Chapter 16 - Disorders & Treatments Flashcards

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1
Q

Disorders & Treatments

  • (2) perspectives
A

Neurological

Psychiatric

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2
Q

Neurological Disorders

A

organic brain/NS disorders

→ symptoms due to brain dysfunction

  • stroke, TBI, Alzheimers
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3
Q

Psychiatric Treatments & Disorders

A

behavioral disorders

  • schizophrenia, depression, anxiety
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4
Q

Neurological vs. Psychiatric Disorders → Causes

  • difficulties
A

Neurological disorders: causes = largely known

Psychiatric disorders: causes = less known

difficult to identify cause since most disorders do NOT involve a single genetic abnormality

cognitive, behavioral & social symptoms = observable

→ BUT do not necessarily indicate underlying cause

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5
Q

Brain & Behavior Abnormalities

  • result from? (5)
A
  • genetic errors
  • epigenetics mechanisms
  • rapid cell death
  • progressive cell death
  • loss of neural connections & functions
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6
Q

Neurobiology of Abnormal Behavior

→extremely difficult to find because of?

A

complexity of NS

abnormal behavior not always clearly related to brain damage

brain damage doesn’t always produce obvious abnormal behaviors

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7
Q

Diagnosing Behavioral Disorders

  • ease/difficulty?
    • Explain.
A

difficult

  • behavioral observations usually from family or individual
    • biased
    • don’t know what to look for
  • skilled evaluators have own conceptual perspectives
    • ​influences Qs asked & info gathered
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8
Q

Anosognosia

A

lack of self-awareness about a certain disability/disorder one suffers from

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9
Q

Define: EPIDEMIOLOGY

A

study of distribution & causes of diseases in human popn

  • helps define & assess behavioral disorders
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10
Q

Identifying & Classifying Psychiatric Disorders

  • (2) sets of criteria for diagnosis
A

1) Diagnostic & Statistical Manual of Mental Disorders (DSM-5)
2) International Classification of Diseases (ICD-10)

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11
Q

Diagnosing Psychiatric Disorders

1) Diagnostic & Statistical Manual of Mental Disorders (DSM-5)

  • author?
  • provides/lists? (2)
  • limitations? (2)
A

American Psychiatric Association (APA)

→ lists symptoms & criteria (inclusion/exclusion) for diagnosis

→ provides statistical info (avg age of onset, prevalence, sex ratio etc.)

  • arbitrary
  • depends on prevailing cultural views
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12
Q

Diagnosing Psychiatric Disorders

2) International Classification of Diseases (ICD-10)

  • author?
A

World Health Organization

  • neurobiological & psychiatric disorders
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13
Q

some psychiatric disorders are to some extent arbitrary & depend on prevailing cultural views

→ based on? NOT?

A

based on consensus not empirical evidence

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14
Q

Identifying & Classifying Mental/Psychiatric Disorders

Role of NEUROIMAGING

  • present vs. future
    • must be?
    • limitation/problem?
A

brain imaging techniques NOT currently used for diagnosis

→ may be used in future in tandem with behavioral diagnoses to make diagnoses more objective

  • must be
    • sensitive enough to detect unique features of brain disorders
    • specific enough to rule out similar conditions
      • problematic: many behavioral disorders display similar abnormalities
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15
Q

Neurological Disorders → TREATMENTS

A

→ causes largely known

treatment fairly primitive

  • provide relief from symptoms, NOT cure
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16
Q

Psychiatric Disorders → TREATMENTS

A

causes largely unknown & complex

existing treatments = relatively effective

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17
Q

(4) Main Types of Treatments

A

a) Neurosurgical
b) Electrophysiological
c) Pharmacological
d) Behavioral

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18
Q

Treatment

a) Neurosurgical

  • goal? (4)
A
  • very invasive
  • goal = treat dysfunction by:
    • removing abnormal tissue
    • repairing abnormality
    • damaging dysfunctional area
    • implanting stem cells or electrode
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19
Q

Neurosurgical Treatments

  • goal = treat dysfunction by:
    1. removing abnormal tissue
    2. repairing abnormality
    3. damaging dysfunctional area
    4. implanting stem cells or electrode
A

1) epilepsy, tumor
2) hydrocephalus → shunt
3) Parkinson’s → lesion part of BG (neurons)
4) Stroke, Parkinsons → electrode - disrupts BG functioning

20
Q

Treatments

b) Electrophysiological (2)

A

non-invasive

1) Electroconvulsive Therapy (ECT)
* electrical stimulation to treat severe depression
2) Transcranial Magnetic Stimulation (TMS)
* alternative to ECT for depression treatment

21
Q

Electrophysiological Treatments

  • ECT vs. TMS
A

ECT

  • anticonvulsants & muscle relaxants
  • memory impairments may follow

TMS

  • more focused
  • shorter-term effects
22
Q

Electrophysiological Treatments → ECT & TMS

  • significance of BDNF
A

ECT & TMS

→stimulate production of BDNF (Brain-derived Neurotrophic Factor)

  • protein that promotes neural health, neurogenesis & synaptogenesis
23
Q

c) Pharmacological Treatments

  • (4)
  • limitations (2)
A

common drugs for neurological/behavioral disorders:

  • neuroleptics (antipsychotics) →schizophrenia
  • anxiolytics (antianxiety agents)
  • SSRIs → depression
  • L-dopa → Parkinson’s

→ alleviate symptoms (NOT a cure)

→ many disorders not reducible to single chemical abnormality

“a pill is not a skill”

24
Q

Pharmacological Treatments

  • “a pill is not a skill”
    • implications?
A

drugs = “bandaids”

