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20 Cards in this Set
- Front
- Back
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Substance-Related Disorders
Features & major syndromes |
Features: effects of drug abuse, side effects of a med, or effects of exposure to a toxic substance
DSM features 11 classes of substances Syndromes -Abuse -Intoxication -Dependence -Withdrawal |
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Substance Dependence
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-Type of Substance Use Disorder
-Major feature: cluster of cog, bx, & physiological symptoms that show cont'd use despite substance-related problems |
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Substance Dependence - symptoms for diagnosis
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*3 or 3+ must be present during 12 month period+
-Tolerance (need more for same effect or show symptoms of w/drawal if don't inc) -W/drawal (appears in absence of subs or subs is taken to relieve/avoid w/drawal symptoms) -take more than or for longer than intended -unable to limit/stop use despite wanting to -devote a lot of time to getting, using, or recovering from subs -reduce imp activities b/c of use -cont'd use despite knowing & experiencing probs that are exacerbated by subs |
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Substance Dependence - Specifiers
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Requires specifiers:
-w/ or w/o physiological dependence Course Specifiers - Early Full (or Partial) Remission -Sustained Full (or Partial) Remission -On Agonist Therapy (ex. methadone) -In a Controlled Environment |
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Substance Abuse - features & DSM criteria
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A. maj feature is a maladaptive pattern of subs use featuring recurrent & significant neg consequences related to repeated use
(+) 1 or more of the following -repeated failure to fulfill major role obligations -repeated use in physically dangerous situations (ex. DUI) -recurrent subs-related legal problems (ex. arrested for DUI) -cont'd use despite probs caused or exacerbated by subs |
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Substance - Induced Disorders
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Substance Intoxication
Substance Withdrawal |
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Substance Intoxication - DSM criteria
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A. development of a reversible subs-specific syndrome due to recent ingestion/exposure to subs
B. Clinically sig harmful bx or psych △s due to effects of subs dvlping shortly after use C. symptoms not due to a gmc |
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Substance Withdrawal - DSM criteria
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A. Subs-specific syndrome due to stopping/reducing previously heavy/prolonged use
B. Subs-specific syndrome causes clinically sig impairment C. Not due to a gmc |
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Substance-Related Disorders
Goals of Assessment & Diagnosis |
1. ID substance(s) used
2. History of substance use 3. History of substance use emergencies & treatments 4. Assess cognitive impairment 5. Assess physiological signs 6. Assess neuro signs, △s in mood or personality, personality defenses, psychomotor agitation/retardation 7. Determine if it is par for course or something more |
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Substance Related Disorders
Biological/physiological issues |
Genetics are big factor in alc abuse & dependence; nearly as imp in risk for illicit drug use
More common in men than women |
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Substance Related Disorders
Environmental considerations? Cultural? |
Familial abuse & assoc problems
Stress Cultural- How much is normal in this culture? |
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What are the 4 stages of alcoholism?
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1. Prodormal Stage - drinking = escape; dependence upon mood altering effects
2. Early Stage - stronger need to drink; earlier in the day 3. Middle Stage - starts losing control, avoids others, rev tolerance (liver overwhelmed so need less to get drunk), need it to wake up 4. Late Stage - chronically out of control, can't hold job, "benders", delirium tremors |
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What are the 4 treatment phases for Substance-related Disorders?
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1. Acute crisis (harm to self or others? what level of care is nec?)
2. Withdrawal from substance 3. Sequelae (the little things that follow...guilt, depression, relapse triggers, relapse is common here) 4. Predisposing factors (genetics) |
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Family Systems Model- Wegscheider-Cruse
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Family relies on alcholic to maintain equilibrium. Unconsciously keeps the status quo, so substance is focus of the family dynamic.
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Family systems Model - roles
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Addict
Co-dependent/Enabler- angry; controlling; hyper-responsible Hero Scapegoat- person blamed for abuse; person feels worthless Lost Child Mascot |
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Enabler/Co-dependent - who is this in Wegscheider-Cruse's Family Systems Model?
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Person that takes responsibility for addict; angry; controlling
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Hero - who is this in Wegscheider-Cruse's Family Systems Model?
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Oldest child; takes attention off of addict and is supposed to bring honor to the family; sets up alliance w/Enabler b/c Enabler needs support. This makes them into the Little Enabler (aka the future therapist)
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Lost Child - who is this in Wegscheider-Cruse's Family Systems Model?
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- get attached to things rather than ppl; relatively independent & not very involved in family; low self esteem; good prognosis in therapy b/c tend to distance selves from family
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Mascot - who is this in Wegscheider-Cruse's Family Systems Model?
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The amusing kid; family tries to protect but in vain; create antics to release tension w/in family; resistant to self reflection; poor stress-coping skills; difficult to deal w/
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Scapegoat - who is this in Wegscheider-Cruse's Family Systems Model?
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2nd born; can't compete w/the Hero so becomes the opposite of the Hero. Sometimes roles are reversed. Usually the "ID'd patient" that leads to treatment b/c act out
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