Chapter 14 Flashcards
Dopamine Deficiency
dopaminergic drugs are ineffective in many
- not all schizophrenic people have excessive dopamine
- side effect of antipsychotic drugs is Parkinson’s like symptoms
Tardive Dyskinesia
tremors and involuntary movements due to long term blocking of dopamine receptors
- happens when you take anti-dopamine drugs
- even after you stop taking it, these symptoms continue for around a year after, creates long term changes
Neuroleptics
atypical or second-generation antipsychotics block receptors less strongly and target other, non-dopamine receptors
Glutamate Theory
hypo function of NMDA receptors; increases in glutamate, increases in dopamine
- this increases positive ND negative symptoms of schizophrenia
Brain Malfunctions in Schizophrenia
brain tissue deficits create ventricular enlargement
- hypofrontality
- decreases in temporal and frontal lobes
- increases activity in orbital frontal cortex and parts of the hippocampus
Wisconsin Card Sorting Test
test for hypofrontality
- requires individuals to change strategies mid- stream
ie; sort these by cloud and then half wa through, you are told to switch to sorting them by even or odd
- schizophrenic patients have less activity in frontal lobe and therefore have troubles switching due to the frontal lobes role in long term planning
Neurological Anomalies in Schizophrenia
- neural connections and synchrony; connections have been disrupted
- white matter is decreases
- cortical thickness decreases
- association between schizophrenia and brain damage
- developmental disease; you have schizophrenia from birth or before then
Winter Birth Effect
more patients with schizophrenia were born in the winter months than the summer months
- winter and spring months
- rates of schizophrenia peak during a particularly high influenza season
Interleukin 1 Beta Level
protein released by the body
- schizophrenic patients have more of this
- we believe this is due to maternal infection during second trimester
Affective/ Mood Disorders
depressive disorders, mania, bipolar disorders
Depressive Disorders
intense sadness and loss of interest
- circadian rhythm is controlled by genes; these genes are messed up
Mania
excessive energy and confidence
Bipolar Disorders
alternate between depression and mania
Reactive Depression
occasional intense sadness in response to life challenges
Major (unipolar) Depressive Disorders (MDD)
intense sadness for long periods of time
- sad to the point of hopelessness at weeks at a time, enjoy ability to enjoy the great things in life
cognitive symptoms- slowness of thought, sleep disturbances, memory impairments
Mania Symptoms
- inflated self-esteem
- decreases sleep
- talkativeness
- racing thoughts or ideas
- easily distracted
- increased goal- directed activities
- agitations
- excessive involvement in risky activities
Must have 3 or more symptoms, must be debilitating, and not caused by drugs
Bipolar 1
alternated between periods of depression and full-blown mania
- often includes psychotic features such as delusions, hallucinations, paranoia, or bizarre behaviour
Bipolar 2
alternate between periods of depression and hypomania
Hypomania
the extreme opposite of mania symptoms
Cyclothymia Disorder
cycle between depression and mania very quickly
- by days or hours
Dopamine and Serotonin in Bipolar
increased sensitivity to dopamine, decreases sensitivity of serotonin or more general dysregulation of dopaminergic system
Drug Treatments of Bipolar Disorder
second- generation antipsychotics
- lithium; reduces mania and limits depressive episodes
- carbamazepine and valproate
Heredity of Affective Disorders
partly heritable
- 37% heritability overall, but more in women than men
- prominent environmental antecedents of depression involve stress
- despite similarities, depression and bipolar disorders are genetically independent
Rhythms and Affective Disorders
- circadian rhythms shift earlier
- less time spent in stages 3 and 4 of sleep and more time spent in REM sleep; stages 3 and 4 is when you get rested and REM is when your brain is active
- they are getting lest restful sleep because their brain is active the whole night
Seasonal Affective Disorder
pattern of depression that rises and falls with the seasons
- circannual rhythm
- leads to excessive sleep and increased appetites
Phototherapy
patient sits in front of high-intensity lights for a couple of hours a day
Neurological Abnormalities in Affective Disorders
prefrontal deficits in depression
