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