Final Exam Flashcards
What is Major Neurocognitive Disorder?
Decline in cognitive functioning severe enough to interfere with daily living. Memory deficits are prominent. Difference b/t normal memory loss and NCD is memory does not spontaneously respond to reminders or other cues.
What is Mild Neurocognitive Disorder?
Milder versions of major neurocognitive disorder that involve modest cognitive declines from a previous level of performance, but do not yet result in significant impairment in functioning.
What are aphasia, echolalia, palilalia, apraxia, and agnosia?
Aphasia: deterioration of language
Echolalia: meaningless repetition of another person’s spoken words as a symptom of psychiatric disorder.
Palilalia: Repeating sounds of words over and over
Apraxia: impairment of the ability to execute common actions such as waving goodbye or putting on a shirt.
Agnosia: failure to recognize objects or people
What are executive functions?
Brain functions that involve the ability to plan, initiate, monitor and stop complex behaviors. Abstract reasoning, tact.
What is Alzheimer’s disease?
form of dementia caused by the progressive deterioration of brain cells. Most common form of progressive dementia and can account for approx 70% of all dementia cases.
What are the brain abnormalities associated with alzheimer’s, and
what are the etiological theories of it?
Widespread deterioration of brain tissues that impacts a broad range of cognitive, behavioral, and physical capabilities eventually become affected. Nerve tissues are invaded by pathogenic structures, Neurotic plaques (deposits of proteins called beta-amyloid) and neurofibrillary tangles, that interfere with nerve conduction impulses. # of tangles is correlated with severity of memory impairment.
Genetic factors:
- 24-49% of 1st degree relatives
- 2-4x higher if there is a family history of Alzheimer’s
- Gene abnormalities on Chromosomes 19 & 21
What are the symptoms of Parkinson’s and Pseudo-Parkinson’s Disease (from [MW])?
Tremors while active and resting, muscular stiffness/rigidity, weakness in throat or facial muscles, stiffness in legs/legs/other muscles, talking/swallowing may be taxing on individ., gait disturbances, slowness in goal-directed movement (bradykinesia), poor balance, postural instability
may include, reduce dexterity, speech difficulties, urinary and digestive problems, drooling, sleep disturbances, flat affect, fatigue
What neurotransmitter system is associated with Parkinson’s?
Dopamine
Know about Snowdon et al’s field study of 93 cloistered nuns described in the text and
casebook, and what factors were found to decrease the risk of dementia
Grammatically complex and psycholinguistic feature termed idea density helped decrease risk of alzheimers. Using your brain.
What are some recommendations Snowdon (in [MW]) makes for postponing the onset of
Alzheimer’s disease?
- Keep mentally stimulated.
- avoid head trauma.
- keep blood folate levels high by taking folic acid supplements.
- stay emotionally positive and physically active.
What is the difference between voluntary hospitalization and involuntary hospitalization?
Voluntary commitment means you have chosen to be admitted to treatment. Involuntary commitment or civil commitment is a legal process through which you are ordered by the court into treatment. In either case, will be through an inpatient facility, or sometimes on an outpatient basis.
What is civil commitment?
post-sentence institutional detention of an offender with the intention of preventing further offenses.
What are the criteria for which someone can be involuntarily hospitalized in AZ?
Dangerousness to self (DTS)*
Dangerousness to others (DTO)*
Persistently or acutely disabled (PAD)
Gravely disabled
*Danger posed must be imminent
*Not due to Alcohol/Drug Abuse only; must be due to
psychiatric disorder
What rights does a person who is civilly committed have?
right to legal representation, to call &
question witnesses, & to appeal ruling
What does it mean that a person is incompetent to stand trial?
People who don’t understand what is
happening to them in a courtroom and who
cannot participate in their own defense are
said to be incompetent to stand trial.
What are the different outcomes that can occur when the question is raised about a defendant’s competence to stand trial?
*Competent to stand trial: Trial continues
*Incompetent & restorable: Patient sent to
Correctional Health Services Restoration to
Competency program for treatment
*Incompetent & not restorable: Charges
dropped. However, person may meet criteria
for civil commitment (24-48 hours to file)
Know the case of John Hinckley [from MW]
Obsessed with Jodie Foster and tried to assassinate Ronald Reagan to prove his love and get her to love him. Was found not guilty by means of insanity and was released from the hospital in 2016.
