Davey: 6, 9, 10, 12, & 16
Luteijn & Barelds: 5, 6, 7, 8, 10, 11
Positive psychology: 2 & 3
Insomnia: 1, 3, & 4
Articles: somatic symptom disorder/ functional neurological disorder
Psychopathology & Psychodiagnostics
Mental Health Exam 2
Inhoudsopgave
CH 9: Substance use disorders.................................................................................................................................................. 2
CH 6: Anxiety and stressor-related problems.......................................................................................................................... 21
CH 12: Personality disorders................................................................................................................................................... 40
CH 10: Eating disorders.......................................................................................................................................................... 57
CH 16: Diagnostics for children and adolescents..................................................................................................................... 68
CH 5: Indirect methods (Luteijn & Barelds)............................................................................................................................. 81
CH 6: Intelligence and intelligence tests (Luteijn & Barelds).................................................................................................... 83
CH 7: Neuropsychological questions and methods (Luteijn & Barelds).....................................................................................85
CH 8: Personality questionnaires (Luteijn & Barelds)............................................................................................................... 88
CH 10: Computer-assisted clinical diagnostics (Luteijn & Barelds)............................................................................................ 90
CH 11: Ethical aspects and the reporting of diagnostics (Luteijn & Barelds).............................................................................92
CH 1: Clinical features of insomnia (Handbook of Insomnia)................................................................................................... 94
CH 3: Patient assessment in insomnia..................................................................................................................................... 95
CH 4: Treating insomnia......................................................................................................................................................... 97
CH 2: The intersection of Positive Psychology and the Practice of Counseling and Psychotherapy (Positive Psychology).........100
CH 3: Positive Psychological Tests and Measures (Positive Psychology)..................................................................................104
Article: Functional Neurological Disorder............................................................................................................................. 108
Article: Somatic Symptoms Disorder..................................................................................................................................... 111
1
, Davey: 6, 9, 10, 12, & 16
Luteijn & Barelds: 5, 6, 7, 8, 10, 11
Positive psychology: 2 & 3
Insomnia: 1, 3, & 4
Articles: somatic symptom disorder/ functional neurological disorder
CH 9: Substance use disorders
DAVEY: CH 9
SUBSTANCE USE DISORDERS
Drug = a substance that has a psychological effect when ingested or otherwise introduced into the body
a. While many of these substances have short-term benefits, they may have longer-term negative physical
Problems that arise and psychological effects with persistent use (e.g., alcohol)
out of the culture b. Many people either become psychologically or physically addicted to a drug and continue to use the
where drugs are drug when it no longer has the original benefits (e.g., sleeping pills and dieting pills)
almost a normal c. Many people move on from taking legal drugs to taking illegal substances, many of which are physically
part of our life damaging, highly addictive, and frequently blight social, educational, and occupational performance (e.g.,
cocaine, heroin, solvents, and hallucinogens such as LSD)
a. In 2017 over 271 million people worldwide aged 15-64 had used an illicit drug at least once in the previous
year, representing 1 in every 18 people in the world
b. There were an estimated 165,000 deaths worldwide from illicit drug use in 2017, and added to this there
World Drug Report were an additional 184,000 direct deaths from alcohol use
(WDR, 2019) c. An estimated 188 million people uses cannabis (2017) > the world’s most widely used illicit substance
estimated that… d. Amphetamine-type stimulants (ATS) second only to cannabis, estimated 40 million users worldwide
- One billion tobacco smokers worldwide, of whom 80% live in low- and middle-income countries
Tobacco & alcohol - 8 million people die each year, of whom 7 million as a direct result of tobacco use
- The world’s population consumes an average of 6.4 L of alcohol a year per person
- Harmful use of alcohol results in 2.8 million premature deaths a year
DEFINING AND DIAGNOSING SUBSTANCE USE DISORDERS
Substance abuse = a pattern of drug or substance use that occurs despite knowledge of the negative effects of the drug, but where use
has not progressed to full-blown dependency
Substance = a cluster of cognitive, behavioural, and physiological symptoms indicating that the individual continues use of the
dependence substance despite significant substance-related problems
- Pathology associated with substance and drug use had fallen into 2 categories: substance abuse and
substance dependence. These categories have been combined into a single substance use disorder in the
DSM-5 > 2 reasons for that
1. Few meeting substance abuse criteria progress to substance dependence.
2. Analysis shows substance dependence and substance abuse criteria represent a single disorder
category, not two.
- The DSM-5 criteria for substance use disorder has 4 general criteria: Impaired control, Social Impairment,
Risky Use, and Pharmacological Criteria
- Behavioural features of dependence include:
o Unsuccessful attempts to cut down on use of the drug
o Preoccupation with attempts to obtain the drug (e.g., theft of money to buy illegal drugs, driving
Substance use
long distances late at night to buy alcohol, multiple visits to doctors to obtain prescription drugs)
disorder
o Unintentional overuse, where people find they have consumed more of the substance than they
originally intended (e.g., ending up regularly drunk after only going out for a quick drink)
o Abandoning or neglecting important life activities because of the drug (e.g., failing to go to work
because of persistent hangovers, neglecting friendships, relationships, and educational activities)
- Substance use disorder is a chronic relapsing condition, in which habits are hard to eliminate, common for
individuals undergoing treatment for substance dependence to experience multiple relapses.
