Chapter 10 (Addictive Disorders)
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Questions and Answers

What is a key indicator of substance use disorder severity classified as 'moderate'?

  • 4-5 symptoms (correct)
  • 6 or more symptoms
  • 3-4 symptoms
  • 1-2 symptoms

Which of the following symptoms is NOT part of the diagnostic criteria for substance use disorder?

  • Recurrent use resulting in failure to fulfill major role obligations
  • Continued use despite knowledge of having a physical problem
  • Inability to gain weight as a result of use (correct)
  • Strong desire or craving for the substance

Which of the following best describes the concept of 'tolerance' in substance use disorder?

  • Craving for the substance after a period of absence
  • The need for more of the substance to achieve the same effect (correct)
  • A physiological reaction when stopping use
  • Continued use despite interpersonal problems

What defines a 'severe' classification of substance use disorder according to the DSM-5?

<p>6 or more symptoms (C)</p> Signup and view all the answers

Which of the following is a course specifier for substance use disorder?

<p>In a controlled environment (D)</p> Signup and view all the answers

What is the focus of the diagnostic criteria for substance use disorders?

<p>A combination of various behavioral and psychological criteria (D)</p> Signup and view all the answers

Which resource would be most helpful for information on alcohol-related issues?

<p><a href="http://www.alcohol.org.nz/">http://www.alcohol.org.nz/</a> (B)</p> Signup and view all the answers

What does the term 'substance' refer to in the context of addictive disorders?

<p>Natural or synthesized products with psychoactive effects (B)</p> Signup and view all the answers

Which aspect is NOT covered by the treatment of substance use disorders?

<p>Dietary requirements (A)</p> Signup and view all the answers

What is a key factor to consider in the epidemiology of substance use?

<p>The geographic distribution of substance users (B)</p> Signup and view all the answers

What might be included in the aetiology of substance use disorders?

<p>All potential influences including psychological factors (A)</p> Signup and view all the answers

Which of the following is part of the learning objectives regarding gambling disorder?

<p>Describing diagnostic criteria and treatment approaches (B)</p> Signup and view all the answers

Which statement about the scope of substance-related disorders is incorrect?

<p>All users of substances are considered to have a disorder. (B)</p> Signup and view all the answers

What is NOT typically included in the treatment options for substance use disorders?

<p>Detoxification only (D)</p> Signup and view all the answers

What does gambling disorder fall under in the context of addictive disorders?

<p>A type of behavioral addiction (A)</p> Signup and view all the answers

What does the disease model of addiction primarily emphasize?

<p>Addiction as a medical disorder with loss of control (B)</p> Signup and view all the answers

Which psychological theory focuses on the role of learning and conditioning in substance use disorders?

<p>Behavioral theories (B)</p> Signup and view all the answers

What is the definition of substance intoxication?

<p>Temporary behavioral or psychological changes due to substance accumulation. (A)</p> Signup and view all the answers

What is proposed by the inhibition dysregulation theory regarding addictions?

<p>Addictions are due to a failure of an inhibitory system (D)</p> Signup and view all the answers

What does tolerance mean in the context of substance use?

<p>An increased amount of substance required to achieve the same effects. (C)</p> Signup and view all the answers

Which brain systems are considered major reward systems impacted by substances leading to dependence?

<p>Dopaminergic and endogenous opioid systems (C)</p> Signup and view all the answers

What is substance withdrawal characterized by?

<p>Physical and psychological disturbances when substance use is discontinued. (C)</p> Signup and view all the answers

What does the tri-dimensional personality theory suggest regarding substance use vulnerability?

<p>It arises from an interaction of three personality dimensions (A)</p> Signup and view all the answers

What role does incentive-sensitization theory attribute to addiction in the brain?

<p>It changes areas responsible for the incentive to use drugs (A)</p> Signup and view all the answers

What refers to a situation with both a mental disorder and a substance use problem?

<p>Dual diagnosis. (C)</p> Signup and view all the answers

Which term is not recognized as a technical term for substance use problems in DSM-5?

<p>Addiction. (C)</p> Signup and view all the answers

Which factor is NOT typically associated with a genetic component in substance use disorder development?

<p>Personal lifestyle choices (B)</p> Signup and view all the answers

Which of the following disorders is classified as a non-substance-related disorder?

<p>Gambling disorder. (D)</p> Signup and view all the answers

Which of the following reflect common misconceptions about the causes of substance use disorders?

<p>They are solely a product of behavioral learning (B), They arise from genetic factors only (C), They are only influenced by social environment (D)</p> Signup and view all the answers

What leads to a condition where the body must have a drug to avoid withdrawal symptoms?

<p>Dependence. (A)</p> Signup and view all the answers

What is substance-induced disorder defined as?

<p>Mental conditions triggered by substance ingestion. (D)</p> Signup and view all the answers

Which of the following is an example of a substance-related disorder?

