Podcast
Questions and Answers
What is the estimated heritability percentage for alcohol dependence?
What is the estimated heritability percentage for alcohol dependence?
50-60%
How did Cloninger's Stockholm Adoption Study contribute to understanding alcohol dependence?
How did Cloninger's Stockholm Adoption Study contribute to understanding alcohol dependence?
It identified traditional early-onset and nontraditional late-onset drinking patterns, highlighting the genetic and environmental influences on alcohol use.
What distinguishes Type 1 and Type 2 alcoholics according to Cloninger's Typology?
What distinguishes Type 1 and Type 2 alcoholics according to Cloninger's Typology?
Type 2 alcoholics have early and heavy drinking patterns, while Type 1 alcoholics have long periods without drinking followed by uncontrollable impulses to drink.
Which personality traits are associated with Type 2 alcoholics?
Which personality traits are associated with Type 2 alcoholics?
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What impact does family environment have on the drinking behavior of Type 2 alcoholics?
What impact does family environment have on the drinking behavior of Type 2 alcoholics?
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What is the relationship between chronic marijuana abuse and psychosis?
What is the relationship between chronic marijuana abuse and psychosis?
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How does tobacco use relate to the onset of schizophrenia?
How does tobacco use relate to the onset of schizophrenia?
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What is the significance of the BT+CMPT approach in autism treatment?
What is the significance of the BT+CMPT approach in autism treatment?
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Describe the typical age of onset for schizophrenia and its implications.
Describe the typical age of onset for schizophrenia and its implications.
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How did the diagnostic criteria for autism change from DSM-3 to DSM-4?
How did the diagnostic criteria for autism change from DSM-3 to DSM-4?
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What are the implications of the statement 'There is no autism epidemic'?
What are the implications of the statement 'There is no autism epidemic'?
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What is the estrogen hypothesis regarding schizophrenia in women?
What is the estrogen hypothesis regarding schizophrenia in women?
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How does socioeconomic status (SES) affect schizophrenia?
How does socioeconomic status (SES) affect schizophrenia?
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What are some examples of persistent deficits in social communication according to DSM-5?
What are some examples of persistent deficits in social communication according to DSM-5?
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Why are Black Americans diagnosed with schizophrenia at higher rates compared to other ethnic groups?
Why are Black Americans diagnosed with schizophrenia at higher rates compared to other ethnic groups?
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Why is the term 'facilitated communication' considered controversial in the context of autism?
Why is the term 'facilitated communication' considered controversial in the context of autism?
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What criteria must be met for a diagnosis of Restricted, Repetitive Patterns of Behavior in autism?
What criteria must be met for a diagnosis of Restricted, Repetitive Patterns of Behavior in autism?
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What impact does early substance use have on schizophrenia?
What impact does early substance use have on schizophrenia?
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What are some social consequences of schizophrenia?
What are some social consequences of schizophrenia?
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What does the term 'early developmental symptoms' imply in the context of autism diagnosis?
What does the term 'early developmental symptoms' imply in the context of autism diagnosis?
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How has the language in the DSM criteria impacted autism diagnosis?
How has the language in the DSM criteria impacted autism diagnosis?
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What compensatory effect does the brain produce in response to excess chemical release during substance use?
What compensatory effect does the brain produce in response to excess chemical release during substance use?
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In classical conditioning with morphine, what is the Unconditioned Stimulus (UCS) and what is its corresponding Unconditioned Response (UCR)?
In classical conditioning with morphine, what is the Unconditioned Stimulus (UCS) and what is its corresponding Unconditioned Response (UCR)?
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What role does conditioned stimulus (CS) play in the context of morphine use and pain sensitivity?
What role does conditioned stimulus (CS) play in the context of morphine use and pain sensitivity?
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Explain why overdoses are more likely to occur in novel environments.
Explain why overdoses are more likely to occur in novel environments.
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Describe the pathway that characterizes substance use leading to substance use disorder (SUD).
Describe the pathway that characterizes substance use leading to substance use disorder (SUD).
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Identify two types of influences that contribute to substance use disorder.
Identify two types of influences that contribute to substance use disorder.
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What critical behavior must be explained regarding substance use disorder and individual drug use?