Know standards of insanity, including who
bears the burden of proof
In 1984 Insanity defense reform act, defense bears burden of proof
What problems have been identified with the insanity defense?
Controversial: while perceived as a means by which guilty people “get off”, the insanity defense is used much less often than many think.
In what percentage of felony cases does a defendant plead Insanity?
Fewer than 1 in 100 defendants in felony cases file insanity pleas, and of these only 26% result in acquittal. Usually used in death penalty cases.
What is mens rea?
guilty mind or intention of guilt
What is Guilty but Mentally Ill?
Defendants incarcerated normal
term for crime, but their mental illness is
recognized.
What are some criticisms of this verdict?
No guarantee defendant receives treatment
for their mental illness
What are the different ways a person can work towards happiness?
*Life is precious. You only get one body. Take care of it.
*Life isn’t fair. Freedom is what you do with what’s been
done to you.(Jean-Paul Sartre).
*Anticipation is worse than the actual experience;
Avoidance makes everything harder.
*If you’re not making mistakes, you’re not doing it right.
*Listen to people’s behavior.
*Cultivate and celebrate good relationships. Be civil, but
keep your distance from the toxic ones.
*Forgive and remember.
*Giving is better than taking.
*Learn from your and others’ experience.
*Laugh. At yourself. At the world. Often.
*You don’t get extra points for suffering.
*Find your passion. Work hard. Seek balance.
What part of the brain does the amyloid plaques accumulate in?
cerebral cortex, hippocampus, amygdala, and other brain structures critical to memory and cognition.
McNaughten rule:
At the time of the crime, individual was so affected by a
disease of the mind that s/he did not know the
nature of the act s/he was committing or did not
know it was wrong
Irresistible Impulse rule:
At the time of
the crime, the individual was driven by an
irresistible impulse to perform the act or had a
diminished capacity to resist performing the act
Durham Rule
The crime was a product of
a mental disease or defect
American Legal Institute (ALI) Rule (1962):
At the time of the crime, as a result of a mental
disease or defect, the person lacked substantial
capacity to either (1) appreciate the wrongfulness
of the act or to (2) conform his/her conduct to
the law.
Insanity Defense Reform Act (1984):
At the time of the crime, as a result of mental disease or
mental retardation, the person was unable to
appreciate the wrongfulness of his/her conduct
(used by Federal Gov’t & many states); also
burden of proof rests on defense.
Fewer than __ in ___ defendants in felony cases
file insanity pleas, and of these only ___ result
in acquittal.
1 in 100, 26%
Incompetent and not restorable
Charges
dropped. However, person may meet criteria
for civil commitment (24-48 hours to file)
Retrograde amnesia:
impaired ability to recall
previously learned information
Anterograde amnesia:
impaired ability to learn new
information
Unlike dementia and delirium, in _______
disorders only memory is affected
amnesic
*Dementia
*Many medical disorders, including stroke,
congestive heart failure, an infectious disease, a
high fever, or HIV infection
*Intoxication with illicit drugs and withdrawal
from these drugs or medications
*Fluid and electrolyte imbalances
*Toxic substances
causes of delirium
*Disturbance of consciousness w/reduced ability to
focus, sustain or shift attention
*Change in cognition or development of perceptual
disturbance
*Disturbance develops over a short period of time
(hours to days) and tends to fluctuate during the
course of the day
*Evidence from the history, physical exam or lab
findings that the disturbance is caused by the
direct physiological consequences of a medical
condition
Delirium
Prevention of NCDs:
¢ Aerobic exercise and mental activity may have
some protective value
¢ Reducing risk factors for TBI (e.g., helmets,
seat belts, concussion awareness)
¢ Reducing the risk factors for stroke/TIAs (e.g.,
avoiding smoking, obesity, and hypertension)
may reduce the risk for vascular dementia
¢ Vitamin B12, D & E may have some protective
effects against cognitive decline
¢ Nun study: Demonstrated a link between
intellectual activity beginning early in life and
reduced risk of Alzheimer’s disease
Treatment for NCDs:
*Medications
-Cholinesterase inhibitors (e.g., Aricept,
Exelon & Remnyl), prevents breakdown of
acetylcholine
-Other drugs (e.g., Namenda) regulate the
activity of glutamate (improves learning & memory)
-Atypical antipsychotics decrease violence,
hallucinations & delusions
-SSRIs help with depression & anxiety
-In some cases, drugs do not work for all patients
and have only temporary effects
*Behavior therapy
actus reas
guilty act
