Describe the Neurology of Addiction Marks: This question is worth 20 marks Background: Many addictive substances can lead to changes in dopamine levels in the brain. For example, both cocaine and alcohol are associated with elevated levels of baseline striatal dopamine. Although other neurotransmitter systems have been implicated, there is strong evidence that substance addiction primarily involves the dopamine (dopaminergic) system. The dopaminergic system also seems to play a key role in behavioural addictions, especially pathological gambling. Suggested Readings: van Holst et al. (2018), DSM-V (2013) criteria for Pathological Gambling, Nutt et al. (2015) Question 2: What do the findings of van Holst et al. (2018) tell us about dopamine in the brains of pathological gamblers? Question 3 (parts a and b): Brain Injury, Cognition, and Communication Marks: Question 3a is worth 25 marks. Question 3b is worth 5 marks. For question 3b you do not need to provide references, as these will be your own strategies. Background: Addiction can damage the brain in different ways, including neurotoxicity, traumatic brain injury, and stroke. One part of the brain particularly vulnerable to damage is the frontal lobe, which is involved in executive functions (EFs). There are three ‘core’ executive functions; inhibition, working memory, and cognitive flexibility (also referred to as set shifting and/or switching) and these are vital for everyday behaviours such as reasoning, problem solving, and planning. EFs impact upon all aspects of human life, including communication. Executive functions that support social communication are often impaired in individuals with damage to the frontal lobes. Much of our knowledge about the role of the frontal lobe is based on research in those with frontal lobe damage, such as those with aphasia related to a stroke. Suggested Readings: Diamond (2013), Rende (2000), Purdy and Koch (2006), Purdy (2002), Chiou and Kennedy (2009) Question 3a: What is cognitive flexibility and what role does it play in successful communication? Question 3b: Imagine you are talking to a client who has frontal lobe damage and impaired cognitive flexibility. Describe two strategies you might employ to facilitate communication with them.
