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PBSI 306 > ch 10 review > Flashcards

ch 10 review Flashcards

1
Q

What are the Neurodevelopmental disorders and when do they begin?

A
  • Begin in childhood
  • 4 in DSM-5
    • Attention-deficit hyperactivity disorder
    • Autism spectrum disorder
    • Intellectual disability disorder
    • Learning, communication, and motor disorders
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2
Q

What are the Neurocognitive disorders and when do they begin?

A
  • Arise in older age
  • 2 in DSM-5
    • Major and mild neurocognitive disorders
    • Delirium
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3
Q

Attention Deficit Hyperactivity disorder definition:

A
  • Persistent pattern of inattention and/or hyperactivity
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4
Q

3 Subtypes of ADHD:

A

Combined presentation
- 6+ inattention symptoms and 6+ hyperactivity-impulsivity symptoms
Predominantly inattentive
- 6+ inattention symptoms and < 6 inattention symptoms
Predominantly hyperactive/impulsive
- 6+ hyperactivity-impulsivity symptoms and < 6 inattention symptoms

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5
Q

Attention Deficit Hyperactivity disorder: prevalence, onset, prognosis

A
  • Prevalence rate: 3.4 -6%?
  • Age limit for onset of symptoms: 12 years
    • More than one setting
  • Boys 2x more likely to be diagnosed
  • Difficulties in school functioning
  • Poorer peer relationships
  • 45-60% develop conduct disorder
  • Increased risk for problems in adulthood
  • 4.4% of adults diagnosed with ADHD
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6
Q

Biological factors for ADHD:

A
  • Abnormal activity in prefrontal cortex, striatum, and cerebellum
  • Less connectivity between frontal cortex and brain areas that influence motor behavior, memory and attention
  • Abnormal functioning of dopamine and norepinephrine
  • Strongly tied to genetic factors
    • Higher rates in twins and siblings
    • Genes that influence dopamine, noradrenaline and serotonin
  • Prenatal birth complications
    • Low birth weight
    • Premature delivery
    • Oxygen deprivation
    • Lead exposure
  • Diet?
    • “Poor Western diet”?
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7
Q

Psychological factors for ADHD:

A
  • Aggressive and hostile behavior from parents
  • Parental substance abuse
  • Family interaction patterns influence course and severity of ADHD
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8
Q

Treatments for ADHD:

A
  • Stimulant drugs increase dopamine
    • Effective but side effects
  • Non stimulant drugs affect norepinephrine
    • Reduce tics and increase cognitive performance
    • Side effects
  • Antidepressants?
    • Some effect on cognitive performance
  • Behavioral therapies
    • reinforce attentive, goal-directed, prosocial behaviors
    • extinguish impulsive and hyperactive behaviors
  • Combination of stimulant therapy and psychosocial therapy is best
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9
Q

Autism spectrum disorder: criteria, symptoms, and prognosis

A
  • Impairment in two fundamental behavior domains
    • Deficits in social interactions and communications
      • Autism: non-reciprocal adoration
      • Echolalia: Echoing what one hears
    • Deficits in restricted, repetitive patterns of behaviors, interests, and activities
      • Preoccupation with one object
      • Obsessed with routine and order
      • Self-stimulatory behaviors
  • 50% show at least moderate intellectual disability
  • Some only show language deficits
  • Wide variation in severity and outcomes
  • Best predictors of outcomes:
    - Child’s IQ
    - Language development before age 6
    - IQ above 50 and communicative speech before age 6
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10
Q

Biological theories for ASD:

A
  • Family and twin studies
    • Siblings 50 times more likely to have disorder
    • Concordance rates: MZ twins = 60%, DZ twins = 0-10%
    • Polygenic
    • Neurological factors
    • 30% develop seizures by adolescence
    • Greater head and brain size
    • Neuroimaging studies
      • Structural abnormalities in cerebellum, cerebrum, amygdala, and hippocampus
      • Less activation in brain areas for perception of facial expressions and thinking about social situations
  • Higher than average rate of prenatal and birth complications
    • Maternal immune activation (MIA)
  • Differences in levels of serotonin and dopamine
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11
Q

Drug therapy for ASD

A
  • SSRIs
    • Reduce repetitive behaviors and aggression
  • Atypical antipsychotic medications
    • Reduce obsessive and repetitive behaviors and improves self-control
  • Naltrexone
    • Reduces hyperactivity
  • Stimulants
    • improve attention
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12
Q

Psychosocial therapies for ASD

A
  • Combination of behavioral techniques and structured educational services
  • Operant conditioning strategies
    - reduce excessive behaviors
  • Comprehensive behavior therapy
    - parents and at school
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13
Q

Intellectual developmental disability: criteria

A

Deficits in the ability to function in 3 broad domains
- Conceptual domain
- language, reading, memory
- IQ under 70
- Social domain
- interpersonal communication skills, social judgment
- Practical domain
- self-care

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14
Q

Intellectual developmental disability: 4 levels of severity

A

Mild
- Some academic or vocational limitations, but can hold non-competitive jobs
- Self-care, with exception of complex situations
Moderate
- Significant language delays
- Low academic ability, but can acquire simple vocational skills
Severe
- Very limited vocabulary
- Require support for daily living
Profound
- Fully dependent on others

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15
Q

Biological factors for intellectual disability:

A

Genetic contributors
- Genes can lead to various conditions that cause ID
- Phenylketonuria (PKU)
- Tay-Sachs disease
- Chromosomal disorders, such as Down’s syndrome
- Fragile X syndrome
Brain damage
- Infectious diseases
- Fetal alcohol syndrome
- Head trauma
- Exposure to toxins

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16
Q

Sociocultural factors for intellectual disability:

