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Intro to Behavioral Neuroscience > Chapter 16: Psychopathlogy > Flashcards

Chapter 16: Psychopathlogy Flashcards

1
Q

Psychiatric Disorders are…..

A

Highly prevalent in society

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2
Q

What fraction of the US will experience a psychiatric disorder at some point in their life?

A

1/3

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3
Q

What did 25% of patients in mental hospitals during the early 20th century suffer from?

A

Paralytic Dementia

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4
Q

Paralytic Dementia

A

Psychiatric disorder includes delusions, grandiosity, euphoria, and impulsiveness

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5
Q

What had caused paralytic dementia in the early 20th century?

A

Syphilis

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6
Q

What was paralytic dementia renamed to?

A

Syphilitic Psychosis

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7
Q

What did the case of paralytic dementia in the early 20th century prove about psychiatric disorders?

A

Psychiatric disorders have “organic” or biological orgins

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8
Q

What plays a large role in psychiatric disorders?

A

Genetics

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8
Q

How can disorders be organized?

A

In clusters based on genetics

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9
Q

What is the prevalence of scizophrenia?

A

Affects 1% of the population

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10
Q

When does schizophrenia usually emerge?

A

Adolescence / early adulthood

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11
Q

What are the 3 types of symptoms in schizoprhenia?

A
  1. Positive
  2. Negative
  3. Cognitive
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12
Q

What aspect in schizophrenia do positive symptoms relate to?

A

Psychosis (loss of reality)

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13
Q

What aspect in schizophrenia do negative symptoms relate to?

A
  • Emotional dysregulation
  • Impaired movement
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14
Q

What aspect in schizophrenia do cognitive symptoms relate to?

A
  • Neuro cognitive impairment
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15
Q

Is schizophrenia heritable?

A

Yes but multiple genes must be involved

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16
Q

What has confirmed the importance of genetics in schizophrenia?

A

Adoption studies

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17
Q

What role do twin studies play in schizophrenia?

A

Genetics are not everything

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18
Q

What % do dizygotic twins have for obtaining the same trait related to schizophrenia?

A

17% rate

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19
Q

What % do monozygotic twins have for obtaining the same trait related to schizophrenia?

A

50% rate

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20
Q

What do studies of discordant twins indicate in schizophrenia?

A

A child who develops schizophrenia tends to be abnormal throughout their whole life.

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21
Q

What is a main feature of children who go on to develop schizophrenia?

A

Differences in eye tracking

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22
Q

Discordant Twins

A

Twins with a significant difference in weight or other characteristics

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23
Q

What individual genes are involved in schizophrenia cases?

A
  1. Neuregulin 1
  2. Dysbindin
  3. COMT
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24
Q

Neuregulin 1

A
  • Schizophrenia
    Regulates NMDA, GABA, and ACh receptors
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25
Q

Dysbindin

A
  • Schizophrenia
    Regulates synaptic plasticity
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26
Q

COMT

A
  • Schizophrenia
    Metabolizes Dopamine
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27
Q

What happens to many schizophrenics?

A

They end up homeless

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28
Q

What is schizophrenia considered?

A

A chronic and overwhelming disorder

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29
Q

What does “schizophrenia” mean?

A

“Split Mind”

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30
Q

What increases the chance of having a child with schizophrenia?

A

Older fathers having kids

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31
Q

What happens to the ventricles in schizophrenics?

A

They enlarge

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32
Q

Ventricular enlargement is a…

A

stable trait

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33
Q

What do patients with ventricular enlargement show a poorer response to?

A

Antipsychotics

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34
Q

What causes ventricular enlargement?

A

Buildup of cerebrospinal fluid in the brains ventricles

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35
Q

Gene DISC1 Protein

A

Regulates dendritic spines at glutamatergic synapses

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36
Q

Where is the Gene DISC1 Protein found?

A

In family with schizophrenia

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37
Q

What happens to mice that have a mutant DISC1 gene?

A

They obtain enlarged ventricles

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38
Q

What forms of limbic system abnormalities are found in schizophrenics?

A
  1. The walls of ventricles are smaller
  2. There is cellular disorganization (hippocampus and other limbic structures)
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39
Q

What do the walls of the ventricles make up in the brain?

