Psychology of Substance-Related Disorders

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Questions and Answers

Which sexual disorder is primarily characterized by a lack of sexual/erotic thoughts or fantasies in men?

Voyeuristic Disorder

Premature (Early) Ejaculation

Male Hypoactive Sexual Disorder (correct)

Exhibitionistic Disorder

Which condition involves intense arousal from exposing genitals to an unsuspecting person?

Sexual Masochism

Voyeuristic Disorder

Exhibitionistic Disorder (correct)

Frotteuristic Disorder

What is a common factor in Female Sexual Interest/Arousal Disorder?

Intense arousal from non-living objects

Having reduced interest in sexual activity (correct)

Having nonconsensual activities

Experiencing sexual preoccupation

Which sexual disorder is associated with anxiety about anticipating vulvovaginal or pelvic pain?

Genito-Pelvic Pain/Penetration Disorder Signup and view all the answers

Which disorder includes intense sexual arousal from the physical suffering of another person for at least 6 months?

Sexual Sadism Signup and view all the answers

Which disorder involves ejaculation approximately 1 minute following vaginal penetration?

Premature (Early) Ejaculation Signup and view all the answers

Which disorder involves intense arousal from touching or rubbing one's genitals against a nonconsenting person for at least 6 months?

Frotteuristic Disorder Signup and view all the answers

What is one of the associated problems of Female Sexual Interest/Arousal Disorder?

Anxiety Signup and view all the answers

What is a characteristic of Genito-Pelvic Pain/Penetration Disorder?

Vaginal pain during penetration attempts Signup and view all the answers

Which disorder requires individuals to be at least 18 years old?

Voyeuristic Disorder Signup and view all the answers

Which of these substances increases alertness and produces euphoria?

Cocaine Signup and view all the answers

What is a significant risk factor for the development of nicotine dependency?

Depression Signup and view all the answers

How long does acute alcohol withdrawal typically last?

4-5 days Signup and view all the answers

What is the minimum duration for the diagnosis of persistent and recurring gambling behavior?

12 months Signup and view all the answers

Which of the following conditions is specifically associated with a deficiency of thiamine?

Wernicke-Korsakoff Syndrome Signup and view all the answers

In which age group is alcohol withdrawal rare?

Individuals younger than 30 years Signup and view all the answers

Which of the following substances is most likely to produce mood swings and dream-like experiences?

Cannabis Signup and view all the answers

What is the primary characteristic of the Chronic Stage in the four-stage model of alcoholism progression?

Primary daily activities involve getting and drinking alcohol Signup and view all the answers

What is an onset age range for gambling disorder?

Both adolescence or young adulthood and middle to older adulthood Signup and view all the answers

Which disorder is commonly co-morbid with Oppositional Defiant Disorder (ODD)?

ADHD Signup and view all the answers

Which neurotransmitter system is involved in why alcohol affects cognitive abilities?

Glutamate Signup and view all the answers

Which disorder is noted to have increased amygdala responses to anger stimuli?

Intermittent Explosive Disorder Signup and view all the answers

Which stage of alcoholism involves drinking heavily but with few outward signs of a problem?

Prodromal Stage Signup and view all the answers

What is the primary function of a Breathalyzer?

To measure levels of alcohol intoxication Signup and view all the answers

Which of the following treatments are used for substance abuse?

Methadone Signup and view all the answers

When diagnosing Oppositional Defiant Disorder (ODD), which condition should be diagnosed if criteria are met, even if all ODD criteria are also met?

Disruptive Mood Dysregulation Disorder (DMDD) Signup and view all the answers

Which syndrome is a chronic memory disorder caused by severe deficiency of thiamine?

Wernicke-Korsakoff Syndrome Signup and view all the answers

Which substance is specifically identified as being produced synthetically in the laboratory?

LSD Signup and view all the answers

Combining alcohol with which of the following substances can be fatal?

