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136 Cards in this Set
- Front
- Back
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What is the diagnostic criteria for substance abuse?
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1 or more in a year:
NOT meeting criteria for substance dependence 1) Don't fulfill role obligations 2) Hazardous drug use 3) Legal problems 4) Interpersonal problems |
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Why is use -> heavy use -> abuse -> dependence heiarchy characteristics?
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Mutually exclusive
Heirarchy Meet dependence, don't classify as abuse and dependence, but just dependence |
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In abuse, what is not fulfilling role obligations?
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Not going to school, work, being good parent
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What are hazards in abuse?
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Drinking and driving
Physical trouble |
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What are legal problems in abuse?
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Criminal justice
DUI Underage drinking Sell/buy illegal drugs |
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Why is it difficult to flesh out underlying disorder vs. bad, irresponsible behavior in abuse?
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Ex) 18-year old stepsister getting arrested for having a beer but not really having substance abuse; more like irresponsible
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What is substance dependence?
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3/7 needed:
1) Tolerance 2) Withdrawal 3) Large amounts of drug; intentions go down toilet 4) Can't quit 5) Much time; most important thing in life 6) Roles given up 7) Continued use despite problem; "i'll only hit rock bottom if i lose my kids/house/job" - when that happens, still keep using drug |
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What is tolerance with regards to dependence?
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Diminished returns
Liver gets quicker at metabolizing Receptors downregulated, need more drug to fire |
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What is withdrawal with regards to dependence?
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Physical and psychological pain getting off substance
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What is alcohol withdrawal delirium?
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1) Disorientation to time and place
2) Hallucinations 3) Fear 4) Suggestibility 5) Tremors 6) Perspiration, fever, rapid heart beat |
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What is disorientation in alcohol withdrawal delirium?
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Don't know where they are, date, time, place
ex) don't know Obama |
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What are hallucinations in alcohol withdrawal delirium?
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Small, scurrying things -> agitation
Same with meth |
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What is acute fear and why is treating it sort of counterproductive/how does it relate to alcohol activity in brain?
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Benzos addictive
Alcohol binds to GABA - major inhibitory neurotransmitter; benzos do same thing; reduces anxiety |
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What is extreme suggestibility linked to?
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Catatonic schizophrenia or hypnotized people
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What is alcohol amnestic syndrome?
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1) Korsakoff
2) Memory defect 3) Confabulation of memory 4) Cortical lesions 5) Vitamin B deficiency |
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What is Korsakoff's?
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Memory defects for recent events
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Why do people get alcohol amnestic syndrome (related to caloric intake?)
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Most calories come from booze; don't get nutrients and Vitamin B
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Out of all the countries, who is most using alcohol? Marijuana?
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Alcohol = Netherlands
Marijuana = USA |
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What does meth do in the brain?
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a) Transporters suck up meth as if it's dopamine
b) Meth enters dopamine vesicles and force meth and dopamine into synapse c) Excess dopamine in synaptic cleft binds to receptors again and again Works on reward pathway, intensely pleasurable and exhilarating |
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What does ecstasy do in the brain?
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a) mimics serotonin (OUTLIER)
b) sucked up c) confused transporter transports serotonin out of cell; serotonin binds again and again, overstimulating cell Indirectly works with reward pathway (affects mood, sleep, perception, and appetite) |
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What does cocaine do?
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a) Blocks dopamine receptors
b) Leaves dopamine in synaptic cleft c) Serotonin binds, overstimulates cell |
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What is mesocorticolimbic dopamine?
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"Reward pathway"
Dopaminergic neurons travel from limbic up to cortical system |
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From an evolutionary perspective, what do you need to know to do to eat good cheese again?
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1) Repeat reward by having a brain signal that it's GOOD
2) Saliency = most important thing |
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Why is this "reward pathway" problematic for those with substance abuse/dependence?
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Don't need drugs to function, yet have attentional bias
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What are long-term adaptive change in fewer D2 receptors after constantly flooding of dopamine?
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Constantly flooding is more than brain can handle; it will "cover its ears" and dial down its sensitivity to dampen signal
Brain adaptation response |
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What evidence shows that fewer/more D2 receptors is an adaption response?
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People who recover show a reuuptake of D2 dopamine receptor.
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In the video, what does the person say about adaptation to meth?
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When not on it, feels unnormal
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Why did the guy in the video not want to get off meth?
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Denial: "messed pictures up"
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How is the brain/body response to substances different due to genetics?
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MZ to DZ ratio shows that there are minimal shared environmental influences but rather gene-gene interactions, showing that there is a strongly heritable component of vulnerability.