→ NOT a fix

→ must also address sources of distress

25
Q

d) Behavioral Treatments
* (4)

A
  • “brain alters behavior & behavior alters brain”*
    1) Behavioral Modification
    2) Cognitive Therapy
    3) Neuropsychological Therapy
    4) Psychotherapy
26
Q

Behavioral Treatments

1) Behavioral Modification

A

→ mostly for psychiatric disorders

change maladaptive behaviors to more constructive behavior

  • therapists apply principles of operant/classical conditioning
  • systematic desensitization
27
Q

Behavioral Treatments

2) Cognitive Therapy

A

change maladaptive thoughts

→ depression, brain injury

  • perspective that thoughts intervene b/w events & emotions*
  • challenge self-defeating attitudes/assumptions*
28
Q

Behavioral Treatments

3) Neuropsychological Therapy

A

retraining cognitive & behavioral processes lost after injury

→ ABIs, stroke

restraint therapy, relearning in novel ways

29
Q

Behavioral Treatments

4) Psychotherapy

A

Emotional Therapy

talking about emotional problems

  • provides insight into & helps overcome causes
30
Q

Neurological Disorders → Traumatic Brain Injury

  • cause
  • factors that damage brain
A

result from blow to head

  • bleeding
  • disrupt blood supply
  • swelling
  • infection
  • scar tissue
31
Q

Neurological Disorders → Traumatic Brain Injury (TBI)

  • (2) types of damage
A

MOVEMENT OF BRAIN CAN CAUSE:

(1) widespread damage → generalized impairments

  • throughout brain

(2) focal damage → discrete impairments

  • specific region
32
Q

Neurological Disorders → Traumatic Brain Injury (TBI)

1) Focal Damage

  • location
    • most susceptible areas
  • impairment(s)
A

at coup (site of impact) or countercoup (opposite side)

  • anterior temporal
  • inferior prefrontal

impairment of specific functions

  • personality
  • social functioning
33
Q

Neurological Disorders → Traumatic Brain Injury (TBI)

1) Widespread Damage

  • location
  • impairment(s)
A

→ minute lesions throughout brain

loss of complex cognitive functions:

  • reduced mental speed
  • poor concentration
  • memory difficulties
34
Q

Traumatic Brain Injury (TBI)

  • diagnosis
A

Diagnosis of chronic behavioral problems resulting from TBI can be difficult

  • often NO obvious damage visible on CT/MRI scans
35
Q

Traumatic Brain Injury (TBI)

Widespread vs. Focal Damage

  • recovery
A

most cognitive recovery occurs within fist 6-9 months

widespread damagecognitive abilities have good prognosis

focal damagesocial skills/personality do not

  • quality of life more challenging to recover
36
Q

Psychiatric Disorders → Symptoms (3)

A

lose touch with reality

irrational ideas (delusions)

distorted perceptions (hallucinations)

37
Q

Psychiatric Disorders → SCHIZOPHRENIA

  • diagnostic symptoms (5)
A

positive symptoms → more responsive to drugs

  • delusions (distorted thoughts)
  • hallucinations (altered sensory/perceptual experiences)
  • disorganized speech
  • disorganized/catatonic behavior

negative symptoms → poor response to neuroleptics

  • blunted affect (apathy) → lack of emotion
38
Q

Psychiatric Disorders → SCHIZOPHRENIA

  • NEURAL CORRELATES
    • abnormalities (2)
A

family history, 5 abnormal xsomes

thin frontal & medial temporal cortices

Abnormal dendritic fields in:

  • dorsolateral prefrontal cortex
  • hippocampus
  • entorhinal cortex

Abnormalities in NT systems:

  • DA, glutamate, GABA, seratonin
39
Q

Psychiatric Disorders → SCHIZOPHRENIA

  • NEURAL CORRELATES
    • relation to symptoms (3)
A

medial temporal cortices → auditory hallucinations & disorganized speech

dorsolateral prefrontal cortex → negative symptoms

hippocampus → memory impairments

40
Q

Psychiatric Disorders → Mood & Anxiety Disorders

  • causes? (2)
A

genetics

early life experiences (negative)

41
Q

Psychiatric Disorders → Mood Disorders (2)

A

Depression

Bipolar Disorder

  • mania & depression
42
Q

Psychiatric Disorders → Mood Disorders

  • neural correlates
    • Depression
A

imaging studies show ↑ activity in:

orbitofrontal cortex → conscious experience/emotion regulation

Anterior cingulate cortex → “ “

Amygdalaprimal threat detector

→ all 3 involved in rumination

43
Q

Psychiatric Disorders → Anxiety Disorders (3)

A

Generalized Anxiety Disorder (GAD)

Panic Disorder

Specific Phobias

44
Q

Psychiatric Disorders → Anxiety Disorder

  • neural correlates
A

imaging studies show ↑ activity in:

At Rest:

  • Cingulate cortex
  • parahippocampal gyrus → role in turning off stress response

Anxiety-provoked:

  • Amygdala
  • prefrontal cortex
45
Q

Psychiatric Disorders → Treatments (3)

  • Depression
A

Antidepressants

  • SSRIs (mainly)

Cognitive-Behavioral Therapy

Electrophysiological (ECT/TMS)

46
Q

Psychiatric Disorders → Treatments (3)

  • Anxiety Disorders
A

Benzodiazepines → acute

SSRIs → long-term

Cognitive-Behavioral Therapy

47
Q

Mood & Anxiety Disorders → Antidepressants

  • Drug Mechanism
A

Similar to ECT

BDNF & stimulate neurogenesis in hippocampus

→ presumably result in:

  • brain health
  • ability to turn off stress response