31 May Psychology of Abnormal Behavior In your opinion, what is an addiction?Why is it so difficult to quit abusing drugs? At least 275 words or more response. Chapter 8:
Discussion topic – Psychology of Abnormal Behavior
In your opinion, what is an addiction? Why is it so difficult to quit abusing drugs?
At least 275 words or more response.
Chapter 8: Eating Disorders Chapter 9: Substance-Related Disorders
Course Materials
Kearney. C & Trull. T, Abnormal Psychology and Life: A Dimensional Approach, 3rd edition.
Cengage, 2018 -ISBN: 9781337273572( Mind Tap)
Weight Concerns, Body Dissatisfaction, and Eating Disorders
Eating Disorders: Features and Epidemiology
Eating Disorders: Stigma Associated with Eating Disorders
Eating Disorders: Causes and Prevention
Eating Disorders: Assessment and Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, and Eating Disorders
• 1) Weight Concerns – Feeling overweight much of the time – Viewing one’s weight negatively
• 2) Body Dissatisfaction – Distress with one’s appearance
• 3) Eating Problems – Restricted Eating or Dieting – Lack of Control over Eating
The Continuum of Body Dissatisfaction to Eating Behavior
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
The Continuum of Body Dissatisfaction to Eating Behavior (cont’d.)
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
DSM-5: Anorexia Nervosa
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
• Refusal to maintain body weight
• Intense fear of gaining weight
• Perceptual disturbance of body image
• Extreme dissatisfaction with body
• Dehydration • Hypotension • Anemia • Kidney dysfunction • Heart problems • Dental problems • Electrolyte imbalance • Osteoporosis
Features of Anorexia Nervosa
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
DSM-5: Bulimia Nervosa
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
• Binge-eating episodes • Inappropriate methods
to prevent weight gain • Self-evaluation greatly
influenced by body shape & weight
• Episodes often triggered by depression, stress or low self-esteem
• Dental Problems • Swelling of salivary
glands • Esophageal
problems • Chronic diarrhea • Bowel problems
Features of Bulimia Nervosa
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
Misuse of laxatives
Misuse of enemas
Excessive exercise
Misuse of diuretics
Behaviors used to prevent weight gain after binge eating are called
compensatory behaviors. They include:
Fasting
Self-induced vomiting
Bulimia Nervosa
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
DSM-5: Binge-Eating Disorder
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Recurrent episodes of binge eating. A binge eating episode involves both:
Symptoms of Binge-Eating Disorder
Eating, in a specified period of time, an amount of food that is larger than what most would eat in the same period of time and in similar circumstances
Feeling a lack of control over one’s eating (inability to stop eating or control how much is eaten)
Binge-Eating Disorder
Eating Disorders: Features and Epidemiology
• Binge-eating episodes without compensatory behaviors
• Eating more rapidly than the “normal person
• Eats despite often uncomfortable full feeling
• Eating when not hungry • Eating alone • Feeling disgusted,
depressed or guilty
• Varying level of obesity • Enroll in weight control
programs
Features of Binge-Eating Disorder
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
Eating Disorder Women Men
Anorexia nervosa 0.30.9
Bulimia nervosa 0.51.5
Binge eating disorder 2.03.5
Source: Hudson, J.I., Hiripi, E., Pope, H.G., & Kessler, R.C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61, 348-358.
