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1. Aging involves inexorable cognitive decline: This is misleading, as severe cognitive problem generally do not occur for most; mild cognitive declines are common
2. Older adults are unhappy: In fact, older adults are more skilled at emotional regulation and attend more to positive emotions. They also tend to display less psychophysiological response to negative emotion
3. Late life is a lonely time: Interests shift away from seeking new social interactions to cultivating a few close friendships (social selectivity)
2. Older adults are unhappy: In fact, older adults are more skilled at emotional regulation and attend more to positive emotions. They also tend to display less psychophysiological response to negative emotion
3. Late life is a lonely time: Interests shift away from seeking new social interactions to cultivating a few close friendships (social selectivity)
What are seven common problems experienced in late life?1. Physical decline and disabilities
2. Sensory acuity deficits
3. Loss of loved ones
4. Social stress of stigmatizing attitudes towards the elderly
5. Cumulative effects of lifetime stressors
6. Decline in quality and depth of sleep
7. PolypharmacyWhat is polypharmacy?Polypharmacy is the phenomenon of prescribing multiple drugs to a personDiscuss the prevalence of polypharmacy among the elderly. What is a potential problem with this?40% of elderly people are prescribed at least 5 medications ; this is potentially problematic, as it increases the risk of adverse drug reactionsDiscuss the findings related to the effects of polypharmacy among the elderly as shown by the Agency for Healthcare Research and QualityThey found that more than 1/5 of the elderly have been prescribed medications deemed inappropriate for people over the age of 65 due to serious side effectsHow is drug testing bias toward younger people?Most drug research is conducted on younger people, which is potentially problematic, as it could mean a lack of information on how these drugs affect the elderlyDefine age effects and provide an exampleThe effects of being a certain age, e.g., being old enough to receive Social SecurityDefine cohort effects and provide an exampleCohort effects are the effects of having grown up during a particular time period; e.g., frugality may be increased among those who lived through the Great Depression of the 1930sDefine time-of-measurement effects and provide an exampleTime-of-measurment effects are the effects of testing people at a particular time in history; e.g., people became franker during the 1990s in their responses to survey about their sexual behavior, as media discussion of sexuality increasedWhat are the two major research designs used to assess developmental change?1. Cross-sectional studies
2. Longitudinal studiesDefine cross-sectional research designs and a problem associated with these studiesIn cross-sectional studies, a researcher compares different age groups at the same point in time on a variable of interest. This design fails to provide information about how people change over timeDefine longitudinal research designs and a problem associated with these studiesIn longitudinal studies, researchers retest the same group of people with the same measurements at different points in time (may extend over several years or decades). A down side of this study design is that attrition can lead to biased samples.What are two ways in which attrition can create a biased sample in longitudinal studies. Describe each1. Selective mortality: people are no longer available for follow-up because of death during the course of the study. This creates a particular form of bias in that results obtained with the remaining sample are more relevant to drawing conclusions about relatively health people than about unhealthy people
2. People with the most problems are also the most likely to drop out from a studyTrue or false: The key to happiness in late life is to have many different types of social activitiesFalseTrue or false: The DSM criteria for psychological disorder are the same for older and younger adultsTrueHow do emotions and responses to emotionally relevant stimuli change as people age?People report less negative emotion, tend to and react to more positive information, and are less reactive to negative informationHow do values about social relationships tend to change as people age?People place more emphasis on close ties rather than broader social networksWhat are five reasons that it is particularly important to rule out medical explanations for Psychological Disorders in Late life?
Hint:
1. Mood
2. Panic
3. Mood + CV
4. Meds + mood
5. Dicks1. Because medical problems can also worsen the course of depression
2. Because Age-related deterioration in the vestibular system can account for panic symptoms
3. Because depression is common after strokes or heart attacks
4. Because antihypertensive medication, corticosteroids, and anti-Parkinson's medication may contribute to depression or anxiety
5. CV problems can cause erectile problemsAre psychological disorders more or less common in the elderly than in younger adults? Provide four reasons for thisPsychological disorders are less common in the elderly than in younger adults, largely due to the following in the elderly:
1. More positive emotionality
2. More close-knit social circles
3. May grow out of those symptoms
4. Methodological issues leads to underestimation of prevalenceTrue or false: The elderly are more likely to have personality disorders than younger peopleFalse: They are LESS likely to experience ALL psychological problems and personality disorders than younger peopleTrue or false: Persons over the age of 65 have the lowest prevalence of psychological disorders of all age groupsTrueTrue or false: Most people with psychological disorders in late life are experiencing a continuation of symptoms that began earlier in lifeTrueName and describe three methodological issues associated with studying psychological disorders in the elderly. Provide examples where necessary1. Response bias: Discomfort discussing symptoms may minimizes prevalence estimates
2. Cohort effects: e.g., many people who reached adulthood during the drug-use-oriented era of the 1960s continued to use drugs as they aged
3. Selective mortality: Psychological disorders are associated with premature mortality in the elderlyHow does treatment of psychological disorders in the elderly differ from treating the young?Treatments for the elderly are similar to treatments that work in earlier life, although it is especially important to consider the side-effect profiles of medications when treating the elderly, as they may experience these more severely.What is the first line of treatment for anxiety in the elderly, and what are four ways in which this form of treatment has been adapted for the elderly?Psychotherapy is the first line approach for anxiety disorders.
-May need to be adapted to adjust for hearing or vision loss
-May need to provide telemental health for people with limited mobility
-May include a caregiver in therapy sessions
-May require the use of memory aids (e.g., worksheets on session content)True or false: the DSM-5 provides tailored criteria to evaluate diagnoses for those in late lifeFalseDiscuss reasons that the elderly may not reveal psychological symptoms in interviewed`Stigma and attitudes toward mental health problems have shifted over time, and older people may feel more embarrassed about about discussing mental symptomsWhat is dementia and what are the most common symptoms?Dementia is characterized by deterioration of cognitive abilities causing impairment. The most common symptom of dementia is diminished memory, especially for recent eventsName four psychiatric symptoms that are considered secondary to memory loss in dementia1. 50% of people with dementia experience depression
2. Sleep disturbances are common
3. Delusions and hallucinations can occur
4. Many experience difficulty with impulse controlDescribe the general progression of dementia including timing and when behavioral deficits emergeMost cases of dementia develop slowly over a period of years. Behavioral deficits often emerge before noticeable impairmentWhat is mild cognitive impairment (MCI)? How does the DSM-5 describe this?MCI is characterized by early signs of cognitive decline that occur before functional impairment. The DSM-5 only requires a low score on a single cognitive functioning test in order to qualify for MCI (full DSM-5 criteria described in another card)What are four problems associated with the fact that the DSM-5 only requires low scoring on a single test of cognitive functioning to meet diagnostic criteria for mild cognitive impairment (MCI)?1. Some cognitive test are more reliable and relevant than others for diagnosis MCI
2. Using more than one test improves diagnostic reliability for MCI
3. 10% of the time, cognitive declines are tied to other problems unrelated to MCI (e.g., infections, sleep loss, thyroid disease, vitamin deficiencies, etc.)
