Lecture 7 - Psychopathology Flashcards
What % fall under the category of abnormal?
30%, 1 in 3
What are the definitions of abnormal?
- Statistical in frequency - outside 2 sd
- Personal suffering
- Norm violation (very culuturally/ historically specific)
- Classification systems (just try make money)
What are the % for standard deviations?
1 SD = 68%
2 SD = 95%
3 SD = 98%
What % of population has sz?
1-2% of world
What does Sz literally mean/
Split mind
What does Sz disturb?
- Thinking (issues with logic and structure, thoughts are random, confused and dont make sense, makes leaps in structure and describes unlikely events)
- Emotion - e.g. laugh at funerals
- Perception - Hallucinations
- Behaviour - strange and disorganised
What are symptoms of sz?
•Delusions (fear of persuction, grandeur)
• Hallucinations (voices can be aggressive or supportive)
- linked to sensory modality, LSD effects same NT’s
• Attentional problems (voices = distracting)
What are the 3 branches of causes for Sz?
- Genetics
- environemtnal
- Psychological factors
- Biological factors
Outline genetic causes of Sz
- Combination of many genes
- herditary
- doesnt make it certain, just more likely
Outline environmental causes of Sz
- predispose abnormal brain development
- Interacts with genetics:
GENETIC VULNERABILITY AND ENV TRIGGER
•Prenatal trauma/ infection/ influenza
• childhood malnutrition/ trauma
• complications with birth
•maternal drug use during pregnancy
• dad older than 45
Outline psychological causes of Sz
- not primary cause
- Maladaptive experiences
- Dysfunctional cognitive habits
Outline biological causes of Sz
- Enlarged ventricles (emotional expression, thinking, info processing, negative symptoms caused by less tisue around these)
- Positive symptoms only assocated with dopamine, not strucutral abnormalities
- Less tissue in:
•Sub-cortical areas
• Thalamic regions - relay station can cause thes issues
• PFC - planning logic, analysis, organisation - contiuned loss makes worse symptoms
- Integration of genetic and env factors - disruption in brain development caused by env factors
- Synaptic pruning
- Abnormalities in dopamine system (why ssri’s work for + symptoms)
•Excessive dopamine = + symptoms
• Not enough = - symptoms
OUtline synaptic pruning
- a cause of Sz
- synapse elimination occurs between childhood and puberty onset
- Number of synapses peak so enzymes destroy those that arent necessary - in sz this is too much and cuts out loads
OUtline dopamine pathways
INvolved in Sz
- Dopamine is involved in regulating movement and experiencing pleasure and reward - if low = no reward
- malfunctioning causes sz or parkinsons etc
What is dopamine associated with?
- Made in substantia nigra
- about movement and reward/ pleasure
What are the 3 dopaminergic pathways associated with sz?
- Nigro-striatal - MOVEMENT
- from substantia nigra
- goes to putamen/ caudate - Mesolimbic - POSITIVE SYMPTOMS
- from ventral tegmental area (VTA)
- goes to limbic structures (amygdala/ nuclues accumbuns) - Mesocortical - NEGATIVE SYMPTOMS
- from VTA
- goes to frontal/ temporal loves
What receptors do anytipsychotics block?
D2 receptors
What symptoms do anti psychotics help?
Just positive symptoms, - symptoms worse
they stop dopamine having any effect
What are the 2 extreme mood disorders?
Depression and mania
- 1 in 5
What % of population has depression?
17%, 3f/ 1m
- men supposed to not show emotion
What are the side effects of antipsychotics?
Serious:
• Tremors, muscle rigidity, restlessness, (slow movement)
• Symptoms of parkinsons (pill rolling)
- Tardive Dyskenisia (motor system) - after prolunged use, due to excessive dopamine - cant control movements
Describe depression
Feelings of inadequacy, worthlessness, helplessness
What can depression cause?
- Weight gain/ loss, sleep problems, cognitive deficitis, risk of suicide
Outline bipolar disorder
Two extreme moods, depression or mania
- mania = abnormally elevated arousaal, affect and energy
What are the neural causes of mood disorders?
