Midterm Flashcards
How does cocaine effect the synapse?
Blocks Dopamine Reuptake Transporters by clogging receptors
What causes the addictive euphoric/pleasurable effects of cocaine?
Dopamine which has accumulated in the synapse due to inhibited reuptake overstimulates the mesocorticolimbic dopamine system
What is Cocaine?
A CNS Stimulant which increases neural and behavioral activity and boost energy temporarily
The effects of cocaine resemble those exerted by which nervous system?
Sympathetic Nervous System
What are some Physical and Psychological effects of Cocaine?
Increased loco motor activity, heart rate, temperature, and blood glucose
Pupil dilation
Euphoria, racing thoughts, reduced appetite
What effect do drugs have on the mesocroticolimbic dopamine system?
Supraphysiological dopamine - dopamine release much larger than that caused by normal rewarding stimuli
This hijacks the reward system causing the brain to over prioritize behavior and stimuli associated with the drug
What are the effects of dopamine released to the Nucleus Accumbens (NAc)?
Feelings of subjective pleasure
What are the effects of dopamine released to the Hippocampus?
Learned association between rewarding feeling and stimuli
What are the effects of dopamine released to the PFC?
Cognitive control necessary to seek/avoid the stimulus
What are the pathways of the Mesocorticolimbic Reward System?
Neurons in the Ventral Tegmental Area (VTA) containing Dopamine project their axons to the Hippocampus, Nucleus Accumbens (NAc), and Prefrontal Cortex (PFC)
What is Intracranial Self-Stimulation (ICSS)
A rat is fitted with an electrode in certain parts of the brain which can be stimulated by a lever, when placed in certain areas the rat will press the lever endlessly, ignoring other rewarding stimuli, until it becomes exhausted or needs to be forcefully removed
What is Reward and why does it exist?
Stimuli that are in some way desirable and can affect behavior
Designed to motivate animals to engage in life-sustaining endeavors such as reproduction, eating, and maintaining social relationships
The DSM-5 characterizes Substance Abuse Disorder as maladaptive pattern of use that has led to subjective distress for a year as well as at least 2 of what six symptoms?
- Substance use results in failure to fulfill obligations
- Spend a great deal of time trying to obtain the drug
- Legal problems associated with drug
- Craving
- Tolerance
- Withdrawal
How do drugs effect Homeostasis?
- Brain normally exists in a state of drug free homeostasis
- Taking drugs lead to an imbalance
- Compensatory adaptations attempt to restore homeostasis
What is addiction?
Uncontrolled drug use that persists in spite of negative consequences
What is Tolerance?
Increase in dose required to obtain desired effects of drug
What is Withdrawal?
Physical and psychological behaviors that are displayed by an addict after drug use ends
What is Substance Use?
Occasional, moderate use of a substance which does not interfere with everyday life
What is Substance Abuse?
When use of a substance significantly interferes with everyday life functions
What is Substance Dependence?
Physiological and psychological dependence on a substance - resulting in tolerance and withdrawal
What is a Psychoactive Drug?
Substances which act to alter mood, thought, cognition or behavior
What is a CNS depressant?
A psychoactive drug which suppresses mental functions and at low doses results in calming effects but at high doses results in intoxication
Alcohol, Anxiolytic, Opiates
What is a CNS Stimulant?
A drug which stimulates arousal and gives a boost in energy and clarity
Amphetamine, Cocaine, Caffeine, Nicotine
What is a Hallucinogen?
A drug which disturbs ones sense of reality
MDMA, LSD, Marijuana
What compensatory actions lead to Cocaine tolerance?
- Some Dopamine receptors on the postsynaptic terminal are removed
- Dopamine release is reduced from the presynaptic terminal
What is Anhedonia?
Inability to feel pleasure
What does the Dopamine Hypothesis of Schizophrenia suggest?
That the symptoms of schizophrenia rise due to excessive amounts of dopamine
Hyperactivity and Hypoactivity of which connections effecting dopamine release are involved in Schizophrenia?
Hyperactivity of the mesolimbic connections (VTA-NAc and VTA-Hippo) result in over stimulation of D2 receptors resulting in Positive symptoms
Hypoactivity of the Mesocortical connections (VTA-PFC) result in under stimulation of D1 receptors resulting in Negative and Cognitive symptoms
Enlargement of what brain structures suggests that there is a change in cellular makeup, density, or organization of the Schizophrenic brain which is being replaced by CSF?