A

The hippocampus and amygdala

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40
Q

What does cellular disorganization in the brain affect?

A

Pyramidal cells

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41
Q

What happens to the brain cortex in schizophrenics?

A

Thicker corpus callosum

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42
Q

What causes thicker corpus callosum in schizophrenics?

A

Abnormal neuronal migration in the frontal cortex.

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43
Q

What happens to gray matter during adolescence with schizophrenics?

A

There is a loss of cortical gray matter

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44
Q

What does evidence regarding the cortex suggest in schizophrenics?

A

Alterations in the frontal cortex results in impairments on tasks that depend on the frontal cortical area.

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45
Q

What did discovering a thicker cortex in schizophrenics lead to?

A

The Hypo Frontality Hypothesis

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46
Q

Hypo Frontality Hypothesis

A

Insufficient activity of the frontal cortex

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47
Q

What role to antipsychotics play in the hypo frontality hypothesis?

A

They increase activation of the frontal cortex

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48
Q

Amphetamines

A

Stimulant drugs (BAD) that can produce psychosis
- Found in schizophrenia

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49
Q

What can block amphetamines?

A

Chlorpromazine

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50
Q

Chlorpromazine

A

A dopamine antagonist used against amhetamines

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51
Q

What were the 1st antipsychotics?

A

Chlorpromazine and its relatives

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52
Q

What do typical antipsychotics block?

A

D2 (dopamine) receptors

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53
Q

What is the recommended dose of antispychotics to treat schizophrenia correlated with?

A

The dopamine D2 receptor binding affinity of the specific drug.

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54
Q

Drugs with a higher binding affinity for D2 receptors….

A

can treat schizophrenia with lower doses

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55
Q

What is the relationship between Parkinson’s and Schizophrenia?

A

L Dopa (Parkinson’s treatment) can produce schizophrenia like symptoms.

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56
Q

What are the 2 Neurotransmitter Hypothesis for schizophrenia?

A
  1. Dopamine Hypothesis
  2. Glutamate Hypothesis
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57
Q

Dopamine Hypothesis

A

Schizophrenia results from either…

  • excessive level of synaptic dopamine
    or
    -excessive postsynaptic sensitivity to dopamine
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58
Q

What are the 4 problems with the Dopamine Hypothesis?

A
  1. There are no consistent results that look at dopamine metabolization.
  2. The DA blockers take too long to affect schizophrenia (compared to their normal speed).
  3. Some people with schizophrenia are not helped by typical antipsychotics (dopamine based).
  4. The atypical antipsychotics have less affinity for DA receptors.
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59
Q

Glutamate Hypothesis

A

Schizophrenia is caused by under stimulation of glutamate receptors.

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60
Q

What drug plays a major role in the glutamate hypothesis?

A

Phencyclidine (PCP)

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61
Q

How does Phencyclidine (PCP) induce schizophrenia?

A

PCP blocks gutamatergic actions, resulting in psychosis sympptoms

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62
Q

What type of effect is PCP?

A

Non competitive NMDA receptor antagonist

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63
Q

What happens when PCP binds to a receptor?

A

No other ligand can bind and activate the NMDA receptor?
= No glutamate production

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64
Q

What does Schizophrenia most likely develop from?

A

The interaction between genetics, development, and environment.

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65
Q

How does your location of living relate to Schizophrenia?

A

Living in a city increases your risk for Schizophrenia
- Increased stress levels

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66
Q

What are the 4 risk factors of Schizophrenia?

A
  1. City vs Rural living
  2. Having the flu during 1st trimester
  3. Birth complications/lack of oxygen
  4. Incompatible blood types
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67
Q

What is the gender ratio of mood disorders?

A

Women are 2x more affected than men

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68
Q

When do the highest rates of mood disorders occur?

A

Around age 40

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69
Q

What is the twin coordinance for mood disorders?

A

Monozygotic: 60%

Dizygotic: 20%

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70
Q

What is the most common mood disorder?

A

Depression

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71
Q

What are the chacaterictics of depression?

A
  • Unhappy mood
    -Loss of interest
  • Difficulty in concentration
  • Restless agitation
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72
Q

Unipolar Depression

A

Depression that alternates with normal emotional states

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73
Q

How long can depression last?