<p>Alcohol intoxication. (C)</p> Signup and view all the answers

What is the primary consequence of repeated substance use leading to tolerance?

<p>Need to consume larger amounts to achieve the same effects. (C)</p> Signup and view all the answers

What is a primary biological factor contributing to alcohol dependence?

<p>Genetic markers (D)</p> Signup and view all the answers

Which treatment method provides regular support and promotes complete abstinence?

<p>Alcoholics Anonymous (D)</p> Signup and view all the answers

What is a limitation of inpatient hospital treatment for alcohol use disorders?

<p>Lack of social support can hinder its effectiveness. (A)</p> Signup and view all the answers

What does the abstinence violation effect refer to?

<p>Negative feelings after a relapse. (C)</p> Signup and view all the answers

What is one strategy included in relapse prevention?

<p>Avoiding high-risk situations (C)</p> Signup and view all the answers

Which of the following is a focus of motivational interviewing?

<p>Helping clients articulate their pros and cons (C)</p> Signup and view all the answers

Which statement about Alcoholics Anonymous (AA) is accurate?

<p>Participation does not guarantee a better outcome. (D)</p> Signup and view all the answers

Which psychological theory addresses how learned behaviors impact alcohol dependence?

<p>Expectancy model (D)</p> Signup and view all the answers

Children of alcoholics face which specific risk regarding alcohol dependence?

<p>Higher risk from environmental stressors (D)</p> Signup and view all the answers

Which method suggests that patients and families should reinforce behaviors inconsistent with drinking?

<p>Cognitive behavioral treatment (D)</p> Signup and view all the answers

What is a critical indicator of gambling disorder according to the DSM-5 criteria?

<p>Being restless or irritable when trying to reduce gambling (C)</p> Signup and view all the answers

Which aspect of gambling habits is considered problematic in the context of gambling disorder?

<p>Increasing amounts of money needed for excitement (A)</p> Signup and view all the answers

How is gambling viewed culturally in Australia?

<p>An integral part of the cultural ethos (B)</p> Signup and view all the answers

What is a necessary condition for the diagnosis of gambling disorder?

<p>Experiencing clinically significant impairment or distress (D)</p> Signup and view all the answers

Which of the following best describes the historical perspective on gambling across cultures?

<p>Gambling has been a part of almost every culture since antiquity (A)</p> Signup and view all the answers

Which behavior is often associated with attempts to reduce gambling according to the DSM-5?

<p>Feelings of restlessness or irritability (A)</p> Signup and view all the answers

What is one common misconception about gambling behavior in culture?

<p>It is universally accepted in all cultures (A)</p> Signup and view all the answers

What might indicate a severe gambling problem as per the DSM-5 criteria?

<p>Needing to gamble with higher amounts to achieve excitement (C)</p> Signup and view all the answers

Flashcards

Substance

A psychoactive substance; any natural or synthetic product that alters perceptions, thoughts, emotions, and behaviors.

Substance Use Disorders

Conditions involving problematic substance use, negatively impacting daily life.

Gambling Disorder

Condition involving problematic gambling habits impacting daily life.

Diagnostic Criteria

Specific aspects used to identify mental health conditions.

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Epidemiology

Study of health conditions within a population.

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Aetiology

The cause or origin of a disease or condition.

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Treatment

Methods aimed at alleviating or curing the issue.

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Alcohol-Related Disorder

Conditions with problematic alcohol consumption, negatively impacting daily life.

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Psychoactive Substances

Substances that influence mental/mood states.

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Learning Objectives

Goals for a specific learning process or course.

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Substance Intoxication

Temporary behavioral or psychological changes caused by a substance building up in the body.

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Tolerance

Needing more of a substance to get the same effect after repeated use.

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Substance Withdrawal

Physical and psychological problems when a substance is stopped.

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Dual Diagnosis

A mental/psychological disorder and a substance use problem occurring together.

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Addiction

A condition where the body needs a substance to avoid withdrawal symptoms.

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Substance-Induced Disorders

Mental/psychological issues caused by substance use.

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DSM-5

Diagnostic manual for mental disorders, including substance-related issues.

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Substance Intoxication (DSM-5)

Specific substance-related maladaptive behaviors/psychological symptoms after taking a substance.

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DSM-5 Criteria for Substance Use Disorder

These include 11 specific criteria that are used to assess the severity of a SUD. They range from taking more than intended to experiencing withdrawal symptoms, and impact daily functioning like work, relationships and health.

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Severity of Substance Use Disorder

The severity of Substance Use Disorder is classified into three levels: mild, moderate, and severe, based on the number of criteria fulfilled. Mild involves 2-3 criteria met, moderate 4-5 and severe above 6 criteria.