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What are the enzymes involved in breaking down ethanol to acetylaldehyde to acetate?
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Ethanol -> Acetylaldehyde by alcohol dehydrogenase
Acetylaldehyde -> Acetate by aldehyde dehydrogenase Acetate removed by body |
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What does a mutation on the enzymes result in?
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The enzyme doesn't get produced well and alcohol breakdown isn't efficient
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What is flushing reaction?
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A sign that alcohol gets metabolized less than everyone else
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What ethnic groups are most likely to get flushing?
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East Asians = 40%
not Whites |
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How is the flushing reaction good for protecting against alcohol abuse?
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Aversive sign of how much you've consumed
Less pleasurable |
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Does the flushing reaction protect against other drug abuse?
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No, no less likely to use any other drug
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What is the worst mutation you could have in enzyme pathway?
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Efficient acetyladehyde (alcohol dehydrogenase) enzyme but inefficient acetate (aldehyde dehydrogenase) enzyme.
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What is GABRA2 related to?
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Alcohol/drug dependence
Adolescent conduct disorder Antisocial personality disorder |
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What is GABRA2, and how can it account for vulnerability?
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Receptor for GABA (alcohol binds to GABA to reduce anxiety)
If receptors bind to GABA differently, so have a risk allele, accounts for vulnerability |
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What are the alcohol dependence effects of GABRA2 related to age?
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At 18-22, don't have much differences between risk/normal GABRA2 alleles. Think sorority/fraternity. Yet as you grow older, this gap widens. Gene x Development interaction, it interferes with developmental life course
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What are the conduct disorder effects of GABRA 2 related to age?
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At 15-22, gene associated with conduct disorder (misbehavior in a serious or problematic way, precursor to antisocial personality)
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Thus why might the fact that GABRA 2 predicts conduct disorder affect how we view alcohol dependence and GABRA2?
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Gene predicts not alcohol dependence but how antisocial you are
Conduct disorder related to impulsivity and rule-breaking and going against social norms |
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What is one example of a gene x environment interaction related to smoking?
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Parental monitoring effect on genes
Given free reign, individual genetic vulnerability high; yet if parents monitor a lot, then effect goes away |
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What does the gene x environment interaction affect how we look at effects of genes?
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Look at people where genes are most important where effects NOT dampened by environment
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Thus why might the fact that GABRA 2 predicts conduct disorder affect how we view alcohol dependence and GABRA2?
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Gene predicts not alcohol dependence but how antisocial you are
Conduct disorder related to impulsivity and rule-breaking and going against social norms |
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What is one example of a gene x environment interaction related to smoking?
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Parental monitoring effect on genes
Given free reign, individual genetic vulnerability high; yet if parents monitor a lot, then effect goes away |
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What does the gene x environment interaction affect how we look at effects of genes?
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Look at people where genes are most important where effects NOT dampened by environment
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Why is it difficult to identify specific genes for substance abuse?
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1) High co-morbidity of co-occuring disorders: ex) GABRA2
2) Gene x Environment: ex) parental strictness and smoking 3) Gene x Development |
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What is antisocial behavior?
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Violates rights of others
May not be indicative of antisocial personality disorder or psychopathy, ex) 15-year old skipping school and running away |
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What is antisocial personality disorder?
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Pervasive pattern of antisocial behavior, some personality characteristics
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What is psychopathy?
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Personality traits, like glib, fearless, dominant, yet don't have to commit a crime
If committed a crime and felt remorse, not a psychopath |
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What is the DSM-IV criteria for ASPD?
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1) Violate rights of people
2) Since age 15 3) Conduct disorder before age 15 |
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Why is there such an emphasis on age for ASPD?
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ASPD is pervasive over a person's life span; it's not enough to regard the present, but need to have evidence that it's gone on before adulthood
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What are the social norm symptoms of ASPD?
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a) Breaks law - crimes
b) Doesn't plan - don't care for basic needs c) Irresponsible - doesn't go to work or pay child support/debts |
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What are the interpersonal symptoms of ASPD?
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a) Lack remorse
b) Disregard safety c) Aggression - assaults, fights d) Lying - aliases, profit |
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What do the symptoms of ASPD focus on as opposed to psychopathy?
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Behavior - do you lie, fight, commit crimes, not hold a job, pay debts, etc., which is deviant from most adult behavior
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Why can we say that someone like Bernie Madoff is not a psychopath?
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Some amount of psychopathy adaptive if someone is a CEO; there is a spectrum.
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What are some problems with disentangling ASPD as a mental disorder vs. issue of niceness?