4. Current MCI criteria may not be very reliable, which could lead to over-diagnosisMSTrue or false: mild cognitive impairment (MCI) will always progress into dementiaFalse: Not all people with MCI will develop dementiaWhat is the official DSM-5 name for mild cognitive impairment (MCI)?Mild Neurocognitive DisorderWhat are the three DSM-5 criteria for Mild Neurocognitive Disorder (Mild Cognitive Impairment)? Describe each1. Modest cognitive decline from previous levels in one or more domains based on BOTH of the following:
-Concerns of the patient, a close other, or a clinician
-Modest neurocognitive decline (i.e., between the 3rd-16th percentile) on formal testing equivalent clinical evaluation
2. The cognitive deficits do not interfere with independence in everyday activities (e.g., paying bills or managing medications), even though greater effort, compensatory strategies, or accommodation may be required to maintain independence
3. The cognitive deficits do not occur exclusively in the context of delirium and are not due to another psychological disorderName and describe the three DMS-5 criteria for Major Neurocognitive disorder (Dementia)1. Significant cognitive decline from previous levels in one or more domains based on both of the following:
-Concerns of the patient, a close other, or a clinician
-Substantial neurocognitive impairment (i.e., below the 3rd percentile on formal testing) or equivalent clinical evaluation
2. The cognitive deficits interfere with independence in everyday activities
3. The cognitive deficits do not occur exclusively in the context of delirium and are not due to another psychological disorderWhat is the official DSM-5 name for dementia?Major Neurocognitive DisorderDiscuss the prevalence of dementia, including how the prevalence changes with ageLess than 2% of people have dementia before the age of 65. Rates of dementia increase dramatically as people age such that more than 1/3 of people have dementia by the time they reach their 90sDiscuss the prevalence of dementia in sub-Saharan Africa and Latin AmericaPrevalence of dementia of dementia appears lower in sub-sharan African and high in Latin AmericaWhat is the most prominent symptom of Alzheimer's Disease?Memory lossDefine disorientation as is seen in Alzheimer's diseaseDisorientation can manifest as visual-spatial abilities decline with the progression of Alzheimer's Disease. It is characterized by confusion with respect to time, place, or identity. The person may become easily lost, even in familiar surroundingsHow is the age of onset for dementia changing over time in Europe and the US? How is this expected to change by 2030?The age of onset for dementia is becoming later over time in the US and Europe. However, the number of cases is expected to double by 2030 as the number of elderly people in the US and Europe increasesThere are many types of dementia, but what are the four that you should know for the exam? Which of these is the most common form?1. Alzheimer's disease
2. Frontotemporal dementia
3. Vascular dementia
4. Lewy body dementia
Alzheimer's disease is the most common form, accounting for more than half of dementiasWhat is Alzheimer's disease, and how soon does death usually occur following onsetAlzheimer's disease is characterized by irreversible brain tissue damage. Death usually occurs within 12 years of onset of dementiaAlzheimer's disease usually begins with what three symptoms?1. Absentmindedness and gaps in memory for new material
2. Leaving tasks unfinished or forgotten
3. Difficulty finding wordsIn addition to the typical symptoms associated the onset of Alzheimer's, what are three additional symptoms and how do these symptoms change over the course of progression of the disease?Other symptoms include apathy, depression, and disorientation. As brain deterioration progresses, the severity of the symptoms increaseTrue or false: At first, people with Alzheimer's Disease are often unaware of their cognitive problems. Explain how this changes as the disease progressesTrue: This progresses to oblivious awareness of surroundings as the course of the disease continuesName and describe two structural changes in the brain that are associated with Alzheimer's Disease1. Plaques: Beta-amyloid protein deposits primarily found in the frontal cortex
2. Neurofibrillary tangles: Protein filaments composed of tau primarily found in the hippocampusHow do we measure brain changes associated with Alzheimer's Disease?Measured using PET scansTrue or false: Ventricles enlarge in Alzheimer's DiseaseTrueThe deposition of beta-amyloid plaques in Alzheimer's disease is associated with what in both the short and long term (the answer is related to brain physiology)?Immune responses to plaques lead to inflammation, which eventually results in the loss of synapses and neuronal deathWhat gene increases the deposition of beta-amyloid plaques in Alzheimer's disease? Describe how these plaques result in cognitive declineThe ApoE-4 gene. In patient's with Alzheimer's disease, accumulation of beta-amyloid plaques leads to the formation of neurofibrillary tangles, synaptic deficits, and loss of neurons, which ultimately results in cognitive declineWhat is the heritability of Late onset Alzheimer's DiseaseHeritability is between 60-80%How many loci have been identified to be associated with Alzheimer's Disease, and what proportion of genetic risk do these loci account for?19 specific loci have been identified, however, most of these genes explain a vary small amount of the risk for developing Alzheimer'sDescribe the polymorphism on a gene of chromosome 19 that is associated with the development of Alzheimer's including three associated symptomsThe polymorphism is on the apolipoprotein ε4 (ApoE-4) allele. Before the development of symptoms, people with two ε4 alleles show:
1. Overproduction of beta-amyloid plaques
2. Loss of neurons in the hippocampus
3. Low glucose metabolism in several regions of the cerebral cortexMost genes that increase the risk of Alzheimer's Disease are associated with ______________ function and _______________ metabolismimmune; cholesterolWhat are two lifestyle factors that increase the risk of developing Alzheimer's disease?1. Social isolation
2. InsomniaWhat are five lifestyle factors that result in a lower risk of developing Alzheimer's disease?1. Fish consumption
2. Mediterranean diet
3. Education
4. Exercise
5. Engagement in cognitive activitiesHow is exercise related to a lower risk of developing Alzheimer's Disease?Exercise predicts less decline in cognitive functioning and decreased risk of developing Alzheimer'sTrue or false: Engagement in cognitive activities is not associated with decreased risk of developing Alzheimer's Disease. ExplainFalse: the "use it or lose it" mantra is true when it comes to developing Alzheimer's DiseaseHow is engagement in cognitive activities related to risk of developing Alzheimer's Disease?Frequent cognitive activity is related to a 46% in risk for developing Alzheimer's. Intellectually stimulating activities protect against the expression of underlying neurobiological diseaseWhat is meant by the term cognitive reserve with respect to cognitive activities decreasing the risk for developing Alzheimer's Disease?Cognitive reserve describes how some people may be able to compensate for the disease by using alternative brain networks or cognitive strategiesWhat is frontotemporal dementia? Discuss the onset, including how soon death follows in your answerFrontotemporal dementia is characterized by a loss of neurons in the frontal and temporal lobes of the brain. It typically begins in the late 50s, and progresses rapidly: death usually occurs within 5 years of diagnosisDiscuss the prevalence of frontotemporal dementia, as well as how it affects memoryAffects less than 1% of the population, and memory is not severely impaired (unlike in Alzheimer's)What is the most common subtype of frontotemporal dementia? What is this subtype characterized by, and how does it interfere with emotional processes in comparison with dementia?The most common subtype of frontotemporal dementia is behavioral variant frontotemporal dementia. This is categorized by deterioration in at least 3 of the following areas: empathy, executive functioning, ability to inhibit behavior, compulsive or perserverative behavior, tendencies to put nonfood in the mouth, and apathy. The behavioral variant of frontotemporal dementia strikes emotional process more profoundly than Alzheimer's disease (thus, it can damage social relationships and marital satisfaction more than Alzheimers)Discuss the results of the study that examined the relationship between depression and the development of dementiaMedical records were reviewed for diagnoses of dementia. Among those who developed dementia, cognitive scores declined significantly 12 years before diagnosis, and their cognitive decline escalated in the years before diagnosis, while depressive symptoms began to increase significantly 10 years before the dementia diagnosis--that is, after cognitive decline had already begun. These findings indicate that the depressive symptoms observed before dementia onset may be a manifestation of neurocognitive declineWhat diseases/psychological phenomena are often misdiagnosed as frontotemporal dementia?1. Midlife crisis