Barbiturates Signup and view all the answers

What does physiological dependence refer to?

Using increasingly greater amounts of a drug to experience the same effect and experiencing withdrawal when not using it Signup and view all the answers

Which personality disorder is characterized by detachment from social relationships and limited range of emotions?

Avoidant Signup and view all the answers

Which personality disorder is associated with magical thinking and odd beliefs?

Schizotypal Signup and view all the answers

Individuals with which disorder are more likely to have turbulent relationships, fearing abandonment but lacking control over their emotions?

Borderline Signup and view all the answers

Which characteristic is NOT typically associated with Antisocial Personality Disorder?

Sensitivity to criticism Signup and view all the answers

Which disorder often involves seeking treatment for anxiety or depression rather than the personality disorder itself?

Schizotypal Signup and view all the answers

Which disorder is associated with having an unreasonable sense of self-importance?

Narcissistic Signup and view all the answers

Which disorder co-occurs more often with Antisocial Personality Disorder?

Histrionic Signup and view all the answers

Which personality disorder is characterized by social dominance and a tendency to get bored with routines?

Histrionic Signup and view all the answers

Which hypothesis is associated with the suggestion that psychopaths have abnormally low levels of cortical arousal?

Underarousal Hypothesis Signup and view all the answers

Which statement is associated with Avoidant Personality Disorder?

Relationships are messy and undesirable Signup and view all the answers

Which of the following is a common characteristic of individuals with Avoidant personality disorder?

Hypersensitivity to rejection Signup and view all the answers

What delusion involves the belief that one's thoughts have been removed by an outside force?

Thought Withdrawal Signup and view all the answers

What is the main issue that people with Obsessive-Compulsive personality disorder face with their perfectionism?

Prevents them from completing tasks Signup and view all the answers

Who first used the term 'demence precoce' to describe schizophrenia?

Benedict Morel Signup and view all the answers

Which personality disorder is associated with the belief 'If they knew the real me, they would reject me'?

Avoidant Signup and view all the answers

Which delusion is characterized by the false belief that another person is in love with them?

Erotomanic Signup and view all the answers

Which of the following is NOT a symptom under Emil Kraepelin's Dementia Praecox?

Obsessions Signup and view all the answers

Which disorder involves a fixation on things being done 'the right way'?

Obsessive-Compulsive personality disorder Signup and view all the answers

Which personality disorder involves agreeing with others' opinions to avoid rejection?

Dependent Signup and view all the answers

Who introduced the term Schizophrenia, meaning 'splitting of mind'?

Eugen Bleuler Signup and view all the answers

Which of the following describes delusions in the context of schizophrenia?

False beliefs that aren't based in reality. Signup and view all the answers

Auditory hallucinations, the most common form of hallucinations in schizophrenia, are experienced as:

Hearing voices or sounds. Signup and view all the answers

Which negative symptom of schizophrenia is characterized by a lack of interest in social interactions?

Asociality Signup and view all the answers

Which term describes disorganized speech that includes excessive details but eventually reaches the point?

Circumstantiality Signup and view all the answers

What term is used for newly created words with meaning relevant only to the person with schizophrenia?

Neologism Signup and view all the answers

What is hypnagogic hallucinations?

Occurs when falling asleep. Signup and view all the answers

Which type of hallucination occurs during seizures?

Ictal Hallucinations Signup and view all the answers

What behavior is described by the choice of words based on their sound rather than their meaning?

Clang Associations Signup and view all the answers

Which of the following disorders is characterized by a repetitive and persistent pattern of behavior that violates the basic rights of others and societal norms?

Conduct Disorder (CD) Signup and view all the answers

What is a common precursor to the childhood-onset type of Conduct Disorder?

Oppositional Defiant Disorder (ODD) Signup and view all the answers

Which disorder is characterized by purposeful fire setting?

Pyromania Signup and view all the answers

At what age is the first significant symptom of Conduct Disorder typically observed?