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Course Specifiers for Substance Use Disorder

These are further descriptions that provide more context to a Substance Use Disorder. They include factors like remission (recovery), maintenance therapy and whether the individual is in a controlled environment.

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Tolerance and Withdrawal

These are two key symptoms associated with Substance Use Disorders. Tolerance means needing more of the substance for the same effect, while withdrawal refers to experiencing unpleasant physical or psychological symptoms when stopping.

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Gambling Disorder (Historical)

A long-standing issue with gambling, impacting daily life, present in various cultures across history.

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Gambling Disorder (Social Acceptability)

The degree to which gambling is seen as acceptable varies significantly across cultures.

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Australian Gambling Culture

Gambling plays a significant role in Australian society, with widespread participation and spending on various forms of gambling.

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Gambling Disorder (DSM-5 Criteria)

A diagnosis requires four or more specific gambling behaviors within a year, causing significant distress or impairment.

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Gambling Disorder (Symptom: Increasing Bets)

Needing to gamble with larger and larger amounts to feel the same excitement.

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Gambling Disorder (Symptom: Restlessness)

Feeling agitated and irritable when trying to cut down or stop gambling.

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Gambling Disorder (Prevalence)

The extent of gambling disorder affecting a population is studied to understand its impact.

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Gambling Expenditure

The total amount of money spent on gambling within a given time period, reflecting the scale of the industry.

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Disease Model of Addiction

This model views addiction as a medical disorder where the primary symptom is a loss of control over substance use.

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Choice Theory

This theory suggests that addictive behaviors are a result of conscious choices made by individuals, not necessarily a loss of control.

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Genetic Component in Addiction

Research suggests that genetics plays a significant role in the development of addiction. Individuals with a family history of addiction are more likely to develop it themselves.

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Non-Specific Genetic Basis

It is not a specific gene that makes you addicted to a particular substance, but rather a general susceptibility to addiction.

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Brain's Reward System

Substances that lead to dependence act on the brain's reward system, which is responsible for pleasure and motivation.

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Inhibition Dysregulation Theory

This theory posits that addiction stems from a dysfunction in the brain's system responsible for inhibiting impulsive behaviors, leading to uncontrolled substance use.

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Classical and Operant Conditioning

These learning theories suggest that addiction can be acquired through repeated associations between certain stimuli and substance use, and the reinforcement of positive experiences.

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Incentive-Sensitization Theory

This theory suggests that drugs of addiction alter the brain's reward system, making the person more sensitive to drug cues and cravings, even in the absence of the drug.

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Alcohol Dependence Theories

Different perspectives explaining why people become dependent on alcohol, including biological, psychological, and sociocultural factors.

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Genetic Influence on Alcohol Dependence

The idea that genetic factors can increase the risk of developing alcohol dependence. This is supported by family studies and genetic marker research.

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Learning Theory in Alcohol Dependence

This theory suggests that alcohol dependence can be learned through associations (classical conditioning) or reinforcement (operant conditioning).

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Expectancy Model of Alcohol Dependence

This model proposes that people's beliefs and expectations about the effects of alcohol influence their drinking behavior.

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Abstinence Violation Effect

This effect describes the tendency for people who have broken their abstinence from alcohol to be more likely to relapse and drink heavily.

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Sociocultural Factors in Alcohol Dependence

These factors include family, community, and cultural influences on alcohol use. For example, children of alcoholics are at a higher risk of developing alcohol problems.

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Inpatient Hospital Treatment for Alcohol Use Disorders

This form of treatment involves hospitalization and medical supervision during detoxification (withdrawal from alcohol). It may be necessary for individuals lacking social support or other serious issues.

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Alcoholics Anonymous (AA)

A large self-help group for people with alcohol problems. Members offer support, understanding, and advocate for complete abstinence.

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Contingency Management Therapy for Alcohol Use Disorders

This therapy focuses on rewarding behaviors that are inconsistent with drinking (e.g., avoiding drinking places) and teaching techniques to cope with situations that trigger cravings.

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Relapse Prevention Therapy

This form of therapy provides individuals with strategies and coping mechanisms to prevent relapse into alcohol use. It helps them identify triggers and develop strategies for managing them.

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Study Notes

  • This material is reproduced for the University of South Australia, in accordance with copyright law.
  • Further reproduction or communication of this material is subject to copyright protection.

BEHL 3004: Chapter 10 (Addictive Disorders)

  • The course covers addictive disorders, specifically Chapter 10.

Learning Objectives

  • 10.1: Diagnostic criteria, epidemiology, etiology, and treatment of substance use disorders.
  • 10.2: Diagnostic criteria, epidemiology, etiology, and treatment of gambling disorder.

