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Psych 257 Chap 11 Psych 257 Psychopathology Barlow et Al: Abnormal Psychology 2nd CDN edition Chapter 11

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Uzma Rehman

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Substance-Related Disorders
-abuse of drugs (ex. Alcohol, cocaine, heroin) taken to alter feelings, thinking etc.
-polysubstance use: multiple drugs
Perspectives on Substance-Related Disorders
-substance: chemical compounds ingested to alter mood/behavior; diff. levels of use
Levels of involvement
-use: moderate ingestion: don’t significantly interfere with social, educational, occupational functioning
-intoxication: physiological reaction, impaired judgment, mood changes, lowered motor ability
-abuse: depends on how significantly it interferes with user’s life
-substance dependence: physiologically dependent on drug; tolerance: ^ use required to produce same effect
-withdrawal: physically negative response if substance is no longer ingested;
-symptoms: delirium (hallucinations), tremors, chills, fever, nausea, aches and pains
-criteria for dependence: drug seeking behaviours: ex. Stealing money, standing in the cold to smoke etc.
-gambling: similar: show tolerance and withdrawal symptoms as well; same treatments for drug abuse may work
-can be dependent w/o abuse; ex. Cancer patients w/ morphine; some drugs easier to be addicted to
-ex. Nicotine, crack, meth most addictive; weed, MDMA, shrooms, LSD least addictive
Diagnostic Issues
-orig. substance use = symptom of other problems; now: subtypes of diagnoses for each substance
-unsure over directionality of substance use and other disorders (ex. Depression); maybe just due to prevalence
-ex. Alcohol -> ^ risk taking-> gambling; PTSD -> self-medication -> substance use
-rule: if symptoms of schizophrenia/anxiety appear during substance use/ w/n 6 weeks, must be due to drug
-5 groups of drugs: depressants, stimulants, opiates, hallucinogens, and other (ex. Airplane glue, steroids, NO)
-decrease CNS activity; help to relax; ex. Alcohol, insomnia sedatives; most likely -> dependence, tolerance, etc.
Alcohol Use Disorders
-description: initial stimulant effect; due to decreased inhibition; then motor coordination, reaction time, etc.
-effects: circulatory system distributes alcohol throughout body; affects number of diff. neuroreceptor systems
-ex. GABA system: inhibitory NT, alcohol use -> difficult for neurons to communicate, -> anti-anxiety
-memory loss, blackouts due to effect on glutamate system; mood, sleep, eating due to serotonin system effect
-pain numbing: due to effect on endogenous opioids release (body’s natural analgesic)
-withdrawal delirium: aka. Delirium Tremens (DT) hallucination/tremors; reduced w/ medical treatment
-briain damage: from alcohol dependence; may -> wernicke’s(unintelligible speech) or dementia (brain poison)
-fetal alcohol syndrome: from mothers drinking while pregnant: -> retardation, cognitive deficits, difficulties etc.
-statistics: 23% of CDNs exceed low-risk; 17 %=high risk; usu. more in men; 4x as much; varies across settings
-9% of all drinkers experience alcohol problems; 3% CDNs become alcohol dependent-> financial problems etc.
-progression: fluctuation b/w heavy, social, and abstinence; 20% of dependents have spontaneous remission
-dependence is progressive but abuse is not; in terms of violence; alcohol -> less fear of punishment
Sedative, hypnotic, or anxiolytic substance use disorders
-sedative: calming; hypnotic: sleep; anxiolytic: less anxiety; barbiturates: meant to replace alcohol, help sleep
-benzodiazepines: anti-anxiety; safer than barbiturates; less risk of abuse/dependence
-anxiolytics: potential for dependence; may also be used for other things; ex. Rohypnol (date-rape)
-description: barbiturates: low dose-> muscle relaxed, feeling well; high: slur, problem walking/concentration
-similar to alcohol: include maladaptive behavioural change; combining w/ other drugs -> synergy effect
-statistics: declining use of barbiturates, ^ benzodiazepines; ^ use of slowly eliminated benzo’s (higher risk)
-ex. Coffee, nicotine; make you more alert and energetic; ex Ma Huang: serious health problems (^ BP)
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