Middle childhood through middle adolescence Signup and view all the answers

In which disorder does an individual struggle to resist impulses to steal objects that are not needed for personal use?

Kleptomania Signup and view all the answers

Which symptom is more likely to appear in adolescence for individuals with Conduct Disorder?

Nonaggressive symptoms Signup and view all the answers

What type of episodes can individuals with paranoid personality disorder experience?

Psychotic episodes Signup and view all the answers

Which disorder is associated with an increased risk of criminal behavior in adulthood if onset occurs in childhood?

Conduct Disorder (CD) Signup and view all the answers

When is a separate diagnosis for fire setting not given in the case of pyromania?

When fire setting occurs as part of a manic episode Signup and view all the answers

Which statement about the diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) is correct?

The onset of recurrent impulsive aggressive outbursts must be before age 10 years. Signup and view all the answers

Which of the following is a characteristic of Central Sleep Apnea?

Evidence of 5 or more central apneas per hour of sleep Signup and view all the answers

What distinguishes Nightmare Disorder from other sleep disorders?

Well-remembered and extremely dysphoric dreams with efforts to avoid threats Signup and view all the answers

Which feature is common to both Obstructive and Central Sleep Apnea?

Occurrence of apneas or hypopneas during sleep Signup and view all the answers

What characterizes Sleep-Related Hypoventilation?

Episodes of decreased respiration associated with elevated CO2 levels Signup and view all the answers

Which symptom is indicative of Restless Legs Disorder?

Urge to move the legs during rest due to unpleasant sensations Signup and view all the answers

Which condition involves repeated episodes of arousal during sleep with complex motor activities?

REM Sleep Behavior Disorder Signup and view all the answers

What feature is specific to Non-REM Sleep Arousal Disorders?

Sleepwalking or sleep terrors with no memory of the episodes Signup and view all the answers

Which of the following is a factor associated with Delayed Ejaculation?

Greater disparity between sexual fantasies and reality with a partner Signup and view all the answers

Which disorder is characterized by a delay or absence of orgasm and intense feelings despite sexual stimulation?

Female Orgasmic Disorder Signup and view all the answers

What is a distinguishing feature of Circadian Rhythm Sleep-Wake Disorders?

Persistent pattern of sleep disruption due to circadian system alteration Signup and view all the answers

Study Notes

Sleep Disorders

Recurrent episodes of irrepressible need to sleep, lapsing into sleep or napping with cataplexy, hypocretin deficiency, and evidence from polysomnography showing REM sleep latency ≤ 15 mins, occurring 3x/week for at least 3 months.

Obstructive Sleep Apnea Hypopnea

At least 4 obstructive apneas or hypopneas per hour of sleep, or evidence from polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep.
Apnea: absence of airflow, Hypopnea: reduction in airflow.

Central Sleep Apnea

Evidence by polysomnography of 5 or more central apneas per hour of sleep.
Cheyne-Stokes Breathing: an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.

Polysomnography demonstrates episodes of decreased respiration associated with elevated CO2 levels.

Circadian Rhythm Sleep-Wake Disorders

Persistent or recurrent pattern of sleep disruption due to alteration of the circadian system or misalignment between the endogenous circadian rhythm, leading to excessive sleepiness or insomnia, or both.

Non-REM Sleep Arousal Disorders

Incomplete awakening from sleep: sleepwalking or sleep terrors, cannot remember anything when they woke up, occurring mostly in childhood and non-rem sleeps, and producing rapid and complete awakening without confusion, amnesia, or motor activity.

Nightmare Disorder

Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity, occurring during REM sleep, and upon awakening, individuals become oriented and alert.
Appear in children exposed to acute or chronic psychosocial stressors.

REM Sleep Behavior Disorder

Repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors, occurring during REM sleep.

Sexual Dysfunctions

During REM sleep, upon awakening, the individual is completely awake, alert, and not confused.