A

Can last up to several months continuously

74
Q

What plays a large factor in depression?

A

Inheritance

75
Q

What are the 3 brain changes that occur with depression?

A
  1. Increased blood flow to the frontal cortex and amygdala
  2. Decreased blood flow to areas involving attention and language
  3. The cortex of the right hemisphere is thinner
76
Q

What are the 3 treatments for depression?

A
  1. ECT
  2. TMS
  3. Antidepressants
77
Q

Electroconvulsive Shock Therapy (ECT)

A

Causes a seizure by passing an electrical current through the brain.

78
Q

What was ECT originally used for?

A

Patients with Schizophrenia

79
Q

What is the go to treatment for individuals who suffer from resistant depression?

A

ECT

80
Q

Transcranial Magnetic Stimulation (TMS)

A

Brain stimulation technique that uses magnetic fields to stimulate nerve cells in the brain.

81
Q

Is TMS proven to be efficient in treating depression?

A

No, it is still under investigation.

82
Q

What are the 4 kinds of antidepressants used to treat depression?

A
  1. MAO Inhibitors
  2. Tricyclics/Heterocyclics
  3. Selective Serotonin Reuptake Inhibitors (SSRIs)
  4. Second Generation Antidepressants
83
Q

Monoamine Oxidase (MAO)

A

A class of enzymes that break down and thereby inactivate monoamine transmitters.

84
Q

What do monoamines include?

A
  • Norepinephrine
  • Dopamine
  • Serotonin
85
Q

MAO Inhibitors

A

Raises the level of monoamines at the synapse.

86
Q

What was an early pharmaceutical treatment for depression?

A

MAO Inhibitors

87
Q

What helped lead to the monoamine hypothesis?

A

MAO Inhibitors

88
Q

Monoamine Hypothesis

A

Depression is caused by decreased monoamines at the synapse

89
Q

What are examples of MAO Inhibitors used to treat depression?

A
  • Marplan
  • Nardil
  • Parnate
90
Q

Tricyclics

A

Inhibits the reuptake of monoamines to increase their synaptic accumulation.

91
Q

What are examples of tricyclics used to treat depression?

A
  • Wellbutrin
  • Elavil
  • Aventyl
  • Norpramin
92
Q

Selective Serotonin Reuptake Inhibitors (SSRIs)

A

Antidepressants that block the reuptake of serotonin at synapses.

93
Q

What is different from SSRIs when compared to tricylics or MAOIs?

A

SSRIs have fewer side effects

94
Q

What are examples of SSRIs used to treat depression?

A
  • Prozac
  • Paxil
  • Zoloft
95
Q

Second Generation Antidepressants

A

Inhibit the reuptake of the monoamines.

96
Q

What are examples of second generation antidepressants used to treat depression?

A
  • NDRI
  • SNRI
  • NaSSA
  • SARI
  • Buprenex
97
Q
A
98
Q

Is the drug or the placebo more effective in patients with mild depression?

A

They were equally effective

99
Q

Is the drug or the placebo more effective in patients with severe depression?

A

The drug was more effective .

100
Q

What are 3 treatments for depression that are being developed?

A
  1. Vagal Nerve Stimulation
  2. Deep Brain Stimulation
  3. Cognitive Behavioral Therapy
101
Q

Vagal Nerve Stimulation

A

Electrodes are surgically wrapped around the vagus nerve (neck) to provide mild stimulation at intervals.

  • Used to treat depression
102
Q

Deep Brain Stimulation (DBS)

A

Mild electrical stimulation is applied to brain sites through a surgically implanted electrode.

  • Used to treat depression
103
Q

Cognitive Behavioral Therapy (CBT)

A

Psychotherapy aimed at correcting negative thinking and improving interpersonal relationships.

  • Used to treat depression
104
Q

What are the problems with Vagal Nerve Stimulation and DBS?

A
  • Expensive
  • Little evidence supported
  • Hard to get matched controls for studies
105
Q

What is the order of best treatment options for depression?

A
  1. SSRIs alone
  2. CBT alone
  3. CBT and SSRIs (BEST)
106
Q

Cushing’s Syndrome

A

A condition in which levels of adrenal glucocorticoids are abnormally high.

107
Q

What relation does depression have to Cushing’s Syndrome?

