Final Exam Abnormal CLP4143 Substance Use Disorders DSM 5 has one category Substance use disorder o Failure to meet obligations Repeated use in situations where it is physically dangerous Continued use despite problems caused by the substance Efforts to reduce or control use do not work Describe some of the more serious symptoms associated with withdrawal symptoms from alcohol and other substances Withdrawal o Negative physical and psychological effects from stopping usage o Using more than intended amounts o Trying unsuccessfully to stop o Having physical or psychological problems made worse by drug o Experience problematic relationships o Delirium tremens DTs Can occur when blood alcohol levels drop suddenly Deliriousness Tremulousness Hallucinations Primarily visual may be tactile e g bugs crawling all over body Briefly describe each drug Marijuana Drug derived from dried and ground leaves and stems of the female hemp plant o Major active ingredient THC o Psychological effects Feelings of relaxation and sociability Rapid shifts of emotion Interferes with attention memory and thinking Alcohol is the most common abused substance worldwide Hallucinogens i e LSD Colorful visual hallucinations o Psychedelic trip expansion of consciousness Barbiturates Amphetamines Stimulants Increase alertness and motor activity reduce fatigue o Produce high levels of energy sleeplessness o Reduce appetite increase HR constrict blood vessels o Opiods Group of addictive sedatives that in moderate doses relieve pain and induce sleep Opium Morphine Heroin Codeine o Psychological Effects Euphoria drowsiness and lack of coordination 1 1 What is the difference between With physiological dependence Presence of either tolerance or withdrawal Without physiological dependence Absence of either tolerance or withdrawal What are LSD flashbacks Effect of using LSD Hallucinogen persisting perception disorder HPPD o Most common during stress Months or years after taking LSD suddenly the trip could come back without warning and suddenly you would be floridly hallucinating again What is alcohol myopia Tension reduction from use of drugs may be due to alcohol myopia o User focuses reduced cognitive capacity on immediate distractions o Less attention focused on tension producing thoughts How does your expectancies about alcohol or drug effects actually influence what you experience after using the dug alcohol People who expect alcohol to reduce stress and anxiety are most likely to drink Drinking and positive expectancies influence each other positively Describe the incentive sensitization theory of substance dependence Distinguish Wanting craving for drug from Liking pleasure obtained by taking the drug wanting or incentive salience is a motivational magnet quality of a stimulus that makes it a desirable and attractive goal Dopamine system becomes sensitive to the drug and the cues associated with drug e g needles rolling papers etc Sensitivity to cues induces and strengthens wanting Brain imaging studies show that cues for a drug needle or a cigarette activate the reward and pleasure areas of the brain involved in drug use Describe Alcoholics Anonymous Largest self help group for problem drinkers Regular meetings provide support understanding and acceptance Promotes complete abstinence Although some studies have shown AA participation predicts better outcome recent studies suggest AA no more effective than other forms of therapy Eating Disorders Describe the three eating disorders Anorexia nervosa characterized by a pursuit of thinness that leads to self starvation 2 2 o Restriction of behaviors that promote healthy weight body weight is significantly below normal weight o Intense fear of gaining weight and being fat o Distorted body image or sense of body shape o Feel fat even when emaciated gaunt thin Bulimia nervosa characterized by a cycle of bingeing followed by extreme behaviors to prevent weight gain such as purging Binge eating disorder characterized by regular bingeing but do not engage in purging behaviors o Similar to bulimia but without purging fasting or excessive dieting to compensate for the binges o Some may eat continuously throughout the day o Some binge on large amounts of food at once Relieve feelings of stress anxiety or depression o Not officially recognized in the DSM o Significantly overweight o History of family obesity o Frequent dieting o 30 of individuals in weight loss programs could be diagnosed with this disorder What are the different anorexia subtypes Restricting weight loss is achieved by severely limiting food intake with no binge eating purging during the last three months Binge eating purging the person has also regularly engaged in binge eating and purging during the last three months What are risk factors for developing eating disorders Onset early to middle teen years o Usually triggered by dieting and stress Women 10x as likely to develop disorder as men o Symptomatology in men similar to that of women Often comorbid with depression OCD phobias panic alcoholism and PDs In men comorbid with substance dependence mood disorders or schizophrenia Suicide rates high in anorexia 5 completing 20 attempting Describe treatments for eating disorders Anorexia Nervosa o The treatment of AN must focus on three primary issues 1 restoring weight 2 modifying distorted eating behavior and 3 addressing the psychological and family issues o Treatment methods typically include nutritional rehabilitation psychotherapy and medication o Treatment is often outpatient often with intensive day treatment 3 3 o In the U S about half of all patients with AN who seek treatment are hospitalized o Immediate goal is to increase weight to avoid medical complications and avoid death o Second goal is long term maintenance of weight gain Can be challenging o CBT Reductions in symptoms through 1 year o Family based therapy FBT found to be effective A problem focused therapy that aims to change behavior through unified parental action The family in FBT is not viewed as the cause of the disorder but rather as a positive resource in the adolescent s weight restoration and return to normal eating and health FBT takes no stance on disease etiology and tries instead to separate the pathology of anorexia from the adolescent herself Anorexia viewed as an interpersonal rather than individual issue Use of Family Lunch sessions Early results show improved outcomes over individual therapy Bulimia o Cognitive Approaches
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