PENYALAHGUNAAN ZAT PADA ANAK DAN REMAJA

Adnil Edwin Nurdin

 INTRODUCTION

Living thing------growth & development

Basic concept-----growth-------measure--------absolute value Based
on measuring
---- development---------assessment------relative value
Based on comparison
Growth-----physical-----ex.womenhood
Development--------behavior-----a very nice and feminine girl
Occurs in stages
 EPIGENETIC PRINCIPLE

Development occurs in sequential, clearly defined stages

Specific issue in each stage
Issues in each stage must be resolved
Development can proceed smoothly
Successful resolution failed in a particular stage
All subsequent stages reflect that failure
Maladjustment of:
Physical growth
Cognitive development
Social development
Emotional development
THE END IS THE MIRROR OF BEGINNING

END OF FIRST LECTURE

 Erik Erikson Stages of Life Cycle
Lecture 2. Early years

1.Basic Trust versus Mistrust (birth-1 year)

Need for instant satisfaction, TRUE LOVE
Resolved-----Strong Basic trust, believe in others, hopeful attitude, self
confidence, trustful personality
Unresolved-------suspicious, cant control urge

2.Autonomy versus Shame and Doubt (1-3 years)

earning to walk, feed it self, talk, TOILET TRAINING
need for firm outer control, first discipline, in love----autonomy
to much outer control------shame
to much punishment, harsh discipline----self doubt
 3.Initiative versus Guilt (3-5 years)
initiative arises in relation to tasks for the sake of activity
guilt arises on contemplated goal
mimic adult world
sibling rivalry
resolution through social role identification
I am a boy, she is a girl. I play with a toy gun, she plays with a doll
4.Industry versus Inferiority (6-11 years)
building, creating, accomplishing
need of systematic intruction for fundamentals of technology
sense of inadequacy and inferiority if child despairs of tools, skills, and
status among peers---socially decisive age---LEADER or FOLLOWER
IMPORTANCE OF SKILL DEVELOPING, TOYS, BOOKS etc.
 Lecture 3.Further development

5.Identity versus Role Diffusion (11 years-end of adolescence)

develop ego identity, peer group identity, group loyalty
appearance, hero worship (see M-TV)
unresolved-----role confusion---going astray
6.Intimacy versus Isolation (21-40 years)
to love, to work, to nurture others, to be responsible for others
resolved-----intimacy, loyalty, responsible, loving
unresolved---isolation, view that others are dangerous
7.Generativity versus Stagnation (40-65 years)
work for the future generation, productive, creativity, concern and
responsibility for others, striving to left some thing good for future
generation after death---GENERATIVITY
Unresolved-----self concern, isolated
 Kata kunci
ZAT PSIKOAKTIF, FUNGSI MENTAL SPESIFIK, NEUROTRANSMITER, SISTEM REWARD
MESOLIMBIK
SINDROMA DEFISIENSI REWARD, PENYALAHGUNAAN,REINFORCEMENT
TOLERANSI, KETERGANTUNGAN, GEJALA PUTUS ZAT, OVERDOSIS
KECANDUAN
GEN-ENVIRONMENT DIATHESIS
DISINHIBISI
TERATOGENIK
DETOKSIFIKASI
 ZAT PSIKOAKTIF

Euphoriant
Zat yang menekan emosi atau persepsi menyakitkan (dysphoric state) tanpa menurunkan
kesadaran, sehingga timbul rasa nikmat. Dunia realitas yang penuh kesulitan dan
kekecewaan diganti dengan dunia sendiri dimana semua masalah teratasi, cemas, sedih,
marah ditenangkan, dan semua keinginan terpenuhi. Contohnya narkotika opium dan
cocaine.
Phantasticant
Halusinogen dan Psychedelic, mencetuskan perubahan sensoris (halusinasi visual dan
auditory) dan persepsi (benda atau suasana yang suram menjadi berwarna-warni).
Contohnya mescaline ekstrak peyote cactus (Anhalonium lewinii), LSD, harmine
(fermentasi ayahuasca yang diekstraksi dari B. caapi and B. inebrians), hashish dari
Cannabis, jamur magic (Psylocybe semilanceata) dan alkaloid antikholinergik seperti
hyoscyamine, atropine dan scopolamine.
Inebriant
Zat yang menghambat pengaruh lingkungan terhadap mental, menimbulkan ketenangan
dan relaksasi, tetapi juga mengakibatkan disinhibisi dan perubahan persepsi disertai
penurunan kemampuan kognitif. Contohnya alkohol dan inhalan.
 Hypnotic
Obat tidur, seperti barbiturate dan benzodiazepine.
Banal Excitant
Obat perangsang libido banal, menimbulkan hiperaktifitas SSP dan meningkatkan
kemampuan fisik tanpa merubah kesadaran. Contohnya derivat amphetamine.
Disinhibitor
Menekan fungsi PFC yang mengendalikan perilaku sehingga terjadi disinhibisi. Contohnya
Cannabis.
Aesthetic Excitant
Obat perangsang libido erotika, menimbulkan hiperaktifitas SSP dan meningkatkan
kemampuan fisik tanpa merubah kesadaran, meningkatkan cita rasa dan erotisme.
Contohnya cocaine.
Emphatogen
Membangkitkan empati secara sukarela: contohnya ecstacy
 Reward & Reinforcement
Konsep reward
Reinforcing positif
Reinforcing negatif
Reward sejati (natural)
Reward palsu(artificial)
 The reward pathway

View of the brain cut down the middle. Reward pathway: the ventral tegmental area (VTA), the nucleus
accumbens, and the prefrontal cortex. The VTA is connectedto both the nucleus accumbens and the prefrontal
cortex via this pathway and it sends information to these structures via its neurons. The neurons of the VTA
contain the neurotransmitter dopamine, which is released
in the nucleus accumbensand in the prefrontal cortex.This pathway is activated by a rewarding stimulus. [Note:
the pathway shown here is not the only pathway activated by rewards, other structures are involved too, but only
this part of the pathway is shown for simplicity.]
 Sindroma Defisiensi Reward SDR)

Polimorphisme (allel A1 Gen DRD2)

Jumlah reseptor dopaminergik di nukleus akumben berkurang (1/3)
Dua arah manifestasi perilaku
Ditentukan pola asuh
 Efek Teratogenesis
Alkohol: fetal alcohol syndrome
Cannabis: fetal cannabis syndrome