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In internal medicine, relapse signifies the initial onset of a disease after a period of complete health.
Answer: False
Explanation: In internal medicine, relapse is defined as the recurrence of a disease or its symptoms following a period of remission or dormancy, not necessarily the initial onset after complete health.
Psychiatric relapse is characterized by the return of pathological drug use or other symptoms following a recovery phase.
Answer: True
Explanation: This statement accurately defines psychiatric relapse as the recurrence of pathological drug use or symptoms after a period of recovery or remission.
Recrudescence is a term used exclusively for the recurrence of psychiatric symptoms after recovery.
Answer: False
Explanation: Recrudescence refers to the recurrence of a past condition after dormancy and is used for various conditions, including infections like malaria, not exclusively psychiatric symptoms.
Recrudescence is a synonym for relapse specifically within the field of psychiatry.
Answer: False
Explanation: Recrudescence refers to the recurrence of a past condition after dormancy and is used across various medical fields, not exclusively in psychiatry as a synonym for relapse.
Relapse in psychiatry specifically refers to the recurrence of symptoms related to mental disorders, excluding drug use.
Answer: False
Explanation: Psychiatric relapse, as defined in the text, explicitly includes the recurrence of pathological drug use, alongside other symptoms of mental disorders.
According to the source, what is the definition of relapse in the context of internal medicine?
Answer: The recurrence of a past medical condition after a period of remission or dormancy.
Explanation: In internal medicine, relapse refers to the reappearance of a disease or its symptoms following a period where they were absent or dormant.
Which of the following best describes relapse in psychiatry, according to the text?
Answer: The recurrence of pathological drug use or symptoms after a recovery period.
Explanation: Psychiatric relapse is characterized by the return of problematic behaviors or symptoms following a period of improvement or abstinence.
The text uses the term 'recrudescence' in the context of which type of condition?
Answer: Recurrence of infections like malaria after dormancy.
Explanation: Recrudescence is exemplified by the reappearance of dormant infections, such as malaria, after a period of inactivity.
Higher availability of dopamine D2 receptors is associated with increased vulnerability to the reinforcing effects of drugs like cocaine.
Answer: False
Explanation: Research indicates an inverse relationship: lower availability of dopamine D2 receptors is associated with increased vulnerability to the reinforcing effects of drugs like cocaine.
Research strongly suggests that low dopamine D2 receptor availability is a predisposing factor for drug addiction.
Answer: False
Explanation: While low dopamine D2 receptor availability is linked to increased vulnerability, studies suggest these changes are often a result of drug use rather than a definitive predisposing factor for addiction.
The dopamine receptor D2 and the medial prefrontal cortex are key neurobiological targets for pharmacotherapy in relapse prevention.
Answer: True
Explanation: These brain regions and receptor systems are critically involved in the neurobiological pathways underlying relapse, making them important targets for pharmacological intervention.
The medial prefrontal cortex is targeted by pharmacotherapy because it is implicated in various forms of relapse.
Answer: True
Explanation: Neuroadaptations in the medial prefrontal cortex are strongly associated with multiple pathways of relapse, making it a critical target for therapeutic interventions.
The source suggests that dopamine D2 receptors may return to normal levels after prolonged abstinence from drug use.
Answer: True
Explanation: Evidence suggests that dopamine D2 receptor availability can potentially recover to pre-drug exposure levels during extended periods of abstinence.
The source implies that addiction involves persistent neurobiological changes that require therapeutic intervention.
Answer: True
Explanation: The text suggests that addiction is characterized by long-term alterations in brain structure and function, necessitating therapeutic interventions to manage or reverse these changes.
The effectiveness of pharmacotherapy targeting neuroadaptations in the medial prefrontal cortex is currently limited due to incomplete understanding of these adaptations.
Answer: True
Explanation: The complexity and incomplete understanding of neuroadaptations in the medial prefrontal cortex currently limit the efficacy of pharmacotherapies targeting this region.
What is the relationship between dopamine D2 receptor availability and vulnerability to drugs like cocaine?
Answer: Low D2 availability increases vulnerability.
Explanation: A lower availability of dopamine D2 receptors is associated with a greater susceptibility to the reinforcing effects of drugs like cocaine.