- reduced total brain activity in unipolar patients and patients and depressed bipolar patients
- cingulate cortex, hippocampus, and ventral prefrontal cortex
- enlarged amygdala and left hypothalamus
- areas responsible for attention and filtering information
Bipolar Disorder Neurological Abnormalities
- decreased thickness and glial density in anterior cingulate cortex
- reduced density of neurons in parts of the amygdala
- decreases in subset of neurons in prefrontal cortex
- connectivity is reduced in the cortex, corpus callosum, and thalamus
- increased brain metabolism during manic episodes
Most likely psychiatric illness to commit suicide
bipolar patients at most risk to commit suicide
Anxiety
SSRI’s used to treat
Panic Disorders
Benzodiazepines used to treat
PTSD
a prolonged stress reaction to a traumatic event
- men more likely to be exposed to these types of traumatic events, but women are 3 times more likely to develop them
Symptoms
- recurrent thoughts and images of the traumatic event
- avoiding reminders of the event
- feelings of emptiness and detachment
- lack of concentration
- overactivity to environmental stimuli
- exposure therapy is the only thing that has been seen to work in treatment; good at reducing symptoms but not fully treat it
Anomalies in Brain Functioning
amygdala is hyper responsive; less stimulation needed to get active
- anterior cingulate cortex in hyperactive in GAD, panic disorder, and phobias
- insular cortex is overly responsive phobias and PTSD
- decreases in medial prefrontal cortex and hippocampus in PTSD
ventral attention network
why we are hypersensitive to certain stimuli and focus our attention on them
salients network
receives information from the ventral attention network and provides error detection
- compare intended response with the appropriate response
- if there is a mismatch
fronto parietal network
is there is a mismatch in the intended and appropriate response, information gets sent here
- part of executive control
default mode network
engages in self monitoring, further planning, and emotional regulation
Disregulation of these Networks
causes anxiety
- these go in order
Personality Disorders
behavioural patterns different relative to their peers
- 10 of them
- onset around puberty or adolescents
- distress or inability to function in a society
Symptoms
- distrust and suspicion
- unstable social relationships
- problems with control and attention
- emotional dysfunction
OCD
obsessions and compulsions occur in the same person
- increased activity in the orbitofrontal cortex, especially the left orbital gyrus, and in the caudate nuclei
- researchers believe that OCD patients are high in serotonergic activity
- drug and behavioural therapy reduce some of this activity in the brain
- white matter is decreased in pathway between the basal ganglia, thalamus, and the cortex
- SSRI’s help treat
- surgery option; if no therapies or drugs work; ACC can be removed (cinculotomy)
Obsession
reoccurring uncontrollable thought
Compulsion
ritualistic behaviour done to remove anxiety of an obsession
OCPD (Obsessive-Compulsive Personality Disorders)
does not experience distress and anxiety over the obsessive and cleaning and organization
;believe it is completely logical
Cinculotomy
lesion the anterior cingulate cortex to help treat OCD
- SIDE EFFECTS
Overgrooming
OCD related disorders
may manifest as nail biting, hair pulling, skin picking
Hoarding
OCD related disorders
dedicated collectors
- hoarders have more activity in the ACC and insula and the rest of the salience network than OCD patients
- trouble assigning value to things so everything is important
Tourette syndrome
a disorder where individuals produce a variety of motor and phonic tics
- symptoms begin between the ages of 2 and 15 years and usually progress from simple to more complex tics. with increasing compulsive or ritualistic qualities
- tics can be surprised for short periods of time
- more frequent in males
- increased activity in basal ganglia
- treatment de-brain stimulation to the thalamus or benzodiazepines
Borderline Personality Disorder
- unstable interpersonal relationships
- poor self-image
- impulsivity
- intense fear pf abandonment and rejection
- strong desire to be loved
- rapid vacillation between feelings of love and hate
- risky behaviour such as gambling and speeding
- high risk of suicide and suicidal thoughts
strong genetic basis; heritability of 48%
- genes involved are same involved in production of serotonin and dopamine
