ABNORMAL PSYCHOLOGY IN A CHANGING

WORLD 10TH EDITION NEVID

Full download link at:

Test Bank: https://testbankpack.com/p/test-bank-for-abnormal-
psychology-in-a-changing-world-10th-edition-nevid-rathus-
greene-0134484924-9780134484921/

Solution Manual: https://testbankpack.com/p/solution-manual-

for-abnormal-psychology-in-a-changing-world-10th-edition-
nevid-rathus-greene-0134484924-9780134484921/

CHAPTER 8

SUBSTANCE-RELATED AND ADDICTIVE DISORDERS

Learning Objectives

8.1 Identify the major types of substance-related disorders in the DSM-5 and describe their key
features.
8.2 Describe nonchemical forms of addiction or compulsive behavior.
8.3 Explain the difference between physiological dependence and psychological dependence.
8.4 Identify common stages in the pathway to drug dependence.
8.5 Describe the effects of depressants and the risks they pose.
8.6 Describe the effects of stimulants and the risks they pose.
8.7 Describe the effects of hallucinogens and the risks they pose.
8.8 Describe biological perspectives on substance use disorders and explain how cocaine affects the
brain.
8.9 Describe psychological perspectives on substance use disorders.
8.10 Identify biological treatments of substance use disorders.
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
93
 8.11 Identify factors associated with culturally sensitive approaches to treatment.
8.12 Identify a nonprofessional support group for people with substance use disorders.
8.13 Identify two major types of residential treatment facilities for people with substance use
disorders.
8.14 Describe the psychodynamic treatment of substance abusers.

Chapter Outline

I. Classification of Substance-Related and Addictive Disorders

A. Substance Use and Abuse
B. Nonchemical Addictions and Other Forms of Compulsive Behavior
C. Clarifying Terms
D. Pathways to Addiction

II. Drugs of Abuse

A. Depressants
B. Stimulants
C. Hallucinogens

III. Theoretical Perspectives

A. Biological Perspectives
B. Psychological Perspectives

IV. Treatment of Substance Use Disorders

A. Biological Approaches
B. Culturally Sensitive Treatment of Alcoholism
C. Nonprofessional Support Groups
D. Residential Approaches
E. Psychodynamic Approaches
F. Behavioral Approaches
G. Relapse-Prevention Training

V. Gambling Disorder
A. Compulsive Gambling as a Nonchemical Addiction
B. Treatment of Compulsive Gambling

VI. Summing Up

Key Terms

substance-induced disorders, p. 299

substance intoxication, p. 299
substance withdrawal, p. 299
tolerance, p. 299
withdrawal syndrome, p. 299
substance use disorders, p. 299
Internet addiction disorder, p. 302
physiological dependence, p. 304

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
94
addiction, p. 304
psychological dependence, p. 305
depressant, p. 306
alcoholism, p. 306
barbiturates, p. 313
narcotics, p. 313
endorphins, p. 314
morphine, p. 314
heroin, p. 314
stimulants, p. 315
amphetamines, p. 315
amphetamine psychosis, p. 315
cocaine, p. 316
crack, p. 316
hallucinogens, p. 318
marijuana, p. 319
detoxification, p. 329
methadone, p. 329
naltrexone, p. 330
gambling disorder, p. 338

Chapter Overview

Classification of Substance-Related and Addictive Disorders

The DSM-5 classifies substance related disorders in two major diagnostic categories—substance-induced
disorders, which are repeated episodes of drug intoxication or development of a withdrawal syndrome, and
substance use disorders, which are maladaptive use of a substance leading to psychological distress or
impaired functioning. The DSM-5 draws the line between substance use and substance abuse as being the
point at which a pattern of substance use significantly impairs the person’s occupational, social, or daily
functioning or causes significant personal distress.

Addiction refers to compulsive use of a drug, accompanied by signs of physiological dependence.

Physiological dependence occurs when repeated use of a substance alters the body’s physiological reactions
leading to tolerance and/or withdrawal syndrome. Psychological dependence occurs when compulsive use
of a substance meets a psychological need.

Gambling disorder is a nonchemical form of addiction that has been categorized as such in the new DSM-
5 system. Compulsive gambling, compulsive shopping, and even compulsive Internet use share some
hallmark features of drug addiction or dependence.

