Exam 4-psychopathology

Question 1

Patho of Depression

Answer 1

Patho: monoamine-deficiency theory posits that the underlying pathophysiological basis of depression is a depletion of the neurotransmitters serotonin, norepinephrine or dopamine in the central nervous system.

Question 2

Patho of Bipolar

Answer 2

Patho: characterized by dysregulation in the dopamine and serotonin systems and by pathology in the brain systems involved in regulating emotion; hereditary

Question 3

Social anxiety

Answer 3

Fear and avoidance in social situations
Etiology: increased activity in limbic and frontal cortical areas
•Reduction of serotonin and GABA in amygdala
•Role of oxytocin ? - antianxiety effects and promotes social attachment, trust and
empathy

Clinical Manifestations:
•Speaking, reading and eating in public, going to parties, speaking to authority figures,
engaging in informal socialization
•More common in children

Patho:

Question 4

General anxiety

Answer 4

Fear and worry about life events
•Marital relationships, jobs, money, health, social status
•More common in women, onset typically in early 20s but lessens with age

Etiology: •High family concordance
•Abnormal norepinephrine and serotonin systems in amygdala (particular on right
side?)

Clinical Manifestations: restlessness, muscle tension, irritability, easily fatigued, difficulty
concentrating, difficulty sleeping

Patho:

Question 5

Post traumatic disorder

Answer 5

Etiology: Exposure to a threat of death, serious injury or sexual violence
•Symptoms develop hours to years after event

Clinical Manifestations: 4 diagnostic clusters: re-experiencing, avoidance, negative cognitions and mood, arousal

Patho: stress alterations in neural structures (amygdala and prefrontal cortex) and neurotransmitters
•Change how memories are stored, retrieved and extinguished

Question 6

Substance use disorder-Etiology

Answer 6

Etiology:
Genetics-Up to 70 genes assocaited, early exposure increases misuse
Psychological-ADHD, anxiety, depression, bipolar
Biological- how body processes/perceives substance
Socio-cultural-peer pressure
Environmental-stress, parental drug use

Question 7

Dopamine

Answer 7

Regulates: mood and muscle movement and plays a vital role in the brain’s pleasure and reward systems.

Mood: Increased levels increases pleasure

Anxiety: increased levels decreased anxiety

Question 8

Norepinepherine

Answer 8

Regulates: concentration; increases alertness and arousal, and speeds reaction time.

Mood: improves/increases mood

Anxiety: responsible for how the person reacts to stress and anxiety and is associated with the fight-or-flight response.

Question 9

Serotonin

Answer 9

Regulates: thought to regulate mood, happiness, and anxiety.

Mood: low levels lead to depression

Anxiety: decreases anxiety

Question 10

How does genetics contribute to mood d/o

Answer 10

•Family and twin studies show strong association with mood disorders
•Bipolar is linked with chromosomes 18 and 22
•Large variation in symptoms suggests developmental and environmental factors
contribute to etiology
•Role of exposure to uncontrollable psychosocial stress in precipitating disorders

Question 11

How does neurochemical contribute to mood d/o

Answer 11

•Monoamine hypothesis of depression:
deficits in monoamine neurotransmitters and
metabolites in CSF is underlying cause of
depression
•Dopamine: reduced = fatigue, low energy,
motivation
•Norepinephrine: depletion planning and
concentration
•Serotonin: ? depletion precedes depression

Question 12

How does neuroendocrine contribute to mood d/o****

Answer 12

it changes the HPA dysregulation

Question 13

How does neuroanatomical contribute to mood d/o

Answer 13

•Decreased serotonin receptor and transporter binding
sites
•Norepinephrine receptor alterations
•Smaller amygdala àrecurrent depressive episodes
•Smaller hippocampus, from chronic stress?
•Decreased prefrontal cortex cerebral blood flow
•Decreased glucose metabolism

Question 14

Substance use d/o

Answer 14

•Mental and physical dependence that results from long-term exposure to
substances
•Nicotine, alcohol, illicit substances including: cannabis, sedatives, hypnotics, anxiolytics,
inhalants, opioids, hallucinogens and stimulants

Question 15

Patho of BASAL GANGLIA with substance use d/o

Answer 15

• All addictive substances produce pleasurable surge of dopamine
• Acts in basal ganglia (reward center of brain)

***responsible for the formation of habitual substance taking

Question 16

Patho of AMYGDALA with substance use d/o

Answer 16

plays a role in stressful feelings like anxiety, irritability, and unease, which characterize withdrawal after the drug high fades and thus motivates the person to seek the drug again. This circuit becomes increasingly sensitive with increased drug use.

Question 17

Patho of PREFRONTAL CORTEX with substance use d/o

Answer 17

•Make stopping difficult
•Support conditioning – associate rewarding high with other cues in life (e.g., friends,
drinking, a place…)

Question 18

Clinical manifestations of depression

Answer 18

5+ symptoms for 2+ weeks

Depressed or irritable mood 
Loss of interest and pleasure 
>5% weight loss/gain in a month 
Insomnia or hypersomnia 
Psychomotor agitation or retardation 
Fatigue or loss of energy 
Feelings of worthlessness or guilt 
Poor concentration or indecisiveness 
Thoughts of suicide or death

Question 19

Clinical manifestations of manic episodes

Answer 19

3+ symptoms for about a week

Elevated mood
 Irritable mood
 Inflated self-esteem
Decreased need for sleep
 Excessive talking
Racing/crowded thoughts
Distractibility
Increased goal-directed activity
Excessive risky activity

Question 20

Manifestations of anxiety

Answer 20

arousal, tenseness, increased autonomic activity (heart rate, blood pressure, respirations), avoidance behavior

Question 21

What does anxiety co-occur with?

Answer 21

depression

Question 22

Patho of SUD (substance use d/o)

Answer 22

•As body adapts to substance à scale back sensitivity to dopamine à reduced euphoria (tolerance) à increased use of substance

• Each substance has a different effect on the brain
• All addictive substances produce pleasurable surge of dopamine
• Acts in basal ganglia (reward center of brain)
• Other centers of brain – amygdala and prefrontal cortex
• Make stopping difficult
• Support conditioning – associate rewarding high with other cues in life (e.g., friends, drinking, a place…)

Question 23

Physical dependence:

Answer 23

refers to the physiologic effects of multiple episodes of

substance abuse.

Question 24

Psychological dependence:

Answer 24

is characterized by craving of the substance to avoid a dysphoric state.

Question 25

Behavioral dependence:

Answer 25

is the display of substance seeking behavior.

Question 26

Factors that influence relapse/recurrent

Answer 26

• Degree of dependence and withdrawal
• The motivation to be committed to abstinence
• Treatment time frame
• Genetics
• The severity of cravings
• How the individual copes during stressful situations

Question 27

Clinical manifestations of bipolar

Answer 27

Bouts of depression and mania

Question 28

Patho of bipolar

Answer 28

characterized by dysregulation in the dopamine and serotonin systems and by pathology in the brain systems involved in regulating emotion.

Question 29

Bipolar

Answer 29

•Type 1: at least one manic episode that is preceded of followed by hypomania or major
depressive episode

•Type II: one major depressive episode for 2+ weeks and at least one hypomanic episode for at least 4 days