2. Bipolar disorder
3. DepressionWhat are three molecular processes/diseases that can cause frontotemporal dementia?1. Pick's disease
2. High levels of Tau
3. Strong genetic predispositionWhat is vascular dementia caused by, and what is the most common cause?Vascular dementia is caused by cerebrovascular disease/event, most commonly strokeVascular dementia has the same risk factors for development of what? Include some examplesSame risk factors as Cardiovascular disease: Older age, "bad" cholesterol, smoking, high BPTrue or are false: Caucasians are at greater risk of developing vascular dementia than African Americans due to the fact that strokes and CV events are more common in Caucasians. ExplainFalse: Caucasians are at lesser risk of developing vascular dementia than African Americans due to the fact that strokes and CV events are less common in CaucasiansTrue or false: The symptoms of vascular dementia vary greatly depending on the location of the stroke (or other CV event)TrueDescribe dementia with Lewy Bodies, as well as the prevalenceDementia with Lewy Bodies is characterized by protein deposits known as Lewy bodies, which form in the brain and lead to cognitive declines. It affects 1% of less of elderly individualsReview: DBT is effective for which mental health disorder(s)
A: Borderline Personality Disorder
B: Substance Use Disorder
C: Mood Disorders
D: All of the aboveD, although particularly effective for borderline personality disorderReview: Personality Disorders are defined as what?Long-standing, pervasive, and inflexible patterns of behaviors and inner experience that deviate from the expectations of a person's cultureReview: A concern about the DSM-5 classification system for personality disorders is that:
A: about half of the people who meet criteria for one OD also meet criteria for another PD
B: Some of the disorders are rare in community settings, and even in most clinical settings
C: Many people who seem to have a serious personality problem don't fit any of the PD disorder diagnoses
D: All of the aboveDReview: Two primary features of Linehan's diathesis-stress theory of borderline PD are:
A: ego functioning and transference
B: Objective representation and cognitive style
C: Cognitive bias and attribution error
D: Emotional dysregulation and experiences of invalidationDThe symptoms of Dementia with Lewy bodies are difficult to distinguish from what two diseases?1. Parkinson's Disease
2. Alzheimer's DiseaseAlthough the symptoms of dementia with Lewy Bodies is difficult to distinguish from Parkinson's and Alzheimer's Diseases, what are four differences?Symptoms of Dementia with Lewy Bodies are more likely to include:
1. Prominent visual hallucinations
2. Fluctuating cognitive symptoms
3. Sensitivity to physical side effect of antipsychotic medications
4. Intense dreams involving movement and vocalizingTrue or false: Medications for dementia can help to slow cognitive decline, but they cannot restore functioningTrueWhat type of medications are prescribed for treatment of dementia? What is important to note about these medications?Cholinesterase inhibitors. Many people discontinue these medication due to side effectsBesides cholinesterase inhibitors, what other medications can be used to treat dementia?Medication to improve CV health and to treat depression or agitation are also used in the treatment of dementiaOngoing prevention research on dementia has focused on what demographics? What is the goal of this research?They study people with early biological markers of dementia. The goals of this research include preventing the development of plaques and tangles in order to reduces changes of developing mild cognitive impairmentWhat are three forms of psychological treatments for dementia?1. Supportive psychotherapy
2. Behavioral approaches
3. Exercise and cognitive training to prevent cognitive decline before it beginsA plaque is:
A: a small, round beta-amyloid protein deposit
B: a filament composed of the protein tau
C: A buildup of myelin sheath surrounding neurons in the hippocampus
D: A small white spot on a brain scanAA neurofibrillary tangle is:
A: a small, round beta-amyloid protein deposit
B: a filament composed of the protein tau
C: A buildup of myelin sheath surrounding neurons in the hippocampus
D: A small white spot on a brain scanBFTD involves profound changes in:
A: Memory
B: Social and emotional behavior
C: Motor control
D: AttentionBWhich NTs are most involved in Alzheimer's Disease?Achetylcholine and GlutamteDescribe the fficacy of current medical treatments for dementiaMedications might slow decline, but they do not cure dementiaDescribe supportive psychotherapy for dementiaIncludes education about the disease and provides care for the patient and the familyWhat are four possible components of behavioral approaches to treating dementia?1. External memory aids
2. Music to reduce agitation and disruptive behavior
3. Psychotherapy to reduce depression
4. Increasing pleasant and engaging activities (e.g., in a reminiscence group)True or false: Exercise and cognitive training to prevent cognitive decline before it begins has shown little to no benefit. ExplainFalse: There has been shown to be a small benefit of exercise and cognitive training in individuals with mild cognitive impairmentName (and describe where necessary) 9 signs of deliriumDelirium is a clouded states of consciousness charactered by:
1. Extreme trouble focusing attention
2. Cannot maintain a coherent stream of thought
3. Trouble answering questions
4. Disturbances in the sleep wake cycle (i.e., drowsy during the day, yet awake and agitated at night)
5. Vivid dreams and nightmares are common
6. Difficult to engage in a conversation (e.g., speech may become rambling and incoherent)
7. Disorientation of time, place, and name
8. Memory impairment of recent events
9. Perceptual disturbancesWhat is the hallmark symptom of delirium?Extreme trouble focusingWhat are the four DSM-5 criteria for Delirium?1. Disturbance in attention and awareness
2. A change in cognition not better accounted for by a dementia (e.g., disturbance in orientation, language, memory, perception, or visuospatial ability)
3. Rapid onset (usually with hours or days) and fluctuation during the course of a day
4. Symptoms are caused by a medical condition, substance intoxication or withdrawal, or toxinsDiscuss the onset and fluctuation of deliriumDelirium has rapid onset and can fluctuate during the course of a day. There are often lucid intervals where a person becomes alter and coherent punctuated by periods of delirium.True or false: Daily fluctuations help distinguish delirium from other symptoms, especially Alzheimer'sTrueWhen is the typical onset of delirium?Delirium can occur at any age, but is most common in very young children and very old peopleTrue or false: Delirium is often misdiagnosedTrueDescribe the mortality rate for untreated deliriumDelirium, if untreated, has a very high mortality rate; delirium is a good predictor of death within the next six months, and is indicative of further cognitive declineDescribe six differences between dementia and delirium
1. Timing/course of onset
2. Types of cognitive deficits
3. Physiological causes
4. course/reversibility
5. Treatment outcomes
6. prevalence with age1. Dementia is characterized by gradual deterioration of abilities, whereas delirium has rapid onset
2. In dementia, deficits in memory are most commonly for recent events, whereas in delirium deficits are better characterized by trouble concentrating and staying with a train of thought
3. Dementia is cause by brain disease processes, whereas delirium is secondary to another medical condition
4. Dementia is usually progressive nonreversible, whereas in delirium, symptoms fluctuate over the course of a day
5. In dementia, treatment offers only minimal benefits, whereas delirium is usually reversible by treating underlying condition but potentially fatal if the cause (e.g., infection or malnutrition) is not treated
