Abnormal Psychology

1
Abnormal Psychology

• Ch. 9 Substance Abuse Dependence

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Psychoactive Drugs

• Def. chemicals that affect the nervous system
  and cause a change in behavior, mental processes
  and conscious experience

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Classifications

• Substance Use Disorders
• Includes substance dependence and substance abuse
• Refers to the maladaptive behaviors brought on by
  the use of psychoactive substances
• E.g. alcohol, opioids, stimulants, sedatives
  and barbiturates, prescription tranquilizers,
  hallucinogenic drugs, marijuana and nicotine

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Classifications

• Substance-induced Disorders
• Refers to disorders that can be brought on by the
  use of psychoactive drugs
• E.g. intoxication, withdrawal symptoms, mood
  disorders, delirium, dementia, amnesia, psychotic
  and anxiety disorders, sexual dysfunction and
  sleep disorders

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Substance Abuse

• Pattern of repeated use of a substance that leads
  to undesirable consequences such as
• Unable to function at a minimum level if
  substance is not used
• Putting oneself in dangerous situations
  (operating heavy machinery while on drug)
• Problems with the law as a result of drug use
• Difficulty in social/personal situations

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Substance Dependence

• The continued use of a substance despite
  significant substance-related problems
• One becomes powerless to resist using the drug
• Pattern repeated taking of the drug ?
• Tolerance
• Withdrawal symptoms
• Compulsive drug taking

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Substance Dependence

• Tolerance
• Need for increased amount of substance to achieve
  the desired effect or
• Diminished effect when using same amount of drug
  that previously achieved the desired effect
• Initial sensitivity varies
• Levels of tolerance can be substantial
• What brings about desired effects in one can be
  lethal to another

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Substance Dependence

• Withdrawal Syndrome
• Symptoms that occur when a person suddenly stops
  taking a substance after having used it heavily
  for a prolonged period of time
• Symptoms vary greatly among the types of
  substances used
• E.g. common among alcohol, opioid and sedative
  abusers nonexistent among hallucinogenic abusers

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Addiction, Physiological and Psychological
Dependence

• Addiction
• Continuous use of a drug accompanied by
  physiological dependence
• Physiological dependence
• Modification of bodily processes that require use
  of the drug for minimum daily functioning
• Result tolerance and withdrawal symptoms

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Addiction, Physiological and Psychological
Dependence

• Psychological dependence
• Mental desire or craving to achieve the effects
  produced by a drug
• One can be psychologically dependent w/out being
  physiologically dependent
• E.g. Alcohol and marijuana

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How Dependence Develops

• Experimentation curiosity and/or peer pressure
  and societal expectations
• Initial use of drug can bring about feelings of
  euphoria, power, etc.
• Person believes s/he is in control of the drug
  and can quit at any time

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How Dependence Develops

• Routine use
• Drug starts to take control
• Life begins to revolve around the drug and its
  effects
• Person often denies having any problems related
  to the drug use

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How Dependence Develops

• Progressive symptoms of routine use
• Values change what was important isnt anymore
• Much of ones income is spent on drugs bills go
  unpaid
• Lie and manipulate friends/loved ones to get
  money for drugs relationships become strained
• Possessions are sold for the money
• Work/school is missed

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How Dependence Develops

• Addiction or Dependence
• Person becomes powerless to resist drug
• Primary goal get more of the drug little else
  matters

15
Intoxication

• Maladaptive behavioral or psychological changes
  that are brought on by the ingestion of a
  substance
• Directly effects the central nervous system
• Changes develop during or shortly after ingesting
  the substance

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Intoxication

• Most common symptoms of intoxication involve
  disturbances of
• Perception
• Wakefulness
• Attention
• Thinking
• Judgment
• Psychomotor and interpersonal behavior

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Intoxication

• Intoxication varies dramatically among
  individuals and depends on
• Which substance is used
• The dose
• The duration or chronicity of dosing
• Ones tolerance for the substance
• Period of time since last dose
• The persons expectations

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Depressants

• Psychoactive drugs which act on the CNS to
• Suppress (slow down) bodily processes
• Reduce overall responsiveness
• Includes alcohol, barbiturates and opioids

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Depressants

• Alcohol
• Alcohol is the most widely abused drug in the
  world (including the U.S.)
• In low doses it has stimulating effects
• The more you drink the more the sedative effects
  become obvious
• At higher doses, it leaves one out of control and
  incapable of voluntary action

