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Substance-Related and Impulse-Control Disorders

Substance-Related and Impulse-Control Disorders. Chapter 11 Abnormal 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

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Substance-Related and Impulse-Control Disorders

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  1. Substance-Related and Impulse-Control Disorders Chapter 11 Abnormal Psychology

  2. Impulse-Control Disorders • Irresistible impulse to perform a behavior • Anticipation of pleasure/release • Harmful/maladaptive consequences

  3. 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”

  4. Kleptomania • Strong urge to steal *not out of necessity* • Sense of tension before stealing, relief/pleasure after stealing • Often co-morbid with mood disorders

  5. Pyromania • Fire-setting • Tension and arousal before, release and gratification afterwards • Family history • Treatment- coping strategies, identifying triggers

  6. Pathological Gambling • Pattern of urge and release • Common characteristics- denial, impulsivity, *continued optimism* • Use of cognitive behavioral interventions

  7. 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

  8. Substance-Related Disorders • Substance Use vs. Abuse- how does the drug affect one’s functioning/life? • Substance Dependence- addiction; physiological dependence • Tolerance • Withdrawal

  9. Can you use drugs and not become addicted/dependent? • Individual differences • Constellation of risk factors • May be difficult to predict

  10. Substance Abuse:Some Considerations • Dual Diagnosis • Mental health problems co-occurring with addiction

  11. 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

  12. Progression • May follow different trajectories for different individuals • Drinking at an early age is correlated with later addictions

  13. 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

  14. Causes of Substance-Related Disorders • Brain areas- a “pleasure pathway” • Role of dopamine • Role of Positive Reinforcement and Negative Reinforcement

  15. Social Factors Influencing Addiction • Exposure to the drug • Peer groups • The role of context • Cultural considerations

  16. Multiple Influences Shaping Addiction • Stress and trauma • Different pathways and individual differences in the development and progression of addictions

  17. 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”

  18. Treatment of Addiction • CBT • Identification of antecedents and consequences- identifying high risk situations • Prevention efforts

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