6. In dementia, prevalence increases with age; in delirium prevalence is highest in the very young as well as the very oldDiscuss treatments options and the course of treatment/recovery for deliriumComplete recovery is attainable if the underlying cause of the delirium is treated. Atypical antipsychotic medications are also used. Delirium usually takes 1-4 weeks to clear, and takes longer to clear in older people than in younger peopleWhat are four risk factors for delirium within the hospital?1. Sleep deprivation
2. Immobility
3. Dehydration
4. Visual and hearing impairmentHow can families aid in the treatment of delirium?Family should learn about delirium symptoms and its reversible nature to avoid interpreting the onset of delirium as a new stage of a progressive dementiaWhat is the most commonly abused legal and illegal substance in the US?Legal: Alcohol
Illegal: MarijuanaWhat are the DSM-5 criteria for gambling disorder?4 or more of the following symptoms:
1. Gambling often occurs when feeling negative emotions
2. Efforts to stop or reduce gambling cause negative feelings and restlessness
3. Repeated reliance on other people to fix financial consequences of gambling
4. Continued gambling despite relationship, job, or school problems caused by it
5. Continued gambling even after losing to try to recoup loses
6. Lying to others about gambling
7. Gambling with more money is needed to get the desired good feelings
8. Efforts to reduce or control gambling do not work
9. Much time spent thinking about and planning gamblingTrue or false: The term "addiction" is not listed in the DSMTrueDo people with gambling disorder participate in some types of gambling more often than those without a gambling disorder?No, however, those with gambling disorder are more likely to participate in a wider variety of gambling activities than people without this disorderDiscuss the similarities and differences between gambling disorder and substance use disordersObviously, one difference is that gambling does not involve consumption of a substance. Similarities include the development of a tolerance (such that more money needs to be gambled to gain the same effects) and consequences of the behaviorTrue or false: People with gambling disorder have similar patterns of brain activation as do people with substance use disordersTrueWhere is gambling disorder found in the DSM?It was recently added to the substance-related and addictive disorders chapterList all DSM-5 criteria for substance use disorder1. Problematic pattern of use that impairs functioning accompanied by two or more of the following symptoms within a one year period:
-Failure to meet obligations
-Repeated use in situations where it is physically dangerous
-Repeated relationship problems
-Continued use despite problems caused by the substance
-Tolerance
-Withdrawal symptoms
-Substance taken for longer time or greater amounts than intended
-Efforts to reduce or control use do not work
-Much time is spent trying to obtain the substance
-Social life, hobbies, or work activities are given up or reduced
-Craving to use the substance is strongName and describe the three DSM-5 severity rating for Substance Use Disorder1. Mild: 2-3 criteria met
2. Moderate: 4-5 criteria met
3. Severe: 6 or more criteria metName and describe two symptoms that are often part of a severe Substance Use Disorder1. Tolerance: Larger does of a drug are needed to produce the desired effect; effects of the drug decrease if the usual amount is taken
2. Withdrawal: Negative physical and psychological effects stopping substance use (e.g., muscle pain, twitching sweats, comiting, insomnia)With respect to Alcohol Use Disorder, what is meant by the term "dependent" or "addicted"These terms describe people who develop an alcohol tolerance or experience withdrawal symptoms when use is stoppedDescribe the symptoms of Alcohol withdrawal. In your answer, define delirium tremensSymptoms of withdrawal include muscle muscle tremors, elevated pulse, increased blood pressure and temperature. Delirium tremens describes a rare withdrawal symptom when blood alcohol levels suddenly drop. It results in delirium, tremulous, and hallucinationsIn what ways is Alcohol Use Disorder associated with a different Substance use? Why is this? Use the term cross-tolerant in your answer80-85% of people with alcohol use disorder also smoke tobacco. This very high comorbidity may occur because alcohol and nicotine are cross-tolerant, meaning nicotine can induce tolerance for the rewarding effects of alcohol and vice versaDiscuss the prevalence of alcohol use disorder. In your answer, discuss and define binge drinking and heavy-use drinking prevalencesAlcohol use is especially frequent among college-age adults. 39.4% of college students report binge drinking (drinking 5 or more drinks in a short period of time). Additionally, 12.5% of college student report heavy-use drinking, which is defined as 5 drink on the same occasion or more drinking 5 or more times in a 30 day periodTrue or false: The prevalence of Alcohol Use Disorder caries by gender, race, and level of educationTrueDiscuss sex differences in the prevalence of Alcohol use Disorder, as well as for married, never married, and divorced men and womenAlcohol Use Disorder is more common in men than in women, but this gender difference continues to shrink. Rates of Alcohol Use Disorder are higher for never married or divorced men and womenDiscuss common comorbidities of Alcohol Use DisorderAlcohol Use Disorder is often comorbid with Borderline and Antisocial Personality Disorders, as well as mood and anxiety disordersDiscuss the physiological metabolism of alcohol in the body. Discuss metabolic rates in your answerAlcohol enters the bloodstream quickly through the small intestine, and it is metabolized by the liver slowly at a rate of 1 ounce of 100 proof alcohol per hourObviously, the effects of alcohol vary based on how concentrated the alcohol is. What are five additional factors that impact the effects of alcohol at a given concentration?1. Gender
2. Height
3. Weight
4. Liver efficiency
5. Presence of food in the stomachThe size of a standard drink is defined by what? Provide three standard drink sizes in your answerThe size of a standard drink is defined by the alcohol content. For example, all of the following drink options are equivalent to one standard drink (i.e., they are all equal in alcohol content) :
-12 oz. glass of beer
-5oz. glass of wine
-1.5oz hard liquorOne of the short-term effects of alcohol is that it interacts with several different neurotransmitters. Describe the effects of alcohol on three specific NTs1. Stimulates GABA receptors, which reduces muscular tension
2. Increases DA and 5-HT, which produces pleasurable effects
3. Inhibits glutamate receptors, which produces cognitive difficulties (e.g., slowed thinking and memory loss)Describe three short-term effects of high-dose alcohol (0.08 blood alcohol content)1. Significant motor impairment
2. Difficulty monitoring errors and making decisions
3. People at the legal limit of alcohol may make poor decisions about driving and not realize that they are making mistakesName and describe three long-term effects of prolonged alcohol use. Provide examples where necessary1. Impaired digestion of food and absorption of vitamins (e.g., efficiency of B-complex vitamins which can lead to severe memory loss)
2. Cirrhosis of the liver
3. Damage to the endocrine glands, brain, pancreas, heart failure, erectile dysfunction, hypertension, stroke, and capillary hemorrhagesDescribe fetal alcohol syndrome, including what is recommended for women's consumption of alcohol during pregnancyFetal alcohol syndrome is syndrome is an infantile disorder which results in intellectual disability, slowed fetal growth, and abnormalities of the head, face, and limbs. Because alcohol consumption during pregnancy can result in FAS, total abstinence from alcohol is recommended for pregnant womenTrue or false: Fetal Alcohol Syndrome does not result in intellectual disability. ExplainFalse: Fetal Alcohol Syndrome is a leading cause of intellectual disability among childrenHow is nicotine physiologically implicated in Tobacco Use Disorder?Nicotine is the addicting agent of tobacco. It stimulates dopamine neurons in the mesolimbic area, which is involved in the reinforcing effect of most drugsList several health consequences of smoking tobaccoCigarette smoking can cause and/or exacerbate:
-Emphysema, cancers of the larynx, esophagus, pancreas, bladder, cervix, and stomach, as well as contribute to the development of CV disease.