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a) Lack of insight - maybe
b) Early abuse - maybe c) Cut-off for continuum d) All behavior has neurological correlates |
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How common is ASPD in women and men?
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1% women
1-3% men |
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How common is psychopathy?
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Less than 1%
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How common is ASPD and psychopathy in prison inmates?
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Among prison inmates, 70-80% qualify for ASPD and 25-30% qualify for psychopathy
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Among the 70% with ASPD yet not psychopathic and those w/o ASPD, do they end up becoming persistently rule-offending? Do they get guilt?
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No, don't rule-offend persistently
Have guilt |
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How does the degree of psychopathic traits predict likelihood of reoffending?
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High in psychopathic traits, see that the probability that you haven't reoffended is low.
3 years out, only 20% have not reoffended, basically meaning that 80% of them have reoffended |
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What are the two dimensions that distinguish ASPD and psychopathy?
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In psychopathy, you have
a) Affective dimension: lack of guilt, glibness, charm, grandiosity, callousness; don't care about you; charming and creepy b) Behavioral dimension: poor behavioral control, irresponsible, parasitic lifestyle |
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Why is it difficult to test psychopathy without incarceration/behavioral aspect?
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People don't really want to say "yes" to negative aspects of themselves, so willing research subjects are incarcerated
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What kind of process of making a moral calculus is there for psychopaths?
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No knee-jerk emotional reaction
Make pros and cons |
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What is deficient fear conditioning and relation to psychopathy?
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Low fear reaction in anticipating bad event
Slow to stop responding even after punished |
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What are the differences in fear conditioning of scaredy cats and psychopaths? How does this relate to psychopaths lacking an intuitive response?
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If psychopaths lack an intuitive response, maybe they've had a lifelong history of deficient fear conditioning
Scaredy cats - get conditioned response more quickly than psychopaths; the response is dependent on fear conditioning |
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In the study of 10 German psychopaths awaiting parole, what happened to their sympathetic nervous system in response to UCS?
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UCS - painful skin pressure
CS - face Psychopaths didn't have an increase in their sympathetic nervous system (electrogernic activity) |
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What are some problems with disentangling ASPD as a mental disorder vs. issue of niceness?
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a) Lack of insight - maybe
b) Early abuse - maybe c) Cut-off for continuum d) All behavior has neurological correlates |
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How common is ASPD in women and men?
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1% women
1-3% men |
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How common is psychopathy?
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Less than 1%
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How common is ASPD and psychopathy in prison inmates?
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Among prison inmates, 70-80% qualify for ASPD and 25-30% qualify for psychopathy
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Among the 70% with ASPD yet not psychopathic and those w/o ASPD, do they end up becoming persistently rule-offending? Do they get guilt?
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No, don't rule-offend persistently
Have guilt |
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How does the degree of psychopathic traits predict likelihood of reoffending?
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High in psychopathic traits, see that the probability that you haven't reoffended is low.
3 years out, only 20% have not reoffended, basically meaning that 80% of them have reoffended |
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What are the two dimensions that distinguish ASPD and psychopathy?
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In psychopathy, you have
a) Affective dimension: lack of guilt, glibness, charm, grandiosity, callousness; don't care about you; charming and creepy b) Behavioral dimension: poor behavioral control, irresponsible, parasitic lifestyle |
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Why is it difficult to test psychopathy without incarceration/behavioral aspect?
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People don't really want to say "yes" to negative aspects of themselves, so willing research subjects are incarcerated
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What kind of process of making a moral calculus is there for psychopaths?
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No knee-jerk emotional reaction
Make pros and cons |
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What is deficient fear conditioning and relation to psychopathy?
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Low fear reaction in anticipating bad event
Slow to stop responding even after punished |
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What are the differences in fear conditioning of scaredy cats and psychopaths? How does this relate to psychopaths lacking an intuitive response?
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If psychopaths lack an intuitive response, maybe they've had a lifelong history of deficient fear conditioning
Scaredy cats - get conditioned response more quickly than psychopaths; the response is dependent on fear conditioning |
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In the study of 10 German psychopaths awaiting parole, what happened to their sympathetic nervous system in response to UCS?
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UCS - painful skin pressure
CS - face Psychopaths didn't have an increase in their sympathetic nervous system (electrogernic activity) |
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In the German 10 psychopath study, did they also show differences in brain after being punished?
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No, in their amygdala and ACC, psychopaths had no response. The brain activity shown in controls was absent in them.
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How can we know that the German 10 psychopaths didn't just not learn that the pain was associated with the face?
