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exam 4 Flashcards

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1
Q

according to the DSM, what are the hallmark symptoms of schizophrenia?

A

positive symptoms (hallucinations, delusions)
negative symptoms (depression, reduced emotional expression)
cognitive impairment (changes in memory, attention, social perception)

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2
Q

compare and contrast delusions and hallucinations

A

delusion - a false belief that is strongly held in spite of contrary evidence
hallucination - a false perception of objects or events involving senses (smell, taste, sound, touch, sight)

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3
Q

what do family, twin, and adoption studies tell us about the heritability of schizophrenia

A

family studies - In general, risk tends to increase along with degree of relatedness
twin studies - Identical twins share identical genes; fraternal (dizygotic) have half of their genes in common
Often, diagnosed twin has developmental history of low birth weight, early life stressors, some neurological markers
adoption studies - Tend to confirm a strong genetic component, with birth parents of children with schizophrenia more likely to have had the disorder than adoptive parents

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4
Q

DISC1; paternal age; no one gene “determines” schizophrenia

A

DISC1 - a mutant, disabled version of a gene that is found in several members of one family diagnosed with schizophrenia
paternal age - a well known epigenetic factor involved; older men are more likely to have children with schizophrenia
no one gene - It is difficult to determine any one gene as most important to developing the disorder; the genes that influence schizophrenia are scattered across many chromosomes

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5
Q

integrative model of schizophrenia & stressors

A

An integrative model of schizophrenia emphasizes the interaction of genetic factors and stress
Stressors include: Prenatal stress, maternal stress
Transition from childhood to adulthood
Ex: City Living - possibly due to pollutants, exposure to other diseases, crowded conditions, tense social interactions

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6
Q

brain changes from schizophrenia

A

-Accelerated cortical thinning of gray matter
-Enlarged lateral ventricles
Also found in mice with DISC 1 mutation
-Differences in the structure and function of the corpus callosum
-Hypofrontality hypothesis: underactive frontal lobe

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7
Q

prevalence of schizophrenia & risk factors

A

-Schizophrenia affects approximately 24 million people or 1 in 300 people (0.32%) worldwide. This rate is 1 in 222 people (0.45%) among adults
-risk factors: both environmental and genetic influences

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8
Q

history of treatment approaches for schizophrenia

A

lobotomy - the surgical separation of the frontal lobes from the rest of the brain (made patients easier to handle but made them reliant on institutional care)
first generation antipsychotics - used in the 1950’s, neuroleptics (antipsychotic medications) revolutionized the treatment of schizophrenia; most blocked dopamine receptors (ex: chlorpromazine, haldol)

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9
Q

the dopamine hypothesis & the problem with it

A

-The dopamine hypothesis proposed that schizophrenia is caused by an excess of either dopamine release or dopamine receptors
-Problems with dopamine hypothesis:
Drugs block D2 receptors much faster than symptoms are reduced
Some other symptoms of schizophrenia respond to manipulations of other NT systems
Second generation antipsychotics (atypical antipsychotics) only moderately act upon D receptors but instead have the biggest impact blocking serotonin receptors (especially 5-HT2A)

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10
Q

the glutamate hypothesis & risk for seizures

A

-Observations of the effects of phencyclidine (PCP) and the ketamine prompted the hypothesis that schizophrenia is caused by an underactivity of glutamate receptors
-PCP is an NMDA receptor antagonist
-Prevents glutamate from acting normally
-Produces schizophrenia-like syndrome
-glutamate agonists are not a viable treatment due to increased risk for seizures

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11
Q

characteristics of depression

A

-Unhappy mood
-Loss of interests, reduced energy
-Changes in appetite and sleep patterns
-Difficulty in concentration
-Restless agitation or mental/motor inactivity
-Pessimism and thoughts of death
-Depression may last for several months
-Inheritance is a determinant in depression

