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Lecture 10

Psychology 2030A/B Lecture Notes - Tegmentum, Mental Disorder, Inhalant
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by OneClass501368 , Fall 2017
11 Pages
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Department
Psychology
Course Code
Psychology 2030A/B
Professor
Bruce Morrison
Lecture
10

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1
Chapter 10 - Substance-Related Disorders
Perspectives on Substance-Related Disorders
Danny, who has poly substance use (use of multiple mood-and behavior altering substances) broke into a
gas station and stole money. He smokes and drinks beer with his friends. He drinks until he gets drunk, and
also experimented with other drugs; he attended college and failed most of his courses. He rarely held a job
for more than a few months. He needed help and planned to check into an alcohol rehab centre, he still
would not admit to using other drugs. Danny later resumed his drinking and using drugs and was arrested
for robbing the place where he worked.
Levels of involvement
Substance refers to chemical compounds that re ingested to alter mood or behavior
Psychoactive substances- Which alter mood and/or behavior to become intoxicated or high, to abuse
these substances, and become dependent on or addicted to them.
Substance Use
The ingestion of psychoactive substances in moderate amounts that does not significantly interfere with
social, educational, or occupational functioning
Intoxication
Our physiological reaction to ingested substancesdrunkenness or getting highis referred to as
substance intoxication. Ex: mood changes, lowered motor ability
Substance Abuse
DSM-IV-TR defines substance abuse in terms of how significantly it interferes with the user’s life. Ex: if it
disrupts your education, if you have related legal problems, you would be considered a drug abuser.
Danny’s use of multiple substances—would classify him as drug dependent, which indicates a severe form
of the disorder.
Substance dependence
Drug dependence is usually described as addiction. Maladaptive pattern of substance use characterized by
the need for increased amounts to achieve the desired effect, negative physical effects when the substance
is withdrawn, unsuccessful efforts to control its use, and substantial effort expended to seek it or recover
from its effects
Tolerance- Need for increased amounts of substance to achieve the desired effect, and diminished effect
with continued use of the same amount
Withdrawal- severely negative physiological reaction to removal of a psychoactive substance which can be
alleviated by the same or similar substance
Alcohol withdrawal delirium is where a person can experience frightening hallucinations and body tremors.
The DSM-IV-TR definition of substance dependence combines the physiological aspects of tolerance and
withdrawal with the behavioral and psychological aspects
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2
Problematic forms of gambling behavior, now classified as “pathological gambling” in the “Impulsive Control
Disorders” (disorders that deprive a person of the ability to resist acting on a drive or temptation) section of
DSM-IV-TR share much in common with substance dependence and should be recategorized as “an
addiction without the drug”.
It may seem counterintuitive, but dependence can be present without abuse
Diagnostic Issues
In early editions of the DSM, alcoholism and drug abuse weren’t treated as disorders; they were categorized
as sociopathic personality disturbances, because substance use was seen as a symptom of other problems
DSM-IV-TR term substance-related disorders indicates several subtypes of diagnoses for each substance,
including dependence, abuse, intoxication, and/withdrawal.
Easy to get hooked on hard to get off drugs- Top 3:
1) Nicotine
2) Ice, Glass
3) Crack
Almost three-quarters of the people with alcohol disorders have an additional psychiatric disorder such as
depression, antisocial personality disorder, or bipolar disorder
Alcohol disorders were found to be highly co morbid with mood and anxiety disorders
Substance use disorder might occur concurrently with other disorders for several reasons:
1) Substance related disorders and anxiety and mood disorders are highly prevalent in our society
and may occur together so often just by chance
2) Drug intoxication and withdrawal can cause symptoms of anxiety, depression, and psychosis, and
increase risk taking
3) Alcohol’s effects in increasing risk taking may contribute to high co-occurrence of alcohol and
gambling disorders. The mental health disorder causes the substance use disorder.
Focus on 5 substances:
1) Depressants- these substances result in behavioral sedation and can induce relaxation. Ex:
alcohol, and anxiolytic drugs in the families of barbiturates and benzodiazepines
Depressants primarily decrease central nervous system activity; it reduces our levels of
physiological arousal and helps us relax.
