Cognitive Assessment Flashcards
Where does Serotonin arise from in the CNS?
- Raphe nuclei make Serotonin
(Brainstem) - Projects extensively to all levels of the CNS
What does Serotonin help regulate ?
- Mood
- Arousal
- Cognition
Where does Norepinephrine arise from in the CNS?
- From the Locus coeruleus (brainstem)
- Extends to areas of the CNS including the spinal cord, cerebellum, thalamus, & cerebral cortex
What does Norepinephrine regulate
- Mood
- Arousal
- Attention
- Cognition
Where does Dopamine arise from in the CNS?
From the Substantia nigra & the ventral tegmental area (brainstem & midbrain)
What does Dopamine regulate?
- Mood
- Arousal
- Cognition
- Motor control
Where does Acetylcholine arise from in the CNS?
- From the Basal forebrain & brainstem (cerebral cortex, including the hippocampus)
What does Acetylcholine (ACh) regulate?
- Sleep
- Arousal
- Attention
Depressive symptoms arise with what chemical imbalance?
- Low levels of Serotonin, Norepinephrine, & Dopamine
Anxiety symptoms arise with what chemical imbalance?
- Low levels of Serotonin
- High levels of Norepinephrine
Psychosis & Mania symptoms arise with what chemical imbalance?
- High levels of Dopamine
- Low levels of Serotonin
Dementia symptoms arise with what chemical imbalance?
- Low levels of Acetylcholine
What is classified as a mental disorder
- Any condition or syndrome with clinical manifestations characterized by Significant impairment in:
- Cognition, Emotion regulation, & Behavior
Leading to significant distress &/or disability in social, occupational, or other important activities of daily life. “DSM-5”
- Cognition, Emotion regulation, & Behavior
What are the 4 most common or concerning symptoms in a cognitive assessment?
- Anxiety/ excessive worrying
- Depressed mood
- Memory problems
- Medically unexplained symptoms
6 Common risk factors for Anxiety
- Family Hx
- Personal Hx or mood disorder
- Childhood stressful life events or trauma
- Female
- Chronic medical illness
- Behavioral inhibition
Generalized Anxiety Disorder
- Excessive worrying predominates over a 4 week period
Social Anxiety Disorder
- Avoidance due to unreasonable fear of situations or activities that could lead to embarrassment, marked by anticipatory anxiety in social situations
Obsessive Compulsive Disorder
- Characterized by intrusive thoughts & ritualistic behaviors
Panic Disorder
- Often presents with recurrent sudden episodes/ spells/ attacks of intense fear or discomfort that are unexpected or w/ intervening periods of living in fear or worrying of having another attack or facing the consequences of the attack
Post Traumatic Stress Disorder
- Characterized by re-experiencing, avoidance, persistent negative alterations in cognition & mood, & alterations in arousal & reactivity
Other potential causes that can mimic Anxiety
- OTC & prescription medications
- Illicit substances/ caffeine/ alcohol
- Mood disorders
- Hyperthyroidism
- Cardiopulmonary disorders
- TBI
- Untreated pain in PACU
5 Risk factors for Depression
- Personal Hx of a depressive episode**
- Family Hx of 1st degree family members w/ depression
- Personal Hx of recent stressful life events or significant childhood adversity
- Chronic/ disabling medical illness
- Female
Premenstrual Dysphoric Disorder (PMDD)
- Depressive symptoms worsen in sync w/ a female’s menstrual cycle
Major Depressive Disorder (MDD)
- At least 2 weeks of depressed/irritable mood, with at least 4 of the following:
- Anhedonia
- Insomnia/hypersonic
- Decreased self-esteem
- Low energy
- Poor concentration/indecision
- Changes in appetite
- Feeling slowed or restless
- Thoughts of death/ suicide
Persistent Depressive Disorder (PDD)
- Depressive/ irritable mood lasting for at least 2 years & > 2+ of the MDD symptoms
MDD & PDD are frequently comorbid with what 3 findings
- Anxiety
- Personality disorders
- Substance use