-Additionally, smoking tobacco during pregnancy can result in in sudden infant death syndrome and many other pregnancy complicationsHow have the rates of smoking changed since 1990?People who smoke has declined by about 1/3 between 1990 and 2015True or false: Smoking is the single most preventable cause of premature death in the USTrueHow does SES impact rates of tobacco usage?Tobacco use disorder is significantly more prevalent among people of lower SESWhat are four differences regarding the prevalence and usage of cigarettes by African Americans compared to the rest of the population?African American cigarette smokers:
-Are less likely to quit smoking cigarettes than the rest of the population
-Are more likely to get lung cancer than the rest of the pop
-Metabolize nicotine more slowly than the rest of the population
-Are more likely to smoke menthol cigarettes due to direct advertising to this communityWhy are menthol cigarettes considered to be more dangerous than non-menthol cigarettes?People tend to inhale more deeply and hold the smoke in for longer when smoking mentholsDiscuss differences in Chinese American smokers compared to European American, or Latino smokersChinese Americans metabolize less nicotine from cigarettes than European American or Latino smokers. This is evident in the fact that Chinese Americans have lower rates of lung cancer than the rest of the population of smokersWhat is secondhand smoke, and why is it potentially even more dangerous than mainstream smoke?Secondhand smoke is tobacco smoke from the environment. It contains higher concentrations of ammonia, carbon monoxide, nicotine, and tar than the the smoke that is actually inhaled by the smoker, making it very dangerous. As a result of secondhand smoke, nonsmokers can suffer lung damage (possibly permanent) from extended exposure to secondhand cigarette smokeWhat does the Surgeon General recommend as the best form of prevention for exposure to secondhand smoke?To promote smoke free environmentsDiscuss the health effects of the babies of women who were exposed to secondhand smoke during pregnancyBabies of women exposed to secondhand smoke during pregnancy are more likely to be born prematurely, have lower birth weights, and have a wide array of birth defectsDiscuss possible health problems among children of smokersChildren of smokers are more likely to experience upper respiratory infections, asthma, bronchitis, and inner-ear infections than children of non-smokersHow are E-cigarettes similar and different from traditional cigarettes?E-cigarettes look like traditional cigarettes, except that they are generally made of plastic or metal, and they are filled with liquid nicotine that is mixed with other chemicals and/or flavors. People inhale and exhale the vapors (vaping)True or false: Among young people, those who vape are less likely to take up cigarettesFalse: Among young people, those who vape are MORE likely to take up cigarettesHow does the FDA regulate E-cigarettes compared to other tobacco products?FDA regulation treat E-cigarettes like other regulated tobacco productsWhat is marijuana and how is it consumed?Marijuana is a drug derived from the dried and crushed leaves and flowering tops of the hemp plant (Cannabis sativa). It is most often smoked, but it can also be chewed, prepared as a tea, or eaten in baked goodsWhat is Hashish? Discuss its strength relative to traditional marijuanaHashish a substance produced by drying the resin exudate of the tops of the hemp plant. It is stronger (more potent) than traditional marijuanaWhat are two alternative/street names for synthetic marijuana?1. Spice
2. K2Is marijuana actually a gateway drug? ExplainGenerally speaking, no. Although there is some evidence that people who use hard drugs often start with marijuana, people who use marijuana are no more likely than people who do not to start using hard drugs like cocaine and heroinDiscuss deficits in IQ and cognitive functioning associated with marijuana usageIn one study, people with severe cannabis use disorder had reductions in IQ and poorer performance on tests of working memory and processing than did non-users. These deficits were not seen in regular, non-chronic, users of marijuanaTrue or false: Marijuana is considered an illicit drugTrueIn how many states is marijuana legal for recreational use? What about medicinal use?Marijuana is legal for recreational use in 8 states: Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington. It is legal for medicinal purposes in 29 statesDiscuss sex differences in the usage of marijuanaMarijuana usage is more common among men than womenDiscuss racial and ethnic differences in usage of marijuanaThere are no differences in marijuana usage across racial and ethnic groupsTrue or false: Rates of daily use of marijuana are on the rise. What might this be related to?True: This may be related to varying degrees of legal status by stateName and describe three psychological effects of marijuana, including the effects of large and heavy doses1. Feeling of relaxation and sociability
2. Large doses can result in rapid shifts in emotions, as well as interference with attention, memory, and thinking
3. VERY large (heavy) doses can result in hallucination and panic, as well as cognitive impairmentWhy is it difficult to regulate the dosage of marijuana?It can take up to thirty minutes for the full effects to appear, which is why many people smoke more than intended while waiting for the effects.Name five short-term physiological effects of marijuana usage1. Bloodshot/itchy eyes
2. Dry mouth and throat
3. Increased appetite
4. Reduced pressure in the eye
5. Increased Blood pressureDescribe four long-term physiological effects of marijuana usage1. Damage to lung structure and function in long-term users
2. Cognitive problems linked to the effects of marijuana on CB1 and CB2 receptors in the hippocampus
3. Different patterns of connectivity between amygdala and frontal cortex among users compared to non-users
4. Can develop tolerance and withdrawalName and describe two therapeutic effects of marijuana usage1. Reduces nausea and loss of appetite caused by chemotherapy
2. Can relieve discomfort associated with the following: cancer, glaucoma, chronic pain, muscle spasms, seizures, and discomfort from AIDSTrue or false: The diagnosis of substance use disorder requires both tolerance and withdrawalFalseTrue or false: Research suggests that nicotine can enhance the rewarding properties of alcoholTrueTrue or false: Even moderate drinking by pregnant women can cause learning and attention problems in their childrenTrueList three types of cancer that are caused by smoking tobaccoAny of the following:
Lung, larynx, esophagus, pancreas, bladder, cervix, stomachMarijuana can have __________ effects on learning and memory; it is less clear if there are ________ effectsshort-term; long-termList three therapeutic benefits of marijuanaAny of the following: Pain relief, reduction of nausea, increased appetite, relief from the discomfort of AIDSWhat are four common types of opioids?1. Opium