Based on the provided text, are changes in dopamine D2 receptor availability typically considered a cause or a result of cocaine use?
Answer: A result, as studies suggest it changes due to drug use.
Explanation: Most research indicates that alterations in dopamine D2 receptor availability are typically observed as a consequence of cocaine use, rather than a pre-existing condition that causes it.
What are identified as key neurobiological targets for pharmacotherapy in relapse prevention?
Answer: The dopamine receptor D2 and the medial prefrontal cortex.
Explanation: These specific neurobiological structures and systems are critically involved in the mechanisms of relapse and are therefore key targets for pharmacotherapeutic intervention.
Which brain region is highlighted as a significant target for pharmacotherapy due to its involvement in various forms of relapse?
Answer: The medial prefrontal cortex
Explanation: The medial prefrontal cortex plays a crucial role in the neurobiological pathways that mediate drug, stress, and cue-induced relapse, making it a key target for therapeutic interventions.
What does the source suggest about the recovery of dopamine D2 receptors during abstinence?
Answer: They may return to pre-drug levels during long periods of abstinence.
Explanation: The text indicates a potential for dopamine D2 receptors to normalize over extended periods of abstinence, suggesting a biological basis for recovery.
What does the source imply about the long-term impact of prolonged drug use on the brain?
Answer: It leads to significant and long-term changes in the brain and nervous system.
Explanation: The text suggests that sustained drug use induces persistent neurobiological alterations that necessitate therapeutic intervention.
Stress, re-exposure to the drug, and environmental cues are the three main factors that can trigger the reinstatement of drug use.
Answer: True
Explanation: These three factors—stress, drug priming (re-exposure), and environmental cues—are consistently identified as primary triggers for the reinstatement of drug-seeking behavior.
Stress can induce relapse primarily by causing physical pain during abstinence.
Answer: False
Explanation: Stress can induce relapse by activating craving and drug-seeking behavior through psychological and physiological pathways, not primarily by causing physical pain.
Drug-priming involves exposing an abstinent individual to a non-drug related stressor to test their resilience.
Answer: False
Explanation: Drug-priming specifically refers to the exposure of an abstinent individual to the addictive substance itself, not a non-drug related stressor.
Environmental cues associated with drug use can trigger relapse by activating learned associations and prompting craving.
Answer: True
Explanation: Environmental cues are powerful triggers that leverage learned associations to evoke craving and initiate drug-seeking behavior, contributing significantly to relapse.
Craving, defined as a mild desire for a drug, is considered a hallmark of substance dependence.
Answer: False
Explanation: Craving is defined as a strong desire or intention to use a drug, and it is considered a hallmark of substance dependence.
Reinstatement of drug-seeking behavior in animal models can be induced by drug exposure, cues, or stressors.
Answer: True
Explanation: These three stimuli are the primary methods used in animal models to experimentally induce the return of drug-seeking behavior after a period of abstinence.
Abraham Wikler first described the concept of craving in the context of substance dependence in the mid-20th century.
Answer: True
Explanation: Abraham Wikler is credited with first defining craving in relation to substance dependence, contributing significantly to the understanding of addiction.
The source suggests that environmental cues play a less significant role in triggering craving in humans compared to laboratory animal models.
Answer: True
Explanation: The text notes that drug-associated stimuli often play a less significant role in triggering craving in humans compared to the controlled laboratory environment of animal models.
Identify the three primary triggers that can initiate the reinstatement of drug use after abstinence.
Answer: Stress, re-exposure to the drug (drug-priming), and environmental cues.
Explanation: These three factors are consistently identified as the principal stimuli that can trigger a return to drug-seeking behavior following a period of abstinence.
What mechanism explains how stress acts as a trigger for relapse?
Answer: Stress cues can stimulate craving and drug-seeking behavior, even during abstinence.
Explanation: Stress acts as a potent trigger by activating learned associations and emotional states that prompt drug-seeking behavior, irrespective of current physiological need.
In the context of relapse, what does 'drug-priming' refer to?
Answer: A brief exposure of an abstinent individual to the addictive substance.
Explanation: Drug-priming is a phenomenon where a small exposure to the drug can reactivate drug-seeking behavior after a period of abstinence.
How do environmental cues contribute to relapse?
Answer: By activating learned associations and prompting craving for the drug.
