vallia
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A 49 year old man is evaluated for suicidal ideation after he is found laying on train tracks by the police. The man is dishelved and malodorous and states that he had "reached the end" and he would rather die. He admits to depressed mood, anhedonia, poor energy and apetite, he feels miserable and regrets what he has done with his life and want to put an end to it. he states he has felt this way since 26 years old after he was discharged from millitary. The man indicates that his life was great until he increased his drinking....an the story goes for another 10 lines. He somehow got in jail, he divorced he experienced withdrawal in jail..)OK..The question is
Which of the following criteria most strongly suggest alcohol abuse
a. desire to cut down
B. recurrent drunk driving
C. seizures after withdrawal
D. suicidal ideation
E. tolerance
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| robin082006
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B
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| Cedrick
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B
and this one is a great question
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| fox
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But where in his story is drunken driving mentioned?
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| goodyear
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Drinking in a situation that is physically dangerous is alcohol abuse. ex. As mentioned here is
drunk driving, other ex.operation of heavy machines.
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| oldkidontheblock
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C
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| fongch
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You must tell the difference between alcohol abuse and alcohol dependence.
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| MRMAVERICK
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| feras
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DSM-IV Substance Abuse Criteria
Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant
impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of intoxication and physical fights).
Alternatively, the symptoms have never met the criteria for substance dependence for this class of substance.
DSM-IV Substance Dependence Criteria
Addiction (termed substance dependence by the American Psychiatric Association) is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of
the following, occurring any time in the same 12-month period:
1. Tolerance, as defined by either of the following:
(a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect
or
(b) Markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
(a) The characteristic withdrawal syndrome for the substance
or
(b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3. The substance is often taken in larger amounts or over a longer period than intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
DSM-IV criteria for substance dependence include several specifiers, one of which outlines whether substance dependence is with physiologic dependence (evidence of tolerance or withdrawal) or without physiologic dependence (no evidence of tolerance or withdrawal). In addition, remission categories are classified into four
subtypes: (1) full, (2) early partial, (3) sustained, and (4) sustained partial; on the basis of whether any of the criteria for abuse or dependence have been met and over what time frame. The remission category can also be used for patients receiving agonist therapy (such as methadone maintenance) or for those living in a controlled, drug-free environment.
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| vallia
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thanks guys for input, yes the answer is B
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| equinoxe
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thank you, great q. you can abuse and not yet be dependent
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