Drugs of Abuse

Depressants include alcohol, sedatives and minor tranquilizers, and opioids. Effects of alcohol include
intoxication, impaired coordination, slurred speech, and impaired intellectual functioning. Chronic alcohol
abuse has been connected with disorders such as alcohol-induced persisting amnestic disorder (Korsakoff’s
syndrome), cirrhosis of the liver and other physical disorders, and with fetal alcohol syndrome. Barbiturates
are depressants or sedatives that have been used medically for relief of anxiety and short-term insomnia,
among other uses. Opioids, such as morphine and heroin, are derived from the opium poppy; others are
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
95
synthesized. Used medically for relief of pain, they are strongly addictive.

Stimulants increase the activity of the nervous system. Amphetamines and cocaine increase the availability
of neurotransmitters in the brain, heightening states of arousal. High doses can produce an amphetamine
psychosis, which mimics features of paranoid schizophrenia. Repeated use of nicotine, usually in the form
of cigarette smoking, can lead to physiological dependence.

The hallucinogens include LSD, cannabis (marijuana), and phencyclidine (PCP). There is little evidence
that these drugs induce physiological dependence, although psychological dependence may occur.

Theoretical Perspectives

Biological perspectives focus on uncovering the role of neurotransmitter imbalance and the biological
pathways that may explain mechanisms of physiological dependence. Genetic factors also play a role in
substance use disorders. The disease model treats problems of substance abuse and dependence as disease
processes.

Learning theorists view substance abuse disorders as learned patterns of behavior that, in principle, can be
unlearned. They focus on the roles of classical and operant conditioning and observational learning.

Cognitive perspectives have focused on the roles of attitudes, beliefs, and expectancies in accounting for
substance use and abuse. Research suggests that the one-drink effect may be a self-fulfilling prophecy.

Psychodynamic theorists view problems of substance abuse, such as excessive drinking and habitual
smoking, as signs of oral fixation. They believe the features contribute to what is termed an oral-dependent
personality.

Sociocultural perspectives have focused on the adoption of culturally sanctioned prohibitions against
excessive drinking in explaining differences among various ethnic and religious groups in rates of
alcoholism. Social factors, such as peer pressure, also influence the development of substance abuse.

Treatment of Substance Use Disorders

Biological approaches to substance abuse disorders include detoxification, the use of disulfiram, smoking
cessation drugs, methadone, naltrexone, and nicotine replacement therapy. Residential treatment
approaches include hospitals and therapeutic communities. Nonprofessional support groups, like
Alcoholics Anonymous, promote abstinence within a supportive group setting.

Regardless of the initial success of a treatment technique, relapse remains a pressing problem in treating
people with substance abuse problems. Relapse-prevention training employs cognitive-behavioral
techniques to help ex-abusers cope with high-risk situations and to prevent lapses from becoming relapses
by helping participants to interpret lapses in less damaging ways.

Psychodynamic therapists focus on uncovering the inner conflicts originating in childhood that are believed
to be at the root of substance abuse problems. Behavior therapists focus on helping people with substance-
abuse-related problems change problem behaviors through such techniques as self-control training, aversive
conditioning, and skills training approaches.

The sociocultural perspective holds that substance use is determined, in part, by where we live, whom we
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
96
worship with, and the social or cultural norms that regulate our behavior. Cultural attitudes can encourage
or discourage substance abuse.

Gambling Disorder

Gambling disorder is classified by DSM-5 as a nonchemical addictive disorder, and is characterized by

loss of control over behavior, a state of high arousal or pleasure when the behavior is performed, and
withdrawal symptoms such as headache. Examples of compulsive gambling include excessive wagering
on horse races or in card games and casinos, betting on sporting events, and chancy stock picks. About
0.4 percent to 1.0 percent of the general population develops a gambling disorder at some point in their
lives. Compulsive gambling has been on the rise in recent years, ostensibly due to the increasing spread of
legalized forms of gambling. Personality characteristics of those with gambling disorder overlap with
those of chemical abusers. Cognitive errors, such as gambler’s fallacy and illusion of control bias, are
common. Treatment for gambling disorder is challenging, although cognitive-behavioral programs and
peer support groups have had some success.

