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BU - PS 371 - Study Guide - Final

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BU - PS 371 - Study Guide - Final

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background image Samantha Gagne  Exam Three Study Guide    Red: confirmed on exam    Table of Contents ​______________________________________________________________  General Information 
Unit 11: Substance-Related and Addictive Disorders 
Unit 11: Impulse-Control Disorders 
Unit 12: Personality Disorders 
Unit 13: Schizophrenia Spectrum and Other Psychotic Disorders 
Unit 15: Neurocognitive Disorders 
Unit 16: Mental Health Services: Legal and Ethical Issues 
Discussion Slides 
● Alcohol Use Disorder 
● Borderline Personality Disorder 
● Schizophrenia  
______________________________________________________________________________  General Information  Date: ​ 5/11/2017, 12:30-2:30 pm  Format: ​ 50 multiple choice questions  Weight: ​ 30% of final grade   Material:  ● Lectures:  ​4/6-4/27  ● Textbook:  ​Chapters 11-16  ______________________________________________________________________________  Unit 11: Substance-Related and Addictive Disorders  Substance Use  ● Ingestion of a psychoactive substance in moderate amounts that does not significantly  interfere with social, educational or occupational functioning  ○ Drinking coffee in the morning 
○ Smoking a cigarette and having a drink with a friend 
○ Occasional ingestion of illegal drugs (marijuana, cocaine, amphetamines or 
barbiturates)   
Intoxication 
● Our physiological reaction to ingested substances (i.e. drunkenness) is referred to as  “substance intoxication”  ● For someone to be intoxicated, it depends on which drug is taken, how much is ingested,  and the person’s individual biological reaction 
background image ● Intoxication defined: impaired judgment, mood changes, lowered motor ability; problems  walking or talking; reversible; symptoms are not due to a general medical condition   
Substance-Related Disorders 
● Two types  ○ Substance use disorder 
○ Substance-Induced disorders  
 
Substance Use Disorder  
● A cluster of cognitive, behavioral, and physiological symptoms indicating that an  individual  continues to use the substance despite having substance-related problems    ● Can be applied across substances 
● Combines abuse and dependence from DSM-IV 
● Specify severity 
● Pathological pattern of behaviors related to use the substance  
 
Recording Procedures 
● A person who is using heroin and endorses 4 symptoms would be diagnosed with…  ○ (severity) + (specific substance) + use disorder 
○ Severe alcohol use disorder 
 
Substance-Induced Disorders 
● Intoxication 
● Withdrawal 
● Other substance/medication-induced mental disorders 
○ Anxiety, Depressive disorders, Sexual dysfunction, and others   
Intoxication 
● The development of a reversible substance-specific syndrome due to the recent ingestion  of a substance  ● The problematic behavior or changes associated with intoxication (i.e. impaired  judgement, mood lability, belligerence) are attributed to effects of the substance and 
develop shortly after use 
● The symptoms are not attributable to another medical condition or mental disorder 
● The more rapid the absorption into the bloodstream (i.e. IV, snorting) the more likely to 
produce immediate intoxication  ● Disturbances in:  ○ Perception 
○ Wakefulness 
background image ○ Attention 
○ Thinking 
○ Judgement  
○ Psychomotor behavior 
○ Interpersonal behavior  
 
Withdrawal 
● The development of a substance-specific problematic behavioral change, with  physiological and psychological concomitants, that is due to the cessation of, or reduction 
in, heavy and prolonged substance use 
● The syndrome causes clinically significant distress or impairment in social, occupational  or other important areas of functioning   ● The symptoms are not attributable to another medical condition or mental disorder    
Substance/Medication Induced Mental Disorders 
● Potentially severe, usually temporary, but sometimes persisting disorders that develop in  the context of the use of a substance of abuse or medication  ● The disorders may be induced by substances that produce substance use disorders, or by  medications used in treatment   ● While the symptoms can be identical to those of mental disorders, most improve in days  or weeks following abstinence    
Psychoactive Substances 
● Sedatives  ○ Alcohol, barbiturates, benzodiazepines   ● Opioids  ○ Heroin, opioids used medically (methadone, codeine, morphine)   ● Stimulants   ○ Amphetamines, cocaine, caffeine and nicotine   ● Hallucinogens and related   ○ Marijuana, Hashish, LSD, PCP, Mescaline   ● For each substance category, can have “use”, “intoxication”, “withdrawal”, and “other”  ○ I.e. under “Alcohol Related Disorders”  ■ Alcohol Use Disorder 
■ Alcohol intoxication 
■ Alcohol withdrawal 
■ Other alcohol induced disorders 
   
