unit 6 - 6210

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Capella University *

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6210

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Psychology

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Feb 20, 2024

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Substance Use and Addictive Disorders, Mental Disorders Due to a General Medical Condition Substance-Related Disorders Overview Classes of Drugs: ● Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco, and other substances. ● Excessive use of these drugs activates brain reward systems, leading to neglect of everyday activities. ● Different pharmacological mechanisms produce a reward, often called a "high." Neurobiological Roots of Substance Use Disorders: ● Neurobiological roots of substance use disorders can be seen in behaviors long before the onset of substance use. ● Substance use disorder is a neutral term describing a wide range of disorders, from mild to severe. Additional Disorders: ● Gambling disorder, Internet gaming, and other excessive behavioral patterns are also included. ● Behavioral addictions, such as sex, exercise, and shopping addiction, are not included due to insufficient peer-reviewed evidence. Substance-Induced Disorders: ● Substance intoxication, substance withdrawal, and substance/medication-induced mental disorders are classified as substance-induced. ● Substance/medication-induced mental disorder refers to symptomatic presentations due to the physiological effects of an exogenous substance on the central nervous system. Stimulant-Related Disorders Overview ● Stimulant use disorder is a substance use disorder involving the abuse of stimulants. ● Caffeine and nicotine are the most popular stimulants used today, with approximately 200 million Americans using some type of stimulant in the past year. ● Stimulant disorders in the DSM-5 include cocaine use disorder, amphetamine-use disorder, and tobacco-use disorder.

● Certain isolated conditions related to caffeine are recognized in the DSM-5’s “substance-related” section: caffeine intoxication, caffeine withdrawal, and other caffeine-induced disorders. Diagnostic Criteria ● A stimulant use disorder is diagnosed as a pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress. ● The disorder is diagnosed by at least two of the following, occurring within a 12-month period: ○ the stimulant is often taken in larger amounts or over a longer period than intended, there is a persistent desire or unsuccessful efforts to cut down or control stimulant use, a great deal of time is spent in activities necessary to obtain the stimulant, use the stimulant, or recover from its effects, a strong craving or urge to use the stimulant is present, recurrent stimulant use results in a failure to fulfill major role obligations, ○ Stimulant use is continued despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the stimulant, important social, occupational, or recreational activities are given up or reduced because of stimulant use, ○ Stimulant use is recurrent in situations in which it is physically hazardous; ○ Stimulant use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant, ○ Tolerance is present, and withdrawal is manifested by either the characteristic withdrawal syndrome for the stimulant or the stimulant (or a closely related substance) used to relieve or avoid withdrawal symptoms. Medication-Induced Movement Disorders: An Overview ● Medication-induced movement disorders are crucial in managing mental disorders and differentially diagnosing mental conditions. ● The causal relationship between medication exposure and movement disorder development is challenging, as some disorders can occur without medication exposure. ● The term "neuroleptic" is being replaced with "antipsychotic medications and other dopamine receptor blocking agents" due to their tendency to cause abnormal movements. ● Antipsychotic medications include conventional, "typical," and "atypical" agents, and certain drugs used for symptom treatment. ● Amoxapine is indicated for the treatment of depression.

U6D1 1. Distinguish between substance use, abuse, and dependence. Use current DSM-5-TR terminology and conceptualizations as you respond to this task. Substance-related disorders are divided into various severity categories in the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision): substance use, substance abuse, and substance dependence. Substance use is defined as the use of a substance in a way that does not always result in significant issues or impairments in one's ability to perform in social, occupational, or other relevant domains. It is essentially the early stages of substance consumption without any serious adverse effects or usage behaviors. A pattern of substance abuse occurs when a person uses a substance despite persistent legal, social, interpersonal, or other issues that are either brought on by or made worse by the substance. Although the user may not yet be completely reliant on the substance, abuse suggests that their use has had unfavorable effects (American Psychiatric Association, 2020). Addiction, or substance dependency, is the most severe type of substance-related illness. It entails a maladaptive pattern of substance use that results in clinically significant impairment or distress. This can be shown by withdrawal symptoms, tolerance, a persistent desire to reduce or stop using substances, and a reduction in or cessation of significant social, professional, or recreational activities due to substance use. 2. Compare the presentation differences you could expect to see in an individual diagnosed with a generalized anxiety disorder who is dependent on one of these: a. Marijuana: Cannabis-dependent people with GAD may feel more anxious than usual, especially while they're intoxicated or going through withdrawal. Long-term usage of marijuana can result in tolerance and could exacerbate anxiety symptoms, even if it may initially make you feel more relaxed or relieve the symptoms of anxiety. b. Alcohol: Abusing alcohol might make GAD symptoms worse. Although alcohol could temporarily lessen anxiety symptoms, it can also create a vicious cycle of dependency and heightened anxiety, particularly during withdrawal. c. Methamphetamines: Methamphetamine-dependent people with GAD may be more agitated, anxious, and paranoid—especially while they're intoxicated or going through withdrawal. Using methamphetamine can make anxiety disorders that already exist worse and raise the possibility of acquiring new mental health problems.