Lecture and Discussion Suggestions

1. Drug effects—psychological considerations. The general effect of most drugs is greatly influenced
by a variety of psychological and environmental factors. Accordingly, in determining the effect of a given
drug, it may be helpful to consider three types of influences as follows: (1) Pharmacological effects. The
physiological effect of a given drug is a crucial factor, with the entire field of pharmacology devoted to
discovering the makeup and effects of drugs. Greater knowledge of drugs has led to specifying drug
dependence by specific type, such as drug dependence of the cocaine type. (2) Mental set. This is a
collective term for a variety of psychological factors that may contribute to the effects of a drug, including
the individual’s personality, his or her past history of drug experience, attitudes toward the drug, motivation
for taking the drug, and expectations of its effects. For instance, experiments have shown that when people
believe they have drunk alcohol (when they have actually consumed only tonic water) they show increases
in sexual arousal, whereas those who have actually imbibed alcohol but believe they have drunk only tonic
water show decreased sexual response. (3) Setting. This refers to environmental factors, including the social
influence of people. Thus, a few drinks of an alcoholic beverage may make a person feel drowsy and
fatigued in some situations, whereas under different circumstances, the same amount of alcohol may
psychologically stimulate and arouse that person. Set and setting are believed to be of greater significance
with respect to psychoactive drugs, especially psychedelic and hallucinogenic substances.

2. Alcohol use and abuse. Ask students where they draw the line between the use and abuse of alcohol.
Do their responses focus more on the amount or type of alcohol used? Review the DSM-5 criteria
distinguishing use from abuse. How does one determine if the pattern of substance use significantly impairs
the person’s occupational, social, or daily functioning or causes significant personal distress?

3. Binge drinking among college students. Consuming alcohol during college has almost become a rite
of passage and normative part of the college experience. Similarly, binge drinking is on the rise, as are the
number of injuries and deaths related to binge drinking. Binge drinking is defined as 4+ drinks (for women)
or 5+ drinks (for men) on one occasion. Based on this definition, it is estimated that 40 percent of college
students engage in this behavior during college. Ask students what they think of this definition. How many
know at least one person who has met the criteria for binge drinking? Do students believe binge drinking
is as problematic as is claimed, or are the potential risks overblown? Challenge attempts to rationalize the
behavior as acceptable simply because it is common.

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
97
4. Controlled drinking. A controversial issue in regard to treating problem drinkers is whether such
persons must practice abstinence or may engage in controlled drinking. According to the disease model
(discussed above), once you’re an alcoholic, you’re always an alcoholic. Thus, organizations like
Alcoholics Anonymous assert that abstinence is the only way to insure a successful recovery from
alcoholism. However, critics of the disease model argue that some problem drinkers may recover with
controlled drinking. Much of the evidence is drawn from a study in which over 900 people with alcoholism
were studied after they had been admitted to a federal alcoholism treatment center. After four years, about
half the subjects were either abstaining from alcohol or drinking in a controlled manner. Especially
interesting is the finding that alcoholics over the age of 40, who were strongly alcohol dependent, had lower
relapse rates when they abstained completely, whereas those under 40, who exhibited lower levels of
dependence, were less likely to relapse if they practiced controlled drinking rather than abstinence. Such
findings suggest that controlled social drinking may be effective with younger problem drinkers who exhibit
relatively low levels of alcohol dependence. However, abstinence remains the most dependable course of
treatment for chronic alcoholics.

5. Relationships with drugs. In their book, Chocolate to Morphine, Andrew Weil, M.D., and Winifred
Rosen (Boston: Houghton-Mifflin, 1983) provide some guidelines for distinguishing between good and bad
relationships with drugs as follows: (1) Recognition that the substance you are using is a drug and being
aware of what it does to your body. People who develop the worst relationships with drugs have little
understanding of the drug they are using. So, a necessary first step is to understand the nature and effects
of the substances being used, including caffeine and nicotine. (2) Experience of a useful effect of the drug
over time. Since the effects of a drug diminish with use, people in bad relationships with drugs tend to use
them heavily but get the least out of them. In contrast, when the experience people like from a drug begins
to fade, that is a sign they are using too much. (3) Ease of separation from using the drug. One of the
striking features of drug abuse is dependence on a drug—psychological or physiological. People with a
good relationship with a drug can take it or leave it. Unfortunately, many drug-dependent users believe they
can take it or leave it when it is abundantly clear to those around them that they are drug dependent. (4)
Freedom from adverse effects on health and behavior. Some people can take a drink before dinner
without it disrupting their family lives or work, whereas other people’s drinking contributes directly to their
troubles at home or work. Adverse effects on one’s health and behavior is another characteristic of drug
abuse.