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Depressants

• If blood alcohol level reaches 0.5 - risk of
  coma/death from respiratory depression
• Women have a higher blood alcohol level than men
  following equal doses. Why?
• Alcohol as a social concern
• Is a factor in nearly half of all murders,
  suicides and accidental deaths in U.S.
• Drunk drivers account for about ½ of all highway
  fatalities

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Depressants

• Alcohol as a social concern
• Alcohol-related car accidents is the number 1
  killer of teenagers today
• Medical authorities list alcohol as the third
  leading cause of all birth defects
• Fetal alcohol syndrome mental retardation
  accompanied by flattened nose, underdeveloped jaw
  and widely spaced eyes

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Depressants

• Who is at risk of becoming an alcoholic
• Men are 2x as likely to become an alcoholic
• Age onset highest in 20s and 30s
• Family history (best indicator)
• Sociodemographic factors (poor, uneducated and
  those who live alone)

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Depressants

• Psychological effects of alcohol
• Uninhibited sexual behavior
• Aggressive behavior
• Impulsive behavior
• Poor decision-making skills (poor judgment)

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Depressants

• Physical effects of alcohol
• Slurred speech
• Poor coordination/motor ability
• Impair sexual performance
• Can lead to alcohol hepatitis (inflammation of
  liver) or cirrhosis
• Can bring about Korsakoffs syndrome confusion,
  disorientation, memory loss

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Depressants

• Alcohol withdrawal symptoms
• Nausea/vomiting
• Anxiety/depression
• Tachycardia (involuntary muscle twitches)
• Headaches
• Insomnia
• High blood pressure
• Delirium tremens sweating, twitching, halluc.

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Depressants

• Barbiturates (sedatives) eg. amobarbital,
  pentobarbital, phenobarbitol, secobarbitol, and
  valium (pill form)
• Tolerance and dependence (both physical and
  psych.) are rapidly acquired with these drugs ?
  strong potential for abuse
• Used to relieve anxiety, pain, hbp, short-term
  insomnia

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Depressants

• Most abusers are middle-age
• Barbiturates are popular because they produce
  feelings of euphoria and are relaxing
• Mostly because they relieve anxiety and pain
• High doses ? same effects as alcohol
• Withdrawal symptoms states of delirium
  hallucinations, difficulty thinking, death

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Depressants

• Opioids (narcotics) drugs that relieve pain by
  numbing the senses (analgesia)
• Derived from poppy plant e.g. morphine (pill,
  liquid solution, IV) heroine (injected)
• Synthetic drugs Demoral and Darvan
• Work by stimulating brain areas that control
  pleasure and pain sensations

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Depressants

• Characteristics of Opioids
• Highly addictive (physiologically)
• Produce feelings of relaxation and euphoria
• Euphoria generally results from relief of pain,
  tension, and anxiety
• Users report feelings of contentment/rosy
  perception

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Depressants

• Opioid withdrawal symptoms
• Flu-like symptoms
• Anxiety and Restlessness
• Rapid heart beat HBP
• Tremors
• Cramps, diarrhea, vomiting
• Hot/cold flashes
• Rarely result in death

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Stimulants

• Uppers drugs that act on the central nervous
  system, increasing overall activity and
  responsiveness
• E.g. amphetamines, cocaine, and nicotine
• Work by increasing norepinephrine and dopamine
  levels in brain ? continuous states of high
  arousal

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Stimulants

• Amphetamines (synthetic stimulants)
• Pill, smoked or injected
• Bring about an euphoric rush
• Extended use can cause people to crash (become
  irritable, depressed, hallucinate, have paranoid
  delusions, insomnia, etc.)
• Amphetamine psychosis hallucinations and
  delusions that can occur with dependence
• Physical/psychological dependence possible

33
Stimulants

• Amphetamine withdrawal symptoms
• Depression
• Fatigue
• Nightmares
• Insomnia/excessive sleeping
• Slowed motor responses
• Increases appetite

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Stimulants

• Cocaine Natural stimulant found in the leaves
  of the coca plant
• Snorted, injected, tea or smoked (crack)
• 2nd most widely used illicit drug in the U.S.
  (marijuana is 1)
• Physically addictive

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Stimulants

• Cocaine seems to be one of the most rewarding of
  all known chemicals
• Increases feelings of energy, power and
  individual dynamism by increasing the amount of
  dopamine available to the brain
• Cocaine psychosis long-term use
• Irritability and anxiety, compulsive behavior
• Paranoia and auditory/visual/tactile
  hallucinations

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Stimulants

• Cocaine withdrawal symptoms
• Depression
• Inability to experience pleasure
• Craving the drug
• Person may crash (severe depression or exhaustion
  following a binge 12-36 hrs)
• Even small doses can be fatal as cocaine
  interferes w/electrical system of the heart