Explanation: Environmental cues, through classical conditioning, become associated with the drug's effects and can elicit powerful cravings and drug-seeking behaviors.
What is craving, as defined by Abraham Wikler and mentioned in the text?
Answer: A strong desire or intention to use a drug.
Explanation: Craving is characterized by a potent urge or intention to consume a substance, representing a key motivational state in substance dependence.
How can reinstatement of drug-seeking behavior be induced in animal models after extinction?
Answer: By presenting the drug, associated cues, or stressors.
Explanation: These stimuli are known to reliably reinstate drug-seeking behavior in animal models, mimicking triggers for relapse in humans.
Animal studies indicate that socially dominant animals are more prone to maintaining self-administration of drugs compared to subordinate animals.
Answer: False
Explanation: Animal studies suggest the opposite: socially dominant animals tend to be less prone to maintaining drug self-administration compared to subordinate animals.
Animal models are used in research because ethical considerations prevent humans from self-administering drugs for study.
Answer: True
Explanation: Ethical constraints on human drug administration make animal models indispensable for investigating the neurobiological mechanisms of drug addiction and relapse.
Non-human primates are less useful than rodents for studying drug relapse due to significant biological differences.
Answer: False
Explanation: Non-human primates are considered highly useful for studying drug relapse due to their biological and behavioral similarities to humans, including shared brain structures and complex social behaviors.
In animal self-administration protocols, animals learn to press a lever to receive drug injections, often associated with a visual cue.
Answer: True
Explanation: This describes the standard operant conditioning paradigm used in self-administration studies, where animals learn to perform an action to obtain a drug reward, often signaled by a cue.
The extinction protocol in animal models involves repeatedly administering the drug to reinforce abstinence.
Answer: False
Explanation: The extinction protocol involves withholding the drug reward (substituting it with saline) and removing associated cues to decrease drug-seeking behavior, not reinforce abstinence by administering the drug.
Functional magnetic resonance imaging (fMRI) is preferred in animal studies over human studies due to its high resolution and lack of radiation.
Answer: False
Explanation: fMRI is commonly preferred for human studies due to its high resolution and non-invasive nature. Other techniques like PET and SPECT are more typical for detailed neurochemical studies in animals.
A major limitation of animal models is that human relapse rarely follows strict laboratory extinction protocols.
Answer: True
Explanation: This highlights a key difference between laboratory models and real-world human relapse, where the controlled extinction process is often not replicated.
The 'predictive validity' of animal models assesses how closely the model's procedures resemble real-world relapse scenarios.
Answer: False
Explanation: Predictive validity assesses the model's ability to forecast real-world outcomes. How closely procedures resemble real-world scenarios is related to 'face validity' or 'formal equivalence'.
Functional equivalence in validating animal models means the underlying mechanisms driving relapse behavior are comparable to humans.
Answer: True
Explanation: Functional equivalence, or 'functional validity,' posits that the behavioral processes and underlying neurobiological mechanisms observed in the animal model are analogous to those in humans.
Animal models are considered highly reliable predictors of human relapse triggers due to their identical neurochemistry.
Answer: False
Explanation: While animal models provide valuable insights, their neurochemistry is not identical to humans, and their reliability as predictors of human relapse triggers is subject to limitations and ongoing research.
PET and SPECT neuroimaging techniques are favored in human studies over fMRI due to their higher resolution.
Answer: False
Explanation: fMRI is generally favored in human studies for its higher resolution and lack of radiation compared to PET and SPECT.
The concept of 'face validity' in animal models relates to their ability to predict real-world outcomes.
Answer: False
Explanation: Face validity, or formal equivalence, assesses how closely the model's procedures resemble the phenomenon being studied. Predictive validity relates to forecasting real-world outcomes.
How does social hierarchy influence substance use vulnerability, according to animal studies mentioned?
Answer: Dominant animals are less vulnerable and less likely to maintain drug self-administration.
Explanation: Animal studies suggest that social dominance is associated with lower vulnerability to drug self-administration, potentially due to differences in dopamine receptor availability.
Why are animal models essential in drug addiction and relapse research?
Answer: Ethical limitations prevent humans from self-administering drugs for study.
Explanation: Ethical considerations preclude direct experimental drug administration in humans, making animal models crucial for studying addiction mechanisms.