Restless Legs Disorder

Urge to move the legs, usually accompanied or in response to uncomfortable and unpleasant sensations of the legs, during rests, sense of relief during movement, and worse in the evening, occurring 3x/week for at least 3 months.

Delayed Ejaculation

Delay or absence of ejaculation, associated with highly frequent masturbation, use of masturbation techniques not easily duplicated by a partner, and marked disparities between sexual fantasies during masturbation and the reality of sex with a partner, occurring at least 6 months.
Less coital activity, higher levels of relationship distress, sexual dissatisfaction, lower subjective arousal, anxiety about their sexual performance, and general health issues than sexually functional men.

Erectile Disorder

Difficulty having, maintaining an erection, and decrease in erectile rigidity, associated with low self-esteem, low self-confidence, and a decreased sense of masculinity, and may experience depressed mood, occurring at least 6 months.

Sexual Disorders

Female Sexual Interest/Arousal Disorder: absent/reduced interest in sexual activity, associated with problems in experiencing orgasm, pain experienced during sexual activity, infrequent sexual activity, couple-level discrepancies in desire, no sexual thoughts or fantasies, no initiation, no sexual excitement or pleasure during sex, distressing low desire associated with depression, thyroid problems, anxiety, urinary incontinence, and other medical factors.
Genito-Pelvic Pain/Penetration Disorder: difficulties in vaginal penetration during intercourse, vaginal pain during intercourse or penetration attempts, anxiety about anticipating vulvovaginal or pelvic pain.
Male Hypoactive Sexual Disorder: persistently deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity, sometimes associated with erectile and/or ejaculatory concerns.
Premature (Early) Ejaculation: ejaculation approx. 1 min following vaginal penetration or even before the individual wishes it, complain a sense of lack of control over ejaculation, and report apprehension about their anticipated inability to delay ejaculation on future sexual encounters.
Voyeuristic Disorder: intense arousal from observing an unsuspecting naked person for at least 6 months, nonconsensual, associated with childhood sexual abuses, substance misuse, sexual preoccupation/hypersexuality, and at least 18 yrs old.
Exhibitionistic Disorder: intense arousal from exposing genitals to an unsuspecting person for at least 6 months, nonconsensual.
Frotteuristic Disorder: intense arousal from touching or rubbing genitals against a nonconsenting person for at least 6 months, nonconsensual.
Sexual Masochism: intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer for at least 6 months.
Sexual Sadism: intense sexual arousal from the physical suffering of another person for at least 6 months.

Substance: chemical compounds that are ingested to alter mood or behavior.
Psychoactive substances: alter mood, behavior, or both.
Substance Use: ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.
Substance Intoxication: physiological reaction to ingested substances.
Substance Use Disorders: how much of a substance is ingested is problematic.
Physiological Dependence: meaning the use of increasingly greater amounts of the drug to experience the same effect (tolerance) and a negative physical response when the substance is no longer ingested (withdrawal).

Alcohol

Produced when certain yeast react with sugar and water, then fermentation takes place.
Depressant: inhibitions are reduced, and we become more outgoing, with more drinking, alcohol depresses the brain, which impedes the functioning.
Withdrawal Delirium (Delirium Tremens): condition that can produce frightening hallucinations and body tremors.
Breathalyzer: measures levels of intoxication.
GABA: seems to be particularly sensitive to alcohol.
The Glutamate system: involved in why alcohol affects our cognitive abilities.
Two types of organic brain syndromes: may result from long-term alcohol use, Dementia and Wernicke-Korsakoff Syndrome.
Fetal Alcohol Syndrome: a condition that affects the fetus.
Alcohol Dehydrogenase: metabolizes alcohol.
Korsakoff syndrome: a chronic memory disorder caused by a severe deficiency of thiamine (vitamin B-1).

