Compare and contrast the neurobiology of addiction with the sociocultural views of chemical dependency. Elaborate on your answer.
Chemical dependency (Substance abuse) has a particular defined cultural and social reaction. According to Maddux & Winstead, (2015), addiction has been widely known to disrupt the normal functioning of the life of the addict.
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Neurobiology of Addiction : The development of drug addiction comprises majorly the drug and the neural circuitry involved. The addiction disorder is piloted by the interactions of drugs or substance taken with the psychosocial, genetic, environmental, and behavioral among other factors. These interactions trigger the commencement and progression of prolonged alterations in the functional and biochemical properties of specific groups of neurons within the brain. Whenever addictive substances are abused with a high dose, chronicity, and frequency, they seize the circuitry responsible for the regulation of emotional motivation and impair volitional control and insight of the addict (Suckling & Nestor, 2016). Additionally, chronic drug abuse leads to the formation of memories that are deeply ingrained which make the addict susceptible to much drug craving and degeneration.
Socio-cultural views of chemical dependency : Negative effects and cultural standards of the society can have implications on individuals and can easily lead to addiction. Most cultural standards are subtle with powerful influences. For instance, in the U.S, some people consider intoxication as humorous and not harmful. Intoxicated movie characters tend to be more entertaining for most viewers. Additionally, in other setups, the police may never give any severe consequences of drunken driving which hypothetically depict a society that may influence its citizens towards addiction of chemical dependency. Societies living in poverty tend to have limited opportunities of advancing in life and thus engage in crime and further into chemical dependency due to frustrations and stressful lives. (Sociocultural models, n.d). In general, different socio-cultural views may aggravate or solve the problem of chemical addiction and dependency in society.
2. Distinguish between Somatic Symptom Disorder with Predominant Pain versus Hypochondriasis as diagnoses. In other words, how does a clinical distinction between the two in a presenting client?
Somatoform disorders demand a valid classification for better understanding. They are heterogeneous psychiatric disorders which are characterized by persevering bodily symptoms and complaints which do not arise from disease or organic dysfunction (Maddux & Winstead, 2015). The two main disorders are Somatic Symptom disorder with Predominant pain and Hypochondriasis. The two have a long history and their definitions arise in a contrasting manner. Literature reveals that there are few clinically distinguishable characteristics among the patients of the two disorders (Salkovskis & Bass, 2015). One key distinguishing feature is that in the somatic symptom disorder with predominant pain, the attention of the patient tends to be highly concentrated on the somatic symptoms while in hypochondriasis, the symptoms are less elaborate and thus the patient tends to concentrate more on the possibility of a certain underlying infection. In this case, patients of hypochondriasis tend to experience accelerated levels of anxiety and on the contrary, the patients of somatic symptom disorder are diagnosed to experience no anxiety or mild levels of anxiety (North & Yutzy, 2018).
3. What are some of the primary impairments that need to manifest in order to change an individual’s diagnosis from Substance Abuse to Substance Dependence?
Addiction is a severe form of a complete spectrum of substance use conditions or disorders which can be diagnosed as a medical illness arising from substance abuse or dependence. A diagnostic criterion reveals that problematic use of intoxicating substances leads to clinical impairment or distress ( Substance Abuse and Dependence, n.d). These criteria can be used to rate one's consumption to have shifted from substance abuse to dependence. The diagnostic criteria comprise the following manifestations: First there is a shift in levels of tolerance. This can manifest as either a need for higher quantities of the substance to achieve the desired effect of intoxication or a diminished effect with prolonged use of the same substance. Secondly, there is a possible manifestation of withdrawal effects through either the characteristic withdrawal pattern for the particular substance or by use of the same or a similar substance in order to relieve withdrawal symptoms. Thirdly, there is the consumption of the substance in large quantities or over-prolonging the period more than intended (Johnson, 2013). Additionally, there is a persistent desire or unfruitful efforts to control the use of the substance. Finally, there is a reduction in occupational, social and recreational activities as well as the recurrent use of the substance even in hazardous situations.
4. What are the important clinical features which help distinguish among the diagnoses of Schizophrenia, Schizoaffective Disorder, and Mood Disorder with Psychotic Features?
Psychotic disorders (Schizoaffective disorder and Schizophrenia) have several similarities especially the core psychotic symptoms such as delusions, poor thinking patterns, and hallucinations. One key distinguishing factor is the prominence of mood features required in the diagnosis of schizoaffective disorder.
Schizophrenia causes severe mental psychotic symptoms which tend to interfere with one’s consciousness of relating to others. The condition denies one the ability to think well, be in touch with reality, and the denial to deductive reasoning. The distinguishing features of this disorder is an incoherent speech and a disorganized way of living as well as exhibiting a flat affect which involves exhibiting little emotion and less concern towards speech and activity. Patients of schizophrenia experience brief mood episodes as well as the chronic and more enduring course of illness (Kooyman & Walsh, 2011).
