Substance Related Disorders Sarason Abnormal Psychology 12e c

Substance Use Disorders Ø Problems associated with Ø Ø Substance dependence Ø Ø using and abusing drugs or substances which alter the way people think, feel, and behave. Maladaptive pattern of substance use that leads to clinically significant impairment or distress Substance abuse Ø Recurrent and significant adverse consequences related to substance use Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 2 by Sarason & Sarason © 2005

Substance Dependence Ø Ø Ø Ø Tolerance Withdrawal Ingestion of more than intended Persistent desire or unsuccessful effort to use less Spending a lot of time on obtaining, using, or recovering from the substance Reduced social, occupational, or recreational activities due to use of substance Continued use despite knowledge of the psychological and/or physical problems caused Presence of 3 or more of the above in a 12 -month period Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 3 by Sarason & Sarason © 2005

Substance Abuse Ø Ø Ø Recurrent substance use leading to failure to fulfill work, school, home obligations Recurrent substance use in hazardous situations, like driving Recurrent substance-related legal problems, like arrests Continued substance use despite persistent social or interpersonal problems caused by using the substance, such as getting in fights The presence of three or more of the above within a 12 -month period Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 4 by Sarason & Sarason © 2005

Substance Intoxication Ø Disturbances of perception Ø wakefulness Ø attention Ø thinking Ø judgment Ø motor behavior Ø interpersonal behavior Ø Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 5 by Sarason & Sarason © 2005

Substance Intoxication Ø Level of intoxication depends on Ø the substance Ø the dose Ø history of use Ø person’s tolerance (related to body size, gender, history of use) Ø person’s expectation of use Ø environment or setting in which substance is ingested Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 6 by Sarason & Sarason © 2005

The effects of alcohol Ø Ø Ø Ethyl alcohol (a CNS depressant), or ethanol, is the alcohol in beer, wine, hard liquor Alcohol blocks messages between nerve cells First affects frontal lobes where reasoning, memory, judgment, and inhibitions take place Next affects cerebellum, seat of motor and muscle control, balance, five senses Finally affects the spinal cord and medulla, which governs breathing, heart rate, and body temperature Blood alcohol content of 0. 5% or more can lead to death Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 7 by Sarason & Sarason © 2005

Alcohol use and risks Ø Ø 70% of Americans drink occasionally 21 - to 34 -year olds drink the most Half of all alcohol is consumed in binge sprees (5 or more drinks at a time) Alcohol use in US implicated in Ø 40% of traffic fatalities Ø 50% of deaths from falls Ø 52% of fire-related deaths Ø 38% of drowning deaths Ø 20% of health-related expenditures Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 8 by Sarason & Sarason © 2005

Models of Alcohol Disorders Ø Ø Ø Biological Ø Metabolic, genetic, and neural processes Psychodynamic Ø Effort to change negative emotional states Behavioral Ø Learned from modeling and social reinforcement Cognitive Ø Expectations about effects of alcohol Interactional Ø Stress precipitates use in people with predisposition to use Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 9 by Sarason & Sarason © 2005

Treatment of Alcohol Disorders Ø Ø Biological Ø Drug Ø Management of withdrawal symptoms Psychodynamic Ø Psychotherapy provides little benefit unless family contexts of drinking explored Cognitive-behavioral Ø Aversive conditioning Ø Covert sensitization Ø Controlled drinking Ø Relapse prevention Community-based treatment Sarason, Abnormal Psychology, Ø Alcoholics Anonymous most widely used Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 10 by Sarason & Sarason © 2005

Relapse in Drug Treatment Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 11

Relapse in Drug Treatment Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 12

Alcohol-related Disorders: Risk Factors Ø Ø Ø Ø Ø Poverty Neighborhood disorganization Childhood behavior problems Poor family management practices Family conflict Lack of family cohesion Academic failure Social pressure to use Alienation and rebelliousness Rejection by peers Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 13 by Sarason & Sarason © 2005

Barbiturates and Tranquilizers Ø Ø Depressing effect on central nervous system Dangerous in combination with alcohol Barbiturates often prescribed to relieve anxiety and prevent convulsions Tranquilizers can lead to tolerance and thus overuse Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 14 by Sarason & Sarason © 2005

Opioids Ø Ø Ø Ø Drugs from the opium class; with morphine-like effect that bind to brain’s opioid receptors Sometimes called narcotics Heroin and morphine most commonly used Endorphins, enkephalins, and polymorphins are body’s endogenous opioids Cause change in mood, sleepiness, mental clouding, constipation, slow respiratory system Withdrawal can be severe Methadone maintenance is most widely used treatment Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 15 by Sarason & Sarason © 2005

Cocaine Ø Ø Ø Produced from leaves of coca plant Stimulates CNS and decreases appetite Can produce mania, paranoia, and impaired judgment Crack is more potent distilled form and is highly addictive Treatment focuses on self-help and social support (AA-type programs) Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 16 by Sarason & Sarason © 2005

Amphetamines Ø Ø Ø Psychomotor stimulants Ø Affect central nervous system and cardiovascular system Moderate use Ø Wakefulness, alertness, elevated mood High dosage Ø Nervousness, dizziness, confusion, elevated blood pressure Tolerance develops rapidly Methamphetamines Ø Chemically similar but has greater CNS impact Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 17 by Sarason & Sarason © 2005

Hallucinogens Ø Ø Ø Also known as psychedelics CNS action produces alterations in consciousness Natural hallucinogens (e. g. , Mescaline, Psilocybin) Synthetic hallucinogens (e. g. , STP, LSD) Abuse leads to respiratory or cardiovascular collapse and psychotic behavior Treatment consists of support groups of enhancing social skills Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 18 by Sarason & Sarason © 2005

Phencyclidine (PCP) Ø Ø Ø Synthetic chemical Causes disorientation and hallucination User may feel dissociated Users may develop severe depression or psychosis Effects may be irreversible Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 19 by Sarason & Sarason © 2005

Inhalents Ø Ø Ø Volatile substances or organic solvents (gasoline, spray paint) Produce changes in perception Use may lead to withdrawal from social, occupational, or recreational activities More commonly used by young people Use can lead to dependence with tolerance and withdrawal symptoms Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 20 by Sarason & Sarason © 2005

Cannabis Sativa (Marijuana/ Hashish) Ø Ø Ø Most often used in marijuana form Hashish is the solidified resin of the cannabis plant Major active ingredient in cannabis is THC Marijuana use Ø Impairs motor coordination and perception Ø Affects short-term memory and learning Treatment Ø Relapse prevention Ø Social support groups Ø Legalized in some countries (e. g. Abnormal Holland) Sarason, Psychology, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 21 by Sarason & Sarason © 2005

Nicotine Ø Ø Ø CNS stimulant found in tobacco Stimulates acetylcholine receptors Increases heart rate and blood pressure Can be highly addictive Cessation requires Ø Ø Ø commitment to change implementation of change relapse prevention Nicotine gum and patch may be helpful if used with counseling. Note that the negative effects are not limited to nicotine addiction, but other effects of smoking Sarason, Abnormal Psychology, 11/e 12/e, (c) 2005, Prentice Hall 22 by Sarason & Sarason © 2005