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DEPENDENCIES AND ADDICTIONS

DEPENDENCIES AND ADDICTIONS. Vocabulary. Dependency is expressed as difficulty making one’s own decisions and initiating actions with an excessive reliance on others

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DEPENDENCIES AND ADDICTIONS

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  1. DEPENDENCIES AND ADDICTIONS

  2. Vocabulary • Dependency is expressed as difficulty making one’s own decisions and initiating actions with an excessive reliance on others • Counterdependency has the same fears of failure but is also afraid of authority and masks this fear and avoidance of authority with behavior and the attitude “I can do it myself” • Habit is a repeated functional behavior (washing the sink repeatedly) • Addiction is a physical and psychological dependence on a substance or behavior. • Cognitive distortions in addicts consist of underplaying the negative outcomes of addiction (denial)

  3. Types of Dependencies A. Normal B. Abnormal • Habit disorders (e.g., eating) • Addictions (e.g., alcoholism)

  4. Developmental Course of Normal Dependence Normal 1. On parents/adults 2. On peers 3. On resources What are the implications for accommodation for a child overly dependent on an teacher?

  5. Etiology • Overcontrolling parents • Overprotective parents • Failure

  6. The Function of Dependence • Avoidance of failure or the social embarrassment of failure

  7. Behavioral Characteristics • Waits for others and watches before beginning • Stays in close proximity to adults • Is generally passive

  8. Communication Characteristics • Often seeks social approval, for example, by saying “did I do a good job?” • Has difficulty with decisions • Often complains

  9. Counterdependency Characteristics • Conveys the attitude “I can do it myself”--by hasn’t a clue • Authority avoidant • Yet like a dependent, s/he complains and waits for others to act first

  10. Slowly transfer dependency on an adult to a: Tape recorder A PDA or phone Buddies/peers Change response to child: Never punish an avoidance behavior! Interventions for Dependency from Overcontrolling Etiologies

  11. Change Tasks Simple to complex questions More time or advance warning to respond Goals clear/structure Use interests/hobbies Alternative Expressions to Verbalizations: Writing/drawing Role playing Accommodations for Dependency when Avoidance of Failure is the Issue

  12. HABIT DISORDERS Of EATING • Anorexia nervosa • Bulimia • Eating disorders are disturbances of identity and autonomy not of appetite

  13. LOOK AT THIS LINKThinhttp://www.hbo.com/docs/programs/thin/video.html (Preview)

  14. DEFINITION ANOREXIA NERVOSA: a condition of self-inflicted starvation DSM-IV: • Refusal to maintain body weight 85% • Intense fear of gaining weight even though underweight • Distortion in the way body weight or shape is experienced • Amenorrhea (missing at least 3 menstral cycles in a row)

  15. DEFINITIONBULIMIA NERVOSA DEFINITION: an eating disorder with frequent episodes of uncontrolled binge eating and alternate purging of food DSM-IV: • Recurrent episodes of binge eating in a discrete period of time • Recurrent compensatory behavior to prevent weight gain These symptoms occur at least twice a week for 3 months • Self-evaluation influenced by body weight/shape • Does not just occur during Anorexia Nervosa • Purging Type and Nonpurging Type

  16. PREVALENCE Average age of onset: 17 (14 - 18 peaks in frequency) 5-20% of population MORE often in families of above average SES 90-95% female Women’s subordinate positions in society • self-sacrificing in support of needs of others • passive and covert in behavior • indirect way to gain control over life • wishes to attain an Ideal physicality

  17. ANOREXIA NERVOSA :ETIOLOGY • BIOPHYSICAL FACTORS (a) genetic factors, hormonal and endocrine problems, or malfunctions of hypothalamus • Changes in blood flow in the brain • PSYCHOSOCIAL FACTORS Linked to control issues; they may perceive themselves as controlled externally, are less assertive, and come from families that do not encourage independence (Williams, Chamove, & Millar, 1990--Journal of Clinical Psychology, 29, 327-335) • ENVIRONMENTAL STRESS put on child to be perfect -- high expectations from significant others; pressure from media to look a certain way; low self-esteem

  18. Behavioral/Physical CHARACTERISTICS Behavioral: • Sharp restriction of food intake (nibbles or picks) • Compulsive exercise • Compulsive behavior Physical: Losing muscle Alterations of bone marrow (periodontal, nails) Extreme fatigue Frequent bruising Dry skin or rash

  19. Cognitive and Academic Characteristics • Strong intellect • Above average school achievement

  20. Emotional Characteristics • Conforming • Perfectionistic • Negative self-perception

  21. Outcomes • 10% of those who are hospitalized die

  22. PREVALENCE GENDER: • primarily female Estimate of: • 1-3% of adolescent/young adult females --most are secretive b) 4-20% of college age

  23. Addictive Behavior From dependency to addictions

  24. Definition Addiction is a physical and psychological dependence on a substance or behavior. (Any substance or behavior is not harmful in moderation, but when it continues no matter what the consequences are, it is addictive.) Developmental Course: • It begins by using something to feel good to "help" the person to avoid painful feelings. • Over time, the person feels less pleasure, and leads to a feeling of "I don't care, as long as I can...", even when the effects are devastating to the addicted person or others.

  25. Prevalence • 10% of American adults • 3% of adolescents

  26. Look at this link. video http://www.hbo.com/addiction/index.html

  27. Types of Addiction Common addictions are: • Shopping • Alcohol • Drugs • Sex • Gambling • smoking

  28. GENETIC ETIOLOGY • If one parent is an alcoholic, the chances of the child becoming addictive is 50-50. • If both parents are alcoholics, the odds are even greater that the child will become addictive.

  29. Contributing factors Environment: Readily available substances Individual’s: Physiological level of anxiety and response to stress Physiological positive reaction to the drug substance, with a need to increase dose and frequency of use. Psychology:Impairment in the ability to obtain real satisfactions and rewards from life; turns to alternative artificial rewards offered by different types of addictions

  30. COGNITIVE DISTORTIONS • “Mental Bookkeeping” -- addicts weigh incorrectly the positive and negatives of their addiction (irrational), which is a form of denial • the addict begins to place more emphasis on the positive aspects of the behavior, this emphasis later becomes a need. • Obsessive thoughts

  31. Example of Cognitive Distortion

  32. INTERVENTIONS Is not curable but is treatable. • Total abstinence: the risk of relapse is present throughout life no matter how long the recovery. • ‘Just say no’ education programs work • Self-help groups work

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