Impaired control
Substance taken for longer than originally intended
Reports desire to cut down but with multiple unsuccessful efforts to quit
Individual spends a significant amount of time obtaining in the substance and recovering from its effects
In severe cases, virtually all the individuals daily activities revolve around the substance
Craving is manifested by an intense desire or urge for the substance that may occur at any time
Social impairment
Substance use results in failure to fulfil major role obligations at work, school, or home
DSM-5 general Individuals persists with substance use despite recurrent social and interpersonal problems caused by the
criteria for substance
substance use The individual may withdraw from family activities and hobbies in order to use the substance
disorder Risky use
Recurrent substance use in situations in which it is physically hazardous
The individual continues to take the substance despite knowledge of persistent or recurrent physical or
psychological problems caused by the substance
2
, Davey: 6, 9, 10, 12, & 16
Luteijn & Barelds: 5, 6, 7, 8, 10, 11
Positive psychology: 2 & 3
Insomnia: 1, 3, & 4
Articles: somatic symptom disorder/ functional neurological disorder
Pharmacological criteria
Tolerance is signalled by requiring increasing doses of the substance to achieve the desired effects
The individual experiences withdrawal symptoms, and continues to take the substance in order to relieve
these withdrawal symptoms
Addiction = drug use to the point where the body’s ‘normal’ state is the drugged state (so the body requires the drug to feel
normal)
Psychological = when individuals have changed their life to ensure continued use of a particular drug such that all their activities are
dependence centred on the drug and its use
Craving = a subjective drive that addicts have to use a particular substance
Tolerance = the need for increased amounts of the substance in order to achieve similar effects across time
Withdrawal = where the body requires the drug in order to maintain physical stability, and lack of the drug causes a range of
negative and aversive physical consequences (e.g., anxiety, tremors, and in extreme cases, death)
Substance = a drug of abuse, a medication, or a toxin
SUMMARY: DEFINING AND DIAGNOSING SUBSTANCE USE DISORDERS
Substance dependence is characterised by both tolerance and withdrawal effects
Substance abuse is a pattern of substance use that occurs despite knowledge of the negative effects of the substance, but where it has
not yet progressed to full-blown dependence
The DSM-5 criteria for substance use disorders has four general criteria covering Impaired control, Social Impairment, Risky
Use, and Pharmacological Criteria
Craving is the term used for the strong subjective drive that addicts have to use a substance
Tolerance refers to the need for increased amounts of a drug to achieve the same effects across time
Withdrawal indicates that the body requires the drug in order to maintain physical stability
THE PREVALENCE AND COMORBIDITY OF SUBSTANCE USE DISORDERS
-
Global lifetime prevalence: over 2%; (US, several Eastern European countries this rise to over 5%)
-
3.1% of adults are diagnosed with substance use disorder (UK); with men (4.3%) showing higher prevalence
rates than women (1.9%)
Prevalence - 7.1% of those with past-year substance use disorders receive minimally adequate treatment (due to obstacles
seeking help > awareness of a perceived treatment need, accessing treatment once a need is recognised, and
compliance)
- Individuals with SUD between 41% and 76% have at least one other co-occurring psychopathology
- Especially strong association of lifetime mood and anxiety disorders with substance use disorders
- Studies showed higher levels of substance use disorders in individuals with major depression, bipolar
Comorbidity disorder, schizophrenia spectrum disorders, ADHD, bulimia nervosa, antisocial personality disorders,
personality disorders, and anxiety disorders (e.g., OCD and panic disorders)
- Substance abuse and dependence may be a risk factor for the later development of a psychopathology (e.g.,
Hypotheses about panic attacks may result from cocaine use and persists even after cocaine abstinence has been achieved, with
why substance use increasing likelihood of relapse back to cocaine or another drug to cope with these panic attacks)
disorders occur - However, current evidence is that psychiatric and psychological disorders usually predate substance abuse
with other and dependence > risk for substance abuse attributable to prior psychiatric illness: 14.2%, psychiatric illness
psychological attributable to substance abuse: 0.2%
disorders - “self-medication” effect: in which individuals with an established psychopathology start using substances to
alleviate the negative emotional and behavioural effects of the disorder
SUMMARY: THE PREVALENCE AND COMORBIDITY OF SUBSTANCE USE DISORDERS
The global lifetime prevalence rate for substance dependence is 2%
Substance use disorders are highly comorbid with a range of other DSM-5 mental health problems
CHARACTERISTICS OF SPECIFIC SUBSTANCE ABUSE DISORDERS
Alcohol and tobacco
Substances Stimulants (e.g., cocaine, amphetamine, and caffeine)
Sedatives (e.g., opiates, such as heroine, and barbiturates)
3
, Davey: 6, 9, 10, 12, & 16