2. Morphine
3. Heroine
4. CodeineWhat do opioids to at moderate doses?Moderate doses relieve painTrue or false: prescription pain medications are among the most abused of all drugsTrueWhat is the difference between synthetic and natural stimulants. Provide examplesAmphetamines are synthetic stimulants, whereas cocaine is a natural stimulant extracted from the coca leafWhat are the most commonly abused prescription opioid drugs, and what percentage of people in the US have misused a prescription drug at least onceThe most common prescription opioid drugs include Vicodin, Zydone, Lortab, Percodan, Tylox, and OxyContin; 7% of US citizens have misused a drug at least onceDiscuss sex differences in the usage of heroin. How do most people start taking heroin?Heroin use is more common in men than in women. People most often start taking prescription pain medicines before heroin use beginsWhat opioids are the most commonly abused?Prescription pain medicationsHow has the use of prescription pain medication changed since 2005?The number of people seeking prescription pain meds as treatment continues to increase. The numbers of people seeking this form of treatment has more than doubled between 2005-2012Among what demographics is misuse of prescription opioid pain medication highest?Misuse is slightly higher among men; misuse is higher among white Americans compared to other ethnic and racial groupsHow many people died from an opioid overdose per day in 2015?Nearly 91 people per dayDiscuss some of the psychological and physical effects of opiates including how long these effects lastOpiates stimulate receptor's of the body's opioid system, which produces euphoria, drowsiness, and a lack of coordination. Additionally, they can lead to a loss of inhibition and increased self-confidence. Severe letdown occurs after about 4-6 hours of useDiscuss the feelings associated with injection of heroin and OxyContinCauses intense feelings of warmth and ecstasy following injectionWhat is an additional health risk of injecting opioids that is not directly related to the effects of the drugs?Intravenous injection of opioids can result in exposure to infectious agents (including HIV) if needles are contaminatedDiscuss the progression and symptoms of opiate withdrawalOpiate withdrawal may begin within 8 hours after a high opiate tolerance has developed. Symptoms include muscle pain, sneezing, sweating, tearfulness, yawning, and symptoms resembling those of influenzesHow does the severity of opiate withdrawal change within 36 hours of non-use? Discuss associated symptoms, as well as how long opiate withdrawal typically lastsWithin 36 hours, the symptoms of opiate withdrawal become much more severe. Symptoms at this stage include uncontrollable muscle twitching, cramps, chills, flushing/sweating, tachycardia, high BP, insomnia, vomiting, and diarrhea. Withdrawal typically lasts about 72 hoursWhat are two stimulants (amphetamines) that you should know for this exam?1. Dexedrine
2. AdderallHow are amphetamine stimulants generally consumed and what is the effect of the drugs with respect to NTs?Amphetamine stimulants can be taken orally or injected intravenously. They trigger the release of dopamine and NE, as well as inhibiting the reuptake of these NTsDiscuss symptoms associated with consumption of amphetamine stimulants, including symptoms associated with high dosagesAmphetamine stimulants cause a person to become alert, be more outgoing, experience feelings of euphoria, and exhibit boundless energy and self-confidence. high doses of amphetamines can lead to nervousness, agitation, confusion, suspiciousness, and hostilityHow soon can a tolerance develop when using amphetamine stimulants?Tolerance can develop after only six says of useWhat is the most commonly used stimulant drug and what are two slang terms for this drugMethamphetamine; also known as "crystal meth" or "ice"Discuss the lifetime prevalence of methamphetamine usage5.4% of people reported ever having used methamphetamine in 2015Discuss demographic differences in the use of methamphetamineMen tend to abuse meth at higher rates than women. Additionally, usage is high in small towns than in citiesHow is methamphetamine consumed?Can be taken orally, intravenously, or intranasally (snorting)Discuss the symptoms of the high and crash with respect to methamphetamine. In your answer, discuss cravings after use is discontinuedMethamphetamine causes an immediate high, or rush, that can last for hours. This good feeling eventually crashes, causing the person to become highly agitated. Craving for meth are strong, lasting several YEARS after use is discontinuedIs ecstasy a hallucinogen or a stimulant? ExplainEcstast contains compounds from both the hallucinogen and amphetamine families, but it is currently classified in the DSM-5 in its own category "other hallucinogen use disorder"True or false: Withdrawal from heroin begins slowly, days after use has been discontinuedFalseTrue or false: The use of OxyContin began in urban areas but quickly spread to rural areasFalseMethamphetamine is a less potent for of amphetamine and so is less likely to be associated with brain impairmentFalseDescribe the mechanistic effects of ecstasyEcstasy acts primarily by contributing to both the release and the subsequent reuptake of serotoninHow is cocaine implicated in cardiovascular health?Cocaine is a vasoconstrictor, and can increase risk of death from heart attack and stroke. Because of its vasoconstriction properties, cacaine poses special danders in pregnancy, for the blood supply to the fetus may be compromisedDescribe three ways in which methamphetamine usage is associated with brain damageMethamphetamine usage:
-Affects the DA and 5-HT systems of the brain
-Causes reductions in brain volume
-Causes damage to areas associated with reward and decision makingWhere does the stimulant, cocaine, come from, and how is it consumed?Cocaine is produced from the leaves of the coca shrub. It can be snorted, smoked, swallowed, or injectionDiscuss demographic differences and prevalence of cocaine useCocaine is used predominantly in urban areas by men. It is used less frequently today than in previous decadesWhat is crack, and how is it consumed?Crack is a cheaper form of cocaine developed in the 1980s. The rock crystal is heated, melted, and smokedDiscuss the effects of cocaine on the brain, as well as psychological/physiological symptoms associated with its useCocaine act rapidly on the brain by blocking reuptake of dopamine in mesolimbic areas. It induces a pleasurable state characterized by increased sexual desire, self-confidence, and staminaName several symptoms associated with cocaine overdose (OD)ODing on cocaine can results in chills, nausea, insomnia, paranoia, hallucination, and possibly even heart attack and deathTrue or false: Prolonged use of