Enlarged Ventricles
The Schizophrenic brain tends to have reduced brain volume in which areas and what symptoms are a result of this?
Frontal and Temporal Lobe - Cognitive and Language Deficits
Basal Ganglia - Reduced Emotional Control and Motoric Changes
Hippocampus - Learning and Memory Deficits
What is psychosis?
A Group of psychological disorders in which patients experience a loss of contact with reality
What is Schizophrenia?
A psychotic disorder producing disturbance in Perception of Reality, Interpersonal Relations, Social Integration, Cognition, and Mood
What are positive symptoms of Schizophrenia?
Behavioral excesses - symptoms not experienced by non-affected individuals such as Delusions or Hallucinations
What type of Delusions are clearly implausible and not understandable?
Bizarre Delusions
What type of Delusions are false but somewhat possible?
Non-Bizarre Delusions
What type of Delusions involve beliefs that the person is being messed with in some way?
Persecutory
What are hallucinations?
Perception in the absence of sensory stimuli
What are negative symptoms of Schizophrenia?
Behavioral deficits or impairments such as Apathy, Autism, Anhedonia, or Affect Flattening
What is Apathy?
Inability or lack of desire to get started resulting in social withdrawal and difficulty with day-to-day functioning as seen in schizophrenics
What is Autism? (Schizophrenia)
Tendency to keep to oneself, no interest in other people or surroundings
What is Affect Flattening?
Overall reduction in the range or intensity of emotional expression as seen in schizophrenics
What is Anhedonia? (Schizophrenia)
Inability to enjoy or general indifference towards normally pleasurable activities
In order to diagnose Schizophrenia under the DSM-5 someone must demonstrate 2/ symptoms and at least 1 of the first 3 symptoms for 6 months, what are those symptoms?
- Hallucinations
- Delusions
- Disorganized Speech
- Disorganized or Catatonic Behavior
- Negative Symptoms
What are Disorganized symptoms of Schizophrenia?
Erratic changes in speech, mood, emotions or motor behavior resulting in:
Cognitive difficulties - planning, learning, memory
Disorganized speech - Impair effective communication
Inappropriate Affect - inappropriate emotions
Motoric changes - unpredictable or catatonic behaviors
When does Schizophrenia usually onset?
Generally occurs in early adulthood (20’s) at a time when individuals are entering the adult world and becoming fully independent
When is Schizophrenia usually diagnosed?
Usually starts with 1-2 years of low grade symptoms (mood and behavioral changes) and diagnosis usually occurs with the first appearance of psychotic symptoms (a Psychotic Break)
What are genetics effects on Schizophrenia?
The amount of DNA shared with an affected family member is directly related to one’s risk of developing schizophrenia
No simple pattern of inheritance - no single gene or mutation has been identified as being causal
What birth have a 5-8% increased risk in developing schizophrenia?
Winter/Early spring - due to environmental toxins, lack of vitamin D, or perhaps prenatal infection
How does stress contribute to schizophrenia?
- Contributes to overall risk of developing schizophrenia (prenatal stress, childhood trauma, later life stressors)
- Can be a precipitating factor in those who are susceptible - Initial psychotic break is usually preceded by a stressful life event
What are Conventional Anti-psychotics?
Drugs which improve positive symptoms of schizophrenia by blocking Dopamine D2 Receptors
Haldol
What are Atypical Anti-psychotics?
Drugs which improve positive and negative symptoms of schizophrenia by blocking D2 receptors and 5-HT2 Receptors
Seroquel
What is Hyperprolactinemia?
A side effect of antipsychotics which leads to disinhibition of prolactin leading to breast development and milk production
What are Extrapyramidal Symptoms?
A side effect of antipsychotics leading to continuous muscle spasms, motoric restlessness, rigidity, and Tardive Dyskinesia (Involuntary movement reminiscent of Parkinson’s Disease)
What is Neuroleptic Malignant Syndrome?
A side effect of antipsychotics leading to muscle stiffness, difficulty breathing, altered mental status, renal failure, tremors, dehydration, fever and can even be fatal
Why is compliance with treatment for schizophrenia a major problem?
In part due to the nature of the illness
In part due to the side effects of the drugs
What is Cognitive Therapy?
