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