A

Low socioeconomic backgrounds
- Parents with intellectual disability
- Poorer prenatal care
Living in lower socio-economic areas
- Exposure to lead
- Poorly funded schools

17
Q

Treatment for intellectual disability:

A

Drug therapy
- Neuroleptic medications control aggression and self-injurious behavior
- Atypical antipsychotics reduce aggression
- Antidepressants reduce depression
Behavioral Programs
- Help individuals learn new skills; social and communication skills * Involvement of parents and caregivers
Social Programs
- Early intervention, mainstreaming, institutionalization, group homes that provide comprehensive care

18
Q

Learning disorders: criteria and types

A
  • Deficits or abnormalities in specific skills or behaviors
  • Specific learning disorder: Deficits in one or more academic skills
    • Reading
    • Written expression
    • Mathematics
19
Q

Communication disorders: criteria, types, and definitions

A

Language Disorder
- Difficulties with spoken, written language, and other language modalities
Speech Sound Disorder
- Difficulty in producing speech
Childhood-onset fluency disorder or stuttering
- Problems with speaking evenly and fluently, voicing frequent repetitions of sounds or syllables
Social communication disorder
- Deficits in using verbal and nonverbal communication for social purposes, in a manner that is appropriate for the social context

20
Q

*Causes of learning and communication disorders:

A

Genetic factors -Abnormalities in brain structure and functioning
- Broca’sarea
Environmental factors
- Lead poisoning
- Birth defects
- Sensory deprivation
- Low socioeconomic status

21
Q

*Treatment for learning and communication disorders:

A
  • Therapies designed to build missing skills
  • Individualized Education Plans (IEP) used in schools
22
Q

Motor disorders: criteria/symptoms of 4 types

A

Tourette’s disorder
- Multiple motor tics and at least 1 vocal tic
- More debilitating than PMVTD
Persistent motor or vocal tic disorder (PMVTD)
- Have only motor or vocal tics, not both
Stereotypic movement disorder
- Engage in repetitive, driven, and purposeless motor behavior
- Behavior persists for extended period of time
- Comorbid with autism, intellectual disability, and ADHD
Developmental coordination disorder
- Deficits or delays in development of basic motor skills
- Prevalence: 5-6%
- Causes unknown
- Treated with physical or occupational therapy

23
Q

Motor disorder: course, comorbidity, causes, and treatment

A
  • All begin in childhood, increase in adolescence and decline in adulthood.
  • All highly comorbid with OCD
  • Dysfunctions in the dopamine system
  • Treated with habit reversal therapy
    • Triggers for and signs of impending tics identified
    • Clients taught to engage in competing behaviors
24
Q

Neurocognitive disorders: definition and disorders

A
  • New category in DSM-5: Neurocognitive Disorders
  • Involve a loss of cognitive ability that is presumed to be caused by brain damage or disease
  • Disorders:
    • Major neurocognitive disorder (FKA dementia)
    • Mild neurocognitive disorder
    • Delirium
25
Q

Major neurocognitive disorder: symptoms

A
  • Decline in cognitive functioning severe enough to interfere with daily functioning
  • Memory loss
  • Aphasia: Deterioration of language
    • Echolalia: Repeating what is heard
    • Palilalia: Repeating sounds or words over and over
  • Apraxia: inability to execute common actions
  • Agnosia: Failure to recognize objects or people
  • Lose of executive functions
    • ability to plan, initiate, monitor, and stop complex behaviors
  • Changes in emotional functioning and personality
26
Q

Mild neurocognitive disorder: symptoms, course

A
  • Modest cognitive decline from a previous level of performance
  • No significant impairment in functioning
27
Q

Alzheimer’s disease: symptoms and description

A
  • Mild memory loss that quickly progresses to profound memory loss and disorientation
  • 2/3s show psychiatric symptoms
  • Some hallucinations and delusions in severe cases
    • 100-year-old kills self and wife
  • Usually begins after 65
28
Q

Vascular neurocognitive disorder: symptoms

A
  • Can be major or mild NCD depending on severity of symptoms
  • Significant decline in:
    • processing speed
    • ability to pay attention *executive functions
  • Evidence of recent Cerebrovascular disease:
    • Blood supply to areas of the brain is blocked, causing brain tissue damage
  • Can occur after 1 large stroke or several small strokes
    - 25% of stroke patients develop NCD
29
Q

Treatment of neurocognitive disorder:

A

Cholinesterase inhibitors
- Treat cognitive symptoms by preventingthe breakdown of the neurotransmitter acetylcholine
Antidepressants and antianxiety drugs
- Help control emotional symptoms
Antipsychotic drugs
- Control hallucinations, delusions, and agitation
Behavior therapieshelp to control patients
- Train family members
Physical and mental activity helps reduce the risk of NCDs
- Nun Study (Snowdon, 1996; 1997)

30
Q

Delirium: criteria, course, onset

A
  • Disorientation, recent memory loss, and a clouding of attention
  • Sudden onset, fluctuating state of reduced awareness
  • Duration is short: approximately 1 month or less
  • Onset: any age
    • Elderly at high-risk
  • Prevalence estimates vary
    • 10-15% of patients who have had surgery
31
Q

Causes of delirium:

A
  • Neurocognitive disorder is strongest predictor
  • Medical disorders
    • Stroke, congestive heart failure, infectious diseases, high fever, HIV
  • Intoxication of illicit drugs and withdrawal – - - Fluid and electrolyte imbalances, medication side effects, and toxic substances
  • Abnormalities in a number of neurotransmitters
32
Q

Treatments for delirium

A
  • Discontinue drugs that contribute to delirium
  • Antipsychotic medications
    • Help treat a delirium person’s confusion
  • Nursing care
  • Secure atmosphere helps create a secure feeling and a feeling of being in control

PBSI 306 (14 decks)

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