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Abnormal Psychology 30
3/18/09 Chapter 10 - Substance-Related and Impulse-Control Disorders
Substance-Related Disorders: Overview
The Nature of Substance-Related Disorders
Use and abuse of psychoactive substances
Broad class of drugs that alters mood/behavior ingested to get intoxicated/high
Wide-ranging physiological, psychological, and behavioral effects
Associated with impairment and significant costs
Costs Billions of $/year
Kills 500,000 people/year
Implicated in street crime, homelessness, and gangs
Some Important Terms and Distinctions
Substance use vs. Substance intoxication
Substance use -
Substance intoxication –
Tolerance vs. withdrawal
Tolerance - needing increasing amounts to achieve intoxication/diminished effect with continued use
Withdrawal - characteristic withdrawal syndrome or relieving/avoiding withdrawal symptoms by taking the
same (or closely related) substance Substance Abuse DSM-IV Checklist
A 12-month period of maladaptive pattern of substance use
Recurrent use in situations in which it
.
.
.
Based on extent of SDI -
Criteria for substance dependence isn’t met
Maduramente
-1-
Abnormal Psychology 30
3/18/09
Substance Dependence DSM-IV Checklist
Addiction is a 12-month period marked by
.
.
.
.
.
Use despite knowledge of a persistent physical or psychological problem caused or exacerbated by the substance
Five Main Categories of Substances
Depressants -
Stimulants -
Opiates -
Hallucinogens -
Other drugs -
The Depressants: Alcohol Use Disorders
Psychological and Physiological Effects of Alcohol
Central Nervous system depressant
Influences several neurotransmitter systems
Maduramente
.
.
.
-2-
Abnormal Psychology 30
3/18/09
Effects of Chronic Alcohol Use
Liver disease, pancreatitis, CVD, brain damage
Withdrawal may include tremors, nausea, vomiting, anxiety, insomnia, agitation, and withdrawal delirium (DTs)
Delirium tremens can produce hallucinations and body tremors
Associated brain conditions
Dementia - neurotoxicity
Wernicke’s disease - thiamine deficiency
Fetal alcohol syndrome (FAS) in babies
Alcohol: Facts and Statistics
In the United States
Most adults consider themselves light drinkers or abstainers
Over 50% of people 12 years and older report current use
Alcohol use is highest among Caucasian Americans
Males use and abuse alcohol more so than females
Violence is associated with alcohol
Does not cause aggression, rather it reduces fear and increases impulsivity
Statistics on Abuse and Dependence
23% report binge drinking (5 or more in one occasion), many people fluctuate in their use
15 million Americans are alcohol dependent
20% with alcohol problems experience spontaneous recovery
Sedative, Hypnotic, or Anxiolytic Substance Use Disorders: Overview
The Nature of Drugs in This Class
Sedatives -
Hypnotic -
Anxiolytic -
Effects Are Similar to Large Doses of Alcohol
Maduramente
Relaxes muscles (Rohypnol or “roofies”)
-3-
Abnormal Psychology 30
3/18/09
Combining such drugs with alcohol is synergistic
.
Depressant Drugs DSM-IV Checklist
Includes maladaptive behavioral changes
nappropriate sexual or aggressive behavior
Variable moods
Impaired judgment
Impaired social or occupational functioning
Stimulants: Overview
Nature of Stimulants
Most widely consumed drug in the U.S.
Used for asthma, nasal congestion, and weight loss, narcolepsy, and ADHD
Such drugs increase alertness and increase energy
Examples include amphetamines (speed and ecstasy), cocaine, nicotine, and caffeine
Stimulants: Amphetamine Use Disorders
Effects of Amphetamines
Produce elation, vigor, reduce fatigue
Such effects are followed by extreme fatigue and depression “crash”
Amphetamines stimulate CNS by
.
.
Excess can cause hallucinations/delusions
Withdrawal similar to depression
Amphetamine Intoxication DSM Checklist
Euphoria or affective blunting
Psychological Symptoms
Maduramente
-4-
Abnormal Psychology 30
3/18/09
Sociability and Interpersonal sensitivity; anxiety, tension, or anger; impaired judgment, social, or occupational
functioning
Physiological symptoms
Changes in HR and BP; perspiration or chills, nausea or vomiting; weight loss; muscular weakness; respiratory
depression; chest pain; seizures or coma Stimulants: Cocaine Use Disorders
Effects of Cocaine
.