background image Sedatives  ● Barbiturates 
● Benzodiazepines 
● Alcohol  
 
Sedatives 
● Barbiturates  ○ Widely prescribed during the 1930s and 40s to help people sleep before  their addictive qualities were known  ○ By 1950s, most widely abused in the US, at low doses barbiturates relax  muscles yet at big doses, similar to heavy drinking; produce alcohol like 
symptoms such as impaired motor control (ataxia), slurred speech, 
dizziness and slow breathing and heart rate  
○ Depressants of the central nervous system (CNS) that impair or reduce the  activity of the brain by acting as a Gamma Aminobutyric Acid (GABA) 
potentiators  
● Benzodiazepines  ○ Benzodiazepines (Valium, Xanax, Ativan) also enhance GABA, may be  used to reduce anxiety, insomnia  ○ Less risk of abuse and dependence, safer than barbiturates unless taken  with another depressant like alcohol   ○ Used in treatment of acute anxiety or panic  ■ Advantage= work quickly 
■ Drawbacks= tolerance, dependence, lack of long-term 
effectiveness  ○ The Hangover  ■ Rohypnol= “Roofies”- induces anterograde amnesia   ● Alcohol  ○ History  ■ The discovery of late Stone Age beer jugs has established the fact  that intentionally fermented beverages existed at least as early as 
the Neolithic period (cir. 10,000 BC) 
■ Wine clearly appeared as a finished product in Egyptian  pictographs around 4,000 BC  ○ In US during the early 1800s, consumption of alcohol (mostly whiskey)  was more than 7 gallons per year for the average person older than 15  ■ 3X the current rate of US alcohol use  ○ Clinical Description: Although alcohol is a depressant, its initial effect is  stimulation; inhibitions are reduced, feeling of well being; this is because 
background image what are initially depressed or slowed are the inhibitory centers in the 
brain 
○ With continued drinking, alcohol depresses more areas of the brain, which  impedes the ability to function properly  ○ Motor coordination impaired (slurred speech, staggering), reaction time  slowed, confusion, poor judgements, vision and hearing are affected   ○ After ingestion, alcohol goes to stomach, to small intestine, absorbed into  bloodstream; contacts every major organ including the heart; some goes to 
the lungs where it vaporizes and is exhaled (notice on elevators?), passes 
through liver, broken down or metabolized into carbon dioxide and water 
by enzymes 
 
Delirium Tremens (“DT’ S”) 
● Occurs on the 3rd day of withdrawal who have been drinking heavily for the past 5 years 
● Life threatening with a mortality rate of 20% 
● Typically includes hand tremors, nausea, vomiting, anxiety, transient hallucinations, 
agitation, insomnia, and delirium tremens (withdrawal delirium), a condition that 
produces frightening hallucinations na body tremors; can be reduced with adequate 
medical treatments (hydration and lorazepam)  
 
Multiple Choice 
● Name the heavy organic brain syndrome that may result from long term heavy alcohol  use   ○ Broca’s Aphasia  ○ Wernicke-Korsakoff Syndrome   ○ Encephalitis Lethargica 
○ Klinefelter's syndrome  
 
Wernicke-Korsakoff Syndrome  
● Wernicke’s syndrome, also known as Wernicke encephalopathy, is a neurological disease  characterized by the clinical triad of confusion, the inability to coordinate voluntary 
movement (ataxia), and eye (ocular) abnormalities 
● Korsakoff’s syndrome is a mental disorder characterized by memory loss, inability to  form new memories, confabulation, and hallucinations  ● When these two disorders occur together, the term Wernicke-Korsakoff syndrome is used  
● Caused by a deficiency in vitamin B1 (thiamine)  
 
