatigue and depression).

How do cocaine and amphetamines increase dopamine activity?

Cocaine blocks dopamine reuptake; amphetamines enhance release and block reuptake of dopamine and norepinephrine.

What receptor does nicotine primarily stimulate?

Nicotinic acetylcholine receptors in the CNS.

Which neurotransmitter’s reuptake is blocked by caffeine?

Adenosine.

Differentiate "opiate" and "opioid."

Opiate = natural chemical in opium poppy; opioid = any natural or synthetic substance with similar narcotic effects.

List two natural opioids and two semi-synthetic opioids.

Natural: opium, morphine, codeine. Semi-synthetic: heroin, fentanyl, hydromorphone, oxycodone, methadone (any two of each).

Name three hallmark opioid withdrawal symptoms.

Excessive yawning, nausea/vomiting, chills, muscle aches, diarrhea, insomnia (any three).

What is the main psychoactive ingredient in cannabis?

Δ⁹-tetrahydrocannabinol (THC).

What endogenous cannabinoid is produced by the brain?

Anandamide.

Give two medical uses of cannabis.

Anti-nausea, appetite stimulation, glaucoma treatment (any two).

Name four classic hallucinogens.

LSD, psilocybin, PCP, mescaline.

Why does tolerance to hallucinogens reverse quickly?

It diminishes after short periods of abstinence, so sensitivity returns rapidly.

Which class of abused substances shows highest use in early adolescence and is found in volatile solvents?

Inhalants.

Why can anabolic-androgenic steroids produce dependence without a typical "high"?

Users wish to maintain increased muscle mass and performance, leading to continued use despite harm.

Identify the core brain reward pathway implicated in substance disorders.

Dopaminergic pathway from the ventral tegmental area (midbrain) to the nucleus accumbens (frontal cortex).

Explain the opponent-process theory of addiction.

The initial positive effects of a drug are followed by opposing negative effects; over time avoiding the crash motivates continued use.

What cognitive phenomenon increases relapse risk when a person violates abstinence?

The abstinence violation effect (self-blame leading to further use).

State one cultural belief model that influences attitudes toward substance misuse.

Moral weakness model (viewing addiction as a personal failing) or disease model (viewing it as a medical illness).

What is agonist substitution therapy?

Administering a safer drug with a similar chemical composition to the abused substance (e.g., methadone, nicotine gum).

Give an example of an antagonist drug used in substance treatment.

Naltrexone or acamprosate (blocks alcohol/opioid effects).

Which medication produces aversive reactions when alcohol is consumed?

Disulfiram (Antabuse).

Is biological treatment alone usually sufficient for long-term recovery?

No; it is generally ineffective without accompanying psychosocial interventions.

Name two key components of relapse-prevention therapy.

Identifying high-risk situations, developing coping skills, cognitive restructuring of expectancies, planning for lapses (any two).

What are the two primary goals often balanced in alcohol treatment?

Controlled drinking versus complete abstinence.

Which motivational therapy is commonly integrated into substance abuse treatment to enhance readiness for change?

Motivational Enhancement Therapy (MET).

Why have many prevention programs shifted away from purely educational models like DARE?

Because such programs showed limited impact on alcohol and tobacco use; comprehensive approaches are more effective.

Provide four diagnostic indicators of gambling disorder.

Difficulty reducing, irritability on cutback, need to gamble with more money, frequent preoccupation, lying to conceal gambling, jeopardizing relationships/jobs, chasing losses, relying on others for bailouts (any four).

How do biological underpinnings of gambling disorder resemble substance use disorders?

Both show similar genetic and neurobiological factors affecting reward pathways.

Which impulse-control disorder involves repetitive aggressive outbursts causing harm or damage?

Intermittent explosive disorder.

Define kleptomania.

A recurrent failure to resist impulses to steal items that are not needed for personal use or monetary value.

What is pyromania?

An irresistible urge to set fires, accompanied by tension before and relief or pleasure after the act.