• reduced brain development (frontal lobes/ hippocampus)
• Malfunctions of endocrine system (abnormal cortisol levels effects brain function)
• NT imbalances (norepinephrine, serotonin, dopamine)
• Malfunctions in ‘good mood’ regions (PFC, hippocampus, amygdala - limbic system)
- difficulties in emotion, and which to suppress/ express
What are the 3 types of anti-depressants?
- SSRI
- MAO-I
- Tricyclic
effective in 50-60% patients
How do SSRI’s work?
- Reduces the feed back mechanism, serotonin is not reputaken and as there is not enough coming back to vessicles, brain makes more!
- Takes abuot 6 weeks
How do MAO-I’s work?
MAO = enzyme that clears up NT’s in synapse
- These drugs inhibit this enzyme family (monamine oxidase)
- leaves more NT in the brain
How do Tricyclics work?
Block absorption of serotonin and norepinephrine
-
What % of population has OCD?
2-4%
Descrease OCD
MMore intense than familiar/ common experiences of having a repetivive thought
- characterised by insight in irrational fear
What are the symptoms of OCD?
- persistant, upsetting unwanted thoughts (obsessions)
- e.g. self harm/ cleaning
- ritualistic, repetitive behaviours (compulsions)
- e.g. checking locks et
What are the 3 anxitey disorders we learn about?
- phobias
- generalised anxiety disorder
- OCD
What are the symptoms of anxiety disorders?
- intense feelings of apprehension
- Long-lasting
- disruptive
What are the biological causes of anxiety disorders?
•Genetic
- no 1 gene
- shared environment - as well as SLT
• Excessive activity of norepinephrine (panic disorder)
• disregulation of serotonin -> Generalised anxiety disorder, OCD
X - cause and effect
What do we need to keep neurotransmission running?
Enzymes
How does depression affect sleep?
- Disrupts biological rhythms/ clock
- Associated with insomnia/ fragmented sleep
How can sleep treatments help depression
- Sleep-deprivation - skipping a nights sleep resets the clock (X - high relapse)
- Physical excerise helps sleep
What are the alternative treatments for depression?
• Electro- conclusive therapy
- Seizures seem to reset sytem, causes memory loss -> improvements
- 40-60% sucess, but high relapse
• CBT
- 70-80%
- Changing thinking and behaviour -learning more adaptive thinking
- used alongside drugs
What are the biological causes of OCD?
• Dopaminergic hypofunction in PFC
- Not enough dopamine
- affects reward, motivation, compulsions (cant stop them)
- Structural abnormalities - more grey matter
- Limbic system - cingulatomy (Cut through cingulate gyrus)
- CBT CAN ALSO HELP
What are the drug treatments for anxiety?
• Anxiolytics
- tranquilising effect, reduces NT
- used in epilepsy
- INCLUDES BENZODIAZEPINES (e.g. Xanax)
Outline Benzodiazepines
• Side effects
- Sleepines, light headed, impaired thinking
- very addictive, can kill with alcohol
• Effects GABA - so dampens neuron excitability
What are the 4 sites of action of Benzos?
- Spinal cord (muscle relaxation)
- Brain stem (ant-convulsant efffect)
- Cerebellum (leads to lack of coordination tho)
- Limbic and cortical areas (inhibit arousal, make you sleepy)
Outline symptoms of ADHD
- Impulsivity
- inability to concentrate
- Problems in memory, decision making
What are causes of ADHD?
- genetic (75%)
- Brain damage
- lead poisining
- low birthweight
- NT abnormalities (Ritalin)
How many does ADHD effect?
3-7% of children
- mainly boys
- can also just be ADD
Outline symptoms of Autism
Neuro-developmental disorder
- Inability to develop social relations
- repetive stereotypical behaviours (mirro neurons)
- savantism
How many does autism effect?
10-20 per 10,000 births
- getting more common
- many types - speecturm
What are causes of autism?
- Brain enlargement/ reduction
- prenatal viral infection
- genetic
- Phenylketonaria (PKA) - disease in childhood
