To diagnose a substance use disorders, the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM 5) uses a pattern of behaviors based on eleven criteria. These criteria have been broken into four groupings: impaired control (criteria 1-4); social impairment (criteria 5-7); risky use (criteria 8-9); and pharmacological criteria (criteria 10-11) (American Psychiatric Association, 2013). Although grouped together, each criteria has its own focus.
Criteria one begins the impaired control group stating the person has taken the substance in larger amounts or for longer than they meant to which can be interrupted as planning to only having one beer, but drinking until blackout or only planning on trying meth once and continuing to use. The inability to cut down, regulate or stop using the substance is the topic of the criteria two. In this criteria, the user is unsuccessful in their ability to manage their use. Criteria three, in this group, involves the user spending a great deal of their time in getting, using and/or recovering from the use of the substance. Here the user is taking away from other parts of their day and life to obtain and use the
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These failed obligations include not attending school, missing work and failure to perform responsibilities at home due to their using of the substance. In criteria six, the person continues to use even when problems arise in relationships. Finally, in this group, due to substance use the person gives up important social, occupational or recreational activities (American Psychiatric Association, 2013). An example for this group would be: A married woman with children drinks heavily throughout the day causing her to miss work, her children’s school events which lead to arguments with her spouse and, yet, she continues to
Fortinash, K. M., & Holoday Worret, P. A. (Eds.). (2012). Substance-related disorders and addictive behaviors. Psychiatric mental health nursing (5th ed., pp. 319-362). St. Louis, MO: Elsevier Mosby.
A psychological assessment is defined as “the gathering and integration of psychology-related data for the purpose of making a psychological evaluation that is accomplished through the use of tools such as tests, interviews, case studies, behavioral observation, and specially designed apparatuses and measurement procedures” (Cohen, Swerdlik, &Sturman, 2013). Although examiners strive toward the assessment being good enough to be useful, they sometimes have to make decisions about what type of error is acceptable. There are many psychological assessments that have been used in the study of addictions, but we will take a look at the Addiction Severity Index.
To understand what mental illness is you have to know what it means. Mental health is the state of our well-being. Mental health has to do with the mind. According to thefreedictionary.com mental health is “a state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life”. Mental illness are behavioral, psychological, and emotional disorders that effect the mind. Mental illness is not something that should be avoided. There many different types of mental illnesses. There are also mental healthcare services that can help people with their mental illnesses.
`In the past, I worked in such a research setting, where if a person was found to meet criteria for opiate dependence they received treatment, however if even slightly short of DSM-IV criteria for the disorder they would have to look elsewhere. This was a continual concern for me, as the person who met criteria was not always the person with the most distress, and alternative treatments were not easy for people to find. Largely from this experience, I find the current categorical approach to classifying persons with psychopathology to be an imperfect system at best, with the primary advantage of being convenience when communicating with other professionals. I question whether this convenience comes at a severe cost to accuracy, the result of which is an artificial limit to the range of presentations that occur in psychopathology. As the example above illustrates, the particular aspect that I find most problematic is the use of cutoffs for specific symptoms, for instance the length symptoms must have been present for it to be classified as a disorder, or even the number of symptoms that need to be present. I think it is unlikely that a person who “almost” meets criteria for a disorder would be significantly different from a person with similar symptoms who just barely meets criteria. In private practice these two cases would likely be treated similarly, but in a setting where diagnosis serves as a screening tool the client who met criteria may get treatment while the other does not. In this case I feel that less specific guidelines, lacking specific numerical limits would alleviate many of the problems.
As illustrated the model of drug abuse and the theories behind addiction are varied. There is no concrete reason for one person who drinks to become alcohol dependent versus the person who does not. Several factors contribute to why a person begins drinking and why they continue to do so despite reasons to stop. The case history exhibits a client with many risk factors associated with alcohol use and dependence.
George F. Koob defines addiction as a compulsion to take a drug without control over the intake and a chronic relapse disorder (1). The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association defined "substance dependence" as a syndrome basically equivalent to addiction, and the diagnostic criteria used to describe the symptoms of substance dependence to a large extent define compulsion and loss of control of drug intake (1). Considering drug addiction as a disorder implies that there are some biological factors as well as social factors.
A study by Karl L. R. Jansen shows three distinct cases where these criteria are met. One subject, age 19, spent his entire disposable income on MDMA. Despite a seizure caused by use of this and other drugs, the subject "was unable to stop using MDMA without external assistance" (Jansen). Another subject exhibited an extremely high tolerance to the drug so that he was able to take 250mg with almost no effect. "Despite severe depression, he was unabl...