A

Depression may involve dysfunction of the HPA axis

108
Q

What do individuals with depression have higher levels of?

A

Cortisol Levels (increase your weight)

109
Q

Dexamethasone

A

A synthetic glucocorticoid that normally suppresses cortisol release by providing negative feedback to the hypothalamus.

110
Q

Does Dexamethasone work on people who suffer from depression?

A

No

111
Q

What does the functioning of Dexamethasone suggest?

A

Dysfunction in the HPA axis.

112
Q

Dexamethasone Suppression Test

A

A test that can show excess cortisol release.

113
Q

What kinds of people display high cortisol levels?

A
  • Depressed patients
  • Suicide victims
114
Q

What is the main reason that supports why women are more depressed than men?

A

Sex differences in endocrine physiology, related to the reproductive cycle.

115
Q

Postpartum Depression

A

A bout of depression that afflicts a woman around the time she gives birth.

116
Q

How is sleep affected by depression?

A
  • The time in SWS is reduced
  • Enter REM sleep quicker
  • Longer lengths of REM sleep in 1st half of the night.
117
Q

Seasonal Affective Disorder (SAD)

A

A type of depression brought on by the shorter days of winter.

118
Q

What does SAD suggest?

A

Seasonal rhythms can influence depression

119
Q

What is the treatment for SAD?

A

Phototherapy

120
Q

Phototherapy

A

Light administered in the treatment of physical/mental illness

121
Q

What does phototherapy reduce?

A

Melatonin levels

122
Q

Melatonin

A

A hormone that is aligned with sleep when secreted.

123
Q

What method of study is used to examine depression in animals?

A

Learned helplessness

124
Q

Learned Helplessness

A

An animal is exposed to a repetitive stressful stimulus, causing the animal to eventually stop attempting to escape the stimulus.

125
Q

What is learned helplessness linked to?

A

A decrease in serotonin function

126
Q

Bipolar Disorder

A

A psychiatric disorder characterized by periods of depression that alternate with excessive, expansive moods.

127
Q

What varies in bipolar disorder?

A

The rate of cycles (mood changes)

128
Q

What gender is more likely to be affected by bipolar disorder?

A

Men and women are equally affected

129
Q

What disorder is bipolar disorder most in common with?

A

Schizophrenia
- Many genes are linked to having both disorders

130
Q

What are the 2 structural changes in bipolar disorder?

A
  1. Larger ventricles
  2. Decreased gray matter
    (increases with manic episodes)
131
Q

Cyclothymia

A

A milder form of bipolar disorder
-fewer extreme moods

132
Q

Dysthymia

A

Poor mood or mild depression

133
Q

Hypomania

A

A state of increased energy and positive mood that lacks some bizarre aspects of frank mania.

134
Q

What does Cyclothymia cycle between?

A

Dysthymia and Hypomania

135
Q

What is the main treatment for bipolar disorder?

A

Lithium

136
Q

Lithium

A

Mood stabilizing drug used to treat bipolar disorder.

137
Q

What does lithium interact with?

A

The circadian clock

137
Q

What is unknown about Lithium?

A

How it is able to treat Bipolar Disorder

138
Q

What does Lithium have?

A

A narrow therapeutic window

138
Q

How does experiencing manic episodes affect patients with bipolar disorder?

A

The lack of manic episodes leads to the desire for patients to stop taking the medication

139
Q

What are the two main connections around bipolar disorder.

A
  • Bipolar Disorder
  • Schizophrenia
  • # Creativity LevelsAll seem to be related due to similar gene connections
140
Q

Generalized Anxiety Disorder

A

Any class of psychological disorders that include persistent, excessive anxiety which is experienced for months.

140
Q

Panic Disorder

A

Recurrent short length attacks of fearfulness

141
Q

What are the symptoms of Panic Disorder?

A

-Heart palpitations
-Rapid breathing/shortness of breath
-Blurred vision
-Dizziness
-Racing thoughts

142
Q

Phobic Disorders

A

Intense, irrational fears that become centered on a specific object, activity, or situation that a person feels compelled to avoid.

143
Q

What does the diagnosis of Phobic Disorder consist of?

A

Symptoms being disruptive to everyday functioning

144
Q

What two brain changes occur with Anxiety?

