Normal Development of Psychopatholgoy Flashcards
How much of the US population has a major mental disorder?
6%
Costly - MDD is the most expensive of them all
30,000 suicides a year
Onset of major mental illness
50% before age 15
75% before age 24
OCD has a significant gap between onset and diagnosis, as many of the other MMI’s do –> results in delayed treatments and poorer prognoses
Embryology of brain development
4-28 weeks - proliferation of neurons
6-24 weeks – migration of neurons
24 wks to 3 years post natal - construction/organization of axons, dendrites, synapses
28 wks - mid life (well into 30s) - myelination of axons
Exposures to the fetus
INFECTIONS (CMV, Rubella) - esp during first and second trimesters –> increases risk of fetal blindness, deafness, mental retardation, schizophrenia, autism
Toxic exposure (cigs, alcohol, amphetamines) increases risk of neural tube defects, MR, ADHD, learning disorders
Maternal obesity increases risk of AUTISM
Extreme stress increases risk of depression, anxiety, schizophrenia
Exposures that are earlier, long in duration, and repetitive all have greater impacts
Childhood trauma/abuse
Has a profound impact on mental and physical health - especially cardiac health!! HTN, hyperlipidemia, diabetes due to their impact on the HPA
Most highly heritable disorder (according to MZ twin studies?
AUTISM (60-90%)
Schizophrenia 50%
BPD 45%
MDD 45%
Ages of presentation for mental disorders
ADHD & AUTISM –> present with symptoms and go to clinical attention BEFORE AGE 5
Conduct Disorders, Antisocial Behaviors, Anxiety –> School age, 5-10
OCD, Eating Disorders, Anxiety –> PRE ADOLESCENTS (10-13)
Addiction, depression, BPD, panic disorder, schizophrenia –> ADOLESCENTS to EARLY ADULTHOOD
ADHD overview
ADHD – develops in preschool, better impact if discovered then; These children have MAJOR problems with IMPULSE CONTROL, MOTOR CONTROL, ATTENTION, EXECUTIVE FUNCTIONS (self control, self regulation, planning, organizing, focusing – all from prefrontal cortex)
ADHD kids also have ABNORMAL BRAIN DEVELOPMENT – delayed cortical maturation, decreased brain size, abnormal connections
ADHD kids reach PEAK CORTICAL THICKNESS by age 10 (normal is about age 7) –> thus there is ~3 year delay in brain maturation for kids with ADHD
NOT a brain disease where we see irreversible insult/damage to the brain
Conduct disorder
Rule breaking, lack of empathy, aggression towards peers/animals – “callous and unemotional” – higher risk of developing adult antisocial behaviors
The brains of these children DO NOT REACT the same way as those without conduct disorders –> LESS ACTIVITY IN THE AMYGDALA IN SITUATIONS THAT WOULD GENERALLY STIR UP FEAR AND AXIETY; lack of changes in HR, BP, skin conductance as well
Amygdala also FAILS TO COMMUNICATE with the other parts of the brain responsible for moral reasoning –> callous/lack of empathy
Adolescents to early adults
Have greater maturity of SUB-CORTICAL LIMBIC STRUCTURES (powerful emotional drive - fear, lust, joy) as compared to that of the PREFRONTAL CORTEX (calming, self-regulating, organizing, impulse-control)
Cutting is a major problem
Peer influence, feeling invincible, lacking access to health care, lacking access to information all play factors
Cortical maturation
Two waves of OVERPRODUCTION of gray matter (cortical thickening) – first during INFANCY and second PRIOR TO PUBERTY
THINNING then occurs in a BACK-to-FRONT wave, starting from the OCCIPITAL lobe working its way forward
THINNING correlates with functional maturity!!!
Schizophrenics have an ACCELERATED back-to-front thinning process –> first present with hallucination and delusions (correspond to temporal lobe) and then, later, they progress to having THINKING/EMOTIONAL deficits, which correspond to the frontal lobes –> this progression is RAPID ins schizophrenics (engulfs the frontal areas within 5 years)