Lecture Outline

  • Key terms and definitions
  • Substance-related disorders in general
  • Scope/Epidemiology of substance use
  • The Aetiology of substance use disorders
  • Treatment of substance use disorders
  • More on Alcohol (including aetiology and treatment)
  • Gambling (time permitting)
  • Useful resources (websites)

Key Terms and Definitions

  • Substance: A psychoactive substance (natural or synthetic) with psychoactive effects.
  • Substance Intoxication: Temporary behavioral or psychological changes due to substance accumulation.
  • Tolerance: A state where more of a substance is needed to achieve the same effect.
  • Substance Withdrawal: Physical and psychological disturbances that occur when a substance is stopped.
  • Addiction: A condition where the body requires a drug to avoid withdrawal symptoms. (A behavior over which an individual has impaired control with harmful consequences).
  • Dual diagnosis: Co-occurring mental/psychological disorder and a substance use problem.

DSM-5 Substance-related & Addictive Disorders Categorization

  • Substance use disorders
  • Substance-related disorders
  • Substance-induced disorders
  • Intoxication
  • Withdrawal
  • Alcohol
  • Caffeine
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives, hypnotics, or anxiolytics
  • Stimulants
  • Tobacco

DSM-5 – Substance-Induced Disorders

  • Substance intoxication: reversible, substance-specific maladaptive behavioral and psychological symptoms.
  • Substance withdrawal: physiological and psychological changes.

Examples of Substance Intoxication and Withdrawal

  • Cannabis Intoxication
  • Alcohol Withdrawal

DSM-5 - Methamphetamine-Induced Psychotic Disorder.

  • Develops soon after ingesting a large amount of Methamphetamine.
  • Symptoms: Hallucinations (e.g., sensation of bugs crawling under skin).
  • Symptoms: Persecutory delusions.

Substance Use Disorder (DSM-5)

  • Symptoms include taking in larger amounts or over a longer period than intended; persistent desire or unsuccessful efforts to cut down; spending lots of time trying to get, using, or recovering from its effects; craving or strong desire.
  • Repeated use leading to failure to fulfill major role obligations; persistent social or interpersonal problems; cessation of important social, occupational or recreational activities due to use.
  • Use in situations that are hazardous; continued engagement despite knowledge of having a physical/psychological problem; tolerance, requiring more of the substance to achieve the same effect; withdrawal (physiological reaction when stopping).
  • Specifiers include 'Severity'. (Mild, moderate and severe) and aspects or types of 'Course'. (Early or Sustained Remission)

Epidemiology of Substance Use Disorders

  • Alcohol is the most commonly used substance in Australia.
  • Opioids, cannabis, and stimulants are also used; but less prevalent.
  • Risk of harm and death (e.g., Paranoid psychosis, opioid related deaths).
  • There is a higher prevalence within Indigenous Australians.

Epidemiology of Substance Use in Australia

  • (Data on prevalence and rates of use for a variety of substances)
  • Data provided on Australian rates of use of various substances in 2001 - 2016.

The Aetiology of Substance Use Disorders:

  • Impaired control vs Choice Theories: The disease model of addiction describes addiction as a medical disorder where loss of control is central. Other theories (e.g., Choice theory) posit that addictive behaviors are reflected in rational choice.
  • Biological Factors: twin studies, genetic basis
  • Psychological Factors: Behavioural Theories, Personality Theories (Novelty Seeking, Harm Avoidance, Reward Dependence), Cognitive Theories (Outcome Expectancy, Relapse)
  • Social and Cultural Factors: Family functioning, parental modeling/monitoring, peer influences, cultural factors affecting acceptability, availability, and cost of substances.

Treatment of Substance Use Disorders

  • Goal Setting (abstinence or controlled use)
  • Detoxification, Use of Meds (+ compliance issues); Motivational Interviewing
  • Brief interventions, Cognitive Behavior Therapy (Contingency Management)
  • Relapse prevention

In Australia and New Zealand

  • A focus on harm minimisation
  • Reducing
  • Alternating
  • Telling others to ease up
  • Stopping from driving while drinking

Gambling

  • Gambling disorder: historical approaches
  • Social acceptability varies by culture.
  • Gambling is culturally significant in Australia..
  • Data on gambling expenditure.
  • DSM-5 Gambling Disorder: criteria to be assessed.

The Epidemiology of Gambling Disorder

  • Adolescents and adult males gamble more frequently and intensely than adolescent and adult females
  • Females seeking treatment may experience negative emotions, while males are motivated by excitement and winning.

The Aetiology of Gambling Disorder

  • (Cognitive Models: cognitive errors: illusion of control, gambler's fallacy, biased evaluation, selective recall, cognitive regret, superstitious beliefs, beliefs & over-magnification of skills, luck as a personal quality, gambling as a source, illusory correlations)
  • Integrated Pathways Model of Pathological gambling.
  • Biological Factors
  • Psychological Factors: Behaviour, Cognitive, personality traits, motivational factors
  • Socio-cultural

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