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12
Q

brain changes from depression

A

-Brain changes with depression found from fMRI/PET studies
-Increased activation in:
Frontal lobes, during cognitive tasks
Amygdala, during emotional processing
Decreased blood flow to areas implicated in attention processes
Reduced hippocampal volume and activity during memory tasks
-Descendants of people with severe depression have a thinner cortex in the right hemisphere

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13
Q

treatment of depression - ECT and rTMS

A

ECT - Electroconvulsive shock therapy: a strong electrical current is passed through the brain, causing a seizure
rTMS - Repetitive transcranial magnetic stimulation: alters cortical electrical activity through magnetic stimulation
-both of these treatments alter cortical electrical activity

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14
Q

treatments for depression - medications (for monoamine levels)

A

MAO inhibitors - raise the level of monoamines at the synapse (first antidepressants developed)
tricyclics - 2nd generation of antidepressants which inhibit reuptake of monoamines which similarly boosts synaptic activity
both of these medications increase monoamine levels

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15
Q

treatments for depression - SSRIs & problems with them

A

selective serotonin reuptake inhibitors - block the reuptake of serotonin in the brain
problem - Long lag-time (often weeks) between treatment and reduction of symptoms, Not everyone responds to SSRIs, Some SSRI benefits are attributable to placebo effect

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16
Q

treatment for depression - CBT

A

cognitive behavioral therapy - can be as effective as SSRIs, and when used together are more effective than either alone
CBT aims to correct negative, self-defeating thinking and to improve interpersonal relationships

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17
Q

treatment for depression - DBS

A

deep brain stimulation (DBS) - through a surgically implanted electrode

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18
Q

gender differences in depression

A

-More females compared to males report suffering from major depression
-May reflect: Patterns of help seeking, Gender differences in endocrine physiology, related to the reproductive cycle, & Postpartum depression, which immediately precedes or follows childbirth

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19
Q

what is mania?

A

periods of expansive mood that include sustained overactivity, talkativeness, strange grandiosity, and increased energy

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20
Q

bipolar 1, bipolar 2, and cyclothymia

A

bipolar disorder is characterized by periods of depression alternating with periods of mania
-bipolar 1: experience more severe highs (mania) and may not have depressive episodes
-bipolar 2: experience a less severe high, their diagnosis includes depressive episodes
-cyclothymia: emotional ups and downs, but they’re not as extreme as those in bipolar I or II disorder

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21
Q

brain changes in bipolar disorder

A

not very well understood, changes are similar to those seen in schizophrenia
-enlarged ventricles and reduced gray matter

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22
Q

treatment for bipolar disorder - lithium

A

an effective treatment that has been reported to increase gray matter in patients’ brains, but its use must be carefully monitored for toxic side effects of overdose
-many patients also will stop taking lithium to experience the mania

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23
Q

treatment for bipolar -TMS

A

used for depressive swings, transcranial magnetic stimulation may provide a nonpharmacological treatment alternative in difficult cases of bipolar disorder

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24
Q

treatment for bipolar - CBT

A

evidence suggests that some forms of CBT for mild cases of bipolar disorder can be as effective as drug treatments and perhaps can be beneficially combined with other forms of treatment.

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25
Q

generalized anxiety disorder

A

persistent, excessive anxiety and worry

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26
Q

phobic disorders

A

intense irrational fears centric on an object, activity, or situation that a person avoids

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27
Q

panic disorders

A

recurrent transient attacks of intense fearfulness

28
Q

brain structures implicated in anxiety disorders & activity levels

A

volume of hippocampus (PTSD), orbitofrontal cortex cingulate cortex and caudate nuclei (OCD), cortex, and amygdala
-volume of hippocampus is smaller
-increased activity of orbitofrontal cortex cingulate cortex and caudate nuclei

29
Q

why are anxiety disorders considered “whole brain disorders”?

