Question 1:
Evidence indicates that as many as 90% of all people seeking treatment for an addictive disorder also meet diagnostic criteria for another psychiatric disorder when they enter treatment. This situation, termed co-morbidity, can arise for many reasons and can take many forms. Name a few highly prevalent forms of co-morbidity (combined psychiatric and addictive disorders) and describe how they might influence long term recovery from the respective disorders.
Question 2:
There is a very strong association between alcohol use and violence or aggression. What does the scientific literature on this topic suggest accounts for this relationship? Noting that correlation does not necessarily imply causation, what are some ways that alcohol-related violence can be reduced?
Question 3:
Current psychiatry uses the term ‘dependence’ to describe the most severe form of substance use disorder. How does the modern psychiatric definition of dependence compare/contrast with Sigmund Freud’s concept of the term, ‘dependence.’? What were the mechanisms or processes involved in dependence according to Freud? Are there any situations that Freud would consider to be “healthy dependence”?
Question 4:
Sylvia meets diagnostic criteria for major depressive disorder and alcohol dependence. Her depression developed in her late teens and her alcohol use disorder emerged in the 10 years since that time. How would a Humanistic-Existential theorist explain Sylvia’s co-morbidity? How would a Behavioral/Learning theorist explain her co-morbidity? In your opinion which of these two theories better accounts for Sylvia’s co-morbid syndrome, and why?
Question 5:
De-institutionalization demonstrated that medication alone is not sufficient for the long-term management of a chronic psychiatric disorder like schizophrenia. Based on the lessons of de-institutionalization, what are some of the key areas that scientists and clinicians should focus on when researching new and better ways to treat chronic mental illness?
Question 6:
Opiate addiction is extremely hard to overcome, with relapse rates in excess of 80% for long term intravenous users. Given that opiate addiction appears to be a form of chronic ‘neurobehavioral’ syndrome, what strategies or lessons can we apply from management of other chronic syndromes (e.g., diabetes, lupus, heart disease) to help reduce the harm (to the person and society) and maximize the quality of life of people addicted to opiates?