6. AIDS and intravenous drug use. Acquired Immunodeficiency Syndrome (AIDS) has greatly
increased the urgency of modifying behaviors associated with drug addiction; sharing needles for
intravenous drug use results in an exchange of contaminated blood and is a leading mode of transmission
of HIV. In addition, IV drug users infected with HIV can transmit the disease to non-drug users through
sexual contact, and infected pregnant women can pass the disease to their children.

Researchers have derived three principles for AIDS risk reduction among IV drug users: (1) IV drug users
need basic information about HIV transmission before they change their needle-sharing behavior; (2)
information is not sufficient; means for behavior change (such as sterilized needles or bleach for sterilizing)
must be readily available for change to occur; and (3) sustained reinforcement for risk reduction behaviors,
especially new peer norms favoring safer behavior, may be necessary for change to occur.

7. Legalizing illegal drugs. Ask students if they think illegal drugs should be legalized. You might have
them list the pros and cons of legalization versus keeping drugs illegal. What are the parallels and
differences in legalizing drugs today compared to the prohibition of alcohol in 1920 and later relegalization
of alcohol in 1933? Have students review the states currently considering decriminalization or medically
approved marijuana. How has the legalization of medical marijuana affected the states that presently do
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
98
allow medical marijuana?

8. Drug education. Discuss the effectiveness of drug education today. How early in school should such
a program begin? Do students believe they received adequate information on newer forms of harmful drug
use, such as sniffing fumes, crystal methamphetamine, crack cocaine, and Ecstasy? What are the most
effective strategies? Are scare tactics overrated? How effective have current efforts like D.A.R.E. been in
preventing children from going on to be drug abusers? Discuss the research that has been done on the
efficacy of the D.A.R.E. program. Review the changes in the program that have come about as the result of
criticism.

9. Smoking. Surveys indicate that, after years of steady declines, cigarette smoking among young people
has increased significantly in recent years. Given the enormous amounts of information available about the
dangers of smoking, why do students believe these increases are occurring? Is it mass marketing of
cigarettes through ads aimed at teenagers (as the government claims), or are there other factors involved?
If so, what are they? If smoking is so dangerous, why doesn’t the government just ban cigarettes
completely? Or would we see a repeat of the crime wave that occurred during the prohibition of alcohol in
the 1920s?

Think About It

Does someone you know show evidence of any nonchemical forms of addiction, such as compulsive
shopping, gambling, or sexual behavior? How is this behavior affecting his or her life? What can he
or she do about overcoming it? This is a personal experience question. Students need to appreciate the
different forms of addiction.

Do you use alcohol? How does it affect you physically and mentally? Have you drunk alcohol and
driven? How do you feel about that? Have you ever done anything under the influence of alcohol that
you later regretted? What? Why? This is a personal experience question. Students are encouraged to
probe the impact of alcohol use in their lives.

Do you think it is wise to use alcohol in moderation to reduce the risk of cardiovascular disease? Why
or why not? This is a personal opinion question. Students should be familiar with the research on the health
benefits of moderate drinking.

Speculate on the reasons that smoking is more prevalent among poorer and less educated segments
of the U.S. population and why smoking is on the rise among teenagers. What kinds of public health
messages might be effective at reaching these at-risk groups? The more educated and higher
socioeconomic classes have gotten the message that smoking is bad for your health. Perhaps the poorer,
less educated classes in the U.S. population feel they have less to lose. Peer pressure is important to teens,
so public health messages that focus on the idea that smoking is not “cool” might help.

Do you believe that illicit drugs should be legalized or decriminalized? Why or why not? This is a
personal opinion question. The pros and cons of drug legalization should be explained clearly with logical
evidence.

