Lecture 23 - Autism, ADHD, Depression

Question 1

What is the difference between mental illnesses and neurodevelopmental disorders?

Answer 1

Mental illnesses can occur at any age and may be temporary or episodic, while neurodevelopmental disorders are evident in childhood or at birth and are lifelong disabilities.

Question 2

Name some examples of neurodevelopmental disorders.

Answer 2

Autism, intellectual disability, ADHD, and motor disorders like Tourette’s syndrome.

Question 3

What mental illnesses affect males and females at similar rates?

Answer 3

Schizophrenia and bipolar disorder.

Question 4

Which mental illnesses are more common in females?

Answer 4

Anxiety disorders, major depressive disorder, obsessive-compulsive disorder, PTSD, anorexia, and bulimia.

Question 5

Which neurodevelopmental disorders are more common in males?

Answer 5

Autism, ADHD, intellectual disability, and Tourette’s syndrome.

Question 6

What is one theory about why sex differences in mental and neurodevelopmental disorders exist?

Answer 6

These differences might not reflect actual biological or psychological disparities. Instead, they could result from perceptual biases, like assuming certain disorders are more common in one sex, or from differences in how boys and girls are socialized, which influence behaviors and diagnoses. For example, boys may be diagnosed with ADHD more often because their hyperactive symptoms align with stereotypes, even though girls might show different, less obvious symptoms.

Question 7

How do males and females differ in expressing symptoms of neurodevelopmental disorders?

Answer 7

Females are thought to be better at masking symptoms (camouflaging), which may contribute to underdiagnosis.

Question 8

How does autism relate to harmful gene variations?

Answer 8

Autism is often associated with rare gene copy number variations (CNVs), and these variations tend to affect males more severely than females.

Question 9

What is the role of CNVs in autism?

Answer 9

CNVs, where sections of the genome are duplicated or missing, seem to cause autism at a higher rate in males than females.

Question 10

Why are males more affected by harmful gene variants in autism, intellectual disability, and ADHD?

Answer 10

It is unlikely that social biases fully explain this difference, suggesting biological factors may play a significant role in gender differences in these disorders.

Question 11

What is the difference between homogametic and heterogametic sexes?

Answer 11

Homogametic sex has two identical sex chromosomes (XX in female mammals, ZZ male in some other species), while heterogametic sex has two different sex chromosomes (XY in male mammals, ZW female in some other species).

Question 12

What traits are more variable in males than in females?

Answer 12

Males show more variability in traits such as birth weight, brain morphology, energy expenditure, blood parameters, and reasoning abilities.

Question 13

Why might females be more protected from harmful gene variants in neurodevelopmental disorders?

Answer 13

Females seem to have more developmental stability due to having two X chromosomes, which may offer protection against disorders linked to X-linked genetic variations.

Question 14

Why are anxiety and depression disorders more common in females?

Answer 14

One explanation is that females experience higher rates of stressors like abuse, poverty, and discrimination. Hormonal fluctuations also contribute to the differences in incidence and severity.

Question 15

How do hormonal changes affect mental health in females?

Answer 15

Hormonal fluctuations during puberty, childbirth, and menopause can significantly impact mental health, especially in disorders like anxiety and depression.

Question 16

What is Autism Spectrum Disorder (ASD)?

Answer 16

ASD is a developmental disorder associated with genetic and environmental factors, characterized by social communication difficulties and restricted, repetitive behaviors.

Question 17

What is the prevalence of autism in the population?

Answer 17

Around 2% of the population is affected by autism.

Question 18

At what age do parents typically notice signs of autism in their child?

Answer 18

Parents usually notice signs during the first two or three years of life.

Question 19

What are some early signs of autism in infants?

Answer 19

Some infants with autism may not seem to care about being held and may arch their backs when picked up.

Question 20

What are some common characteristics of individuals with autism?

Answer 20

Many have abnormal language, engage in stereotyped behaviors (e.g., hand flapping, rocking), and may not develop enough speech to communicate effectively.

Autism often involves cognitive impairments, reduced imaginative ability, deficient or absent social interactions, repetitive behaviors, and obsessive interests in narrow subjects. Mild forms, like Asperger’s syndrome, show fewer or no language delays or cognitive deficits.

Question 21

What comorbid conditions are often seen with autism?

Answer 21

Autism often co-occurs with intellectual disability, seizure disorder, ADHD, depression, and anxiety disorder. About a third of individuals with autism have intellectual disability and seizure disorder.

Question 22

What is the heritability rate of autism?

Answer 22

The heritability of autism is between 70% and 90%.

Question 23

What are some genetic factors linked to autism?

Answer 23

10% of autism cases are linked to rare chromosomal abnormalities (deletions, duplications, and inversions). Other cases involve multigene interactions with common and uncommon gene variants. Some cases are associated with maternal viral infections during pregnancy.

Question 24

What brain abnormalities are observed in children with autism?

Answer 24

Brain growth may proceed abnormally, with total brain volume 10% larger than average by ages 2–3. This is linked to altered neuronal migration, abnormal synapse formation, overconnectivity in brain regions, and unbalanced excitatory–inhibitory neural networks.

Question 25

What fMRI findings are often seen in individuals with autism?

Answer 25

fMRI studies often show less activity in the fusiform face area when individuals with autism look at photos of human faces.

Question 26

What are the main goals of treating children with autism?

Answer 26

The goals are to lessen the impact of deficits and family distress, improve quality of life, and promote functional independence.