Lifetime Prevalence Rates (%) for Major Eating Disorders
Epidemiology of Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Eating Disorders: Features and Epidemiology
Male Body Ideal
Eating Disorders: Features and Epidemiology
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Female Body Ideal
Eating Disorders: Features and Epidemiology
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Focus on College Students: Eating Disorders
Eating Disorders: Features and Epidemiology
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Gender and Eating Disorders
Eating Disorders: Features and Epidemiology
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Stigma Associated with Eating Disorders
• Research suggests many blame those with eating disorders for their problems
• Eating disorders are self-inflicted and related to “willpower”
• Factors for anorexia nervosa are lack of social support, lack of discipline and poor parenting
• Stigma associated with perceptions that those with anorexia nervosa are responsible for these problems
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment
& Treatment
Stigma Associated with Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment
& Treatment
Statement Eating Disorders Alcoholism
19981998
Danger to others 657
Unpredictable
Depression
1998
23
2003
7
2003
64
2003
19
Hard to talk to
Feel different from us
0.7-4.0They are to blame
Could pull themselves together
Treatment wouldn’t help
Will never fully recover
7129 5627 70 53
5938 6233 55 56
3549 4333 25 30
6034 1333 54 11
5238 1935 50 17
119 1610 12 15
2411 2315 29 25
Stigmatizing Statements
Stigma Associated with Eating Disorders
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Amygdala
Prefrontal cortex
Nucleus accumbens
Thalamus
Somatosensory cortex
Hypothalamus
© William Howard/Stone/Getty Images
Biological Factors for Eating Disorders
Biological Factors for Eating Disorders (cont’d.)
• Neurochemical Features – Serotonin
• Satiety
– Dopamine – Endogenous Opioids
• Personality Traits – Perfectionism – Impulsivity
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Environmental Risk Factors for Eating Disorders
• Family Factors – Reinforcement on weight loss
• Media Exposure to the “Thin Ideal” • Cognitive Factors
– Body Dissatisfaction – Body Image Disturbance
• Cultural Factors
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Environmental Risk Factors for Eating Disorders (cont’d.)
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Causes of Eating Disorders
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Prevention of Eating Disorders
Prevention of Eating Disorders (cont’d.)
• National Eating Disorders Awareness Week – A media campaign to educate & screen for eating disorders – Approximately 51% of prevention programs reduce risk factors – Approximately 29% reduce current & future risk factors
• Student Bodies – An 8 week program administered via the internet – Combines a structured cognitive-behavioral curriculum with a
discussion group
– Primary goals are to reduce weight concerns & body dissatisfaction – Each week they can log onto the website with updated content
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Assessment of Eating Disorders
Assessment of Eating Disorders (cont’d.)
• Interviews • Self–Report Questionnaires
– The Eating Disorder Diagnostic Scale
• Self-Monitoring – Diaries
• Physical Assessment – Monitor & record daily symptoms & behavior
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Copyright © Cengage Learning®
Treatment of Eating Disorders
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Controlled weight gain
Medication
Biological Treatment of Eating Disorders
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Low self esteem
Negative affect
Diet to feel better about self
Restrict food intake too much
Diet brokenBinge
Compensatory behaviors (e.g., vomiting to reduce fear of weight gain)
Psychological Treatment of Eating Disorders
Eating Disorders: Assessment & Treatment
• Family Therapy – Helpful for adolescents with anorexia nervosa – The Maudsley Model Approach
• Cognitive-Behavioral Therapy (CBT) – Dominant approach to treat eating disorders – Conducted with a nutrition program & medication – Episodes are negatively reinforcing – Focuses on the binge & purge cycles
Psychological Treatment of Eating Disorders (cont’d.)
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Bulimia Nervosa: The Binge Purge Cycle
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Cognitive Behavioral Therapy (CBT)
• CBT try to interrupt the binge-purge cycle – Question social standards for physical
attractiveness
– Challenge beliefs that encourage severe food restriction
– Develop “normal” eating patterns & habits – Lasts approximately 18 weeks in a stage-like
treatment plan
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Cognitive Behavioral Therapy (CBT) (cont’d.)
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Eating Disorders: Assessment & Treatment
Weight Concerns, Body Dissatisfaction, & Eating Disorders
Eating Disorders: Causes & Prevention
Are you constantly thinking about your weight and food?
Are you dieting strictly and/or have you lost a lot of weight?
Are you more than 10% below your healthy weight?
Are people concerned about your weight?