What critical behavior must be explained regarding substance use disorder and individual drug use?
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How does cultural context affect attitudes towards alcohol consumption in different countries?
How does cultural context affect attitudes towards alcohol consumption in different countries?
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What are positive symptoms of schizophrenia?
What are positive symptoms of schizophrenia?
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How do positive symptoms differ from negative symptoms in schizophrenia?
How do positive symptoms differ from negative symptoms in schizophrenia?
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What is a common characteristic of delusions in schizophrenia?
What is a common characteristic of delusions in schizophrenia?
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What percentage of schizophrenia patients typically experience auditory hallucinations?
What percentage of schizophrenia patients typically experience auditory hallucinations?
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Name one type of negative symptom in schizophrenia.
Name one type of negative symptom in schizophrenia.
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Describe what is meant by 'bizarre behavior' in the context of positive symptoms.
Describe what is meant by 'bizarre behavior' in the context of positive symptoms.
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How has the DSM-III contributed to diagnosing schizophrenia symptoms?
How has the DSM-III contributed to diagnosing schizophrenia symptoms?
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What is the most common type of hallucination experienced by schizophrenia patients?
What is the most common type of hallucination experienced by schizophrenia patients?
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What effect do medications typically have on positive symptoms of schizophrenia?
What effect do medications typically have on positive symptoms of schizophrenia?
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What characterizes catatonic behavior in schizophrenia?
What characterizes catatonic behavior in schizophrenia?
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What is the primary purpose of antagonist treatment in addiction recovery?
What is the primary purpose of antagonist treatment in addiction recovery?
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Why is it crucial for individuals using Naltrexone to be highly motivated?
Why is it crucial for individuals using Naltrexone to be highly motivated?
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How does Acamprosate function in managing withdrawal symptoms?
How does Acamprosate function in managing withdrawal symptoms?
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What is a core principle of Alcoholics Anonymous (AA)?
What is a core principle of Alcoholics Anonymous (AA)?
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What role does social support play in the Alcoholics Anonymous approach?
What role does social support play in the Alcoholics Anonymous approach?
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What is the goal of the harm reduction movement in addressing drug use?
What is the goal of the harm reduction movement in addressing drug use?
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Describe one advantage of the controlled use approach.
Describe one advantage of the controlled use approach.
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What does the harm reduction movement contrast with in terms of addiction policy?
What does the harm reduction movement contrast with in terms of addiction policy?
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In what way does AA's lack of enforced confidentiality affect its members?
In what way does AA's lack of enforced confidentiality affect its members?
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What criticism exists regarding the sex bias in Alcoholics Anonymous?
What criticism exists regarding the sex bias in Alcoholics Anonymous?
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Study Notes
General Treatment Issues
- Recognizing America's Drug Problem
- Common issue: Denial
- Failure to recognize a problem until it destroys their lives
- Especially common for substance use disorders (SUDs)
- Leads to reluctance in seeking help (unless mandated).
- Withdrawal Challenges
- Symptoms, detoxification, cravings—high-risk periods of 18 months
- Intense cravings and withdrawal symptoms
- Overpowering cravings and access to the substance makes relapse highly likely
- High rate of relapse during the withdrawal period.
- Seeking Treatment
- Importance of personal motivation
- Old thinking: needing to hit rock bottom
- New thinking: help can be provided earlier to help prevent this issue.
Psychopharmacological Treatment
- Marked as anti-craving drugs, but not a magical pill
- Combined with therapy
- Aversive Treatment (e.g., Disulfiram [Antabuse])
- Prevents breakdown of acetaldehyde: causes unpleasant effects when drinking
- Dizziness, sweating, rapid heartbeat.
- Agonist Substitution (e.g., Methadone)
- Mimics opioid effects to reduce cravings; slower, less intense high.
- Has sedative effects to curb cravings for heroin, but it's addictive.
- Antagonist Treatment (e.g., Naltrexone)
- Blocks the effects of the drug (like heroin or alcohol)
- Prevents euphoria from these drugs
- Theoretically reduces cravings.
Community-Based Approach
- Alcoholics Anonymous (AA)
- Core principle: disease model, powerlessness, spirituality.
- First step: admitting powerlessness over the substance/alcohol
- Sex bias: disproportionate number of male members
- Social support: crucial component based on anonymity.
