PSYC 210 Lecture Notes - Lecture 15: Intertemporal Choice, Wine Bottle, Motivational Interviewing
19 May 2018
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PSYCH 210 – Adult Abnormal Psychology
Lecture 15
Neurobiology and treatment
• Question 1: approx. what percent of people who use addictive substances become addicted?
o 9%
• Question 2: The criteria for substance abuse include the following categories:
o Social Impairment
o Physiological Changes
o Excessive risk
• Question 3: What is the most commonly used substance in the US?
o Alcohol
• Etiology: pathophysiology: Reward and Dopamine
o All addiction increases levels of striatal dopamine
▪ All of these drugs of abuse still lead to the same neurobiological result but for
different reasons?
o Incentive Sensitization Theory:
▪ Craving (wanting) vs. Pleasure (Liking)
▪ DA system becomes supersensitive to direct effects of drugs and also to drug
associated cues
• Cues – needles, wine bottle if you drink, rolling papers for weed
▪ Sensitivity leads to craving go to extreme lengths to seek out and obtain drugs
▪ Over time, liking decreases wanting remains intense
▪ Transition from liking to wanting maintains addiction facilitated by DA
o Dopamine Hypothesis of SCZ:
▪ Midbrain DA
• Square square triangle – JUICE – peek in DA
• Begin to associate particular cue with a reward – track the triangle
▪ Schizophrenia – inappropriate phase fire to a square (positive symptom) and a
failed response to actual reward cue (negative symptom)
▪ In view of drugs:
• 1) Extreme response to drugs – more dopamine
• 2) Overtime associate cues to drug youll see that extreme response to
the cue – much larger than usual
• 3) Diminished response to everything else
o No longer loves juice – only wants cocaine
o Juice used to be rewarding but much more of a flattening to
juice
o Don’t need to memorize figures on screen of addicted brain versus non-addicted brain
▪ Change from liking to wanting
▪ Addiction is a disease of reward learning and motivation
o Why do we need help?
▪ People still smoke cigarettes – even though know information – why is it so
hard to make a change
▪ Addition is an intertemporal choice problem –
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• Balancing feel really good right NOW but may hurt family and
friends…but LATER
▪ All change boils down to cost-benefit problem
• Difficult to weigh things in a rational way
• You can stop drinking and may see kids grow up or can keep drinking
because I really enjoy it
o Stages of Change Model
▪ 1. Pre-contemplation
• No intention of changing behavior
▪ 2. Contemplation
• Aware of a problem exists
• No commitment to action
▪ 3. Preparation
• Intent upon taking action
▪ 4. Action
• Active modification of behavior
▪ 5. Maintenance
• Sustained change – new behavior replaces old
▪ 6. Relapse – fall back into old patterns of behavior
o Motivational interviewing
▪ When changing is hard often because of ambivalence – procrastinate about
making a change because we don’t like to be anxious – which is often
mistaken for resistance
• Don’t use the word resistance
o But actually ambivalence – get stuck here
▪ Can help resolve ambivalence and help elicit a person’s own motivation to
change
▪ The Spirit of MI:
• Partnership
o Work collaboratively and avoids the expert role
• Acceptance
o Respecting the client’s autonomy potential strengths and
perspective
• Compassion
o Keeps the client’s
• Expression
▪ Core Skills:
• Open Questions
o How do you feel?
o Closed: How much alcohol do you drink a day?
▪ Vs. what role does alcohol play in your life?
▪ Encourage talking – rather than questioning based on
counselors agenda
• Affirmation
o You really care a lot about your family
find more resources at oneclass.com
find more resources at oneclass.com