What characteristic makes non-human primates particularly valuable for studying drug relapse?
Answer: They share similarities with humans in brain anatomy, social behavior, and lifespan.
Explanation: The phylogenetic proximity to humans, particularly in brain structure and complex social dynamics, makes non-human primates valuable models for addiction research.
In animal models, what occurs during the extinction protocol for studying relapse?
Answer: The drug is replaced with saline, and the reward is removed until drug-seeking behavior decreases.
Explanation: The extinction protocol aims to reduce drug-seeking behavior by removing the drug reward associated with a specific action.
What is a primary limitation of using animal models to study human relapse, according to the text?
Answer: Human relapse rarely follows the strict extinction protocols used in labs.
Explanation: The artificial nature of laboratory protocols, such as extinction, represents a significant divergence from the complex and often less structured reality of human relapse.
Which neuroimaging technique is commonly used in human subjects for studying brain activity due to its high resolution and lack of radiation?
Answer: Functional Magnetic Resonance Imaging (fMRI)
Explanation: fMRI is a preferred neuroimaging modality in human research owing to its superior spatial resolution and absence of ionizing radiation.
A primary goal in treating substance dependence is to help individuals develop healthier coping mechanisms to meet needs previously fulfilled by drug use.
Answer: True
Explanation: A central aim of addiction treatment is equipping individuals with alternative strategies to address fundamental needs that were previously met through substance use.
Pharmacotherapy, cognitive behavioral techniques (CBT), and contingency management are the three main approaches to reducing drug relapse.
Answer: True
Explanation: These three modalities—pharmacotherapy, CBT, and contingency management—represent the primary evidence-based approaches for mitigating drug relapse.
Pharmacotherapy aims to prevent relapse by altering the individual's social environment.
Answer: False
Explanation: Pharmacotherapy primarily aims to prevent relapse by using medications to normalize neurobiological changes associated with addiction, not by altering the social environment.
Cognitive behavioral techniques (CBT) primarily use medication to alter drug-seeking behavior.
Answer: False
Explanation: CBT focuses on altering thoughts, emotions, and behaviors through psychological techniques, not primarily through medication, which is the domain of pharmacotherapy.
Cue exposure therapy aims to gradually reduce the power of drug-related triggers by repeated exposure without substance use.
Answer: True
Explanation: This therapeutic technique is designed to diminish the conditioned response to drug cues through systematic, non-reinforced exposure.
Relapse prevention (RP) models primarily focus on the immediate environmental consequences of drug use.
Answer: False
Explanation: RP models consider both immediate determinants (including environmental factors) and covert antecedents (like stress and cravings), not solely immediate environmental consequences.
Covert antecedents in relapse prevention include high-risk situations and outcome expectancies.
Answer: False
Explanation: Covert antecedents refer to less obvious factors such as stress, urges, and cravings. High-risk situations and outcome expectancies are classified as immediate determinants.
Contingency management focuses on altering thoughts and emotions related to drug use.
Answer: False
Explanation: Contingency management focuses on altering behavior through reinforcement of abstinence and consequences for drug use, rather than directly targeting thoughts and emotions.
Contingency management relies on the principle of punishment for drug use, without offering rewards for abstinence.
Answer: False
Explanation: Contingency management primarily utilizes reinforcement principles, offering rewards for abstinence and sometimes employing sanctions for drug use, but its core is positive reinforcement of desired behavior.
Cognitive Behavioral Therapy (CBT) for relapse prevention includes techniques like cue exposure and teaching coping mechanisms.
Answer: True
Explanation: These are core components of CBT applied to relapse prevention, aiming to manage triggers and build resilience.
Pharmacotherapy for relapse prevention primarily targets the alteration of cognitions and emotions.
Answer: False
Explanation: Pharmacotherapy targets neurobiological mechanisms, whereas the alteration of cognitions and emotions is the primary focus of Cognitive Behavioral Therapy (CBT).
Contingency management is a treatment approach that focuses on identifying underlying needs previously met by drug use.
Answer: False
Explanation: While identifying underlying needs is a general goal of addiction treatment, contingency management specifically focuses on altering behavior through reinforcement based on abstinence.
Pharmacotherapy aims to normalize brain changes by directly altering an individual's cognitive processes.
