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Lecture 8

PSYC 465 Lecture 8: PSYC 361 Lecture 8

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PSYC 465

PSYC 361 Lecture 8 Abnormal Psychology Substance-Related and Addictive Disorders • Substance Use vs. Disorder o According to DSM-5 ▪ Substance Use - • Low to moderate use that does not lead to social, educational, or work-related problems ▪ Substance Use Disorder - • Pattern of use leading to serious social/legal/interpersonal problems • Continued use despite problems • Can include physiological (tolerance/withdrawal) and/or psychological dependence • Includes 10 separate classes of drugs ▪ At least 2 sx’s within 12 month period ▪ There are 10 listed substances in the DSM • Ex. Alcohol Use Disorder o Criteria (at least 2 or more sx’s) ▪ Impaired control criteria • Take more than intended, unsuccessful efforts to cut down • Great deal of time spent drinking or trying to obtain alcohol • Craving, or strong desire to use ▪ Social Impairment Criteria • Recurrent use result in failure to fulfill obligations, missing importation events • Use continues despite persistent social/interpersonal problems ▪ Risky use Criteria • Recurrent use in situations where it may be dangerous • Use continued despite knowing of physical/psychological problem caused by alcohol ▪ Pharmacological Criteria • Tolerance – need for increased amounts in order to obtain desired effect or a diminished effect from the usual dose • Withdrawal – intense discomfort or sickness when stop, or drinks to avoid o E.g., Shaking, vomiting, headache, sweats, pains • Examples of “Licit” and “Illicit” Substances o Caffeine ▪ CNS stimulant, no dx in the DSM-5 • But not without its problems o Nicotine ▪ Both stimulant and sedative, highly addictive • Dopamine (DA) release o CNS Stimulants ▪ Cocaine and amphetamines – DA release • MDMA (serotonin and oxytocin) o Oxytocin is naturally released during pregnancy and breast feeding o CNS Depressants ▪ GABA agonists • GABA inhibits the CNS, reduces activity in the brain ▪ Alcohol, Sedatives : barbiturates, benzodiazepines (i.e., Valium, Xanax) o Opioids ▪ Pain modulation (e.g., endorphins = endogenous opioids) ▪ DA release; for both sedatives and opioids, tolerance develops rapidly – easy addictive ▪ Considered a crisis in MD – opioid related deaths have doubled in past year o Marijuana ▪ THC – agonist at receptors for endogenous cannabinoids – DA release ▪ Tolerance and withdrawal are possible • Sx’s include anxiety, depression, irritability, insomnia, psychological addiction ▪ Can impair cognition and lead to memory problems ▪ Medicinal uses? o Hallucinogens ▪ E.g., LSD, mushrooms ▪ Not physically addictive, but can trigger panic/psychosis (also true for marijuana) • Epidemiology o Prevalence Rates ▪ 8.9% past-year US adults (12+) ▪ Alcoholism : 13.3% lifetime, 4.4% past-year ▪ Men > women (first one!) • But may have to do with types of problems assessed, or access to tx o Alcohol alone causes 88,000 deaths per year, increase risk for >60 disease (e.g. esophageal/liver cancer, seizures) o Ethnicity Considerations ▪ Whites and Native Americans have > risk of alcohol use dx ▪ But Native Americans, Hispanics, and Blacks experience more severe negative consequences • Expensive tx, cannot
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