Sample Screening Questions for Eating Disorders
Is your energy level down?
Do you constantly feel cold?
Long-Term Outcome for People with Eating Disorders
Eating Disorders: Assessment & Treatment
Chapter Reflections
• Which assessment techniques do you think are most effective for each of the major types of eating disorders?
• What treatments appear to be most effective for specific eating disorders?
• What is the long-term outcome for individuals with eating disorders?
- Slide 1
- Weight Concerns, Body Dissatisfaction, and Eating Disorders
- The Continuum of Body Dissatisfaction to Eating Behavior
- Slide 4
- DSM-5: Anorexia Nervosa
- Features of Anorexia Nervosa
- DSM-5: Bulimia Nervosa
- Features of Bulimia Nervosa
- Bulimia Nervosa
- DSM-5: Binge-Eating Disorder
- Binge-Eating Disorder
- Features of Binge-Eating Disorder
- Epidemiology of Eating Disorders
- Male Body Ideal
- Female Body Ideal
- Focus on College Students: Eating Disorders
- Gender and Eating Disorders
- Stigma Associated with Eating Disorders
- Stigmatizing Statements
- Biological Factors for Eating Disorders
- Biological Factors for Eating Disorders (cont’d.)
- Environmental Risk Factors for Eating Disorders
- Environmental Risk Factors for Eating Disorders (cont’d.)
- Causes of Eating Disorders
- Prevention of Eating Disorders
- Prevention of Eating Disorders (cont’d.)
- Assessment of Eating Disorders
- Assessment of Eating Disorders (cont’d.)
- Treatment of Eating Disorders
- Biological Treatment of Eating Disorders
- Psychological Treatment of Eating Disorders
- Psychological Treatment of Eating Disorders (cont’d.)
- Bulimia Nervosa: The Binge Purge Cycle
- Cognitive Behavioral Therapy (CBT)
- Cognitive Behavioral Therapy (CBT) (cont’d.)
- Long-Term Outcome for People with Eating Disorders
- Chapter Reflections
,
Normal Substance Use and Substance Related Disorders: What Are They?
Substance-Related Disorders: Features and Epidemiology
Stigma Associated with Substance-Related Disorders
Substance-Related Disorders: Causes and Prevention
Substance-Related Disorders: and Treatment
Many of us engage in substance use that somehow affects our behavior. Such use is normal and may not lead to significant problems if we use the drug carefully.
Normal Substance Use and Substance-Related Disorders: What Are They?
Substances affecting our behavior
Examples include alcohol, nicotine, caffeine, or a morphine derivative
Substance-related disorder
Substance use to a severe degree
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Some people engage in substance use to a greater degree than normal. In severe cases of misuse, daily functioning is impaired, or some physical harm takes place. This describes a substance-related disorder.
2
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Emotions
Cognitions
Behaviors
Normal
Stable mood.
No concern about substance use.
Occasional but appropriate alcohol use or use of medication.
Mild
Moderate
Substance-Related Disorder – Less Severe
Substance-Related Disorder – More Severe
Mild discomfort about the day, feeling a bit irritable or down.
Thoughts about the difficulty of the day. Worry that something will go wrong at work.
Drinking a bit more than usual; relying on medication to sleep.
Considerable stress and sadness (note that opposite
emotions occur when drug is used).
Dwelling on negative aspects of the day; worry about
threats to one’s job or marriage. Thoughts about ways
to hide substance abuse.
Drinking alcohol regularly at night; occasionally
missing work on Mondays; heavy use of medication.
Intense stress, sadness, and feelings of emptiness;
agitation about not having access to a specific
drug or drugs.
Frequent thoughts about using substances and
worry about harm to personal health.
Regular intoxication such that many days are
missed from work; arguments with spouse about
substance use; arrests for impairment.
Extreme stress, sadness, and feelings of emptiness.
Extreme agitation when drug is not available.
