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Chapter 12
Substance-Related Disorders
Abnormal Psychology, Eighth Edition
by
Gerald C. Davison and John M. Neale
Lecture notes created by Paul J. Wellman, Texas A&M University
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12
Definitions of SubstanceRelated Disorders
• Substance dependence is characterized by
– Tolerance to drug action occurs (greater doses,
diminished drug action)
– Withdrawal symptoms occur with drug cessation
– Person recognizes excessive use of the drug
– Much of the person’s time is spent getting the drug or
recovering from its effects
– Substance use continues despite physical or
psychological problems caused by the drug
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.1
Definitions of SubstanceRelated Disorders
• Substance abuse is characterized by
– Failure to fulfill major obligations (e.g. work or
child care)
– Exposure to physical dangers (e.g. driving
while intoxicated)
– Legal problems brought on by drug use
– Persistent social or interpersonal problems
(e.g. arguments with spouse)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.2
Alcohol Abuse and Dependence
• Alcohol dependence can include tolerance and
withdrawal reactions
– Abrupt cessation can lead to anxiety, depression,
weakness, and an inability to sleep
– Delirium tremens (DTs) is a severe alcohol withdrawal
reaction that includes hallucinations
– Alcohol tolerance is common in alcoholism
• Alcohol abuse can be part of a polydrug abuse
(80-85% of alcohol abusers smoke)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.3
Short-term Actions of Alcohol
• Alcohol is absorbed from the stomach into the
blood
– Alcohol is metabolized by the liver (1 oz/hr)
• Alcohol is a drug
• Alcohol acts within brain to
– Stimulate GABA receptors (reduces tension)
– Increases dopamine/serotonin levels (pleasurable
aspects of intoxication)
– Inhibits glutamate receptors (cognitive actions)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.4
Long-term Actions of Alcohol
• Alcoholics reduce their food intake when
consuming alcohol
– Alcohol has no nutrient value
– Alcohol impairs food digestion
– Result is vitamin deficiency (B-complex)
• Can lead to brain damage and amnesia
• Alcohol kills brain cells, leading to loss of gray
matter from the temporal lobes
• Alcohol suppresses the immune system
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.5
Nicotine and Tobacco Smoking
• Smoking tobacco results in absorption of nicotine
into the blood
– Nicotine reaches brain receptors that control dopamine
release
– Dopamine action of nicotine mediate its addictive
properties
• Cigarette smoking is responsible for 1 of every 6
deaths in the US
– Smoking is THE SINGLE MOST PREVENTABLE cause
of early death
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.6
Marijuana
• Marijuana consists of the dried and crushed
leaves of the hemp plant Cannabis sativa
• Smoking marijuana results in
– Relaxation
– Shifts in attention
– Impaired memory
• Marijauna effects depend on dose and potency
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.7
Adverse Actions of Marijuana
• Marijuana
– Interferes with cognitive function including loss of shortterm memory
– Interferes with the operation of complex equipment
(e.g. an automobile)
– Contributes to psychological problems in adulthood
– Elevates heart rate
– Impairs lung structure and function
– Can produce reverse tolerance
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.8
Therapeutic Actions of
Marijuana
• Marijuana
– Reduces the nausea and loss of appetite
associated with chemotherapy
– Can reduce pain signaling (via THC)
– Can be used to treat the discomfort of AIDS
– Can reduce the pressure increases in the eye
associated with glaucoma
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.9
Sedatives
• Sedatives slow the activities of the body and
reduce its responsiveness
– Opiates relieve pain and induce sleep
• Include opium, morphine, heroin
• Opiates are physiologically addictive
– Barbiturates induce relaxation and sleep
• Act by stimulating GABA receptors
• Can result in tolerance and severe withdrawal reactions
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.10
Stimulants
• Stimulants act on the brain to increase alertness
and motor activity
– Amphetamines release norepinephrine and dopamine
in brain to produce alertness and to reduce appetite
• Tolerance quickly develops to amphetamine use
– Ephedrine is a variant of amphetamine that induces
alertness and reduces appetite (found in herbal weight
loss preparations)
– Cocaine blocks the reuptake of dopamine to produce
alertness and produce euphoria
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.11
Hallucinogens
• Hallucinogenic drugs alter sensory perception and
create sensory experiences
• Hallucinogenic drugs include
– LSD, mescaline, ecstasy and phencyclidine
• General effects of LSD include
–
–
–
–
Synesthesia: blending of sensory information
Subjective time is altered (slowed)
Rapid shifts in mood
Effects depend on set and setting
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.12
Development of Substance
Abuse
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.13
Etiology of Substance Use
• Sociocultural variables include family, friends,
media (television, billboards)
• Psychological variables include
– Mood alteration (enhance positive, reduce negative
moods)
– Beliefs about prevalence and risks (harmful actions of
drug)
– Personality variables include
• High levels of negative affect
• Enduring desire for arousal, increased positive affect
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.14
Therapy for Alcohol Abuse
• Admitting the problem is a prerequisite for therapy
• Hospital treatment is expensive and does not lead to
better results than outpatient care
• Antabuse is a drug that creates nausea when
alcohol is consumed
• Self-Help groups (Alcoholics Anonymous)
• Aversion therapy
• Controlled drinking training
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.15
Therapy for Cigarette Smoking
• The long-term efficacy of psychological
treatments for smoking are not good
– Making smoking unpleasant
– Scheduled smoking involves gradual reduction of
number of cigarettes smoked and controls when
smoking will happen
– Advice from a physician
• Biological treatments for smoking involve
substitution of nicotine for smoking
– Use of a nicotine patch or gum
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 12.16
Copyright
Copyright 2000 by John Wiley & Sons, New York, NY. All
rights reserved. No part of the material protected by this
copyright may be reproduced or utilized in any form or by
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copyright owner.
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e