Short lived sensations of elation, vigor, reduce fatigue
Highly addictive, but addiction develops slowly
Most Cycle Through Patterns of Tolerance and Withdrawal
Stimulants: Nicotine Use Disorders
Effects of Nicotine
.
Small doses results in sensations of relaxation, wellness, pleasure
High doses can blur vision, cause confusion, cunvulsions, death
Long term use can cause high BP, Heart disease, COPD, and cancer
Highly addictive
Smoking has complex relationship to negative affect
Appears to help improve mood in short-term
Related to depression, anxiety, and anger
Depression occurs more in those with nicotine dependence
Relapse rates equal those seen with alcohol and heroin
About 30% of Americans are smokers
Stimulants: Caffeine Use Disorders
Effects of Caffeine – The “Gentle” Stimulant
Maduramente
.
-5-
Abnormal Psychology 30
Small doses elevate mood and reduce fatigue
Large doses produces jitteriness and insomnia
Regular use can result in tolerance and dependence
Withdrawal includes headaches, drowsiness, and general unpleasant mood
3/18/09
Used by over 90% of Americans
Opiods: Overview
The Nature of Opiates and Opiods
Opiate -
Opiods -
Often referred to as analgesics (relieves pain)
Includes Methadone, Heroin, opium, codeine, and morphine
Effects of Opiods
.
Low doses induce euphoria, drowsiness, and slowed breathing
High doses can result in death if respiration is completely depressed.
Opiates are analgesics (i.e., substances that help relieve pain such as morphine).
Opiods: Facts and Statistics
Withdrawal symptoms can be lasting and severe (Symptoms for 1-3 days)
excessive yawning, nausea and vomiting, chills, muscle aches, diarrhea, and insomnia
Mortality rates are high for opiod addicts
High risk for HIV infection
28% die prematurely due to homicide, suicide, and accidents
Maduramente
33% of these result from overdose
-6-
Abnormal Psychology 30
3/18/09
Hallucinogens: Overview
Nature of Hallucinogens
Change the way the user perceives the world
May produce
Delusions, paranoia, hallucinations, altered sensory perception
Examples include marijuana, LSD, psilocybin, and mescaline
Hallucinogens: Marijuana
Marijuana (from cannabis sativa)
Reactions to marijuana include mood swings, heightened sensory experiences, paranoia, hallucinations,
dizziness, and impairment of memory, concentration, amotivational syndrome, self-esteem, and interpersonal and occupational relationships.
Withdrawal and dependence are uncommon
Evidence suggest tolerance in heavy users, reverse tolerance in regular users
Hallucinogens: LSD
LSD is most common form of hallucinogenic drug
Produced synthetically from the ergot fungus
This fungus was known in the Middle Ages to lead to ergotism - constricted blood flow to the arms or legs,
eventually resulting in gangrene and loss of limbs
Another type of illness resulted in convulsions, delirium, and hallucinations
Hallucinogens: Other Hallucinogens
Other Hallucinogens
Psilocybin- found in certain species of mushrooms
Lysergic acid amide- found in the seeds of the morning glory plant
Dimethyltryptamine- found in the bark of the Virola tree which grows in South and Central America
Mescaline- found in the peyote cactus plant
LSD and Other Hallucinogens: Facts
LSD and Other Hallucinogens
Tolerance is rapid and withdrawal symptoms are uncommon
Maduramente
Repeated use causes loss of effectiveness, complete abstinence for a week returns sensitivity
-7-
Abnormal Psychology 30
3/18/09
Can produce psychotic delusions and hallucinations (e.g., people jumping out of windows because they believed
they could fly). Hallucinogens: Marijuana and LSD
Structure of these drugs mimic natural neurtransmitters
Marijuana contains cannabinoids, most common is tetrahydrocannabinol (THC)
.
LSD and psilocybin is similar to serotonin
Mescaline resembles norepinephrine
Hallucinogens DSM Checklist
Hallucinogen intoxication are similar to those for marijuana
Include perceptual changes
ntensification of perceptions
Depersonalization
Hallucinations
Papillary dilation
Rapid heart beat
Sweating
Blurred vision.
Other Drugs of Abuse: Inhalants
Nature of Inhalants
.
Breathed directly into lungs and rapidly absorbed into bloodstream
.
Tolerance and prolonged symptoms of withdrawal are common
Examples
Aerosole sprays, paint thinner, gasoline, markers, and nitrous oxide (whippets), etc.
Other Drugs of Abuse: Anabolic Steroids
Nature of Anabolic-Androgenic Steroids
Maduramente
.
