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 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