PSY230H1 Lecture Notes - Lecture 5: Cocaine Intoxication, Antisocial Personality Disorder, Major Depressive Disorder
Week 5 – Wednesday February 24th, 2016
Externalizing Disorders
• Internalizing disorders - inwardly focused emotional problems (similar symptoms)
o Major depressive disorder
o Dysthymic disorder
o Generalized anxiety disorder
o Social phobia
o Specific phobia
o Panic disorder
• Externalizing disorders - outwardly focused behaviour problems
o Alcohol dependence
o Drug dependence
o Antisocial personality disorder
• Don't care about breaking the law or hurting people, etc.
• Conduct disorder for children
Substance Use
• Substance: any product with psychoactive effects
o Influences how we feel, think, act
• ~50% have tried an illegal substance (U.S.)
o 15% in the past year
• Problematic use differs
o Across the lifespan
• Adolescents different from adults and older adults
o Across different cultures
• Certain cultures do not whatsoever tolerate substances whereas other
condone it as a part of spiritual practices
• Also differences WITHIN cultures
▪ Canadians prefer hallucinogens, Americans prefer cocaine
• Categories of substances
o CNS Depressants
o CNS Stimulants
o Opioids
o Hallucinogens and phencyclidine (PCP)
o Cannabis
• The most frequent DSM disorder
• Most commonly used among adolescents
• Frequency of DSM-IV disorders
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• Substance-Related Conditions (DSM-IV)
o Substance intoxication
• Being drunk, high
• Maladaptive symptoms due to effect of substance on CNS
o Substance withdrawal
• Distress/impairment in function due to cessation/reduction of use
• If you cut back or stop
• Sever impediment
o Substance use
• Recurrent substance use leading to
▪ Harmful consequences
• Need to happen at least twice
o Substance dependence
• Recurrent substance use leading to
▪ Physiological dependence
• Can happen in a couple of different ways
• How our body works whether we take the substance or not
▪ Significant impairment
▪ Significant distress
• Substance Abuse (DSM-IV)
o 1+ symptoms occurs during a 12-month period (recurring)
• Failure to fulfill important obligations
▪ Not taking care of your cat, etc.
• Repeated use in hazardous situations
▪ Driving drunk, operating heavy machinery
• Repeated legal problems
▪ Getting arrested
• Use despite social problems
▪ Fights with loved ones
o Same criteria for all types of substances (alcohol, cocaine, etc.)
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o Causes significant impairment or distress
• Some clinicians say that this isn't always necessary
▪ If someone is constantly drinking and driving, they don't have to be
stressed out about it for it to be a problem
• Substance Dependence (DSM-IV-TR)
o Maladaptive pattern of substance use (3+)
• Tolerance
▪ When you take the same amount of a substance that you used to, it's not
having the same effect
• You need to increase the dosage to achieve the same "high"
• Withdrawal
▪ Symptoms vary depending on the substance being used
• Substance taken in more/longer than intended
▪ Use the substance for a longer period than you mean to
• Expectation: "I'm just gonna stop at the pub for a beer after work"
• Reality: "Oops it's 4am and I'm still not home and oops I drank a whole
keg"
• Persistent desire/unsuccessful efforts to cut back/control
▪ "I stopped smoking pot for a month, and then I started smoking it again,
and then I signed up for a program to help me quit, etc."
• Substance use is time-consuming
• Important activities are reduced because of substance use
▪ Stop going to work, etc.
• Use continued despite persistent problems
▪ Either physical or psychological problems
• Changes in DSM-5
o Criteria and terminology
• Diagnostic thresholds
▪ Combines the two categories from DSM-IV (substance abuse and
substance use disorder)
• Severity is based on the number of criteria involved
▪ Mild disorder: 2-3 criteria
▪ Moderate disorder: 4-5 criteria
▪ Severe disorder: 6+ criteria
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find more resources at oneclass.com
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