Four-Stage Model for the Progression of Alcoholism

Pre-Alcoholic Stage: drinking occasionally with few serious consequences.
Prodromal Stage: drinking heavily but with few outward signs of a problem.
Crucial Stage: loss of control, with occasional binges.
Chronic Stage: primary daily activities involve getting and drinking alcohol.

Other Substances

Caffeine: most common psychoactive substance, a gentle stimulant.
Cannabis (Marijuana): reactions include mood swings or even dream-like experiences.
Hallucinogens: most common, LSD, produced synthetically in the laboratory.
Phencyclidine (PCP): is snorted, smoked, or injected intravenously, and it causes impulsivity and aggressiveness.
Inhalant: solvents, aerosol sprays, gases, nitrites, usually found at home or workplace.
Opioid: natural chemicals in the opium poppy that have a narcotic effect, relieves pain and induces sleep.
Sedative, Hypnotic, or Anxiolytic: calming, sleep-inducing, and anxiety-reducing.

Cocaine, Tobacco, and Alcohol

Cocaine: increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite.
Tobacco: contains nicotine and is linked with signs of negative affect such as depression, anxiety, and anger.
Acute alcohol withdrawal: can last 4-5 days and only occurs after an extended period of heavy drinking.

Gambling Disorder

Persistent and recurring gambling behavior: present for at least 12 months.
At least 4 symptoms within 12 months.
Gambling disorder onset: can occur during adolescence or young adulthood, but in other individuals, it may manifest during middle or even older adulthood.
Progression of gambling disorder: appears to be more rapid in women than in men.

Oppositional Defiant Disorder

Diagnosed when angry, irritable mood, argumentative/defiant behavior against authority figures: present for at least 6 months.
Other symptoms: annoys others, blames others for their mistakes.
Two of the most common co-occurring disorders: ADHD and CD.
Oppositional Defiant Disorder precedes: the development of conduct disorder.
Common in children: with the childhood-onset subtype.
Conveys risk: for the development of anxiety disorders and MDD.
Oppositional Defiant Disorder is linked: with an increased risk for a number of problems in adjustment as adults.
Less severe than CD: and does not include aggression toward people, property, or IED.

Int### Disruptive Mood Dysregulation Disorder (DMDD)

Diagnosis can only be made when recurrent problematic impulsive aggressive outbursts occur before age 10
First-time diagnosis should not be made after 18 years
Differentiated from ODD by broader array of provocations and physical assault
Co-morbid with depressive disorders, anxiety disorders, PTSD, Bulimia, Binge-eating, and substance use disorder

Conduct Disorder

Pattern of behavior violating basic rights of others or societal norms/rules
May include bullying, initiating fights, physical cruelty, destroying property, and theft
Onset may occur in preschool years, but first significant symptoms usually emerge during middle childhood to middle adolescence
ODD is the most common precursor to the childhood-onset type
Physically aggressive symptoms = childhood, nonaggressive symptoms = adolescence
May be diagnosed in adults, but onset is rare after age 16
Childhood-onset type predicts worse prognosis and increased risk of criminal behavior in adulthood
Both ODD and CD diagnoses can be given if criteria are met
Both ADHD and CD diagnoses can be given if criteria are met
Diagnosis requires substantial levels of aggressive or nonaggressive conduct problems during periods without mood disturbance
IED diagnosis is only given when recurrent impulsive aggressive outbursts warrant independent clinical attention

Pyromania

Purposeful fire setting on more than one occasion
Advance preparation for starting a fire
Arousal before the act, fascination with fire and situational context
Not done for monetary gain or other reasons
Separate diagnosis not given when fire setting occurs as part of CD, manic episode, or antisocial personality disorder

High Co-Occurrence

High co-occurrence of substance-use disorders, gambling, depressive, bipolar disorders, and other disruptive impulse-control and conduct disorders