cocaine results in formation of tolerance for all users. Why is this important?False: Not all users develop a tolerance to cocaine. This is important because it may increase the risk of OD in some usersDiscuss the predominate demographic usage of hallucinogensHallucinogens are used more often by men than women, and more often by European Americans than other demographicsWhat is LSD? In your answer, discuss its popularity, as well as implications for tolerance and withdrawalLSD is a hallucinogen that was popular in the 1960s, but its regular usage has since declined. There is no evidence of withdrawal, but tolerance develops quicklyTrue or false: Hallucinogens primarily affect the DA systemFalse: They primarily affect the 5-HT systemDiscuss the effects of Hallucinogens, including progression of these effectsThe effects of hallucinogens generally take place within 30 minutes and can last for up to 12 hours. As their name implies, hallucinogens induce hallucinations. In addition, they can disrupt sense of time, cause mood swings, and induce expanded consciousness. They can also induce flashbacks (visual recurrences of perceptual experiences after the effects of the drug has worn off)How is ecstasy (molly) consumed, and what is the average age of first use?Ecstasy (molly) can be taken in pill or powder form, and the average age of first use is 21True or false: Ecstasy acts primarily on the serotonin systemTrueDiscuss several positive and negative symptoms associated with ecstasy usageIncreases feelings of intimacy, insight, positive emotions, and self-confidence. Can also cause muscle tension, nausea, anxiety, depression, confusion, and feelings of depersonalizationWhat does PCP stand for and what is a slang term for it?PCP stands for phencyclidine, also known as angel dustIs PCP used more frequently by men or women?MenDiscuss some symptoms associated with use of PCP?PCP can cause severe paranoia and violent outbursts. Coma and death are also possibleTrue or false: Relatives and children of problem drinkers have higher-than-expected rates of alcohol use disorderTrueAmong what four substance related disorders is there greater concordance between MZ twins than DZ twins?1. Alcohol use disorder
2. Smoking
3. Heavy use of marijuana
4. Drug use disorders in generalHow do genetic and shared environmental risk factors for substance abuse differ based on the drug? What about differences between men and women?Genetic and shared environmental risk factors appear to be the same no matter what the drug. Additionally, these risk factors are the same for men and womenHeritability for at-risk adolescents is higher for those with what three social factors (with respect to substance use)?1. Having many peers who drank
2. Having a best friend who also smoked and drank
3. Being part of the "popular crowd" where smoking is more commonTrue or false: Tolerance for large quantities of alcohol may be inherited?TrueName and describe due genes that have been linked to smoking1. People with SLC6AS (regulates dopamine re-uptake) are less likely to smoke and more likely to quit
2. Smokers with a defect in the CYP2A6 (regulate nicotine metabolism) gene are less likely to become dependentDiscuss prevalence of alcohol problems among Asians compared to the rest of the population and why thisEthnic groups, such as Asians, may have a low rate of alcohol problems because of a physiological intolerance, which is caused by an inherited deficiency in the enzymes involved in processing alcohol, alcohol dehydrogenasesNearly all drugs stimulate the ___________ system, particularly the _____________ pathway, which is linked to ____________ and ___________Dopamine; mesolimbic; pleasure and rewardWhat is the difference between the vulnerability model vs. the Toxic effect model (with respect to neurobiological factors)The vulnerability model states that vulnerability in the dopamine system leads to substance use; the toxic effect model states that substance use leads to dopamine system problemsAn additional reason that people may take drugs is to avoid the bad feelings associated with not taking them. What might this help to explain?The use of drugs for purpose of avoiding withdrawal symptoms may help to explain the high frequency of relapse among usersIn detail describe the incentive-sensitization theory of cravings and maintenance of addictionAccording to this theory, the DA system linked to pleasure or liking becomes supersensitive not just to the direct effects of drugs but also to cues associated with the drugs (e.g., needles, papers, etc.). This sensitivity to cues induces craving, or wanting, and people go to extreme lengths to seek out and obtain drugs. Over time, the liking for drugs decreases, but the wanting remains very intense. These investigators argue that the transition from liking to powerful wanting, accomplished by the drug's effects on brain pathways involving DA, is what maintains the addictionWhat have brain imaging studies shown about drug-use cues?Brain imaging studies have shown that cues for a drug (needle or a cigarette) activate the reward and pleasure centers of the brain involved in drug useHow do people who are dependent on substances value immediate (short-term) vs. delayed (long-term) rewardsPeople dependent on substances discount delayed rewards (i.e., value immediate rewards more) more steeply than people who are not dependent on drug-useWhat brain regions are implicated in valuing immediate and delayed (long-term) rewards?Delay reward is associated with the prefrontal cortex, whereas immediate reward is associated with the amygdala and the nucleus accumbensWhat is mood alteration, and how is it associated with substance use?Mood alteration is a form of emotional regulation that enhances positive feelings or diminishes negative ones. People with substance use disorders may be less successful in regulating negative emotionsWhat are three ways in which substance use can be seen as a form of emotional regulation?Substance use as an emotional regulation tool:
1. Can dampen down though of rejection in social situations
2. Provides relief or distraction from negative emotions
3. Increases positive emotions when boredTrue or false: Social networks, media, and advertisements influence substance useTrueWhat are two ways in which expectancy and personality factors impact the likelihood to abuse substances?1. People who expect alcohol to reduce stress and anxiety are most likely to drink
2. Expectancies about a drug's effect predict increased drug use in generalName and describe three personality traits that predict the onset of substance use disorders?1. High levels of negative emotionality or neuroticism
2. Persistent desire for arousal and positive affect
3. Low levels of constraint (constraint is characterized by harm avoidance, conservative moral values and cautious behavior)Which of the following is NOT on eof the sociocultural factors implicated in the etiology of substance use disorder?
