-Peers estimated their friends to drink more on their 21 st birthday but in reality drank less Etiology: Genetic Factors: -Greater concordance in MZ than DZ twins 1. Men: alcohol, caffeine, smoking, marijuana, & drug abuse in general 2. Women: role genetics less clear (fewer available studies—findings are mixed) -Ability to tolerate large quantities of alcohol may inherited diathesis- a tendency to suffer from a particular medical condition 1. Asians have low rates of alcohol abuse (evidence for physiological intolerance in this group)
Etiology: Neurobiological Factors: -Incentive-sensitization theory 1. wanting (craving for drug) 2. Liking (pleasure obtained by taking the drug) 3. Dopamine sys. becomes sensitive to the drug & associated cues (ex. needles, rolling paper) 4. Sensitivity to cues induces & strengthens wanting Treatment & Prevention: • Family-based approaches that seek to: – Modify negative interactions between family members, improve communication, and develop effective problem-solving skills to address areas of conflict • Motivational interviewing (MI) – A patient-centered and directive approach – Addresses ambivalence and discrepancies between a person’s current values and behaviors and their future goals Treatment & Prevention (cont.): • Adolescents with more severe levels of abuse, unstable living conditions, or comorbid psychopathology require an inpatient or residential setting • Effective approaches address multiple influences (peer, family, school, and community) on the individual Substance Abuse & Violence: • (1) Substance use causes violence • (2) Violence leads to substance use • (3) Relationship is reciprocal • (4) Relationship reflects “third” variable (e.g., potential common causes) Comorbidity: • WHY ELEVATED COMORBIDITY? – Self-medication hypothesis – Less appreciation for the (-) consequences of use – Poor judgment with respect to peer group selection – Substance use/abuse exacerbates mental health disorders and psychopathology – Psychopathology accelerates onset of abuse or dependence • Depression unrelated to nicotine use or onset but significantly predicts nicotine addiction SU Causes Violence: • Psychopharmacological model – Intoxication effects induce or cause disinhibition, cognitive/perceptual changes, neurochemical – Chronic substance use may also influence: • Withdrawal • Sleep deprivation • Nutritional deficits • Neuropsychological impairment • Enhance psychopathology or negative personality traits Violence leads to SU: • Aggressive individuals more likely to select (or be pushed into) social contexts where substance use encouraged/accepted • Lifestyles of violent individuals conducive to significant substance use/abuse – Unstable employment Third Variable Explanation: • Potential shared traits or characteristics.
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- Fall '14
- Diagnostic Criteria