Abnormal Psych Chapter 11 Part 2

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most important risk factors for alcoholism among adolescents

experimentation, parental modeling, alcoholic parents, high negative affect in the home, girls w/ male friends

T/F: expectations play a large role in drug response

True

most important factor leading to drug addiction

exposure to drug

stages of alcoholism

1. initiation & continuation
2. escalation and transition to abuse
3. development of tolerance & withdrawal

results from twin adoption studies on alcoholism

higher concordace rates for alcohol depedence were found in MZ twins vs DZ twins, both male & female
The offspring of alcoholic parents who are reared by nonalcoholic adoptive parents are more likely than people in the general population to develop drinking problems of their own.
manner in which genetic and envionmental events combie proably differs from one type of alcoholism to another

factors that determine who will develop drug problems

dependence requires continued use and is influenced by the manner in which the drug is consumed

influences on drug use

initial experimentation is most likely to occur in ppl who are rebellious and extroverted and whose parents and peers model or encourage use

T/F: adolescents with alcoholic parents are more likely to drink

True. could be b/c of several reasons:
1. alcoholic parents monitor their children's behavior less --> more opportunities
2. higher parental monitoring associated with reduced risk of tabacco and alcohol use

alcoholic families

level of negative affect is also relatively high in the families of alcoholic parents

genetics & alcoholism

lifetime prevalece of alcoholism among parents, siblings, and children of ppl with alcoholism is at least 3-5 times higher than in gen. pop.
2/3 of variance in risk for alcoholism produced by genetic factors

race & alcoholism

asians are less tolerant of alcohol, skin becomes flushed ("asian glow" lol). not as much alcoholism with asians

genes that influence alcohol dependence

ADh and ALDH genes are involved the the metabolism of alcohol

type 1 alcoholism

1. • Type 1:
1. Later onset
2. Prominent psychological dependence
3. Absence of antisocial personality traits
4. Present in both men and women

reinforcing properties of drugs and alcohol

Dopamine and Reward pathway »People may become dependent on psychoactive drugs because they stimulate areas of the brain that are known as "reward pathways."
• Medial forebrain bundle
» This may be a "final common denominator"
Natural rewards like food and sex increase dopamine in "mesolimbic dopamine pathway"

alcohol and neurotransmitters

affects several diff types of neurotransmitters: may stimulate mesolimbic dopamine pathway directly or act indirectly be decrasing the activity of GABA neurons (which normally inhibit dopamine neurons)

endorphins

• Endorphins - endogenous endorphins, short chains of amino acids, or
neuropeptides.
» Appear to be important in the activities associated with systems that control pain, emotion, stress, and reward.
- It is theorized that alcoholism is associated with activation of this system in response to alcohol.
appear to be impt in activities associated with systems that control pain, emotion, stress, and reward
some theorists associate alcoholism with exaggerated activation of the endogenous opiooid system in response to alcohol stimulation

animal studies & endorphins

lab animals can develop tolerance to injections of endorphins, just like morphine, also exhibit symptoms of withdrawal

tension-reduction hypothesis

- Avoiding or reducing unpleasant stress
--the relation b/t stress and acohol has turned out to be more complex than this theory suggests

balanced placebo design

allows investigator to separate the direct, biological effects of the drug from the subjects' expectations about how the drug should affect their behavior. results indicated that expectations can account for many effects that have been attributed to drug itself

Expectations About Drug Effects

- Longitudinal studies: adolescents who are just beginning to experiment with alcohol and who initially have the most positive expectations about the effects of alcohol go on to consume greater amounts of alcoholic beverages.
- Expectations play a role in the onset of the problem
rather than being consequences of heavy drinking.
• Substance abuse disorders are a huge strain on society

detoxification

the removal of a drug on which a person has become dependent - usually takes 3 to 6 weeks.
extremely difficult
depressants are stopped gradually, but stimulants can be stopped abruptly
ppl are usually given medication to minimize withdrawal symptoms

treatment: agonist stubstitution

• Agonists substitution
○ Safe drug with a similar chemical composition as the abused drug
○ Examples include methadone for heroin addiction, and nicotine gum or patch

debate over controlled use vs complete abstinence as treatment goals

• Inpatient vs. Outpatient Care
- Data suggest little difference in terms of overall
effectiveness
• Community Support Programs
- Alcoholics Anonymous and related groups

Psychosocial Treatment: Components of Comprehensive Treatment and Prevention Programs

- Individual and group therapy
- Aversion therapy and covert sensitization
- Contingency management
- Community reinforcement
- Relapse prevention
- Preventative efforts via education

Project MATCH: 3 forms of psychological treatment and best predictor of long-term outcome

1. cognitive behavior therapy
2. 12-step facilitation therapy
3. motivational enhancement therapy
long term outcome is best predicted by the person's coping resources, social support

relapse prevention model

addresses issues that confront th addict in trying to deal with the challenges of life w/o drugs. emphasizes increasing people's belief that they can control their own behavior/events in life

abstinence violation effect; relapse prevention view

the guilt and perceived loss of control that the person feels whenever he/she uses drugs or drinks alcohol. relapse prevention teaches patients to expect occasional slips and to look at them as temporary rather than total and permanent

type 2 alcoholism

2. 1. Type 2:
1. Earlier onset
2. Co-occurrence with antisocial traits
3. Present primarily in men

treatment: antagonist treatment

• Antagonistic Treatment
○ Drugs that block or counteract the posititve effects of substances
○ Examples include naltrexone for opiate and alcohol problems

treatment: aversive therapy

• Aversive Treatment
- Drugs that make the ingestion of abused substances extremely unpleasant
- Examples include antabuse for alcoholism and silver nitrate for nicotine addiction
• Efficacy of Biological Treatment
- Such treatments are generally not effective when used alone
SSRI's are also used for alcoholism

self help groups and AA

• Self-Help Groups and Alcoholics Anonymous
Fundamentally spiritual
• The original12-step program
complete abstinence is the goal
• Difficult to evaluate its efficacy.
- Long-term follow-up difficult and you can't use traditional clinical methods of research; early dropout is common
• Appears to help people, it is not clear how it helps, or why
could be b/c its a stable social network that discourages rather than encourages use of drugs

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