A: The media
B: Gender
C: Availability of substance
D: Social networksBWhich of the following statements best captures the link between wanting, liking, and drinking according to a large prospective study:
A: Wanting, but not liking, predicted more drinking among heavy drinkers
B: Wanting predicted more drinking for heavy drinkers
C: Wanting and liking predicted more drinking among heavy drinkers
D: Sedation predicted less drinking for all types of drinkingCGenetic research on substance dependence indicates that:
A: Genetic factors may be the same for many drugs
B: Additional studies need to be done to determine heritability
C: The dopamine receptor, DRD1, may be faulty
D: Twin studies show that environment is just as important as genesAWhat are the two broad explanations for how social environment is related to patterns of substance abuseSocial influence (your social group reinforces substance use) and social selection (you pick a social group that endorses substance use; more important)True or false: Tobacco is the most commonly abused substance worldwide. ExplainFalse: Alcohol is the most commonly abused substance worldwideTrue or false: Cultural attitudes and patterns of drinking influence the likelihood of drinking heavily and therefore of abusing alcoholTrueDo men or women tend to consume more alcohol?Men consume more alcohol than womenWhat are three family factors that increasing the risk of abusing alcohol?1. Parental alcohol use
2. Marital discord
3. Lack of parental support and monitoringOnly ____ % of people who are physiologically dependent on alcohol ever get treatment24%One form of inpatient hospital treatment for alcohol use disorders is detoxification. Define this termDetoxification describes withdrawal from alcohol under medical supervisionWhat are four things you should know about Alcoholic Anonymous (AA)?1. AA is the world's largest self-help group for problem drinkers
2. AA provides regular meetings that provide support, understanding, and acceptance for problem drinkers
3. AA endorses total abstinence from alcohol
4. Although some studies have shown AA participation predicts better outcome, recent studies have shown AA to be no more effective than other forms of therapyDiscuss the effectiveness of Alcoholics Anonymous compared to other forms of therapy for problem drinkingAlthough some studies have shown AA participation predicts better outcomes, recent studies suggest that AA is no more effective than other forms of therapyDiscuss the practice and effectiveness of couples therapy for alcohol use disordersCouples therapy for alcohol use disorder combines skills covered in individual CBT with a focus on dealing with alcohol-related stressors together as a couple. It has been shown to be more effective than individual treatment approaches to alcohol use disorderDescribe the practice of motivational interventions for alcohol use disorderMotivational interventions are designed to curb heavy drinkings in college students. It begins with a Timeline follow back assessment (TLFB) of drinking in the past 3 months. Brief motivation treatments include individualized feedback on a person's drinking in relation to community and national averages. These treatments also include education about the effect of alcohol, as well as tips for reduction of harm associated with alcohol use. The combination of TLFB and motivational interventions is associated with a long-lasting reduction in drinking behaviorsDescribe the practice (including hypothetical examples) of controlled drinking treatments for alcohol use disorderControlled drinking treatment focus on guided self-change of drinking habits. The goal of this type of treatment is to teach people that they have more control over their drinking behaviors than they realize. This is accomplished by teaching strategies for managing drinking habits (e.g., delaying 20 minutes before having a second drink, allowing the person to reflect on the costs/benefits of drinking to excess)What are three medications used to treat alcohol use disorder?1. Antabuse (disulfiram)
2. Naltrexone
3. AcamprosateOne medication used to treat alcohol use disorder is Antabuse (disulfiram). Discuss the side effects of this medication, and what this can lead to in patients taking this medicationAntabuse produces nausea and vomiting if alcohol is consumed. Dropout rates for Antabuse trials are as high as 80%, and it has not been shown to be effective in controlled trialsUnder what conditions are alcohol use disorder medications like naltrexone and acamprosate most effective?Most effective when combined with CBTDescribe the mechanisms by which naltrexone and acamprosate functionNaltrexone blocks the activity of endorphins that are stimulated by alcohol, thus, reducing craving for it. Acamprosate is believed to interfere with the glutamate systems and thereby reduced the craving associated with withdrawalTrue or false: a person is much more likely to stop smoking if someone in their social circle also stopsTrue. In short, peer pressure to quit smoking appears to be as effective as peer pressure to start smokingHow have changes in the law served as treatments for smoking?Laws prohibiting smoking in most public places, have contributed to a broader social context that provides incentives to stop smokingName and describe nicotine replacement treatments for treatment of smokingNicotine gums, patches, inhalers, and e-cigarettes help to alleviate withdrawal symptoms from quitting smoking by reducing cravings for nicotineDiscuss a school-based program that appears effective in reducing rates of smokingProject EX: the treatment include training in coping skills and psychoeducation about the harmful effects of smoking. It is effective in the long-termIs it better/easier to quit smoking all at once, or to gradually taper offMuch more effective to gradually taper offTrue or false, substance used disorders are typically chronic, and relapse occurs oftenTrueDiscuss the relative effectiveness of CBT vs. contingency management for treatment of substance use disordersContingency appears to be more effective in the short-term, while CBT is more effective in the long-termTrue or false: Nicotine replacement therapies are highly effective to quit smokingFalse: they are only minimally related to success in quittingTrue or false: Detoxification is not central to the treatment of substance use disordersFalseWhat percentage of people who need treatment for substance use disorder do NOT get it?90% of people who need treatment for substance use disorder do not get itDiscuss the practice of CBT for Substance use disordersCBT is mean to help drugs users learn to avoid high-risk situations, to recognize triggers, and develop safer alternatives to drug useOne psychological treatment for substance use disorder is contingency management. What is this?Contingency management is a type of treatment in which substance users receive vouchers for not using drugs. These vouchers can later be traded in for desirable rewardsWhat is motivational enhancement theory for substance use disorders?CHECK BOOK. Motivational enhancement therapy combines CBT plus solution focused therapy, which has been shown to be effective for alcohol and drug useWhat are three benefits of self-help residential homes for treatment of substance use disorders?1. Provides a drug-free environment
2. Offers group therapy
3. Provides guidance and support from former usersWhat are three specific (and/or classes) of opioid substitutes that you should know?1. Synthetic narcotics
2. Methadone
3. Bupreophine (Suboxone)What is the purpose of opioid substitutes and how do they work? Discuss dropout rates and side effects in your answerOpioid substitutes are used to gradually wean people off opioids. They combat withdrawal symptoms, but they do not cause the person to experience the euphoric high associated with opioid use. Dropout is high, as these medications can cause severe side effects including insomnia, constipation, excessive sweating, and diminished sexual functionWhat is one opioid antagonist you should know for the exam? What does it do?Naltrexone is an opioid antagonist that is used to gradually wean people off of heroin or opioid pain medication. Naltrexone prevents a person from experiencing the euphoric high if they use opioidsName and describe two programs that are designed to discourage young people from experimenting with tobacco, including their effectiveness.1. The truth Initiative: Counters advertising that encourages young people to smoke
2. The Truth Campaign: Makes ads to tell youth about the health and social consequences of smokng and the ways in which the tobacco industry targets them. Awareness and agreement with Truth messages is associated with less smoking among teensDiscuss the effectiveness of statewide comprehensive tobacco control programs, and provide several examplesStatewide comprehensive tobacco control programs appear to be effective at reducing teenage smoking. These programs include increasing taxes on cigarettes, restricting tobacco advertising, conducting public education campaigns, and creating smoke-free environmentsTrue or false: The measures that hold promise for persuading young people to resist smoking may also be useful in dissuading them from trying other drugs and alcoholTrueDiscuss the effectiveness of brief family interventions for teen alcohol useBrief family interventions are associated with less initiation of alcohol use among teensWhat is gambling disorder characterized by?Needs to gamble with increasing amounts of money in order to achieve the desired excitement
Is restless or irritable when attempting to cut down or stop gambling
Has made repeated unsuccessful efforts to control, cut back, or stop gambling
Is often preoocupied with gambling
Often gambles when feeling distressed
After losing money gambling, often returns another day to get even ("chasing" one's loses)
Lies to conceal the extent of involvement with gambling
Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling
Gambling disorder cannot be explained by a manic episode
Relies on others to provide money to relieve desperate financial situation
Early expression of gambling is more common in males than females
Early-life gambling disorder appears to be associated with impulsivity and substance abuse
Mis and later laife onset of gambling disorder is more common in females than among males
Gambling activities vary by age (young people bet on sports, older adults go to casinos and play bingo)Internet gambling disorderThe APA has not deemed gambling disorder to be a new mental health problem
It's a "condition warranting more clinical research and experience before it might be considered for inclusion" in its own diagnostic manual
Gamblers use money as a way of keeping scores whereas gamers use points
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