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21 Cards in this Set
- Front
- Back
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What is addiction?
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-repetitive and compulsive behavior resulting in neuroadaptation
0complex, dynamic and ever evolving neurochemical event develops and is maintained by biological, psychologica, and cultural factors |
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Symptomatology of withdrawal: Depressants
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-anxiety
-insomnia -increased heart and respiratory rates -elevated body temperature -anxious-Depressed mood -panic attacks |
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Symptomatology of withdrawl: Stimulants
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-hyperphasia & hypersomnia
-languid |
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Symptomatology of withdrawl: Opiates
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-runny nose
-diarrhea -generalized pain |
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Treatment
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-Psychoeducation (for client and loved ones)
-psyhopharmaceutical methods: may recover over time -motivational interviewing (what client wants) -Behavioral techniques: CBT: avoidance, time-out, refusal skills -increase self-disclose to gain client trust -involve significant others and family -emphasize self-awareness: pattern of thoughts (break cycle) -relapse prevention (b/c most end up in relapse stage) -increase coping skills -Contingency management: reinforce/punish actions in order to increase abstinence and enhance therapy -outpatient treatment -Community reinforcement approach: 24 individual sessions, 24 follow-up sessions (esp. for cocaine users) |
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what are three kinds of neurology of chemical addictions
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-impaired motivational reward
-impaired affect regulation -impaired behavioral inhibition |
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Describe impaired motivational reward
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-exposes addicts to unsatisfied states of
-irritable tension, -emptiness -restless anhedonia -behaviors that are associated with the activation of the reward system are more strongly reinforced |
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Describe impaired affect regulation
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-renders addicts chronically vulnerable to
-painful affect emotional instability -behaviors to escape painful affects are reinforced |
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Describe impaired behavioral inhibition
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-the short-term will override consideration of longer term consequences
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What are the motivational neural circits
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-Prefrontal cortex: decision making and impulse control (inhibition system)
-Hypothalamus: info on nutrient ingestion, aggression, and reproductive drive (Motivation/Drive system) -Amygdala: affective info (Reward value) -Hippocampus: contexual memory data (learning) |
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Specific Neuronal Pathways
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-Reward: Mesocorticolimbic Dopamine System (Ventra Tegmental Area (VTA) and Nucleus Accumbens (NA); Dopamine relases to VTA & NA creates a GO signal
-Inhibition: Ventral-Medial Prefrontal Serotonin system: Low 5HT (serotonin) in VMPFC results in Bad Break System, thus less impulse control |
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Describes the sequences of addictions
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-DA is released in the Ventral Tegmental Area
-VTA stumulates the necleus accumbens (NA) -NA assesses the amount of pleasure -If pleasure is high, NA secretes glutamate -Glutamate stimulates the PFC, to make a decision -Glutamate locks the pleasure experience into the memory centers, and the trouble follows |
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Reward
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-does not distinguish between chemical, behavior, and experiences
-natural rewards: food, sex, water, nurturing -evolutionary influence rewards anything with survival value -reward system is a dopamine based system -genetic predisposition increases vulnerability to establishing the neuronal netword to maintain it and be resistance to treatment |
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5 neurochemistry of addiction
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-NE (Norepinephrine): arousal, excitement
-Glutamate/ GABA: shutting down -5HT (serotonin): inhibition/cessation -DA (Dopamine): reward/reinforcement -Opioid: pleasure, urges |
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Psychological factors in addictions
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-attachment
-differentiation/indivudation influence ability to Negotiate healthy boundaries and relationships -learning experiences influence ability to control impulse & delay gratification & confusing happiness and pleasure |
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Psychology of repetitive behavior
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-dopamine released far more than the brain was meant to manage with equilibrium
-develop neurological "strech marks" as the repetition/compulsion rubs the PFC of its synaptic plasticity -the compulsion becomes stronger and stronger -each experience increases the reward threshold and desensitizes the brain to "normal" rewards -eventually an aggrandized, unrealistic, experience which can last for years |
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Narcissims & Addiction
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-don't learn about their emotions
-don't learn from their emotions -learn to disavow their needfulness -rather eat dirt than ask for HELP or acknowledge NEED |
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What are some cultural factors on addiction?
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-tolerance and acceptance
-romanticizing the Lifestyle -Social and communal rituals -Persistence of Myths despite Mounds of Scientific evidence to the contrary -Economical and Political Ramification |
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What are impacts of Dual diagnosis
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-increases hospitalization and acute service utilization
-increases risks for marginalization -increases risks of suicide and criminal behavior -a MI patient has 29% chance of developing SUDas compared to 13% of GP -Early intervention and accurate diagnosis may prevent the secondary problems -rate of SUD in Bipolar patients is 2-3 times higher than those with depression -at onset only 17% suffer from SUD |
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What is treatment for addictions?
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-prevention
-integrative intervention -addressing multiple system (Bio-Psycho-Social) -More comprehensive More effective -Maintenance -Relapse prevention |
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What can clients receive in weekly sessions for treatment?
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-recognize antecedents and consequences of drug use
-healthier social network/activities -teach skills to address any skill deficiencies -if applicable, help search for a job -if a partner is not a drug abuser, offer behavioral couple tx -educate about HIV/AIDS -Treatment options for comorbid diagnosis |