-8-
Abnormal Psychology 30
Used medicinally (asthma, anemia, breast cancer) or to increase body mass
Users may engage in cycling or stacking
.
Can result in long-term mood disturbances and physical problems
3/18/09
Other Drugs of Abuse: Designer Drugs
Drugs produced by pharmaceutical companies for specific diseases/disorders
All produce tolerance and withdrawal
Ecstasy
MDEA or “Eve” and BDMPEA or “Nexus”
.
Ketamine (street name “K,” “Special K,” or “Cat Valium)
.
.
GHB or “Liquid Ecstasy”
CNS depressant marketed in health food stores in the 1980s as muscle growth stimulants
.
.
Causes of Substance-Related Disorders: Family and Genetic Influences
Results of Family, Twin, and Adoption Studies
Substance abuse has a genetic component
Much of the focus has been on alcoholism
Maduramente
-9-
Abnormal Psychology 30
3/18/09
Genetic differences in alcohol metabolism
Multiple genes are involved in substance abuse
Neurobiological Influences
Results of Neurobiological Research
Drugs affect the pleasure or reward centers in the brain
Positive reinforcement –
Negative reinforcement –
Psychological Dimensions
Role of Positive and Negative Reinforcement
Positive reinforcement –
Negative reinforcement –
The self-medication and the tension reduction hypotheses
.
Opponent-Process Theory
.
.
Role of Expectancy Effects
Maduramente
.
- 10 -
Abnormal Psychology 30
3/18/09
.
Cravings
Social and Cultural Dimensions
Exposure to Drugs is a Prerequisite for Use of Drugs
Media, family, peers
Parents and the family appear critical
Societal Views About Drug Abuse
Psychological view –
Biological view –
The Role of Cultural Factors
Influence the manifestation of substance abuse
College subculture normalizes episodes of binge drinking
Korean culture expects binge drinking in certain occasions
Native Americans use substances for religious ceremonies
Treatment of Substance-Related Disorders
Motivation to work on the problem is essential
Generally, prognosis is not positive
Balancing Treatment Goals
Complete abstinence –
Controlled use –
Biological Treatment of Substance-Related Disorders
Agonist Substitution
.
Maduramente
.
- 11 -
Abnormal Psychology 30 Antagonistic Treatment
.
3/18/09
.
Aversive Treatment
.
.
Other kinds include antidepressants and sedatives
Efficacy of Biological Treatment
Generally ineffective when used alone
Psychosocial Treatment of Substance-Related Disorders
Inpatient vs. Outpatient Care
Community Support Programs
Little difference in effectiveness
Alcoholics Anonymous (AA) and related groups (e.g., NA) seem helpful and are strongly encouraged
Comprehensive Treatment and Prevention Programs
Individual and group therapy
Aversion therapy and convert sensitization
Contingency management
Community reinforcement
Relapse prevention
Preventative efforts via education
DSM-IV-TR Impulse-Control Disorders
Each is Characterized by
.
.
.
Maduramente
- 12 -
Abnormal Psychology 30
3/18/09
Intermittent Explosive Disorder
.
.
Facts
Rare condition
Leads to injury and/or destruction of property
Few controlled treatment studies, but CBT interventions and approaches modeled after drug treatment programs
seem to be most effective Kleptomania
.
Facts
Seems rare, but it is not well studied
Highly comorbid with mood disorders
Also co-occurs with substance-related problems
Pyromania
.
Facts
Diagnosed in less than 4% of arsonists
Little etiological and treatment research
Pathological Gambling
.
Facts
Affect 3-5% adult Americans
Treatment is similar to that for substance dependence
Maduramente
- 13 -
Abnormal Psychology 30
3/18/09
Trichotillomania
.
Facts
Observed in 1-5% of college students, mostly female
Clomipramine and CBT have been shown to be helpful
Summary of Substance-Related Disorders
.