Schizoaffective disorder is a condition in which the patient suffers the symptoms of schizophrenia along with the symptoms of mood disorder. This disorder exhibits itself in two types; a bipolar condition which is comprised of major depression and mania and the depressive type which exhibits depression. Patients of this disorder experience more extreme severe mood symptoms which cover the better part of the illness duration as well as symptoms-free intervals (Current Pharmacotherapy, 2016).
Mood disorders are effective temperamental conditions characterized by depressive state. They are grouped into depressive, bipolar, recurrent, acute, chronic depression types among others. Some of the clinical features in the diagnosis of mood disorders include; depressed mood, fatigue or lost energy, loss of confidence and self-esteem, insomnia, fluctuations in appetite, recurring thoughts regarding traumatizing events, psychomotor agitation and so on (Hulvershorn & Leibenluft,2015).
5. Discuss the approach of applied behavioral analysis in the treatment of Autism Spectrum Disorder. What symptoms are traditionally targeted by the therapist and how do they promote change and skill acquisition?
Autism refers to a neural developmental condition that is characterized by social difficulties as well as unworthy behaviors. Autism spectrum disorders are separate from childhood mental disorders (Cortese, 2016). Patients exhibit a number of symptoms used by therapists to diagnose the condition; problems in the development of non-verbal communication abilities, delayed non-verbal communication, poor empathic response, much focus on specific topics, repetitive behaviors, for instance, hand-flapping.
The Applied Behavior Analysis helps to analyze Autism Spectrum disorder by giving advice to healthcare providers and caregivers on the best ways of upholding behavior intervention plans. Among the many applied interventions in the diagnosis and treatment of Autism spectrum disorder, some include; The Discrete Trial Training which involves teaching patients about disruptive antecedents and encouraging them to be in environments which foster their good interests and direct therapy for several hours in a week. We also have the token economies for the analysis of behaviors as well as Pivotal Response Treatment (PRT) ( Sundberg, 2016).
Some of the traditional symptoms of autism spectrum disorder include; hyperactivity, aggression, short attention span, temper tantrums, self-injury, impulsivity, lack of fear or extremely fearful, unusual mood and emotional reactions as well unusual reactions to so sound, smell (Cortese, 2016).
6. Distinguish among Dissociative Amnesia and Dissociative Fugue? Which is more common? What might precipitate the emergence of each disorder
Dissociative amnesia and dissociative fugue are both dissociative disorders but they exhibit a number of differences. Such disorders are characterized by mental disruption which leads to memory loss, lack of awareness and identity, etc.
Dissociative Amnesia is characterized by failure to recall important information and is the most common type of dissociative mental disorder exhibited in several types. However, the information can be awakened from the lapsed status through a certain event or the specific surrounding of the individual. Possible causes of this disorder include; accidents, violence, disasters or general traumatic experiences (Dallam, 2012).
Dissociative Fugue, on the other hand, is a condition in which an individual tends to lose their identity temporarily and moves away from home. Such patients are usually confused about their identity. Such persons have difficulties in recalling their past experiences and also they are highly distressed.
The differences are that; individuals who suffer from dissociative amnesia fail to remember only personal information in relation to traumatic experience while in dissociative fugue individuals lose their identity for a season and leave their home. Individuals with Dissociative fugue also tend to create new identities unlike those who suffer from dissociative amnesia (Loewenstein, 2016).
References
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Dallam, S. (2012). The evidence for dissociative amnesia. Psyc EXTRA Dataset . doi:10.1037/e609232012-087
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Johnson, S. L. (2013). Defining Substance Abuse and Dependence. Therapist's Guide to Substance Abuse Intervention , 3-10. doi:10.1016/b978-012387581-5/50001-x
Kooyman, I., & Walsh, E. (2011). Societal Outcomes in Schizophrenia. Schizophrenia , 644-665. doi:10.1002/9781444327298.ch31
Loewenstein, R. J. (2016). Dissociative Amnesia and Dissociative Fugue. Handbook of Dissociation , 307-336. doi:10.1007/978-1-4899-0310-5_15
Maddux, J. E., & Winstead, B. A. (Eds.). (2015). Psychopathology: Foundations for a contemporary understanding. Retrieved from https://ebookcentral.proquest.com
North, C. S., & Yutzy, S. H. (2018). Somatization Disorder. Goodwin and Guze's Psychiatric Diagnosis 7th Edition , 207-226. doi:10.1093/med/9780190215460.003.0008
Salkovskis, P. M., & Bass, C. (2015). Hypochondriasis. Oxford Clinical Psychology . doi:10.1093/med: psych/9780192627254.003.0013
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Substance Abuse and Dependence. (n.d.). Diversity Issues in Substance Abuse Treatment and Research , 19-36. doi:10.1007/978-0-306-47888-8_2
Suckling, J., & Nestor, L. J. (2016). The neurobiology of addiction: the perspective from magnetic resonance imaging present and future. Addiction , 112 (2), 360-369. doi:10.1111/add.13474
Sundberg, M. L. (2016). The Value of a Behavioral Analysis of Language for Autism Treatment. Comprehensive Models of Autism Spectrum Disorder Treatment , 81-116. doi:10.1007/978-3-319-40904-7_5