Answer: False
Explanation: Pharmacotherapy utilizes medications to normalize neurobiological changes, whereas the direct alteration of cognitive processes is the domain of psychotherapeutic interventions like CBT.
What are the fundamental goals of treating substance dependence mentioned in the text?
Answer: To identify underlying needs met by drugs and develop alternative coping skills.
Explanation: Effective treatment addresses the root issues that led to substance use by identifying unmet needs and fostering healthier strategies to fulfill them.
Which of the following is NOT one of the three main approaches to reducing the likelihood of drug relapse mentioned?
Answer: Psychodynamic therapy
Explanation: The text explicitly lists pharmacotherapy, CBT, and contingency management as the three primary approaches for relapse reduction.
How does pharmacotherapy primarily aim to prevent relapse?
Answer: By using medications to normalize long-term brain changes caused by drug use.
Explanation: Pharmacotherapy leverages medications to address the neurobiological alterations underlying addiction, thereby supporting sustained abstinence.
Which therapeutic approach focuses on altering cognitions, thoughts, and emotions related to drug-taking behavior using conditioning principles?
Answer: Cognitive Behavioral Techniques (CBT)
Explanation: CBT employs principles of learning and conditioning to modify maladaptive thought patterns and emotional responses associated with substance use.
What is the goal of cue exposure therapy within CBT?
Answer: To gradually reduce the power of drug-related triggers through repeated exposure without use.
Explanation: This therapy aims to extinguish the conditioned response to drug cues by repeatedly exposing individuals to them without the opportunity for substance use.
According to relapse prevention (RP) models, what are 'covert antecedents'?
Answer: Less obvious factors like overall stress, urges, and cravings.
Explanation: Covert antecedents represent internal, less apparent factors that contribute to relapse risk, contrasting with immediate determinants which are more situational.
How does contingency management approach relapse prevention?
Answer: By using reinforcement (rewards or punishments) based on abstinence.
Explanation: Contingency management leverages behavioral principles by providing tangible rewards for abstinence and potentially sanctions for relapse.
What is the main difference in focus between contingency management and CBT for relapse prevention?
Answer: Contingency management focuses on consequences (rewards/punishments); CBT focuses on precursors (thoughts/emotions/skills).
Explanation: Contingency management targets behavioral outcomes (consequences), while CBT addresses the cognitive and emotional precursors to drug use.
Women generally show lower relapse rates and less responsiveness to drug cues compared to men.
Answer: False
Explanation: Research indicates that women typically exhibit higher relapse rates and greater responsiveness to drug cues than men.
Ovarian hormones like estradiol and progesterone are believed to influence drug-primed relapse in females.
Answer: True
Explanation: These hormones fluctuate throughout the menstrual cycle and are implicated in modulating vulnerability to relapse in females.
During the luteal phase, increased estradiol and decreased progesterone levels are associated with higher relapse risk.
Answer: False
Explanation: During the luteal phase, progesterone levels typically increase while estradiol levels decrease, a hormonal state associated with increased anxiety and depression, potentially elevating relapse risk.
The luteal phase of the menstrual cycle in females is associated with hormonal changes that can potentially increase vulnerability to relapse.
Answer: True
Explanation: Hormonal fluctuations during the luteal phase, characterized by increased progesterone and decreased estradiol, can exacerbate negative mood states and withdrawal symptoms, potentially increasing relapse vulnerability.
How do women generally differ from men regarding relapse and cue responsiveness, based on the source?
Answer: Women have higher relapse rates and are more responsive to cues.
Explanation: Research indicates that women tend to experience higher rates of relapse and exhibit greater sensitivity to drug-related cues compared to men.
Which ovarian hormones are mentioned as potentially playing a significant role in drug-primed relapse in females?
Answer: Estradiol and progesterone
Explanation: Estradiol and progesterone are key ovarian hormones whose cyclical fluctuations are implicated in modulating relapse vulnerability in females.
What changes occur during the luteal phase that might affect relapse risk in females?
Answer: Increased progesterone and decreased estradiol, potentially increasing anxiety and depression.
Explanation: The hormonal milieu of the luteal phase, characterized by higher progesterone and lower estradiol, is associated with increased negative affect, which can heighten relapse risk.