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Stimulants

• Nicotine
• Is highly addictive (physically)
• Causes a release of epinephrine within the brain,
  thereby causing endorphins to be released

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Hallucinogens(Psychedelics)

• Drugs that
• Alter perception
• Produce visual, auditory and other sensory
  hallucinations
• Its been reported that when taken
• Colors are brighter and more luminous
• Patterns seem to pulsate and rotate
• Senses fuse colors are heard, sounds tasted

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Hallucinogens(psychedelics)

• E.g. Masculine (peyote cactus), psilocybin
  (mushrooms), phencylidine (PCP-synthetic)
  lysergic acid diethylamide (ergot a rye mold)
  and marijuana
• Cravings for these drugs may develop, but there
  are no known withdrawal symptoms

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Hallucinogens(psychedelics)

• Lysergic acid diethylamide (LSD)
• Odorless, colorless, and tasteless white powder
• One of the most potent drugs known to man
• An LSD tablet the size of an aspirin could
  produce effects in 3,000 people
• People can experience bad trips and dangerous
  flashbacks long after ingestion
• Flashbacks may be the result of changes in the
  brains structure due to previous LSD use

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Hallucinogens(psychedelics)

• Increases dopamine ? brain activity rise
• Some LSD users have epiphanys (insights) while
  high, but cant recall them when no longer high
• Others report experiencing a new kind of reality
  while high
• Many report having colorful visions similar to
  looking through a kaleidoscope

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Hallucinogens(psychedelics)

• Phencyclidine (PCP, angel dust THC)
• Smoked, liquid and tablet form
• Originally developed as an anesthetic
• Causes hallucinations
• Stimulates sympathetic nervous system
• Heart rate and BP increase
• Sweat
• Become flushed

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Hallucinogens(psychedelics)

• High doses of PCP can result in
• Drowsiness
• Impaired judgment
• Convulsions
• Paranoid/aggressive behavior
• Can bring about a state of delirium
• Coma

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Hallucinogens(psychedelics)

• Marijuana derived from the cannabis sativa
  plant smoked (joints)
• Hard drug to classify because it has properties
  of depressants, stimulants and hallucinogens
• Most popular illicit drug today
• Psychological dependence no known withdrawal
  symptoms

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Hallucinogens(psychedelics)

• Low doses of marijuana
• Induces a sense of relaxation (esp. in social
  situations) and mild euphoria impairs coord.
• High doses
• Makes many users become withdrawn
• Can cause disruption in time/sensory perception
  (time seems to slow down drastically feel blood
  pulsing through veins, heart beating, etc.)

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Hallucinogens(psychedelics)

• Very high doses of marijuana
• Visual or auditory hallucinations
• Disorientation (wonder what is happening to them
  and if they will return to a normal state
• Nausea
• Vomiting

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Hallucinogens(psychedelics)

• More negative effects of marijuana
• Impairs learning
• Impairs short-term memory
• Some report feelings of anxiousness and confusion
• Causes the heart rate to jump to approximately
  140-150 beats/minute
• Can cause psychotic reactions (rare)

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Hallucinogens(psychedelics)

• Still more negative effects
• Impairs lung functioning
• Suppresses immune response
• Can cause declines in testosterone levels and
  sperm count
• Can disrupt menstrual cycle and ovulation
• Can cause throat and respiratory disorders
• Can cause brain damage

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Theoretical Perspectives

• Genetic Factors
• Familial pattern (via twin studies) exists for
  the following substance use disorders
• Alcohol
• Opioids
• Cocaine
• Marijuana (less frequently)

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Theoretical Perspectives

• Learning Theory
• Operant conditioning
• Pleasurable effects of drugs become positively
  reinforcing (eg. relieve stress)
• Withdrawal symptoms make using drugs negatively
  reinforcing
• Observational learning
• May explain the familial pattern of alcoholism

51
Theoretical Perspectives

• Cognitive Theory
• Self-efficacy expectations drugs produce
  feelings of dynamism and self-assurance
• Beliefs and expectations One is more likely to
  use drugs if one
• Holds a positive attitude toward drug use
• Expects and believes that use of the drug will
  result in a positive experience

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Theoretical Perspectives

• Psychodynamic Theory
• People who use drugs probably have an
  oral-dependent personality
• Sociocultural Theory
• Alcohol and drug use occurs frequently in social
  settings
• Religious ties, such as attending Church, results
  in less drug use by those individual
• One is likely to use drugs if peer group does