In life, no one ever anticipates being sick or suffering from illness associated with mental health or substance abuse. The purpose is to promote healthy living and encourage preventative care in areas such as prenatal care, immunization, and infectious diseases in adults. Coverage indicators are typically calculated by dividing the number of people receiving a defined intervention by the population eligible for or in need of the intervention (World Health Organization, 2009). Mental health and substance abuse is also an indicator that poses as a very prevalent issue in societies today. Those who suffer from mental and substance abuse usually shares some underlying causes, including changes in brain composition, genetic vulnerabilities, and early exposure to stress or trauma (Mental Health and Substance Use Disorders, n.d.). Substance abuse is often times associated with either drugs or alcohol, which can lead to spiraling social or economic issues such as financial problems, domestic violence, child abuse, and eventually graduating into committing
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
Substance abusers seek this impairment for a variety of reasons such as to get away from reality or to escape their problems. In the process of getting this “high” their brain chemistry changes and they become addicted. “Addiction is the repeated compulsive use of a substance even after the person suffers from the physical, mental, and legal consequences” (Williams, 2011). Substance abuse causes many negative effects to the person who is addicted as well as their loved ones. Even though these effects are devastating, the person continues to use because their brain and body are reprogrammed to need the substance. When the person isn 't using the substance they begin to suffer from withdrawal symptoms. “Withdrawal is a physical response to the sudden cessation of a substance that has been used over a period of time; these symptoms are specific to the substance” (Williams, 2011). When a person is suffering from withdrawal symptoms they have mental and physical effects. These effects can range from sweating to seizures. Physical symptoms are usually the first step followed by mental symptoms, these two steps together can last up to a few weeks. (Melemis, 2016). I was recently able to observe at a substance abuse rehabilitation facility where I witnessed a client withdrawing. This client seemed to be agitated and anxious. Also he was very red in
Generally speaking, the Diagnostic and Statistical Manual of Mental Disorders (DSM) references substance dependence (in this case, alcohol) as a cluster of cognitive, behavioral, and physiological symptoms that shows that the person is continuing use of the substance even with adverse effects on the individual’s life. Specifically, for a person to be diagnosed with substance dependence they must show at least three of the following symptoms; tolerance, withdrawal, substance being taken in larger amounts of over a longer period of time than intended, an unsuccessful desire or effort to control the use of the substance, there is a great deal of time devoted to the drug, important social, occupational, or recreational activities are given up or reduced due to the substance, and the individual continues use of the substance even with the knowledge that the substance is causing physical or psychological problems (APA, 2000).
Some people only drink on the weekend, or just not at work. Some people attempt to hide their alcohol abuse while others demand company, or anything in between these various elements. Alcohol abuse or addiction is defined as an individual who a) needs to use alcohol every day to function, b) makes attempts to limit use to specific time with periods of sobriety between incidents of heavy drinking, c) have “binges” of continuous use for long periods of time interspersed with the aforementioned periods of abstinence, d) use in excess of the medical and social norms (Doweiko, 2015). To be diagnosed with an AUD requires the individual to meet 2 of eleven criteria laid out by the DSM-5 within a year, then severity is assessed on the basis of how many criteria are met (NIMH, n.d.). Severity is assessed as mild meeting 2-3 criteria, moderate meeting 4 to 5, and severe meaning meeting 6 or more criteria. These eleven criteria include factors such as having drank longer than intended, reduced interest in activities, increased risk behavior, and other factors that look at how drinking has affected you socially (NIAA,
Identification of any psychosocial or contextual factors to be considered, as outlined in the DSM-5
Research shows that 17.6 million people are suffering from alcohol abuse. According to the article “Facts about Alcohol”, it states that 88,000 people has died from excessive alcohol use and that alcoholism is the 3rd leading lifestyle related cause of death in the nation. Many people can debate on what excessive drinking truly is. Some may say having two to three drinks on a daily bases is excessive and then you have people that argue and say having a drink every day is excessive. Doctors and phycologist often say that excessive drinking goes to the purpose of why the person is drinking and often ask is the drink a want or a need. If the person answers as if they need the drink or drinks then they would classify those individual’s as excessive drinkers and that they are experiencing substance
...the definitions and I found myself being aware of my tone. Each group member was very vocal and had no inhibition in expressing the exact nature of their thoughts, feelings, and experiences. In hind sight each group member was very adamant about their position and it was interesting to watch the passion from which they spoke. As I continue to explore and challenge my own ideologies, beliefs systems, and experiences I also give permission to myself to accept ideologies, belief system, and experiences of others. Many people have tried to account for why people use especially why they continue despite negative consequences. I believe even though people have different beliefs there are many factors that contribute to substance use no one set factor can account for all types of use. The five models are a guide of exploration for the client as well as the clinician.