How has your cultural background affected your attitudes and your use of drugs such as alcohol and
tobacco? This is a personal experience question. It assumes that students are in touch with their cultural
backgrounds.

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
99
Do you know anyone who has received treatment for a drug abuse problem? What was the outcome?
This is a personal experience question. Students may or may not have personal experience on this issue, but
they certainly can comment on celebrities in the media.

What do you think of the concept of using methadone, a narcotic drug, to treat addiction to another
narcotic drug, heroin? What are the advantages and disadvantages of this approach? Do you believe
the government should support methadone maintenance programs? Why or why not? This is a
personal opinion question. Students need to be familiar with the philosophy of methadone maintenance
treatment programs.

Many teenagers today have parents who themselves smoked marijuana or used other drugs when
they were younger. If you were one of those parents, what would you tell your kids about drugs? This
is an opinion question. Students may have direct experience from the vantage point of being a kid.

What do you think about e-cigarettes as an alternative to traditional cigarettes? Do you, or anyone
you know, use e-cigarettes? How do you think they compare to traditional cigarettes with regard to
odor, expense, and health concerns? Would you recommend them as an alternative to traditional
cigarettes? This is an opinion question and the response will be based on the student’s personal
experiences.

How does the behavior of an individual with compulsive gambling disorder differ from someone who
gambles but does not have compulsive gambling disorder? Compulsive gamblers lack control over their
behavior. They experience a state of high arousal when gambling, followed by withdrawal symptoms, such
as headaches, insomnia, and a loss of appetite, when they cut back or stop the compulsive behavior.

Activities/Demonstrations

1. The most commonly used drugs. Instruct students to list the three most commonly used drugs among
people ages 15–30. Have them rank their responses in order beginning with the most frequently used drug.
Then, have someone collect the lists and summarize the results on the whiteboard or via projector. In
discussing the results, remind students that caffeine, nicotine, and alcohol are defined as drugs with
addictive potential. Are students aware that caffeine is found in diverse products such as coffee, tea, hot
cocoa, soft drinks, milk chocolate candy, baking chocolate, pain relievers, alertness tablets, and cold/allergy
relief remedies?

2. Risk factors for alcohol abuse. Have students complete the inventory adapted from the National
Council on Alcoholism’s self-test. Then, discuss their responses. Do most students feel they have their
drinking habits well under control? How much awareness do they show of the various risk factors for
alcoholism discussed in the text? Are they aware that the best predictor for problem drinking in adulthood
appears to be family history of alcoholism?

3. Drugs and other addictive behaviors in college. Similar to the National Council on Alcoholism’s
self-test, have students complete substance use and abuse inventories for drugs and other addictive
behaviors (e.g., compulsive gambling). Students may be surprised to discover that behaviors that appear
normative in a college environment, such as excessive drinking or marijuana use, are potentially
problematic and may warrant a substance-related diagnosis.

4. Alternatives to drugs. Ask students to first list various reasons students use drugs in regards to the
needs and motives being met. Then, have them list alternative ways to meet these same needs. For example,
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
100
if people drink alcohol to relax or feel good, have students list alternative ways to accomplish this, including
relaxation, food, constructive exercise, swimming, and yoga. Similarly, if people smoke or drink to fit into
the crowd, have them list alternative ways to meet this need, such as participation in clubs, sports, hobbies,
growth groups, or social skills training. Also, those who use drugs to magnify sensory experience might try
sauna; massage; art training; meditation; outdoor activities such as hiking, canoeing, or bicycling; or more
risky and adventurous activities like hang gliding, skydiving, or whitewater rafting. Although most of the
alternatives to drugs require an initial investment of time, effort, and the acquisition of skills, they remind
us that we have the capacities within ourselves to feel good and can do so without huge expenditures of
time or money, much less the detrimental effects of drugs.

5. Pre-test on alcohol expectations. Before students read the chapter, discuss their impressions about the
effects of alcohol and other drugs on aggression, sex, and anxiety, or have them list questions on a
questionnaire and compile the results. After reading the chapter, these impressions can be discussed in terms
of the impact that expectations about drug effects have on the behavior of those under the influence of a
drug. How might expectancies influence other responses to alcohol or to other drugs? What are the
expectancies about the effects of cigarette smoking, marijuana use, or psychedelics?