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Validity check to see both groups learned it fine
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What was the relationship of decreased fear conditioning during 3-8 years and relation to aggression at age 8?
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Reduced fear conditioning from 3-8 is associated with aggressive behavior at age 8
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How did they test that decreased fear conditioning during 3-8 years related to aggression at age 8?
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Paired a bell with loud noise
Normally, more rapidly acquire fear response than when you are 3 Yet some already below initial level at 3, and then demonstrated an attenuated developmental increase People rated those poor-conditioning children as more aggressive and antisocial |
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Would low aggressive or high aggressive kids be better at fear conditioning?
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Low aggressive would be better at fear conditioning
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What is heterotypic continuity?
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Constant underlying development process or impairment, with developmentally-specific manifestations
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What are 3 concepts used to understand how not every aggressive person becomes antisocial, but antisocial behavior has a history of aggression dating back to childhood?
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1) Heterotypic
2) Multifinality 3) Equifinality |
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What is multifinality?
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Start with kids with same development (ex. aggressive, yet one is high and the other low anxiety, and so branch out in different ways)
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What is equifinality?
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People arrive at same place from different places
ex) No history of problems yet influenced by peers during adolescence |
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Who is more at risk of stable course of antisocial acts, those that commit when they are young or old?
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When they were younger starters
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How does automatic conditioning process help you when it comes to decision making? (Iowa gambling task)
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In bad decks, losses are bigger and happen more frequently; wil lose more money; over time you would play more from good and avoid bad decks
Bad decks have an aversive response though not consciously aware = somatic marker |
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(Iowa Gambling task) - What happens if we give people with deficits in medial prefrontal cortex (b/c teens, injury, or psychopathic?)
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No change in electrogernic activity and keep pulling from bad decks over and over again
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Do psychopaths have good implicit learning in Iowa Gambling?
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NO; they chose bad decks without being consciously aware of it, lacking implicit fear process
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What is the callous-unemotional scale?
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It measures psychopathy in children
a) no emotions; doesn't help; doesn't feel guilt; no friends; not considerate or kind; truant |
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How heritable is unemotionality on the callous-unemotional scale?
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Twin study - 80%
Kids inherit differential responses to fear conditioning, translating to "psychopathy" |
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What is the trend of arrests, considering age?
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Peak at 16, 17 year olds commit
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Why might there be the trends of arrests?
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Developmental processes of maturation
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What are the two types of antisocial behavior?
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1) Life-course persistent; start as kids->adolescents->adults, LESS THAN 5%
2) Adolescence Limited - mature later |
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Who are adolescence limited people different from?
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Different from psychopaths or adult antisocial personality disorders
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What long-term effects does risk-taking behavior in adolescents have?
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1) increased risk for adult psychopathology
2) mortality higher 3) 50% of new HIV infections 4) commit 30% of crimes |
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Why might maturing even though you have adolescent limited antisocial personality disorder be useless in some ways?
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Real-life consequences
ex) unprotected sex->HIV ex) jail -> criminal record |
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What is the developmental perspective of antisocial personality disorder?
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1) Bio/Psych maturity and social/financial autonomy asynchronous
2) Emulate adult-like behaviors to achieve mature social status |
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Why is it that there is an increase in adolescent limited antisocial behavior as compared to before?
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People have better health and nutrition, but delay adulthood milestones like getting babies after grad school
Long gap where someone is biologically mature yet socially immature |
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What is correlated with a bigger gap between biological and social maturation?
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Delinquency
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How is the gap of biological and social maturation correlated with rule-breaking activities?
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15-year olds want to be autonomous and respected--> more likely antisocial
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As age increases, what happens to white matter?
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Prefrontal cortex keeps maturing, improving inhibition of responses
Peak at 24 years old |
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What is limbic system influenced by (during adolescence)?
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Pubertal hormones
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During adolescence, what do pubertal hormones initiate?
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Parts of brain responsive to rewards and novelty
ex) adolescents more excited than adults when given $$ Brakes for inhibition have another 10 years before they reach full potential |
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In the mean age trends in impulsivity and sensation seeking, what is going up or down during age?
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After puberty, sensation seeking (new, danger) spikes, yet then decreases after age 15
Impulsivity, after age 12, goes down 24 year olds less impulsive than 16-year olds |
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What did the graph of sensitivity to positive and negative feedback by age
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As people got older, then learn more rapidly that bad decks are bad (more negative slope); if slow on uptake, then have a less negative slope
Ability to learn information is based on negative feedback, improving in impulsivity; adolescents are worse learners |
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Why do we say that adolescent delinquency is NOT in a vacuum?
