Aug 23, 2024
Genetic mediators of alcohol use disorders (AUDs) risk
Biological mediators of AUD risk
Psychological and Sociocultural theories in alcoholism risk
Babor’s Classification
Cloninger Classification
Lesch typology (Syndrome)
Jellinek 5 ‘species’
Genetic factors contribute to 60% of the risk for AUD. There is a 3-4 times higher risk if a close family member of the person is with AUds. The Risk increases with a greater number of such relatives, greater severity of AUDs, and closer genetic relationships. Risks are higher in monozygotic twins as compared to dizygotic twins. Adopted children of the person with AUD also show the risk of AUD with 4 times higher risk, given that he/she is not raised by the parents with AUD. Risk does not increase when adopted parents have AUD. A family history of alcoholism increases risk among people of different socioeconomic classes. Multiple factors increase risk (high impulsivity and low level of response to alcohol). Multiple gene interactions with the environment.
Biological mediators of AUD risk include the following factors:
It includes variations in genes that control alcohol dehydrogenase enzyme (ADH) on chromosome 4 and ALDH on chromosome 12. These variations can also decrease the risk of alcoholism. The most potent polymorphism occurs in the mitochondrial low km ALDH2 gene (ALDH2*2 genotype). It is seen in 40% of the Japanese, Chinese, and Korean populations.
It happens through genes that affect sensation seeking, impulsivity, and disinhibition. Antisocial PD (extreme impulsivity, disinhibition). It increases the risk for AUDs and substance use disorders (SUDs) by 80%.
It increases the risk for AUDs and SUDs through genes that increase the vulnerability to psychiatric disorders. Psychotic disorders include antisocial PD, schizophrenia, and bipolar disorder. Some relationships due to the use of alcohol or illicit drugs decrease psychiatric symptoms or decrease the effect of medications.
It increases with the people who experience high stimulation at rising blood alcohol levels and lower response at peak and falling levels. Lower response rate, people need higher doses to get alcohol effects. It leads to an increase in consumption, increases positive expectations, and increases use to handle stress. Lower response is either due to genes or possible cognitive inefficiency, making it difficult to recognize the effects of low alcohol doses.
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Type A alcoholism Type B Alcoholism It is also known as APOLLO It is known as BACCHUS Late age of onset Early age of onset Childhood shows early risk factors Conduct disorders during childhood Males= females More seen in males It happens more due to environmental factors It happens more due to genetic factors Low personality impulsivity High personality impulsivity Less family history More family history Less severe Higher severity Interaction group therapy for treatment Coping skills training as a treatment
Type I Type II Found in both sexes Mostly found in males Onset age (> 25 years) Onset age < 25 years Genetic factors + Genetic factors + Environment factors + Limited environment factors Family history may be positive Positive family history Loses control Doesn’t lose control Higher psychological dependence Drinking and aggressive behavior, spontaneous alcohol seeking
Type I Type II Type III Type IV - It is an allergy model- Person craves due to withdrawal of alcohol - Conflict solving (craving due to stress) - Depressive model (craving due to mood or family history) - Conditioning model (craving due to compulsion)- cerebral damage or childhood problems
A. 20%
B. 40%
C. 60%
D. 80%
Answer: C. 60%
A. ADH1C
B. ALDH2
C. ADH1B
D. ALDH1A1
Answer: B. ALDH2
B. Antisocial Personality Disorder
Answer: B.
A. P3
B. Alpha waves
C. Theta waves
D. Delta waves
Answer: A. P3
A. Genital stage
B. Phallic stage
C. Anal stage
D. Oral stage
Answer: D. Oral stage
A. Early age of onset
B. High personality impulsivity
C. More Severe
D. Coping skills training as a treatment
Answer: C. More Severe
A. APOLLO
B. BACCHUS
C. Dionysus
D. Hermes
Answer: B. BACCHUS
A. Allergy model
B. Conflict-solving model
C. Depressive model
D. Conditioning model
Answer: D. Conditioning model
A. Excessive and inappropriate drinking to rescue physical or emotional pain
B. Drinking due to physical complications without dependence
C. Physical then psychological dependence
D. Compulsive drinking (dipsomania)
Answer: C. Physical then psychological dependence
Also Read: Assessment And Prognosis of Alcohol-Related Disorders
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