A
  1. Temporal lobe volume may be reduced/abnormal
    - 40% have lesions
  2. Amygdala activity could be lowered
145
Q

What is the amygdala involved with?

A

Fear conditioning and memory

146
Q

What are the 3 treatments for Anxiety?

A
  1. Benzodiazepines
  2. SSRIs
  3. Exposure Based Therapy
147
Q

Benzodiazepines

A

A class of anti anxiety drugs that bind with high affinity to receptors molecules in the central nervous system.

148
Q

How do Benzodiazepines work?

A
  • Bind to GABA receptors as non-competitive agonists
  • In the presence of GABA, it makes the neuronal membranes more permeable to Cl- ions.
149
Q

What is an example of a benzodiazepine used to treat Anxiety?

A

Valium

150
Q

Are SSRIs effective to treat anxiety?

A

Only sometimes

151
Q

When is exposure based therapy used to treat anxiety?

A

When the anxiety is related to a specific stimulus in the environment.

152
Q

Post Traumatic Stress Disorder (PTSD)

A

Memories of an unpleasant episode repeatedly plague the victim.

153
Q

What induces PTSD?

A

Highly stressful, traumatic events

154
Q

What is a structural change caused by PTSD?

A

Lower volume of the right hippocampus

155
Q

What are the symptoms of PTSD?

A
  • Memory changes (amnesia)
  • Flashbacks
  • Deficits in short term memory
156
Q

What is the pathway of PTSD similar to?

A

Fear conditioning

157
Q

What parts of the brain are involved in the pathway of PTSD?

A

-Amygdala
- Other brainstem pathways

158
Q

Pathway of PTSD

A
  1. The original trauma activates 2 systems (amygdala and other brainstem systems)
  2. The brainstem system sensitizes the person to related stimuli in the future
  3. The amygdala system conditions a long lasting fearful reaction
159
Q

What has a weaker suppression to the amygdala?

A

The hippocampus and prefrontal cortex

160
Q

Obsessive Compulsive Disorder (OCD)

A

A syndrome in which the affected person engages in recurring, repetitive acts that are carried out without rhyme, reason, or the ability to stop.

161
Q

What does the “obsession” part of OCD consist of?

A

Persistant thoughts

162
Q

What does the “compulsion” part of OCD consist of?

A

Repetitive thoughts/acts

163
Q

How many people in the world suffer from OCD?

A

1-2% worldwide

164
Q

When does OCD often begin?

A

In childhood but peaks young adulthood to middle age

165
Q

What are the 2 treatments of OCD?

A
  1. Cognitive Behavioral Therapy
  2. Drugs
166
Q

What is the main drug used to treat OCD?

A

Prozac

167
Q

Prozac

A

Inhibits the reuptake of 5HT at the synapse, causing an increase in 5HT available in synapse.

168
Q

What conditions can OCD co-occur with?

A

Depression and Tourette’s

169
Q

How can having OCD lead to Tourette’s?

A

Can be triggered by an infection that causes the immune system to attack the brain

170
Q

What are the 3 brain areas affected in OCD?

A
  1. Orbitofrontal Cortex (prefrontal)
  2. Cingulate Cortex (prefrontal)
  3. Caudate Nuclei (striatum)
171
Q

What does structural evidence suggest for OCD?

A

There may be a dysregulate circuit

prefrontal cortex -> striatum
-> thalamus -> back to cortex

172
Q

What are the 5 neurosurgery treatments for psychiatric disorders?

A
  1. Trephination
  2. Lobotomy
  3. Cingulotomy
  4. Remove portions of epileptic brains
  5. Deep Brain Stimulation
173
Q

Trephination

A

Drill holes in the skull

174
Q

When did Trephination commonly occur?

A

Roman times

175
Q

Lobotomy

A

Disconnect parts of frontal lobes

176
Q

Why are lobotomys not looked up to?

A
  • The outcomes are not as positive as intended
  • HUGE changes in personality
177
Q

Cingulotomy

A

Lesion pathways in the cingulate cortex

178
Q

What disorders is Cingulotomy used to treat?

A

Depression and OCD

179
Q

What is the purpose in removing portions of the epileptic brain?

A

The portions are thought to cause seizures

reduce seizures

Intro to Behavioral Neuroscience (15 decks)

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