A treatment for schizophrenia which focuses on social symptoms and can lead to neuroanatomical improvements and protection as well as address deficits in planning, memory, and attention
What is resilience?
The ability to maintain psychobiological allostasis
Ability to easily adapt to misfortune or change and sever chronic stress
What are Psychosocial Factors Associated with Resilience?
Facing fears and active coping
Optimism and positive emotions
Cognitive reappraisal, positive reframing, and acceptance
Social competence and support
Purpose in life, moral compass, meaning, and spirituality
What are Underlying Neurobiological Mechanism associated with resilience?
Cognitive flexibility and control Healthy reward system Well regulated emotional responses Optimal hormone function and fer circuitry Stress inoculation
What effects do positive life experiences have on resilience?
Develop healthy stress axis with functional feedback
Healthy CNS structures which promote cognitive control
What is Stress Inoculation?
Short term actions of cortisol promote adaptations
During stressors we practice using adaptive coping strategies and gain confidence
What effects do Endorphins have on Resilience?
Touch can stimulate release of endorphins and the Anterior Cingulate Cortex has receptors which when activated can create feelings of reward and increase rational decision making (coping)
What effects do Oxytocins have on Resilience?
Love/bonding hormone - increases trust and reduces anxiety - when released it can help regulate emotional responses and reduce stress response via the amygdala
What effect do social interactions have on resilience?
Release of Endorphins and Oxytocin following social interactions or touch could help to regulate emotional responses and reduce stress responses (Oxytocin), as well as increase feeling of reward and allow for rational decision making (Endorphins) all which contribute to increased resilience
What is the Cingulum and how does it relate to resilience?
A white matter tract within the Cinglate Cortex connecting the Frontal Lobe (Reasoning circuitry of the PFC) and Temporal Lobe (Limbic System) - resilient individuals have a stronger physical connection between the ACC and Hippocampus via the Cingulum
How does increased activity in the PFC impact resilience?
Greater ability to reason, plan, enact coping strategies, and ultimately take control during stress
Which type of genotypes are positively correlated with Resilience?
Genotypes which promote effective activation and termination of HPA Axis activity
CRH type 1 receptor gene
GR gene
What is Neuropeptide Y and how does it relate to Resilience?
A hormone released in brain the brain during stress - acts on receptors in the amygdala, PFC, Hippocampus, and Brainstem to shut down stress response by inhibiting ACTH and Norepinephrine
NPY levels are higher in those who are more resilient
What is a Neurodevelopemental Disorder?
A group of disorders in which development of the CNS is impaired and whose symptoms appear during early development period (before 6 years)
What is Autism?
A Neurodevelopmental Disorder resulting in deficits in social interaction and communication, elaborate stereotyped movements, marked distress in response to change, little ability to form friendships, and intense absorption in special interest
How does the DSM-5 characterize Autism?
Deficits in Social Communication and Social Interaction
Restricted repetitive behaviors, interests, and activities
In Autism difficulties forming relationships due to limited social interaction are a result of issues with?
Verbal Communication
Social Communication
Social Cognition
Lack of Flexible Thinking
What are some Verbal Communication issues faced in Autism?
1/3 will never develop ability to speak
Uneven language development
Inability to hold 2 way conversation
What are commonly observed speech patterns seen in Autism?
Repetitive or Rigid Language - Saying things that don’t make sense or out of context
Echolalia - Repeating words/phrases over and over
Odd tone of voice
Literal understanding of language
What are some Non-Verbal social communication issues faced in Autism?
Eye Contact - Inability to engage/maintain
Body Language - difficulty interpreting or inappropriate use
Facial Expression - display few of their own and have difficulty interpreting those of others
Emotional competence is our ability to express emotions and perceive the emotions of others, people with autism lack this ability, what are some ways this shows?
Emotional Expression - show little emotion, appear aloof
Emotional Regulation - when emotions are expressed they are intense and with little build up
Emotional Understanding - unable to perceive emotions of others
What is Theory of Mind?
The ability to attribute mental states to other and realize that other individuals have their own distinct mental state entirely separate from one’s own
Impaired in those with Autism
What are some restrictive repetitive behaviors displayed by those with Autism?
Repetitive stereotyped movements - self-stimulatory (stimming)
Set in their ways - resistant to change
Ritualistic Behaviors