Psychosocial Factors Interact with Biological Influences
Treatment of Substance Dependence
Largely unsuccessful
Highly motivated persons do best
Important to use comprehensive approach
DSM-IV-TR Substance Related Disorders
Cover Four Classes
Depressants, stimulants, opiates, and hallucinogens
Diagnoses include dependence, abuse, intoxication, or withdrawal
An Integrative Model of Substance-Related Disorders
Exposure or Access to a Drug
Is a necessary, but not sufficient
Drug Use/Abuse Depends on many complex reasons
Social and cultural expectations
The pleasurable consequences
Presence of major stressors
Genetic Influences
The premise of equifinality
Consider psychological, genetic, social, and learning factors
Maduramente
- 14 -
3/18/09 Chapter 10 - Substance-Related and Impulse-Control Disorders
Substance-Related Disorders: Overview
The Nature of Substance-Related Disorders
Use and abuse of psychoactive substances
Broad class of drugs that alters mood/behavior ingested to get intoxicated/high
Wide-ranging physiological, psychological, and behavioral effects
Associated with impairment and significant costs
Costs Billions of $/year
Kills 500,000 people/year
Implicated in street crime, homelessness, and gangs
Some Important Terms and Distinctions
Substance use vs. Substance intoxication
Substance use -
Substance intoxication –
Tolerance vs. withdrawal
Tolerance - needing increasing amounts to achieve intoxication/diminished effect with continued use
Withdrawal - characteristic withdrawal syndrome or relieving/avoiding withdrawal symptoms by taking the
same (or closely related) substance Substance Abuse DSM-IV Checklist
A 12-month period of maladaptive pattern of substance use
Recurrent use in situations in which it
.
.
.
Based on extent of SDI -
Criteria for substance dependence isn’t met
Maduramente
-1-
Abnormal Psychology 30
3/18/09
Substance Dependence DSM-IV Checklist
Addiction is a 12-month period marked by
.
.
.
.
.
Use despite knowledge of a persistent physical or psychological problem caused or exacerbated by the substance
Five Main Categories of Substances
Depressants -
Stimulants -
Opiates -
Hallucinogens -
Other drugs -
The Depressants: Alcohol Use Disorders
Psychological and Physiological Effects of Alcohol
Central Nervous system depressant
Influences several neurotransmitter systems
Maduramente
.
.
.
-2-
Abnormal Psychology 30
3/18/09
Effects of Chronic Alcohol Use
Liver disease, pancreatitis, CVD, brain damage
Withdrawal may include tremors, nausea, vomiting, anxiety, insomnia, agitation, and withdrawal delirium (DTs)
Delirium tremens can produce hallucinations and body tremors
Associated brain conditions
Dementia - neurotoxicity
Wernicke’s disease - thiamine deficiency
Fetal alcohol syndrome (FAS) in babies
Alcohol: Facts and Statistics
In the United States
Most adults consider themselves light drinkers or abstainers
Over 50% of people 12 years and older report current use
Alcohol use is highest among Caucasian Americans
Males use and abuse alcohol more so than females
Violence is associated with alcohol
Does not cause aggression, rather it reduces fear and increases impulsivity
Statistics on Abuse and Dependence
23% report binge drinking (5 or more in one occasion), many people fluctuate in their use
15 million Americans are alcohol dependent
20% with alcohol problems experience spontaneous recovery
Sedative, Hypnotic, or Anxiolytic Substance Use Disorders: Overview
The Nature of Drugs in This Class
Sedatives -
Hypnotic -
Anxiolytic -
Effects Are Similar to Large Doses of Alcohol
Maduramente
Relaxes muscles (Rohypnol or “roofies”)
-3-
Abnormal Psychology 30
3/18/09
Combining such drugs with alcohol is synergistic
.
Depressant Drugs DSM-IV Checklist
Includes maladaptive behavioral changes
nappropriate sexual or aggressive behavior
Variable moods
Impaired judgment
Impaired social or occupational functioning
Stimulants: Overview
Nature of Stimulants
Most widely consumed drug in the U.S.
Used for asthma, nasal congestion, and weight loss, narcolepsy, and ADHD
Such drugs increase alertness and increase energy
Examples include amphetamines (speed and ecstasy), cocaine, nicotine, and caffeine
Stimulants: Amphetamine Use Disorders
Effects of Amphetamines
Produce elation, vigor, reduce fatigue
Such effects are followed by extreme fatigue and depression “crash”
Amphetamines stimulate CNS by
.
.
Excess can cause hallucinations/delusions
Withdrawal similar to depression
Amphetamine Intoxication DSM Checklist
Euphoria or affective blunting
Psychological Symptoms
Maduramente
-4-
Abnormal Psychology 30
3/18/09
Sociability and Interpersonal sensitivity; anxiety, tension, or anger; impaired judgment, social, or occupational
functioning
Physiological symptoms
Changes in HR and BP; perspiration or chills, nausea or vomiting; weight loss; muscular weakness; respiratory
depression; chest pain; seizures or coma Stimulants: Cocaine Use Disorders
Effects of Cocaine
.