6. Personal experiences with smoking. How did the smokers in the class get started? Do their parents
smoke? Did they begin smoking with friends? Was it “cool” to smoke? How did the nonsmokers resist peer
pressure? You might break the class into groups, including both smokers and nonsmokers in each group,
and ask them to come up with a smoking prevention program based on their own experiences. The following
questions could be addressed: (1) What age group should be targeted? (2) In what setting(s) should the
program be implemented? (3) Who should convey the message to the target group? (4) How could the mass
media be used to help in the prevention program? (5) How would you measure the effectiveness of your
program?

7. Personal experiences with alcohol. Conduct the same exercise as number 6 (above), only this time
have students discuss their alcohol-related experiences.

8. Local resources. What local resources exist for the diagnosis and treatment of substance disorders?
Students can assemble a list and description of these resources, as well as resources that exist for family
members of substance abusers. Perhaps a representative from a detoxification center or treatment program
can speak to the class about what goes on in their work.

9. Alcoholic stereotypes. Present the following scenario to students. “You are walking down the street in
a major city. You see a person as you walk by and think to yourself, that person is an alcoholic.” Have the
students jot down on a sheet of paper the imaginary person’s age, gender, socioeconomic level, and
appearance. Compile the data on the board using age categories of 0–20, 21–40, 41–60, 61+; male–female;
socioeconomic level—white collar, blue collar, unemployed; and note appearance such as well-groomed,
disheveled, etc.

Results should be obvious stereotypes. Alcoholics are usually considered to be male, in the 21–40 age
range, blue collar or unemployed, and with disheveled appearance. This always leads to a good discussion
on stereotypes. You can counter with the percent of women, elderly, and young alcoholics. It’s always
powerful to note that it’s not them (other), it’s us.

Media Resources

Video – Substance-Related and Addictive Disorders (1:12)

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
101
Video available on MyPsychLab.com
https://mediaplayer.pearsoncmg.com/assets/mypsychlab-nevid10e-Addictive_Disorders

In this brief video, the character, who is addicted to cocaine, tells a story about his wife asking him to
choose between her and cocaine. He said it was an easy choice – nothing, not even his wife, is more
important than his coke. The narrator discusses common psychoactive substances, how drug use begins,
and the power of the drug over time, as it becomes more important than friends, family, work, or their
own welfare.

Speaking Out Videos in Abnormal Psychology

Chris: Alcoholism (3:12)

Video available on MyPsychLab.com
https://mediaplayer.pearsoncmg.com/assets/mypsychlab-2015-butcher17e_0134224973-
Chris_Alcohol_Use_Disorder

VIDEO BACKGROUND:

In this interview, Chris discusses the course of alcoholism during his life and the impact it has had. He
began using alcohol at the age of 12 and began experimenting with marijuana soon thereafter. All this led
to harder drugs until he was spending $1,000 per week on his cocaine habit and drinking twelve-packs
within thirty minutes to be able to sleep. He discusses his attitude about the goal of drinking, which was
to get drunk to the point of having frequent blackouts, and the pain he experienced from past sexual
abuse. His alcoholism led him to physical fights (one of which shattered his face) and being kicked out of
college, among other things. He also engaged in infidelity largely due to his alcoholism, which caused
serious problems in his marriage. Of particular interest in this video is that even after these negative
events occurred, he was unable to see the problems stemming from his alcoholism.

DISCUSSION QUESTIONS:

1. Which of the following means a person requires more and more of a substance to achieve the same
sensation?

a) Withdrawal
b) Tolerance
c) Stamina
d) Addiction

Answer: b.

As a person increasingly uses a substance, he or she requires more and more of the substance to achieve
the same high. This is tolerance. Withdrawal is a reaction to the removal of a substance from one’s
system.

2. If a person regularly partakes in a substance, requires more and more of it over time to achieve the
same highs, has physiological reactions when the substance is removed, and has difficulty at work
because of the substance, what is the best diagnosis?

a) Substance use disorder

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
102
b) Substance withdrawal disorder
c) Substance dependence disorder
d) Substance tolerance

Answer: a.