- Normalization: emphasizes togetherness to combat this mental health issue
- Harm Reduction Movement
- Goal: reduce public health risk and potential harm from substance use
- Examples: needle exchange, methadone maintenance, and safe use campaigns.
Controlled Drinking (CD)
- Techniques (e.g., Problem-solving training, moderation skills)
- Monitoring internal cues, simulated drinking practice
- Training in these skills: can help address severe abuse in a limited manner
- Positive findings using controlled drinking (in labs) but inconsistent long-term results.
- Results in some cases show that controlled drinking is a potentially useful treatment but not in all cases.
Relapse Prevention & Cognitive Behavioral Therapy (CBT)
- Underlying dysfunctional psychological mechanism
- Faulty/maladaptive learning + thinking
- Positive expectancies + Abstinence Violation Effect:
- Distorted thinking patterns e.g. "I can't drink like I used to"
- Identifying distortions
- Strategies to change maladaptive patterns
- High-Risk Situations & Coping Strategies
- Develop problem-solving techniques and coping skills.
Alternative Community-Based Approaches
- Examples: Rational Recovery (RR), Self-Management & Recovery Training (SMART), Moderation Management (MM), Moderatedrinking.com (MD)
- Resource: SAMHSA's National Helpline
The Challenge of Clinical Work with Children
- Key issues
- Complexity of cases
- Age-out of problems
- Larger number of disorders (other than personality disorders) experienced
- Assessment issues
- Limitations of self-reports, developmental level (vocabulary / complexity).
- Importance of multi-mode assessments (multiple reporters, multiple tools).
- Critical diagnostic process
DSM Limitations for Children
- Lacks sensitivity to childhood differences
- OCD, SAD, PTSD - differs in manifestation & expression between adults and children
- No change in duration, feeling of detachment as a symptom for children in the DSM (different from adults)
- Symptom presentations (e.g. PTSD) are different in children than in adults
- No formal criteria, nor subtypes (e.g. PDD) for childhood mood disorders
- Criteria for disorders have been modified to better capture and understand their presentations, including considering family history and other traits specific to childhood.
Pediatric Bipolar Disorder (PBD)
- Diagnosis: Same as adults.
- Prevalence: Rare, increased office visits, hospitalizations under 12.
- 40% increase in office visits (1990s compared to now)
- 50% of children experiencing it for over 2 years; a high rate of diagnosis.
Disruptive Mood Dysregulation Disorder (DMDD)
- Criteria: "Severe" recurrent temper outbursts, grossly out of proportion to the situation.
Childhood Major Depression
- Prevalence: Less than 5% in general to 35% at 19 years
- Disorder course
- Average major depressive episodes lasts ~8 months
- 90% recover in 2 years
- 70% within 5 years.
- High comorbidity: 30-95%
- Mood disorders (e.g., bipolar disorder).
- Anxiety disorders.
- Conduct disorder.
- Etiology
- Temperament has a crucial role in this disorder
- Negative emotionality is related to depression/anxiety and low positive emotionality
- Early parental loss is associated with later onset depression, especially in young children
General Child Treatment Issues
- Contextual factors
- Children's functioning within contexts.
Childhood Depression Treatment
- Dealing with skill deficits.
- Promising approaches, including CBT, IPT (interpersonal therapy), family therapy, SSRIs.
- Challenges with pharmacotherapy
- Biological differences; need for appropriate child-specific dosing.
- Side effects, developmental impact.
- Treatment needs to focus on parents, teachers, and daycare providers.
Antidepressant Controversy
- Paxil vs placebo
- Increase in suicidality rates with Paxil (3.4%) compared to placebo (1.2%)
- FDA Black Box Warnings _ Change in prescription rate post-warning.
- Current Recommendations _Prozac is the only SSRI approved for use in children/adolescents.
The Antidepressant Controversy
- Continued interest in efficacy and safety of antidepressants in children.
- Ongoing research efforts to better understand and treat childhood disorders.
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Description
Explore key issues surrounding substance use disorders, including denial and withdrawal challenges. The quiz also covers the importance of seeking treatment and examines psychopharmacological options. Gain insights into the complexities of treatment and recovery.