Thoughts focused almost exclusively on drug
use and self-destruction of one’s lifestyle.
Very frequent intoxication; loss of job or marriage;
physical addiction to a drug; seeking to secure
or use drugs most of the time.
Continuum of Substance Use and Substance-Related Disorders
Substance-related disorders, like other disorders, occur on a continuum of normal to severe.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Substance Use Disorder
Repeated use of substances to the point that recurring problems are evident
Alcohol use disorder
Diagnostic criteria is listed in Table 9.1
Substance-use disorders usually involve impaired control, social impairment, risky use, and tolerance and/or withdrawal.
DSM-5: Alcohol Use Disorder
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
DSM-5: Alcohol Intoxication
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Slurred Speech
Incoordination
Unsteady gait
Nystagmus
Impairment in attention or memory
Stupor or coma
Substance Intoxication
Substance intoxication is a reversible condition brought on by excessive use of alcohol or another drug.
For example, these are some of the main diagnostic criteria for alcohol intoxication in the DSM-5.
DSM-5: Alcohol Withdrawal
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
1) Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm)
2) Increased hand tremor
3) Insomnia
4) Nausea or vomiting
5) Transient visual, tactile, or auditory hallucinations or illusions
6) Psychomotor agitation
7) Anxiety
8) Generalized tonic-clonic seizures.
Substance Withdrawal
Substance withdrawal refers to maladaptive behavioral change when a person stops using a drug.
Here are some of the behaviors associated with alcohol withdrawal.
Types of Substances
Depressants
Stimulants
Opiates
Hallucinogens
Marijuana
Other drugs
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Depressant, or sedative, drugs are those that inhibit aspects of the central nervous system.
Stimulant drugs activate or stimulate the central nervous system.
Opiates (sometimes called narcotics or opioids) are drugs commonly used to relieve pain or cough, such as morphine or codeine.
Hallucinogens are drugs that cause symptoms of psychosis, such as hallucinations (seeing or hearing things not actually there), disorganized thinking, odd perceptions, and delirium (a cognitive state of confusion and memory problems).
Marijuana comes from Cannabis sativa, or the hemp plant, that contains an active ingredient known as THC (delta-9-tetrahydrocannabinol).
Other drugs also relate to excessive substance use: designer drugs or club drugs, inhalants, and steroids are some examples.
10
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Acid (LSD)
Club drugs
Cocaine
Ecstasy/MDMA
Heroin
Inhalants
Marijuana
Methamphetamine
PCP/phencyclidine
Prescription medication
Acid, blotter, and many others
XTC, X (MDMA); Special K, Vitamin K (ketamine); liquid ecstasy, soap (GHB); roofies (Rohypnol)
Coke, snow, flake, blow, and many others
XTC, X, Adam, hug, beans, love drug
Smack, H, ska, junk, and many others
Whippets, poppers, snappers
Pot, ganga, weed, grass, and many others
Speed, meth, chalk, ice, crystal, glass
Angel dust, ozone, wack, rocket fuel, and many others
Commonly used opioids include oxycodone (OxyContin), propoxyphene (Darvon), hydrocodone (Vicodin), hydromorphone (Dilaudid), meperidine (Demerol), and diphenoxylate (Lomotil); common central nervous system depressants include barbiturates such as pentobarbital sodium (Nembutal), and benzodiazepines such as diazepam (Valium) and alprazolam (Xanax); stimulants include dextroamphetamine (Dexedrine) and methylphenidate (Ritalin)
Types of Substances (cont’d.)
Major substances and their street names and effects are listed here. In this chapter, we focus on the main categories of drugs including depressants, stimulants, opiates, hallucinogens, and marijuana.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Alcohol
Binge drinking can lead to many untoward consequences.
Depressants inhibit the central nervous system, whereas stimulants activate the central nervous system.