Question 27

What types of treatments are commonly used for autism?

Answer 27

Intensive special education and behavior therapy help children acquire self-care and communication skills. Medications (anticonvulsants, antidepressants, antipsychotics, stimulants) may reduce irritability, inattention, and repetitive behaviors but do not address core symptoms.

Question 28

What symptoms define Attention-Deficit/Hyperactivity Disorder (ADHD)?

Answer 28

ADHD is characterized by difficulty paying attention, controlling behavior, and hyperactivity. Symptoms include reckless behavior, difficulty inhibiting actions, and being easily distracted.

Question 29

How is ADHD diagnosed?

Answer 29

ADHD is diagnosed when symptoms occur before age 12, persist for more than six months, and interfere with school or home life. Diagnosis can be difficult as symptoms are sometimes part of normative behavior.

Question 30

What are common associations with ADHD?

Answer 30

ADHD is often linked to learning disabilities, depression, anxiety, low self-esteem, aggression, and conduct disorder.

Question 31

What is the heritability of ADHD?

Answer 31

ADHD has a heritability rate of 75% to 90%.

Question 32

What factors are associated with an increased risk for ADHD?

Answer 32

Risk factors include prenatal exposure to drugs and alcohol, infections during pregnancy, low birth weight, and trauma.

Question 33

What is the treatment approach for ADHD?

Answer 33

ADHD is typically managed with counseling and medications, especially stimulants like Ritalin and Adderall, which increase dopamine levels. Antidepressants may also help.

Question 34

What are mood disorders?

Answer 34

Mood disorders, or affective disorders, are characterized by disordered feelings or emotions. The main types are bipolar disorder and major depressive disorder (MDD).

Question 35

What is bipolar disorder?

Answer 35

Bipolar disorder is characterized by cycles of mania and depression. It affects about 2% of the population, with 80% of the risk attributed to genetics.

Question 36

What is major depressive disorder (MDD)?

Answer 36

MDD involves long-lasting depression without alternating manic periods. It affects approximately 7% of women and 3% of men, with about 40% of the risk due to genetics.

Question 37

What environmental factors contribute to mood disorders?

Answer 37

Traumatic or abusive childhood experiences are significant environmental risk factors for mood disorders.

Question 38

What are mood disorders and why are they dangerous?

Answer 38

Mood disorders are common and dangerous because they increase the risk of self-harm and suicide. People with mood disorders often feel unworthy, hopeless, and experience strong feelings of guilt.

Question 39

What is mania in bipolar disorder?

Answer 39

Mania is characterized by a sense of euphoria not justified by circumstances, along with nonstop speech and motor activity. It is diagnosed based on the intensity of the symptoms.

Question 40

How is mania in bipolar disorder treated?

Answer 40

Mania is commonly treated with lithium, which is effective for eliminating mania and preventing depression. Other treatments include anticonvulsant drugs, antipsychotics, and antidepressants.

Question 41

What are some treatments for bipolar disorder?

Answer 41

Lithium, anticonvulsants, antipsychotics, and antidepressants are commonly prescribed. Lithium is particularly effective during the manic phase.

Question 42

What are the biological treatments for major depressive disorder (MDD)?

Answer 42

Treatments for MDD include drugs that increase serotonin and/or norepinephrine, electroconvulsive therapy (ECT), ketamine, deep brain stimulation, transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), bright-light therapy, and sleep deprivation.

Question 43

How do tricyclic antidepressants work?

Answer 43

Tricyclic antidepressants inhibit the reuptake of serotonin and norepinephrine, though they also affect other neurotransmitters.

Question 44

What is the role of serotonin-specific reuptake inhibitors (SSRIs) in treating depression?

Answer 44

SSRIs, like Prozac, specifically inhibit the reuptake of serotonin without affecting other neurotransmitters, helping to alleviate depression.

Question 45

What is the monoamine hypothesis of depression?

Answer 45

The monoamine hypothesis suggests that depression may be due to insufficient activity of the monoamine neurotransmitters (serotonin, norepinephrine, and dopamine).

Question 46

How does serotonin depletion contribute to depression in some people?

Answer 46

A low-tryptophan diet, which decreases serotonin, can trigger depressive episodes in susceptible individuals, though serotonin levels alone are not a simple cause of depression.

Question 47

What is the role of the frontal cortex in depression?

Answer 47

fMRI studies show that the anterior cingulate cortex (subgenual ACC) is less active after successful treatment for depression, but clinical trials targeting this area with deep brain stimulation (DBS) have been unsuccessful.

Question 48

What is electroconvulsive therapy (ECT) used for, and how does it work?

Answer 48

ECT is used for severe depression and bipolar disorder. It involves inducing seizures through brief electrical shocks to the head and provides rapid symptom relief compared to other treatments.

Question 49

How does sleep affect depression?

Answer 49

People with depression often experience shallow, fragmented sleep and spend more time in stage 1 sleep. They enter REM sleep earlier than non-depressed individuals.

Question 50

How does total sleep deprivation help with depression?

Answer 50

Total sleep deprivation has an immediate antidepressant effect, though symptoms return after a normal night’s sleep. It may be due to a chemical that builds up during waking hours and is cleared away during sleep.

Question 51

How does REM sleep deprivation affect depression?

Answer 51

REM sleep deprivation has a slow antidepressant effect over several weeks, similar to SSRIs, by reducing the amount of REM sleep a person experiences.