A

Experts now think of anxiety disorders and PTSD as “whole brain” disorders involving the complex interplay of neurons across different brain areas

30
Q

treatments for anxiety - drugs

A

-Benzodiazepines are anxiolytic drugs, used to treat anxiety (also have sleep-inducing and anticonvulsant properties); They bind to GABA receptors and enhance GABA’s inhibitory actions
-GABAa receptors are widely distributed, especially in the cortex, hippocampus, and amygdala
-Serotonin agonists and SSRIs can also treat anxiety

31
Q

PTSD main symptoms

A

PTSD is when unpleasant memories are heightened sense of anxiety affect individuals who experienced trauma
-Memory changes, such as amnesia
-Flashbacks
-Deficits in short-term memory

32
Q

heritability of PTSD and role of hippocampal volume

A

-Twin studies indicate that risk for PTSD has a heritable component
-Volume of hippocampus found to be smaller in combat vets with PTSD
-However identical twins of those diagnosed also had reduced hippocampal volume, suggesting that it could be a risk factor for those exposed to trauma

33
Q

OCD hallmark symptoms & difference between the two

A

Obsessions: unwanted intrusive and repetitive thoughts
Compulsions: repetitive behaviors/actions

34
Q

Obsession examples

A

concern with dirt, germs or toxins
something terrible happening like fire, death or illness
symmetry, order and exactness

35
Q

Compulsion examples

A

excessive hand washing, bathing, toothbrushing or grooming
repeating rituals
checking doors, locks, appliances, etc

36
Q

brain structures and functions implicated in OCD

A

-People with OCD display increased metabolic rates in the orbitofrontal cortex cingulate cortex, and caudate nuclei
-Evidence that OCD may be heritable, with genes that relate to serotonin signaling implicated
-Some evidence that OCD may be triggered by infections such as strep throat

37
Q

treatments for OCD - CBT, SSRIs, and DBS

A

-OCD shows excellent response to cognitive behavioral therapy
-SRIs in most cases are successful, suggesting that serotonin dysfunction plays a major role (Depression and OCD often occur together and may be related)
-DBS is a type of psychosurgery using a surgically implanted electrode

38
Q

function of corpus callosum

A

connects the two brain hemispheres

39
Q

split-brain patients

A

Severing the corpus callosum (a corpus callosotomy) can control atonic seizures (drop seizures)
Results in split-brain individuals

40
Q

Wada test

A

confirms left hemisphere specialization of language in most individuals, regardless of handedness
-injection of the anesthetic amobarbital into the carotid artery via a catheter
-temporarily shuts down the cerebral hemisphere on the same side, thereby revealing the functions performed by that hemisphere

41
Q

how language abilities are lateralized
- dichotic presentation tasks

A

-Studies of split-brain individuals have tested language function in each hemisphere:
-Individuals are able to verbally report words only when presented to the left hemisphere (e.g., right visual field)
-In contrast, the right hemisphere has limited linguistic capability, and appears to be mainly for spatial processing in addition to face perception and attention
-The two hemispheres process information differently (in most people)
-A dichotic presentation delivers different sounds to each ear at the same time
-Right-handed people identify verbal stimuli delivered to the right ear more easily - a right-ear “advantage”
-Up to 50% of left-handed individuals show no difference between ear or a left-ear advantage

42
Q

planum temporale - functions of left and right hemispheres in auditory specialization

A

-The planum temporale is an auditory region at the upper surface of the temporal lobe
-It is larger in the left hemisphere, even in infants before language acquisition
-Wernicke’s area is in this region, thus it seems likely that enlarged PT is relation to language specialization

43
Q

music - functions of left and right hemispheres in auditory specialization

A

-Auditory areas of the right hemisphere play a major role in perception of music
-Musical perception is impaired by damage to the right hemisphere, and music activates the right hemisphere more than the left
-However, perfect pitch relies on left-hemisphere mechanisms

44
Q

prosody - functions of left and right hemispheres in auditory specialization

A

-The right hemisphere is also important for prosody - the perception of the emotional tone of language

45
Q

how handedness relates to lateralization

A

-Handedness is associated with cerebral lateralization
-Left-handedness is influenced by heredity, and left-handed people make up about 10% of the population
-Similar to right-handers, the left-hemisphere is specialized for language in most left-handed people
-Right-hemisphere dominance for language is rare, but when it does occur it is more likely to be in a left-handed person