Fetal Alcohol Syndrome 
background image ● A combination of problems that can arise in a child whose mother drank while she was  pregnant  ○ Fetal growth retardation 
○ Cognitive deficits  
○ Behavior problems 
○ Learning difficulties 
○ Facial features- skin folds at eyes, low nasal bridge, short nose, small head 
circumference, small eye opening, small midface, thin upper lip   ● Alaska is the state with the highest FAS   
Binge Drinking 
● The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a  pattern of drinking that brings a person’s blood alcohol concentration to .08 grams 
percent or above 
● Typically happens when men consume 5 or more drinks, and when women consume 4 or  more drinks in about 2 hours  ● Although college students commonly binge drink, 70% of binge drinking episodes  involve adults age 26 years and older  ● Higher among men  
● About 90% of alcohol consumed by youth under the age of 21 in the US is in the form of 
binge drinks  ● About 75% of the alcohol consumed by adults in the US is in the form of binge drinks    
Sedative Detox and Treatment 
● Detoxification and withdrawal  ○ Seizure, cardiovascular issues, death 
○ 4 to 7 days, inpatient 
○ Consider a Benzo to prevent seizure and vitamin B1 (Thiamine) 
● Alcohol Use Management   ○ Antabuse, Naltrexone- nausea when combined with alcohol  ● Psychological counseling  ○ Family or couples therapy 
○ Alcoholics Anonymous- 12 step program 
 
Opioids  
● Heroin 
● Medically used opiates 
 
Heroin 
background image ● Derived from the poppy flower 
● Mexico is the major supplier for the US which has increased availability and decreased 
cost  ● May be injected or smoked 
● Tolerance increase with use 
● Frequent comorbidities  
○ Hepatitis 
○ HIV 
● Up to 1/3 of all patients with HIV are heroin users 
● China White (H4) 
○ Off white powder, water soluble, more potent 
○ Injected 
● Black Tar (H3)  ○ Brown, sticky, low boiling point 
○ Smoked  
 
Medically Used Opiates 
● Derivatives of Opium used for moderate to severe pain:  ○ Morphine 
○ Oxycodone- synthesized from Codeine 
■ Oxycontin- time released oxycodone 
■ Percocet- oxycodone plus acetaminophen 
● Methadone- a synthetic opioid that is used for pain management (particully neuropathic  pain) and addiction   
Street Value Comparison of Opioids 
● Oxycontin- $50 to $80 ($1/mg) 
● Oxycodone- $12 to $40  
● Hydrocodone- $5 to $20 
● Percocet- $10 to $15 
● Vicodin- $10 to $25 
● Heroin- $10 to $25 
 
Opioid Detox and Treatment 
● Death from withdrawal is rare, but includes depression, anxiety, flu-like symptoms  (muscle aches, sweating)  ● Treatment  ○ Methadone (replacement drug for opiates) or buprenorphine   ■ Taken orally (drink) 
background image ■ Cause less euphoria/ drowsiness  ○ Suboxone (“Suboxone Clinics”)  ■ A combination of Buprenorphine (decreases cravings and symptoms) and  Naltrexone (prevents the “high”)   
Stimulants 
● Caffeine  
● Nicotine 
● Amphetamines 
● Cocaine  
*most commonly consumed class of drugs in the US* 
 
Caffeine 
● MOST COMMON of psychoactive substances (90% of all Americans)   ● In low doses (20 to 200 mgs) caffeine can…  ○ Elevate mood 
○ Increase alertness and concentration 
○ Increase self-confidence and motivation 
○ Increase desire to talk to people  
● Moderate dose= 200 to 300 mgs  ○ 2 to 3 cups  ● Heavy dose= 500 to 600 mgs  ○ 4 or more cups 
○ Jittery, insomnia, headaches, drowsiness, unpleasant mood without morning 
coffee  ● DSM 5- Caffeine Induced Intoxication   ○ Consumption in excess of 250 mgs (2 to 3 cups) 
○ 5 or more symptoms during or after use 
■ I.e. twitching, insomnia, agitation  ○ Symptoms cause significant distress or impairment 
○ Not better accounted for by another mental condition 
● Caffeine Consumption: Problems of the Future?  ○ Inhalable caffeine with zero calories 
○ Each AeroShot gives 4-6 puffs and 100mg of caffeine  
● Effects of Caffeine on our Health  ○ Heart  ■ A slight, temporary rise in heart rate and blood pressure is common in  those who are sensitive to caffeine; however, habitual coffee drinkers are 
half as likely to die of heart failure as those who don’t fill their mug daily 

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School: Boston University
Department: OTHER
Course: Abnormal Psychology
Professor: Donna Pincus
Term: Spring 2017
Tags: Psychology and Abnormal psychology
Name: PS 371 Final Study Guide
Description: Notes for Final exam.
Uploaded: 05/07/2017
66 Pages 69 Views 55 Unlocks
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