Short lived sensations of elation, vigor, reduce fatigue
Highly addictive, but addiction develops slowly
Most Cycle Through Patterns of Tolerance and Withdrawal
Stimulants: Nicotine Use Disorders
Effects of Nicotine
.
Small doses results in sensations of relaxation, wellness, pleasure
High doses can blur vision, cause confusion, cunvulsions, death
Long term use can cause high BP, Heart disease, COPD, and cancer
Highly addictive
Smoking has complex relationship to negative affect
Appears to help improve mood in short-term
Related to depression, anxiety, and anger
Depression occurs more in those with nicotine dependence
Relapse rates equal those seen with alcohol and heroin
About 30% of Americans are smokers
Stimulants: Caffeine Use Disorders
Effects of Caffeine – The “Gentle” Stimulant
Maduramente
.
-5-
Abnormal Psychology 30
Small doses elevate mood and reduce fatigue
Large doses produces jitteriness and insomnia
Regular use can result in tolerance and dependence
Withdrawal includes headaches, drowsiness, and general unpleasant mood
3/18/09
Used by over 90% of Americans
Opiods: Overview
The Nature of Opiates and Opiods
Opiate -
Opiods -
Often referred to as analgesics (relieves pain)
Includes Methadone, Heroin, opium, codeine, and morphine
Effects of Opiods
.
Low doses induce euphoria, drowsiness, and slowed breathing
High doses can result in death if respiration is completely depressed.
Opiates are analgesics (i.e., substances that help relieve pain such as morphine).
Opiods: Facts and Statistics
Withdrawal symptoms can be lasting and severe (Symptoms for 1-3 days)
excessive yawning, nausea and vomiting, chills, muscle aches, diarrhea, and insomnia
Mortality rates are high for opiod addicts
High risk for HIV infection
28% die prematurely due to homicide, suicide, and accidents
Maduramente
33% of these result from overdose
-6-
Abnormal Psychology 30
3/18/09
Hallucinogens: Overview
Nature of Hallucinogens
Change the way the user perceives the world
May produce
Delusions, paranoia, hallucinations, altered sensory perception
Examples include marijuana, LSD, psilocybin, and mescaline
Hallucinogens: Marijuana
Marijuana (from cannabis sativa)
Reactions to marijuana include mood swings, heightened sensory experiences, paranoia, hallucinations,
dizziness, and impairment of memory, concentration, amotivational syndrome, self-esteem, and interpersonal and occupational relationships.
Withdrawal and dependence are uncommon
Evidence suggest tolerance in heavy users, reverse tolerance in regular users
Hallucinogens: LSD
LSD is most common form of hallucinogenic drug
Produced synthetically from the ergot fungus
This fungus was known in the Middle Ages to lead to ergotism - constricted blood flow to the arms or legs,
eventually resulting in gangrene and loss of limbs
Another type of illness resulted in convulsions, delirium, and hallucinations
Hallucinogens: Other Hallucinogens
Other Hallucinogens
Psilocybin- found in certain species of mushrooms
Lysergic acid amide- found in the seeds of the morning glory plant
Dimethyltryptamine- found in the bark of the Virola tree which grows in South and Central America
Mescaline- found in the peyote cactus plant
LSD and Other Hallucinogens: Facts
LSD and Other Hallucinogens
Tolerance is rapid and withdrawal symptoms are uncommon
Maduramente
Repeated use causes loss of effectiveness, complete abstinence for a week returns sensitivity
-7-
Abnormal Psychology 30
3/18/09
Can produce psychotic delusions and hallucinations (e.g., people jumping out of windows because they believed
they could fly). Hallucinogens: Marijuana and LSD
Structure of these drugs mimic natural neurtransmitters
Marijuana contains cannabinoids, most common is tetrahydrocannabinol (THC)
.
LSD and psilocybin is similar to serotonin
Mescaline resembles norepinephrine
Hallucinogens DSM Checklist
Hallucinogen intoxication are similar to those for marijuana
Include perceptual changes
ntensification of perceptions
Depersonalization
Hallucinations
Papillary dilation
Rapid heart beat
Sweating
Blurred vision.
Other Drugs of Abuse: Inhalants
Nature of Inhalants
.
Breathed directly into lungs and rapidly absorbed into bloodstream
.
Tolerance and prolonged symptoms of withdrawal are common
Examples
Aerosole sprays, paint thinner, gasoline, markers, and nitrous oxide (whippets), etc.
Other Drugs of Abuse: Anabolic Steroids
Nature of Anabolic-Androgenic Steroids
Maduramente
.
