Higlights:
- new chapter title
- types of disorders: substance use, substance induced, non-substance related disorders (gambling)
- dependence and abuse combined into spectrum
- changing face of dependence
Substance-Use Disorder
- divided into 2 separate conditions; substance abuse and substance dependence (combined into one diagnosis - substance use disorder)
- 2 or more symptoms over a year before diagnosing
- rate the severity of the disorder as moderate (2-3 criteria met) or severe (4+ criteria met)
- craving the substance added, it is a common symptom of abuse and dependence
- legal problems removed due to its low prevalence
Substance
- natural or synthesized product that has psychoactive effects: changes in thoughts, perceptions, emotions, and behaviors
1) Substance-Related Disorders
a. Alcohol
b. Caffeine
c. Cannabis
d. Hallucinogen
e. Inhalants
f. Opioids
g. Sedative/Hypnotics/Anxiolytics
h. Stimulants
i. Tobacco-Related
j. Other (or unknown) Substance
2) Substance Use Disoders
- cluster of cognitive, behavioral, and physiological symptoms, a person continues to pathologically use the substance despite substance-related problems
- applied to a substances except caffeine
- change in brain circuits persisting despite detoxification
- severity: mild (2-3 symptoms), moderate (4-5 symptoms), severe (6+ symptoms)
Criteria
a. Impaired Control - instense desire or urge
b. Social Impairment
c. Risky Use
Pharmacological Criteria
d. Tolerance - increase dose of substance
e. Withdrawal - blood or tissue concentration of substance declines in a person after prolonged heavy use
3) Substance-Induced Disorders
a. Substance Intoxication
- developing reversible substance syndrome due to ingestion of substance
- problematic behavioral and psychological changes associated with intoxication
- disturbances: perception, wakefulness, attention, thinking, judgment, psychomotor behavior, interpersonal behavior
b. Substance Withdrawal
- developing substance problematic behavioral change physiologically and cognitively due to reduction of heavy prolonged use
- causes clinically distress in important areas of functioning
4) Substance-Induced Mental Disorders
- toxic effects of substance can mimic mental illness
Theories
- biological; genetic factors or reward sensitivity
- psychological; social learning (modelling), cognitive (coping stress), behavioral undercontrol (impulsive, sensation seeking, antisocial behavior)
- sociocultural; poverty, adolescents with fighting parents, gender differences
a. Susbtance-induced Delirium
b. Susbtance-induced persisting Dementia
c. Susbtance-induced persisting Amnestic Disorder
d. Susbtance-induced Psychotic Disorder
e. Susbtance-induced Mood Disorder
f. Susbtance-induced Anxiety Disorder
g. Hallucinogen persisting Perceptual Disorder
h. Susbtance-induced Sexual Dysfunction
i. Susbtance-induced Sleep Disorder
5) Non-Substance-Related Disorders
- Gambling Disorder
- maladaptive gambling behavior that disrupts personal, family, or vocational pursuits
- 4 or more symptoms within 12-month period
- needs gamble with increasing amounts of money
- restless or irritable when attempting to cut down
- repeated unsuccessful efforts to control, cut, or stop
- preoccupied with gambling
- gambles when feeling distressed
- after losing money, returns another day
- lies to conceal involvement in gamblimg
- loss significant relationship, job, or educational/career opportunities
- relies on others to provide money