Kleptomania

Failure to resist impulses to steal objects not needed for personal use
Attempt to resist the impulse, aware that the act is wrong and senseless
Increase tension before committing the theft
Pleasure after committing the theft
Often feels depressed or guilty about the thefts
Associated with compulsive buying, depressive, bipolar, anxiety, eating, personality, substance-use, and other disorders

Personality Disorders

Cluster A

Paranoid

Excessively mistrustful and suspicious of others without justification
Problems with close relationships
Overt argumentativeness, complaining, or hostile aloofness
Need for control over those around them
Rigid, critical of others, and unable to collaborate
More common among relatives with schizophrenia
Maybe due to early mistreatment or traumatic childhood experiences
Associated with prior history of childhood mistreatment, externalizing symptoms, bullying, and adult appearance of interpersonal aggression
"I cannot trust people"
Too much use of projection
Males = Females
May experience brief psychotic episodes
May develop MDD, Agoraphobia, and OCD

Schizoid

Difficulty expressing anger, even in response to direct provocation
Tendency to turn inward and away from the outside world
Childhood shyness is reported as a precursor to later personality disorder
"Relationships are messy and undesirable"
Males>Females
Sometimes experience brief psychotic episodes

Cluster B

Histrionic

Overly dramatic, almost like acting
Express emotions in an exaggerated manner
Characterized by social dominance
More likely to get divorced or never get married
Have a tendency to get bored with their usual routine
Histrionic and antisocial co-occur more often
"Ako ang bida"
Females>Males

Borderline

Unstable moods and relationships, poor self-image
Pattern of undermining themselves at the moment the goal is about to be realized
May feel more secure with transitional objects than interpersonal relationships
Often feel empty, at high risk of dying by their own hands
Often engage in suicidal behaviors
Turbulent relationships, fearing abandonment but lacking control over their emotions

Narcissistic

Consider themselves different from others, deserving special treatment
Unreasonable sense of self-importance, preoccupied with themselves, lacking sensitivity and compassion
Grandiosity
Very sensitive to criticism
Interpersonal relationships impaired due to self-preoccupation, entitlement, need for admiration, and disregard for others' sensitivities
"I am the greatest in the world"
Males>Females

Antisocial

History of failing to comply with social norms
At least 18 years of age
Evidence of CD before 15 years old
Irresponsible, impulsive, and deceitful
Lacking in conscience and empathy, selfishly taking what they want, violating social norms and expectations
CD will be given if the criteria for Antisocial PD is not met
Underarousal Hypothesis: psychopaths have abnormally low levels of cortical arousal
Fearlessness Hypothesis: psychopaths possess a higher threshold for experiencing fear than most other individuals
"I am entitled to break rules"
Males>Females
May experience dysphoria, including complaints of tension, inability to tolerate boredom, and depressed mood

Cluster C

Avoidant

Detachment from social relationships and limited range of emotions
Difficulty expressing anger, even in response to direct provocation, contributing to the impression of lacking emotion
Tendency to turn inward and away from the outside world
Childhood shyness is reported as a precursor to later personality disorder
"Relationships are messy and undesirable"
Males>Females
Sometimes experience brief psychotic episodes

Dependent

Rely on others to make ordinary and important decisions, due to unreasonable fear of abandonment
Characterized by pessimism and self-doubt, and tend to belittle their abilities and assets
Take criticism and disapproval as proof of their worthlessness, and lose faith in themselves
Agree with others' opinions just to avoid rejection
Feel uncomfortable or helpless when alone
"I need people to survive and be happy"
Females > Males

Obsessive-Compulsive

Perfectionist, fixated on details, and need to control
This preoccupation with details prevents them from completing much of anything
Need to control
When criteria for both OCD and OCPD are met, both diagnoses can be given
"I am a perfectionist; everything should be done under my control and liking"
Males > Females

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Learn about substance-related and addictive disorders, including psychoactive substances, substance use, intoxication, and substance use disorders. Understand the impact on social, educational, and occupational functioning.