-8-
Abnormal Psychology 30
Used medicinally (asthma, anemia, breast cancer) or to increase body mass
Users may engage in cycling or stacking
.
Can result in long-term mood disturbances and physical problems
3/18/09
Other Drugs of Abuse: Designer Drugs
Drugs produced by pharmaceutical companies for specific diseases/disorders
All produce tolerance and withdrawal
Ecstasy
MDEA or “Eve” and BDMPEA or “Nexus”
.
Ketamine (street name “K,” “Special K,” or “Cat Valium)
.
.
GHB or “Liquid Ecstasy”
CNS depressant marketed in health food stores in the 1980s as muscle growth stimulants
.
.
Causes of Substance-Related Disorders: Family and Genetic Influences
Results of Family, Twin, and Adoption Studies
Substance abuse has a genetic component
Much of the focus has been on alcoholism
Maduramente
-9-
Abnormal Psychology 30
3/18/09
Genetic differences in alcohol metabolism
Multiple genes are involved in substance abuse
Neurobiological Influences
Results of Neurobiological Research
Drugs affect the pleasure or reward centers in the brain
Positive reinforcement –
Negative reinforcement –
Psychological Dimensions
Role of Positive and Negative Reinforcement
Positive reinforcement –
Negative reinforcement –
The self-medication and the tension reduction hypotheses
.
Opponent-Process Theory
.
.
Role of Expectancy Effects
Maduramente
.
- 10 -
Abnormal Psychology 30
3/18/09
.
Cravings
Social and Cultural Dimensions
Exposure to Drugs is a Prerequisite for Use of Drugs
Media, family, peers
Parents and the family appear critical
Societal Views About Drug Abuse
Psychological view –
Biological view –
The Role of Cultural Factors
Influence the manifestation of substance abuse
College subculture normalizes episodes of binge drinking
Korean culture expects binge drinking in certain occasions
Native Americans use substances for religious ceremonies
Treatment of Substance-Related Disorders
Motivation to work on the problem is essential
Generally, prognosis is not positive
Balancing Treatment Goals
Complete abstinence –
Controlled use –
Biological Treatment of Substance-Related Disorders
Agonist Substitution
.
Maduramente
.
- 11 -
Abnormal Psychology 30 Antagonistic Treatment
.
3/18/09
.
Aversive Treatment
.
.
Other kinds include antidepressants and sedatives
Efficacy of Biological Treatment
Generally ineffective when used alone
Psychosocial Treatment of Substance-Related Disorders
Inpatient vs. Outpatient Care
Community Support Programs
Little difference in effectiveness
Alcoholics Anonymous (AA) and related groups (e.g., NA) seem helpful and are strongly encouraged
Comprehensive Treatment and Prevention Programs
Individual and group therapy
Aversion therapy and convert sensitization
Contingency management
Community reinforcement
Relapse prevention
Preventative efforts via education
DSM-IV-TR Impulse-Control Disorders
Each is Characterized by
.
.
.
Maduramente
- 12 -
Abnormal Psychology 30
3/18/09
Intermittent Explosive Disorder
.
.
Facts
Rare condition
Leads to injury and/or destruction of property
Few controlled treatment studies, but CBT interventions and approaches modeled after drug treatment programs
seem to be most effective Kleptomania
.
Facts
Seems rare, but it is not well studied
Highly comorbid with mood disorders
Also co-occurs with substance-related problems
Pyromania
.
Facts
Diagnosed in less than 4% of arsonists
Little etiological and treatment research
Pathological Gambling
.
Facts
Affect 3-5% adult Americans
Treatment is similar to that for substance dependence
Maduramente
- 13 -
Abnormal Psychology 30
3/18/09
Trichotillomania
.
Facts
Observed in 1-5% of college students, mostly female
Clomipramine and CBT have been shown to be helpful
Summary of Substance-Related Disorders
.
Psychosocial Factors Interact with Biological Influences
Treatment of Substance Dependence
Largely unsuccessful
Highly motivated persons do best
Important to use comprehensive approach
DSM-IV-TR Substance Related Disorders
Cover Four Classes
Depressants, stimulants, opiates, and hallucinogens
Diagnoses include dependence, abuse, intoxication, or withdrawal
An Integrative Model of Substance-Related Disorders
Exposure or Access to a Drug
Is a necessary, but not sufficient
Drug Use/Abuse Depends on many complex reasons
Social and cultural expectations
The pleasurable consequences
Presence of major stressors
Genetic Influences
The premise of equifinality
Consider psychological, genetic, social, and learning factors
Maduramente
- 14 -
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