01:830:364 Lecture Notes - Lecture 5: Generalized Anxiety Disorder, Social Anxiety Disorder, Posttraumatic Stress Disorder

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Genetics - alcohol use disorder runs in families, with 40%-60% of the variance of risk accounted for by genetic factors. The rate of this disorder is 3-4 times higher in close relatives of individuals with alcohol use disorder. The concordance rate for alcohol use disorder in monozygotic (identical) twins is significantly higher than in dizygotic (fraternal) twins. Highest vulnerability - preexisting schizophrenia or bipolar disorder, combined with low sensitivity to alcohol"s effects. Lowest vulnerability - acute alcohol-related skin flush (seen most predominantly in asians) indicates prevalence of virtually 0% The increase in da neurotransmission is due to opiate inhibition of gaba inhibition. Opiates such as beta endorphin inhibit gaba"s tonic inhibitory effect on da neurotransmission. Opiates substitute for alcohol. morphine reduces alcohol intake in alcohol abusers. Naltrexone, an opiate receptor antagonist, reduces urges and cravings for alcohol in some alcoholics (approximately 20%-25%), suggesting that in some alcoholics, opiate receptors mediate the desire to drink.

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