Chapter 16: Psychopathology

Question 1

what are the symptoms of schizophrenia?

Answer 1

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic
behavior, diminished emotional expression or
avolition, includes positive, negative, and cognitive symptoms

Question 2

how does genetics play a role in schizophrenia?

Answer 2

concordance rates: about 50
percent in identical twins, susceptibility genes for
schizophrenia overlap with those implicated in bipolar disorder, saccades may be an important marker, linked to several schizophrenia
candidate genes

Question 3

how do environmental factors influence schizophrenia?

Answer 3

environmental factors interact with genetic vulnerability, rates are somewhat higher in urban environments, more likely in those from a middle or lower socioeconomic status, socioeconomic status is also associated with differences in nutrition, and rates of stress and drug use, prenatal environmental factors: gestational diabetes, birth complications, and low birth weight

Question 4

how does the mother’s immune system play a role in the development of neurodevelopmental disorders?

Answer 4

maternal antibodies routinely cross the placenta
to provide protection for the fetus, abnormal immune activity influences brain
development, likely by impacting glial cells and
synaptic pruning, strongly implicated in schizophrenia and autism, but also perhaps bipolar disorder and depression

Question 5

what brain structures are associated with schizophrenia?

Answer 5

enlarged ventricles, smaller hippocampus, cellular disorganization in the hippocampus, hypofrontality, higher degree of brain symmetry, ambiguous handedness, adolescent loss of gray matter

Question 6

what is the biochemistry of schizophrenia?

Answer 6

dopamine hypothesis: schizophrenia is treated by typical antipsychotic medications which are
dopamine antagonists, abuse of stimulant drugs (cocaine, amphetamines) produce schizophrenia-like behavior, atypical antipsychotic medications act on other NT systems (serotonin, norepinephrine, glutamate)

Question 7

what are some causes of autism spectrum disorder?

Answer 7

genes involved with the regulation of brain development; synaptic changes, interaction of genetics with environmental factors, birth complications, increased parental age, prenatal exposure to infection, toxins, and nutritional factors

Question 8

what brain structures are associated with autism spectrum disorder?

Answer 8

brain development is abnormally accelerated through early childhood,
producing first brain enlargement, followed
by a period of deceleration, the structure of minicolumns is different in
individuals with ASD, Increased total cerebellar volume is a biomarker, right hippocampus was relatively enlarged but this eventually normalizes, disruptions in default-mode network (DMN) activity may also be involved

Question 9

how is autism spectrum disorder treated?

Answer 9

usually treated with intensive, early-childhood learning experiences provided during most of the child’s waking hours, medications to improve core behavior problems have been ineffective, research does not support gluten and casein-free diets for ASD individuals, applied Behavioral Analysis (ABA)

Question 10

what are the causes of ADHD?

Answer 10

heritability is about 70% or higher, likely that multiple genes are involved, research has focused on genes associated with dopamine transport, environmental risks are lead contamination, low birth weight, and prenatal exposure to tobacco, alcohol, and other drugs

Question 11

what brain structures play a role in ADHD?

Answer 11

the prefrontal cortex, the basal ganglia, and the circuits that connect these two areas, rich in dopaminergic neurons, people with known frontal lobe damage behave in ways that are similar to those with ADHD

Question 12

what are some treatments of ADHD?

Answer 12

stimulant medication, methylphenidate (Ritalin), dextroamphetamine, and amphetamine salts
(Adderall), act as dopamine and norepinephrine reuptake inhibitors

Question 13

how does genetics play a role in bipolar disorder?

Answer 13

concordance rate among identical twins as high as 40% to 70%, significant overlap in the susceptibility genes for bipolar and schizophrenia

Question 14

what is the biochemistry of bipolar disorder?

Answer 14

bipolar disorder is related to oxidative stress, more apoptosis, higher amounts of DNA damage, accelerated aging, therefore lithium salts produce antioxidant effects to promote adult neurogenesis

Question 15

what causes major depressive disorder?

Answer 15

heritability is about 40%, some genes implicated in MDD regulate serotonin reuptake and circadian rhythms, influence of short version of serotonin transporter gene and stressful life events, environmental contributions, prenatal events might contribute to a vulnerability

Question 16

what brain structure is associated with major depressive disorder?

Answer 16

reduced volumes in the hippocampus and the orbitofrontal cortex, damage to the left frontal lobe from a stroke or another pathological condition typically produces a profound depression, reduced left frontal lobe activity; increased right frontal lobe activity

Question 17

what is the biochemistry of major depressive disorder?

Answer 17

abnormalities in monoamine activity, and serotonin activity in particular, selective serotonin reuptake inhibitors (SSRIs) frequently used to treat MDD, altered norepinephrine function is strongly associated with MDD, reduced dopamine activity, larger and more prolonged release of cortisol

Question 18

what are the treatments for major depressive disorder?

Answer 18

most commonly, antidepressant medication, particularly SSRIs, cognitive-behavioral therapy, electroconvulsive therapy (ECT)

Question 19

what brain structures are altered by anxiety disorders?

Answer 19

PFC – Amygdala connections, abnormalities observed in: pathways connecting the brainstem, amygdala, and related subcortical structures and decision-making areas of frontal lobes
the HPA axis: norepinephrine, serotonin, and GABA neurotransmitter
systems, treated with SSRIs, SNRIs and GABA-agonists, plus cognitive behavioral therapy

Question 20

what are the causes of OCD?

Answer 20

63-87% concordance rates, abnormalities in circuits connecting thalamus,
basal ganglia, and orbitofrontal cortex

Question 21

what are the treatments for OCD?

Answer 21

typically treated with anti-depressant medications, CBT is also often effective in OCD, produces similar changes seen in medicated
patients, the results of both types of treatment appear
to be similar