Transcript Substance-Related and Impulse

Substance-Related and
Impulse-Control Disorders
Chapter 11
Abnormal Psychology
Impulse-Control Disorders
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Irresistible impulse to perform a
behavior
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Anticipation of pleasure/release
Harmful/maladaptive consequences
Intermittent Explosive
Disorder
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Acting on violent/aggressive impulses
Rule out- personality disorders, psychotic
disorders
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Controversy- used as a legal defense?
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Use of CBT- identifying “triggers”
Kleptomania
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Strong urge to steal *not out of
necessity*
Sense of tension before stealing,
relief/pleasure after stealing
Often co-morbid with mood disorders
Pyromania
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Fire-setting
Tension and arousal before, release and
gratification afterwards
Family history
Treatment- coping strategies, identifying
triggers
Pathological Gambling
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Pattern of urge and release
Common characteristics- denial,
impulsivity, *continued optimism*
Use of cognitive behavioral
interventions
Trichotillomania
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Pulling one’s hair
Hair loss, distress, social impairments,
attempts to hide the behavior
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Stress, trauma, anxiety are risk factors
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SSRIs, Cognitive-Behavioral Therapy
Substance-Related Disorders
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Substance Use vs. Abuse- how does the drug
affect one’s functioning/life?
Substance Dependence- addiction;
physiological dependence
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Tolerance
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Withdrawal
Can you use drugs and not
become addicted/dependent?
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Individual differences
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Constellation of risk factors
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May be difficult to predict
Substance Abuse:
Some Considerations
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Dual Diagnosis
Mental health problems co-occurring
with addiction
Alcohol Use Disorders
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Brain effects of Alcohol Abuse
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Complex effects
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GABA- anti-anxiety effects of alcohol
Glutamate- excitatory effects
Serotonin- mood properties- associated with
cravings
Progression
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May follow different trajectories for
different individuals
Drinking at an early age is correlated
with later addictions
Causes of
Substance-Related Disorders
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Family studies indicate genetic
vulnerabilities
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Research: initial use of drugs may have
more to do with environment/experience,
later dependence is more closely linked
with genetics
Causes of Substance-Related
Disorders
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Brain areas- a “pleasure pathway”
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Role of dopamine
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Role of Positive Reinforcement and
Negative Reinforcement
Social Factors Influencing
Addiction
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Exposure to the drug
Peer groups
The role of context
Cultural considerations
Multiple Influences Shaping
Addiction
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Stress and trauma
Different pathways and individual
differences in the development and
progression of addictions
Treatment of Addiction
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Biological approaches: medication
Psychosocial approaches: inpatient and
outpatient treatment; AA and 12-step
programs; community-based programs
Controversy surrounding the teaching of
“controlled drinking”
Treatment of Addiction
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CBT
Identification of antecedents and
consequences- identifying high risk
situations
Prevention efforts