46
Q

spatial processing - impairments related to right hemisphere damage

A

-the right hemisphere has limited linguistic capability, and appears to be mainly for spatial processing in addition to face perception and attention
-People reliably demonstrate a right-hemisphere advantage for processing spatial stimuli
-Spatial tasks include understanding shapes and their relationships, positioning and navigation tasks, face processing, mental rotation of objects

47
Q

astereognosis - impairments related to right hemisphere damage

A

-Lesions to the parietal lobe can produce a range of deficits in these areas
-Damage to the postcentral gyrus is related to astereognosis, which is the inability to recognize objects by touch or manipulation despite being able to feel them

48
Q

prosopagnosia

A

(face blindness) is the inability to recognize faces, including one’s own

49
Q

brain structure implicated in prosopagnosia

A

-Both hemispheres have some capacity for recognizing faces, although right hemisphere damage seems to have a greater effect on impairment
-Bilateral damage, particularly to the fusiform gyrus, causes complete prosopagnosia
-fusiform gyrus underactivity

50
Q

phonemes

A

basic speech sounds

51
Q

morphemes

A

simple units of meaning; assembling into words with meaning; semantics

52
Q

syntax

A

-rules
-how words are assembled into meaningful strings

53
Q

aphasia - impairments related to left hemisphere damage

A

-impairment in language ability, to varying degrees, caused by brain injury, especially to the left hemisphere
-25-50% of stroke patients will have aphasia as a primary symptoms

54
Q

paraphasia - impairments related to left hemisphere damage

A

substitution of a word by a sound, incorrect word, or unintended word

55
Q

agraphia - impairments related to left hemisphere damage

A

impairment in writing

56
Q

alexia - impairments related to left hemisphere damage

A

impairment in reading

57
Q

apraxia - impairments related to left hemisphere damage

A

motor impairment; difficulty in making sequences of movements

58
Q

Broca’s area vs Wernicke’s area

A

-Broca’s area - regions of the left inferior frontal region involved in speech production (expression)
-Wernicke’s area - region of the left posterior temporoparietal cortex involved in perception and production of speech (comprehension)

59
Q

global aphasia

A

complete loss of language ability

60
Q

connectionist model of aphasia aka Wernicke-Geschwind model

A

says deficit results from a disconnect between brain regions in the language network
-Wernicke’s area decodes sounds and transmits information to Broca’s area via the arcuate fasciculus
-Broca’s area sends a speech plan to adjacent motor cortex to produce speech
-Lesions that disrupts the arcuate fasciculus connections produce conduction aphasia, an impairment in the repetition of words and sentences

61
Q

arcuate fasciculus

A

a bundle of axons that connects the temporal cortex and inferior parietal cortex to locations in the frontal lobe

62
Q

critiques of the connectionist model of aphasia

A

-brain imaging studies imply greater complexity than
-Critics argue that it oversimplifies the neural mechanisms of language
-more modern fMRI data confirms that left-hemisphere language zones are not as rigidly modular as was previously believe
-technological advances in the visualization of white matter pathways in the living brain have raised questions about the assumptions underlying the connectionist model

63
Q

motor theory of language

A

-proposes that anterior and posterior left-hemisphere language zones are motor control systems
-The systems are involved in both production and perception of complex motions that produce speech

64
Q

ASL users using motor theory of language

A

Users of sign language employ the same neural mechanisms that speakers do, and following comparable brain injury they exhibit the comparable aphasias

65
Q

how brain mapping allows us to understand organization of language abilities in the brain

A

-Cortical stimulation of neurosurgical patients provided a map of language-related cortical regions

66
Q

how functional neuroimaging allows us to visualize localized brain activity associated with distinct language abilities (during speech)

A

-PET scans reveal different brain regions activation patterns for different levels of processing words
-Event-related potentials (ERPs) reveal the time base for language processing
-A word with an error in meaning is processed more quickly than an error in grammar, indicating the additional time needed for the brain to process

Brain & Behavior (4 decks)

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