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d. Cocaine: More anxiety, agitation, and paranoia can result from cocaine use, which exacerbates GAD symptoms. Just as methamphetamine effects, cocaine usage may offer short-term respite from anxiety symptoms; it can also worsen anxiety disorders and accelerate the onset of further mental health problems. 3. Briefly assess the factors involved in at least one ethnic and cultural issue related to substance abuse that is at the heart of current controversy, being sure to include a perspective on diathesis-stress issues. Almost every civilization on the planet has long viewed drug and alcohol use as a social and spiritual cornerstone. Assimilation is the process wherein the new culture is fully embraced in place of the previous culture, reaching its height of intensity. Conversely, other possible effects include marginalization, transmutation, separation, and integration (Abbott & Chase, 2008). These can occur at different points along a continuum, from minor change to complete transformation. Drug addiction and usage are assumed to be associated with a person's level of acculturation or how much they identify with their original culture. The disproportionate impact of drug misuse on Native American communities in the United States is one ethnic and cultural problem connected to substance abuse that has been at the center of contemporary contention. Certain drugs are used ceremonially or medicinally in some Native American communities according to their traditional rituals. However, when cultural customs are broken, or when people are not given proper direction on how to use these substances, abuse can result. In terms of diathesis-stress perspective, individuals from Native American tribes may have a genetic predisposition to drug misuse, which combines with external stressors such as poverty, prejudice, and trauma. This combination raises the risk of acquiring drug use disorders. Efforts to combat drug abuse in Native American communities must thus address both the underlying environmental stresses and provide culturally relevant preventive and treatment measures. References: Abbott, P., & Chase, D. M. (2008, January 1). Culture and Substance Abuse: Impact of Culture Affects Approach to Treatment . Psychiatric Times. https://www.psychiatrictimes.com/view/culture-and-substance-abuse-impact-culture- affects-approach-treatment American Psychiatric Association. (2020, December). Psychiatry.org - What Is a Substance Use Disorder? American Psychiatric Association.

https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what -is-a-substance-use-disorder American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). U6D2 1. What diagnostic possibilities does Ben's case present? Ben's symptoms suggest a Neurocognitive disorder and a personality disorder based on the evidence presented. (F02.81) Neurocognitive Disorder due to Traumatic Brain Injury (F60.9) Unspecified personality disorder 2. What have you read in the case history so far that presents these possibilities? Neurocognitive Disorder due to Traumatic Brain Injury Ben was involved in an automobile accident that resulted in a brain injury. Even mild brain trauma can eventually result in substantial cognitive problems, even if the injury was not thought to be severe initially. “TBI symptoms can occasionally take weeks or months to appear. Ben has been displaying signs of these symptoms lately, such as rage, irritation, and problems with impulse control. These behaviors can be explained by the possibility that the injury impacted the brain's frontal lobe, which controls executive functions, including impulse control, decision-making, and emotional regulation (APA, 2022). Consequently, Ben's changes in behavior may be explained if there was any frontal lobe impairment. Unspecified Personality Disorder These symptoms also resemble those of personality disorders such as Bipolar II and Borderline Personality Disorder, even if the previously described diagnosis may explain his behavior change. For instance, mood swings and anger may also be signs of a mood illness, while improper language and conduct may point to a personality contention. 3. What kind of questions you might ask to evaluate each diagnostic possibility? You must consider at least two, but no more than three, diagnostic possibilities, and develop a series of questions to interview for each possibility.

a. How significant were the changes or developments in brain activity? Have you compared the initial MRI scan to the most recent one? b. Do the symptomatic episodes occur frequently, or are they sporadic? 4. What possible answers would lead you toward or away from each of your possibilities? a. Visuals; providing brain scans from appointments b. Accounts of episodes before the accident 5. What further information and referrals would you want to clarify Ben's diagnosis? a. Ben may be subjected to a series of neuropsychological tests. These thorough evaluations can be used to detect cognitive deficits, including issues with memory, focus, and problem-solving abilities. b. If Cindy returned for a conversation without Ben, she might be able to offer helpful information. If she does this, she could feel more comfortable sharing any observations or worries in front of Ben. c. A background in family history could be beneficial. Given that many physical and mental health illnesses have a hereditary component, learning whether Ben's diagnosis has any family history of such problems might be crucial. References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

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