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PSYC 245 Final, Lecture 17
Terms in this set (24)
Why haven't psychologists usually cared about substance abuse disorders?
1. Not seen as a "psychological problem"
2. Separation of Mental Health and Substance Abuse Services.
3. Other health care providers are traditionally primary counselors.
4. Common exclusion criteria for treatment outcome studies.
% of 12th graders that have ever used alcohol
% of 12th graders that have ever used marijuana
% of 12th graders that have ever used cigarettes
Substance abuse peaks between ages of...
18 and 20.
Rates of overall use is ______ but rate of substance abuse is _______
People who start drinking prior to age 15 are ____ times more likely to have alcohol problems later on in life
___ out of 10 teenage automobile accidents involve the use of alcohol.
Suicide attempts among heavy drinking adolescents are __ to ___ times greater than among abstainers.
Alcohol use leads too...
Memory impairment and smaller hippocampal volume in teens who began drinking at any age.
Consequences of adolescent substance use
1. Compromised cognitive functioning in college.
2. Increased rates of internalizing disorders in adulthood.
3. Problematic alcohol use during adolescence predicts adulthood depression and antisocial personality disorder.
4. Marijuana use during adolescence is related to suicidal ideation and attempts as well as criminal involvement.
5. Even with empirically-supported treatments, the course of recovery from alcohol related problems is marked by chronic relapse.
According to DSM IV, what constitutes a problem? (1)
Maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12 month period.
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
2. Recurrent substance use in situations in which it is physically hazardous.
3. Recurrent substance-related legal problems.
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substances.
According to DSM IV, what constitutes a problem? (2)
Maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by 3 or more of the following occurring at any time in the same 12 month period.
3. Substance is often taken in larger amounts or over a longer period than was intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance abuse.
7. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
Genetic theory reasoning for substance abuse
Relatives of people with a SUD are eight times more likely to have a SUD.
Higher Reward Sensitivity Theory of SUD
In general, people that suffer from a SUD are more reinforced by rewards; children of problem-drinkers are more reinforced by the effects of alcohol.
Social Learning Theory
Modeling by parents or peers leads to abuse.
Multifinality of a risk factor
Means that a particular risk may lead to different outcomes across development.
Equifinality of a risk factor
A number of different pathways may lead to same outcome.
Vulnerabilities for Alcohol use disorders before age 5
1. Difficult temperament.
2. Elevated internalizing (anxiety, depression) by age 2.
3. Elevated externalizing (conduct problems, aggression) by age 2.
4. Lower social competence, particularly in girls.
5. Greater knowledge about alcohol.
6. Challenging family contexts.
A. Greater stressful life events like abuse and violence
B. More feeding difficulties and less maternal response to crying (with substance using mothers)
C. Lower parental sensitivity, greater parental aggravation with infant and less secure attachment (assessed at or before age 3)
Two paths to alcoholism
Antisocial (externalizing) and depressive (internalizing). More research as been done on antisocial, externalizing.
External Pathway to AUD
Neurobiological Dysregulation --> Emotional and Behavioral Dysregulation (difficult temperament) --> Externalizing with or without internalizing disturbance --> ATOD use --> Antisocial behavior or DSM antisocial personality disorder --> SUD
Those with internalizing pathway to SUD usually have a _____ temperament
inhibited. And they use substances to cope with problems like interpersonal skill deficits, persistent internalizing symptoms, as well as often simply having positive beliefs about alcohol and drugs.
Family stories program
Targets parents and children 2-6. It aims to bolster support in the family context so support child's emotional regulation in order to prevent later substance abuse.
Teaches parents behavior management, including comm skills, and anger management.
More about internalizing pathways during adolescence
Self-medication during this period is common and is associated with heavy alcohol abuse.
Peer context becomes more important in adolescence,and teenagers may be more vulnerable to increases in negative affect, but thye lack the neurobiological systems to regulate changes in affect and may seek maladaptive coping methods.
Likewise, they often have positive expectancies about the effects of drugs and alcohol.
Some animal research indicates that alcohol is more socially facilitative in adolescent rats compared to adult rats.
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