Alcohol Use Disorders
The Temperance Movement allowed for the benefits of moderate drinking while morally
condemning the heavy use of spirits
The work of the Temperance Movement proponents paved the way for the American prohibition
Clinical Description
Although alcohol is a depressant, its initial effect is an apparent stimulation
Our inhibitions are reduced, and we become more outgoing
Effects
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Alcohol effects many parts of the body
Stomach (where small amounts are absorbed), small intestines, bloodstream, circulatory system
including the heart, some alcohol goes to the lungs (breath analyzer measures levels of
intoxication), liver
Alcohol influences a number of different neuro-receptor systems
GABA- inhibitory neurotransmitter
Alcohol makes it harder for neurons to communicate with each other
Glutamate system is excitatory which helps neurons to fire. It is suspected to be involved in
learning and memory
Blackouts, the loss of memory for what happens during intoxication, may result from the interaction
of alcohol with the glutamate system
Serotonin system affects mood, sleep, and eating behavior and is thought to be responsible for
alcoholic cravings
The dopamine reward system is responsible for the pleasurable feelings people experience
Certain doses, alcohol also results in release of endogenous opioidsour bodies naturally
occurring analgesicswhich may explain why alcohol has pain numbing effects
Withdrawal from chronic alcohol use includes hand tremors and, within several hours, nausea or
vomiting, anxiety, transient hallucinations, insomnia and withdrawal delirium- causes frightening
hallucinations and body tremors that result when a heavy drinker withdraws from alcohol
2 types of organic brain syndromes may result from the long-term heavy alcohol use:
1) Dementia- general loss of intellectual abilities and can be a direct result of neurotoxicity or
“poisoning of the brain”
2) Wernicke’s disease- results in confusion, loss of muscle coordination, and unintelligible speech,
caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers.
Fetal alcohol syndrome (FAS) pattern of problems including learning difficulties, behavior deficits, and
characteristic physical flaws, resulting from heavy drinking by the victim’s mother when she was pregnant
with the victim
Reduced consumption may reflect increased public awareness of the health risks associated with
alcohol use and abuse
Men are more likely than women to drink alcohol and are also more likely to drink heavily
Found that 16% of adult men were classified as heavy drinkers compared with only 4% of adult
women
Statistics on Abuse and Dependence
Researchers estimate that about 10% of Canadian drinkers experience some level of problems
with alcohol with about 3% of Canadian adults thought to be alcohol dependent in any given year
About 20% of people with severe alcohol dependence have a spontaneous remission and do not
re-experience problems with drinking
Alcoholism will get progressively worse if left unchecked
Alcohol dependence may be progressive for most people, although the course of alcohol abuse
may be more variable
Drinking at an early agefrom ages 11 to 14-was predictive of later alcohol use disorders
Statistics show alcohol does not increase aggression but it may increase a person’s likelihood of
engaging in impulsive acts and it may impair the ability to consider the consequences of acting
impulsively.
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Description
1 Chapter 10 SubstanceRelated Disorders Perspectives on SubstanceRelated Disorders Danny, who has poly substance use (use of multiple moodand behavior altering substances) broke into a gas station and stole money. He smokes and drinks beer with his friends. He drinks until he gets drunk, and also experimented with other drugs; he attended college and failed most of his courses. He rarely held a job for more than a few months. He needed help and planned to check into an alcohol rehab centre, he still would not admit to using other drugs. Danny later resumed his drinking and using drugs and was arrested for robbing the place where he worked. Levels of involvement Substance refers to chemical compounds that re ingested to alter mood or behavior Psychoactive substances Which alter mood andor behavior to become intoxicated or high, to abuse these substances, and become dependent on or addicted to them. Substance Use The ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning Intoxication Our physiological reaction to ingested substancesdrunkenness or getting highis referred to as substance intoxication. Ex: mood changes, lowered motor ability Substance Abuse DSMIVTR defines substance abuse in terms of how significantly it interferes with the users life. Ex: if it disrupts your education, if you have related legal problems, you would be considered a drug abuser. Dannys use of multiple substanceswould classify him as drug dependent, which indicates a severe form of the disorder. Substance dependence Drug dependence is usually described as addiction. Maladaptive pattern of substance use characterized by the need for increased amounts to achieve the desired effect, negative physical effects when the substance is withdrawn, unsuccessful efforts to control its use, and substantial effort expended to seek it or recover from its effects Tolerance Need for increased amounts of substance to achieve the desired effect, and diminished effect with continued use of the same amount Withdrawal severely negative physiological reaction to removal of a psychoactive substance which can be alleviated by the same or similar substance Alcohol withdrawal delirium is where a person can experience frightening hallucinations and body tremors. The DSMIVTR definition of substance dependence combines the physiological aspects of tolerance and withdrawal with the behavioral and psychological aspects
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