Luteijn & Barelds: 5, 6, 7, 8, 10, 11
Positive psychology: 2 & 3
Insomnia: 1, 3, & 4
Articles: somatic symptom disorder/ functional neurological disorder
Hallucinogenic drugs (e.g., LSD and other hallucinogenics, cannabis, and MDMA (=ecstasy))
ALCOHOL USE DISORDER
A pattern of alcohol use causing impairment or distress leading to at least two of the following within 12-
month period:
o Alcohol is taken in greater amounts or for longer than was intended
o A continuing desire or unsuccessful efforts to control alcohol use
o A lot of time is spent in acquiring, using, and recovering from the effects of alcohol
Summary: DSM-5 o Craving, or a strong desire to use alcohol
diagnostic criteria o Alcohol use results in a failure to fulfil major life roles at work, home and so forth
for alcohol use o Persistent alcohol use despite the effect on interpersonal, recreational, or social interaction or
disorder despite having an ongoing physical or psychological problem that is likely to have been caused or
made worse by alcohol
o Tolerance symptoms associated with high alcohol use
o Withdrawal symptoms associated with high alcohol use
Binge drinking = a high intake of alcohol in a single drinking occasion
Ethyl alcohol = the intoxicating constituent of alcoholic drinks
- One of the most commonly used drugs in a very large number of countries worldwide
- Alcohol has its physical and psychological effects when its main constituent, ethyl alcohol, is absorbed into
the bloodstream through the lining of the stomach and intestine. Alcohol then reaches the brain and central
nervous system via the bloodstream.
- First, alcohol influences the receptors associated with the neurotransmitter GABA. This facilitates this
neurotransmitter’s inhibitory function by preventing neurons firing and making the drinker feel more
relaxed. Initially, this makes the drinker more talkative, friendly, confident, and happy.
- As more alcohol is absorbed into the central nervous system, the second stage of intoxication makes the
drinker become less able to make judgements and talk less coherently, memory is affected, and they may
switch from being relaxed and happy to emotional and aggressive.
- Finally, the physical effects of alcohol intoxication include motor coordination difficulties (in balance and
Course of the effect walking), slowed reaction times, and blurred vision.
of alcohol - This course of the effect of alcohol is known as biphasic, because the initial effect act as a stimulant, but the
later effect act as a depressant
- Drinking alcohol is appealing because of its initial effects (i.e., it helps alleviate stress after a busy day at
work, increases sociability, reduces inhibitions)
- However, many of the so-called effect of alcohol are actually mythical, and result from a drinker’s
expectations about the effects of alcohol rather than its real effects.
- Expectations about the effects of alcohol appear to play an important role in drinking behaviour, with
positive expectancies about the effects of alcohol being a significant predictor of its use.
ALOCOHOL ABUSE AND DEPENDENCE
Delirium tremens = a severe form of alcohol withdrawal that involves sudden and severe mental or nervous system changes
(DTs)
Korsakoff’s = a syndrome involving dementia and memory disorders which is caused by long-term alcohol abuse and dependency
syndrome
Fetal Alcohol = physiological risk associated with heavy drinking in women, in which heavy drinking by a mother during pregnancy
Syndrome can cause physical and psychological abnormalities in the child
Alcohol use = a problematic pattern of alcohol use leading to clinically significant impairment or distress
disorder
- Alcohol is seen by many as a way of enduring life’s problems and relieving tension
- Because of its availability, many use alcohol to the point where it begins to have significant negative effects
on both physical and psychological health
- Tolerance: with increased us, the body shows tolerance, where the drinker has to consume larger amounts to
achieve the same effects
- Withdrawal symptoms: long-term physical effects of heavy alcohol: restlessness, inability to sleep, anxiety
and depression, muscle tremors, and rise in blood pressure and temperature.
- Delirium tremens: severe form of alcohol withdrawal after drinking over a number of years, the drinker
may become delirious, experiences unpleasant hallucinations, and exhibits shaking and muscle tremors.
- Longer-term negative physical effects of heavy alcohol consumption: hypertension, heart failure, stomach
ulcers, cancer, cirrhosis of the liver, brain damage (shrinkage of the frontal lobes), early dementia
- Effects of long-term alcohol dependence are similar to malnutrition > alcohol contains calories, but it
entirely devoid of any required nutrients. This leads drinkers to feel full but take in little or no nutrition. The
consequence is vitamin and mineral deficiencies which can lead to dementia and memory disorders
(Korsakoff’s syndrome)
- 9.8% of women consume alcohol during pregnancy; 1 in 67 women who consume alcohol during pregnancy
will deliver a child with Fetal Alcohol Syndrome
- The physical effects of alcohol abuse and dependence substantially reduce longevity in drinkers (alcohol-
related deaths in the UK has increased by 16% between 1007 and 2016)
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