Substance use disorders are patterns of maladaptive use of psychoactive substances that lead to significant
levels of impaired functioning or personal distress.

3. What are common problems for people with substance use disorder?

Suggested answers: Failure to fulfill obligations at work, school, or home; substance use in hazardous
situations; recurrent substance-related legal problems; continued use despite problems in social or
interpersonal functioning due to the substance, etc.

4. Chris discusses the difficulty he had during withdrawal. What are some common symptoms of
withdrawal?

Suggested answers: An autonomic hyperactivity; increased hand tremor; insomnia; nausea or vomiting;
transient visual, tactile, or auditory hallucinations or illusions; psychomotor agitation; anxiety; grand mal
seizures, etc.

CLASS ACTIVITY:
1. In this interview, Chris notes that he used both alcohol and other drugs in unison. Discuss how
Chris’s alcohol and other drug problems are interrelated.

Suggested answer: Chris began with alcohol use, then began experimenting with other soft drugs (e.g.,
marijuana) before moving on to hard drugs, then began using alcohol to counteract the strong effects of
the hard drugs. Review the Pathways to Addiction section in the text (p. 305).

Ed: Gambling Disorder (3:44)

Video available on MyPsychLab.com
https://mediaplayer.pearsoncmg.com/assets/mypsychlab-DSM_In_Context-Ed_Gambling_Disorder_edit

VIDEO BACKGROUND:

In this interview, Ed talks about his history with gambling that started in high school. After failing at
athletics, academics, and his original goal (being a priest), Ed decided that gambling represented his path
in life. Ed said that it made him very excited and nervous before and during games. He wanted
recognition for being smart and making good decisions. He said it appeared to outsiders like he was a
very intelligent man, at the top of his game, and was respected. His biggest rush was being right. But it
wasn’t the truth. He often lost and struggled with finances, yet he continued to gamble. Even when his
mother, as she was dying, asked him to stop, he continued. Gambling had taken control of his life.

DISCUSSION QUESTIONS:

1. Which of the following is a personality trait associated with compulsive gambling?

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
103
a) High tolerance for frustration
b) Need for consistency
c) Self-denying
d) Manipulative

Answer: d.
Personality characteristics associated with compulsive gambling include manipulativeness, low tolerance
for frustration, self-centeredness, need for stimulation, and emotional instability.

2. Approximately _____ percent of the general population will develop a gambling disorder at some
point in their life.

a) 0.1%–.3%
b) 0.4%–1.0%
c) 3.0%–4.0%
d) 7.0%–10.0%

Answer: b.

Research indicates that about .4% to 1.0% of the general population in the United States will develop a
gambling disorder at some point in their life, and that rate appears to be on the rise.

3. Why is it difficult to successfully treat compulsive gamblers like Ed?

Suggested answer: Similar to those with personality disorders and substance abuse disorders, compulsive
gamblers show little insight into the causes of their problems, are reluctant to seek treatment, and resist
efforts to help them.

4. What aspect of gambling gave Ed the most intense rush?

Suggested answer: The biggest rush for Ed was not the winning, but that when he won, it made him look
smarter than others around him.

CLASS ACTIVITY:

Ask students to break up into pairs. Ask one member of each pair to play the role of a compulsive
gambler and the other to play the role of the spouse or partner of the compulsive gambler. Ask the pair to
role play a conversation that a couple may have where the non-gambler is trying to convince the gambler
to stop, and the gambler is trying to convince the partner that it is okay to continue. Assume that the
couple has had financial struggles from the gambling, but the gambler has made a significant profit on the
most recent bet.
Suggested answer: There is no correct answer for this activity.

Video – In the Real World: Neurotransmitters (3:03)

Video available on MyPsychLab.com
https://mediaplayer.pearsoncmg.com/assets/mypsychlab-videoseries-Neurotransmitters_edit

The narrator describes how chemical imbalances affect behavior. The role of dopamine is discussed—
where it is produced, pathways in the brain, how it facilitates communication between brain areas, and its
Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
104
role in various disorders like Parkinson’s and schizophrenia. The narrator also discusses how drugs like
cocaine can cause alter brain chemistry and how such drugs have played an important role in our society.

Copyright © 2018, 2014, 2011 by Pearson Education, Inc. All rights reserved.
105