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28 Cards in this Set

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Substance Use and Abuse: Childhood- Early Adulthood

Childhood


-47% tried alcohol


-21% been drunk


-19% tried marijuana


-Rates of illicit drug use (EX: Cocaine, ecstasy)are low in childhood


Adolescents= rates highest for drinking

Emerging Adulthood

unstructured socializing- linked with substance use


substance use declines in the mid-to-late 20s because of role transitions (Marriage, parenthood, full-time work)

Sequence of Substance Use
beer and wine-> cigarettes and hard liquor -> marijuana-> "hard" drugs
Gateway Theory of drug use
research shows that people who use one substance in the sequence are more likely to use the next one
Types of Users

1) Experimental- "to see what it's like"


2) Social- occasional use in social situations (bonding)


3) Medicinal- to relieve an unpleasant emotional state


4) Addictive- person has come to depend on regular use of substances to feel good physically or psychologically

Research on the four types of users

Social and experimental users are psychologically healthier than Medicinal and Addictive users


Medicinal and Addictive users have more problems such as personality difficulties, problems in relationships with peers and parents, trouble in school, mental health issues and problems with delinquency

Substance Abuse (DSM Criteria)

1 or more criteria for over a year


- Role impairment= failed work/ home obligations


- Hazardous Use= drunk driving


-Legal problems


-Social or interpersonal problems=considered less severe and chronic

Substance Dependence (DSM Criteria)

3 criteria for 1 year


- Tolerance (increased amount to achieve some effect)


- Withdrawal


- Drinking/ Taking more than intended


-Unable to cut down


- Excessive time (obtaining/ hangover)


- Impairment


- Use despite physical or psychological consequences

Risk Factors for Substance Use Disorders

Temperament (in-born personality)- low inhibition (self-control), low harm avoidance, high sensation seeking, trait anxiety


Childhood problems


History of abuse- early disruptive behavior, internalizing (anxiety)/ externalizing (ADHD) disorders or problems


Perceptions of peer use


Age of 1st use- odds of developing alcohol dependency decrease by 9% for each year that onset is delayed


Family history (4-9 fold risk for boys, 2-3 fold risk for girls)


Family environment (high conflict, inconsistent or harsh discipline)

Is marijuana a "safe" drug?

Early use (before early 20s) has very different effects than later use


Early and frequent use of marijuana


- brain abnormalities; small bran size


- fewer connections in the brain


- schizophrenia and other psychotic and anxiety disorders


- lower IQ scores, cognitive decline

Prevention of substance abuse

School programs -> mostly ineffective


Combined programs (schools, families, media) -> slightly more effective


College binge drinking preventions -> mixed; increasing awareness of # of students who do not binge drinking


- 70% (estimate) vs. 45% (real)

Eating Disorders
psychiatric disturbances involving abnormal eating behaviors, maladaptive efforts to control body shape or weight, and disturbances in perceived body shape or size
3 types of eating disorders and prevalence rates

Anorexia nervosa- 2%


Bulimia nervosa- 3%


Binge eating disorder- 1%

Age and gender differences

Most cases have their onset among females in their teens and their early 20s


Female-Male ratio: 10:1


14 and 18 are peak periods of risk

Anorexia Nervosa (Diagnostic criteria)

Weight less than 85% of expected for height


Intense and persistent fear of gaining weight


Disturbed perception of weight and shape


Undue influence of weight or shape on self-evaluation


Amenorrhea in females


- when your period stops

Types of Anorexia Nervosa

Restricting


Binge-eating/ purging

Other clinical features of Anorexia Nervosa

relentless pursuit of thinness


preoccupation with food


ritualistic and stereotyped eating

Physical Signs of Anorexia Nervosa
yellowish skin, dry skin and hair, lanugo, hypersensitivity to cold, low blood pressure, slow heart rate, brittle bones
Bulimia Nervosa (DSM Criteria)

consumption of large amounts of food coupled with a sense of eating being out of control


compensatory behaviors to prevent weight gain -> self-induced vomiting, laxative abuse, excessive exercise


Undue influence of weight and shape on self- evaluation


behaviors occur more than twice a week fr 3 months

Other Clinical features of Bulimia Nervosa

secrecy, shame, and guilt


normally in average weight range


normal mortality rates

Physical Signs of Bulimia Nervosa
fatigue, headaches, enlarged salivary glands, erosion of dental enamel, electrolyte abnormalities
Binge Eating Disorder (DSM Criteria)

repeated episodes (2X/ week for 6 months) of uncontrollable binge eating


rapid eating, eating even after full, eating when not hungry, eating alone because of embarrassment


Marked distress regarding binge eating


Absence of regular compensatory behaviors


Obesity is common


Do not do compensatory behaviors (laxatives, self-induced vomiting)

Causes of eating disorders

Sociocultural model of bulimia


Genetic and biological risk factors


heritability

Sociocultural model of bulimia
Media portrayed images of the thin ideal -> internalization of the socially sanctioned thin ideal for females-> body dissatisfaction-> dieting ad other risky behaviors-> bulimia nervosa
Genetic and Biological Risk Factors
relatives of an individual with an eating disorder are 10x more likely to develop an eating disorder themselves
Heritability

Anorexia= 33-84%


Bulimia= 28-83%


Binge eating= 41%

Treatments for Eating Disorders

hospital based programs


- physical therapy


- individual therapy


- group therapy


- family therapy

Outcomes

2/3 anorexics improve; 1/3 chronically ill


1/2 bulimics improve; 1/2 repeated relapse