Lecture 21 - Mental Health Disorders

Question 1

Two-hit hypothesis

Answer 1

Genetic susceptibility OR infection/inflammatory processes

coupled with

developmental insult (stress/trauma/drugs)

Question 2

Bipolar 1 - had previous mania

Bipolar II - no history of mania, but current episode

both have MDD symtoms either current or history

Question 3

prevalence of bipolar

Answer 3

1% of global pop

Question 4

Brain regions and bipolar

Answer 4

Enlarged ventricles

Hypoactive prefrontal Cortex

reduced hippocamal volume

overactive amygdala

Question 5

euthymic

Answer 5

brain while not depressed or manic

Question 6

Bipolar and prefrontal areas

Answer 6

Ventral prefrontal cortex

• Very tightly connected to the amygdala àdeals with what is/isn’t rewarding in our environment.
• Too active in people with bipolar disorder.

Dorsal-lateral prefrontal cortex

• The dorsolateral prefrontal cortex àdeals with rational thinking; figuring out stimuli and strategizing on how to behave.
• Less active in people with bipolar disorder.
• Emotional –overactive, logical-underactive

Question 7

neurotransmitter theory of bipolar

Answer 7

dopamine hypothesis: faulty homeostasis of dopamine for manic phase

Serotonin hypothesis: serotonin reduced in depressive phase

Question 8

bipolar treatment medication

Answer 8

lithium, mood stabilizer

antidepressants, second line (mitigates cell death, but usually need pairing with mood-stabilizer, so not the best)

Question 9

bipolar therapy

Answer 9

psychotherapy

cbt

(good time to catch em is in manic state)

Question 10

positive schizophrenia symtoms

Answer 10

•present in schizophrenia but not in healthy individuals. (inner voice, hallucination, delusion)

Question 11

negative schizophrenia symptoms

Answer 11

•-the absence of functions that are present in healthy individuals. These are generally harder to treat (flat affect, lack of motivation, catatonia,

Question 12

brain and schizophrenia

Answer 12

reduced gray matter volume (esp in frontal and temporal)

•Increased cell density in the frontal and occipital cortex.??…

enlarged ventricles

excessive synaptic pruning,

less activity in PFC

Question 13

therapy for schizophrenia

Answer 13

cognitive training

family intervention/psychoeducation

Question 14

PFC in Trauma/PTSD

Answer 14

PFC in Trauma/PTSD:

• PFC is notably less active and less able to override the hippocampus as it flashes fragments of memory, nor to signal the amygdala that the danger is not real.
• Animal studies show that early stress is associated with a decrease in branching of neurons in the medial prefrontal cortex.

Signs and symptoms of PTSD associated with PFC:

•Irritability, difficulty with logical decision making, avoidance (eg.Numbing, avoidance).

Question 15

Hippocampus in Trauma/PTSD

Answer 15

•When experiencing PTSD, memory becomes fragmented, and the hippocampus has trouble coherently piecing events together, discriminating from past or present, and integrating memory of experiences with feelings and factual knowledge.

Signs and symptoms of PTSD associated with the hippocampus:

•Confusion, disorientation, recurring thoughts, flashbacks, nightmares, difficulty sleeping.

Question 16

Triune Brain

Answer 16

• Reptilian (basal ganglia): the innermost part of the brain is responsible for survival instincts and autonomic body processes.
• Mammalian (limbic system): processes emotions and conveys sensory relays.
• Neommalian(neocortex): most highly evolved part of the brain, controls cognitive processing, decision-making, learning, memory and inhibitory functions.
• Children who experienced trauma have a difficult time learning in school because their survival brain is fired up,

•

Question 17

Therapy for Trauma (Current understanding)

Answer 17

• With our new understanding of neurobiological trauma processes in the brain, we have learned that when talk therapy attempts to engage parts of the brain that are “off-line” and deep in a trauma response, the PFC and cognitive part of the brain are not going to able to work through the trauma logically.
• Trauma therapy has therefore shifted to include “bottom up” processing where we first deal with calming arousal systems in the deeper regions of the brain before talking through and processing the trauma on a cognitive level.
• Eg. Trauma focused CBT.
• Firstly in therapy, you teach the client to quiet down their survival brain BEFORE you get them to rationalize with frontal cortex and logic about their problems/problem solve