Alcohol is perhaps the most widely used of these. It affects the neurotransmitter GABA, which is an inhibitory neurotransmitter, producing disinhibited behavior. The initial effects of this are the elated “high” associated with alcohol consumption. Drinking past this point results in the more excitatory areas of the brain becoming depressed. Symptoms with this stage of drinking might involve more aggressive behavior, impaired judgment and attention, overconfidence in one’s problem solving ability, impaired sexual performance, and memory impairment.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Copyright © Cengage Learning
Fetal Alcohol Syndrome
People are dealing with alcoholism are at risk for a variety of health problems, including cirrhosis of the liver, Korsakoff’s syndrome, and fetal alcohol syndrome (FAS) for the offspring of women who abused alcohol during pregnancy.
Characteristic facial features of individuals with fetal alcohol syndrome are pictured here. Slowed physical growth and cognitive impairment also accompany FAS.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Stimulants
Cocaine is often smoked in the form of crack.
Stimulants include caffeine, nicotine, cocaine, and amphetamines.
The pleasurable effects of meth are extremely intense and include strong euphoria, enhanced sexual drive and stamina, and lowered sexual inhibition. The drug helps stimulate pleasure centers in the brain to release large amounts of dopamine.
Downsides include brain and liver damage, malnutrition, skin infections, immune system problems, convulsions, stroke, and death.
These are booking photos of a woman arrested for meth use. They were taken only two years apart.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Opiates
Opiates include morphine, codeine, and heroin
Opiates stimulate different types of opiate receptors in the brain
Modern-day painkillers are also related to morphine and can be highly addictive
Commonly abused, heroin is a strong opiate that leads to an increased risk of cancer and infertility.
Prescription drug use is becoming one of the fastest-growing forms of substance-related disorder.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Many people who take LSD reportedly experience psychedelic
hallucinations marked by bright colors and shapes. Some artists have
tried to represent their experiences with the drug in art, as highlighted
in this edition of Life magazine.
Hallucinogens
Hallucinogens cause symptoms of psychosis such as hallucinations, disorganized thinking, odd perceptions, and delirium.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Marijuana
Angel Raich is seen with cannabis buds at her home in Oakland,
California. She began smoking after her doctor suggested it might ease
pain she suffers from an inoperable brain tumor.
Heavy users of marijuana may become physically and psychologically dependent. It produces feelings of joy, well-being, and humor and a dream-like state. But time feels distorted, memory and attention are often impaired, and long-term use can result in fertility problems. It is also used as treatment for glaucoma and other medical symptoms.
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Epidemiology of Substance-Related Disorders
Substance use disorders are more common among males than females. Drug use is most common among people between 12 and 30 years of age.
The following graph shows percentage of individuals by age using illegal drugs.
Stigma Associated with Substance-Related Disorders
Social discrimination may be faced with respect to:
Employment
Housing
Interpersonal rejection
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Several interventions have been designed to reduce stigma associated with substance-related disorders. These interventions often involve learning about substance-related disorders, accepting difficult feelings, emphasizing human connection and mutual acceptance, focusing more on the process of thinking (i.e., thinking about how thinking happens in the mind) rather than the content of negative thoughts, exploring goals and values in life, communicating positive stories of people with substance-related disorders, and boosting employment skills.
19
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Prefrontal cortex
Nucleus accumbens
Ventricle tegmental area
Copyright © Cengage Learning
Biological Risk Factors for Substance-Related Disorders
The mesolimbic system is a major dopamine pathway implicated in sensations of pleasure and reward. It links to other areas central to addiction, including the amygdala, anterior cingulate, bed nucleus of the stria terminalis, hippocampus, insular cortex or insula, prefrontal cortex, and orbitofrontal cortex
Features and Epidemiology
Causes and Prevention
Assessment and Treatment
Environmental Risk Factors for Substance-Related Disorders
People often engage in substance use to relieve stress and depression.
Environmental risk factors include, stress, cognitive factors, learning, personality factors, family factors