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Crimes happen in groups
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What is the Larry Steinberg study?
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People played risky driving task; get there as fast as you can to get $$, but run yellow lights; see how much they crash
Crash more around friends Ventral striata activity was highest in adolescents peer conditions - inherently rewarding |
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Why is it that there is an increase in adolescent limited antisocial behavior as compared to before?
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People have better health and nutrition, but delay adulthood milestones like getting babies after grad school
Long gap where someone is biologically mature yet socially immature |
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What is correlated with a bigger gap between biological and social maturation?
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Delinquency
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How is the gap of biological and social maturation correlated with rule-breaking activities?
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15-year olds want to be autonomous and respected--> more likely antisocial
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As age increases, what happens to white matter?
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Prefrontal cortex keeps maturing, improving inhibition of responses
Peak at 24 years old |
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What is limbic system influenced by (during adolescence)?
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Pubertal hormones
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During adolescence, what do pubertal hormones initiate?
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Parts of brain responsive to rewards and novelty
ex) adolescents more excited than adults when given $$ Brakes for inhibition have another 10 years before they reach full potential |
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In the mean age trends in impulsivity and sensation seeking, what is going up or down during age?
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After puberty, sensation seeking (new, danger) spikes, yet then decreases after age 15
Impulsivity, after age 12, goes down 24 year olds less impulsive than 16-year olds |
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What did the graph of sensitivity to positive and negative feedback by age
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As people got older, then learn more rapidly that bad decks are bad (more negative slope); if slow on uptake, then have a less negative slope
Ability to learn information is based on negative feedback, improving in impulsivity; adolescents are worse learners |
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Why do we say that adolescent delinquency is NOT in a vacuum?
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Crimes happen in groups
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What is the Larry Steinberg study?
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People played risky driving task; get there as fast as you can to get $$, but run yellow lights; see how much they crash
Crash more around friends Ventral striata activity was highest in adolescents peer conditions - inherently rewarding |
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What is ventral striata?
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Rewarding part of brain
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Do boys or girls have more crashing around friends in Larry Steinberg study?
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More differential for boys
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What is the differential vulnerability someone has for alcohol use if your best friend drinks?
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Low genetic risk - no association with BF
High - association Maybe genetic risk influences choosing peers |
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Why might there be a difference between men and women for borderline personality disorder?
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When females are impulsive or aggressive, call them borderline, not antisocial
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What is DSM-IV description of borderline personality disorder?
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Instability of relationships and self-image, Impulsivity (cognitive and behavioral)
ex) love you hate you |
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What is the interpersonal DSM criteria of borderline personality disorder?
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a) avoid abandonment - suicide attempts, calling
b) alternate between idealization and devaluation - woman beat her partner with pipe and love justified c) anger |
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What is the affective/cognitive aspect of borderline personality disorder?
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a) reactivity of mood - on days, triggered by interpersonal relationships
b) emptiness - uncomfortable c) paranoia/dissociation because of stress - ex) evil biatch doctor that really hates me d) unstable self-image - changing looks, partners, clothing, religion |
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What is the behavioral aspect of borderline personality disorder?
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a) impulsivity - spending, eating, shoplifting, drugs
b) suicide/mutilation |
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What is the "spectrum of functioning" of BPD?
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Psychotic -> borderline (self-harm and suicidality) -> neurotic -> well
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What are the major theories of BPD?
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a) Object relations theory - transference focused psychotherapy
b) CBT/DBT- dialectical-behavior therapy c) bipolar-cyclothymia theory - drugs |
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What is the core of BPD?
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Difficulties in interpersonal functioning (impulsive, unstable mood/self-image)
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How do we test BPD interpersonal conflicts in lab?
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Game theory - BPD takes but doesn't give
- BPD trustee, decreased amount of investment over game - don't want to repair cooperation - breakdown of cooperation |
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The less someone gives you $$, what happens to your anterior insula?
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Anterior insula increases - detect broken interpersonal relationship, and try to repair it
in BPD - repair broken |
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What does the MZ:DZ ratio reflect?
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The MZ:DZ ratio reflects how much more similar MZ twins are than DZ twins. Because MZ twins share 100% of their genes, and DZ twins share 50%, then if all of similarity between family members is due to genes, then the MZ twin: DZ twin ratio should equal 2:1.
The main point of the slide is that all of the ratios are above 1 (MZ twins are always more similar than DZ twins) and in many cases they are around 2. So, that means that all of the different types of substance use are more heavily influenced by genes than by differences in family environment. |
