Psychopathology Flashcards

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1
Q

What does psychiatry use to diagnose patients

A

Solely behavior

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2
Q

What % of the population fit the criteria of a psychological disorder

A

almost 50% (46.4% to be exact)

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3
Q

Positive symptoms of schizophrenia

A

Symptoms not present in neurotypicals

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4
Q

Give an example of positive symptoms

A
  • Hallucinations
  • Delusions
  • Disorganized thoughts and speech
  • Bizarre behaviors
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5
Q

Negative symptoms

A

Characteristics that should be present but are absent

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6
Q

Give an example of a negative symptom of schizophrenia

A
  • Flat affect
  • Anhedonia
  • Lack of emotional expression
  • Reduced conversation
  • Social withdrawal
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7
Q

Give an example of cognitive symptoms of schizophrenia

A
  • Memory problems
  • Poor attention span
  • Difficulty making plans
  • Reduced decision making capacity
  • Abnormal movement patterns
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8
Q

How do people with schizophrenia have differing eye movements

A
  • Difficulty smoothly tracking a moving object
  • “Jagged” eye movements when looking at something stationary
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9
Q

What is the degree of heritability of schizophrenia

A

The more related you are to a person with schizophrenia, the more likely you are to develop schizophrenia yourself

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10
Q

What role do DISC proteins play in schizophrenia

A

If you a have a certain version of the DISC protein/gene, you are more likely to develop schizophrenia

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11
Q

Explain the interaction between environmental stress and gene influence on schizophrenia

A

The fewer genes you have that favor schizophrenia, the more environmental stress you can take before you develop schizophrenia.

The more genes you have that favor schizophrenia, it takes less stress to develop schizophrenia.

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12
Q

What change occurs in the ventricles when affected with schizophrenia

A

Ventricles become enlarged

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13
Q

What change occurs in the hippocampus in people with schizophrenia

A

The pyramidal cells in the hippocampus are disorganized, which lead to a disrupted circuitry

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14
Q

What change occurs in grey matter in adolescents with schizophrenia

A

Adolescents have an accelerated loss of gray matter

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15
Q

Hypofrontality in schizophrenia

A

When presented with a card sorting task (which uses the frontal lobe), people with schizophrenia exhibit less activity than they should

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16
Q

Dopamine hypothesis of schizophrenia

A

People with schizophrenia have an excess of dopamine release or dopamine receptors

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17
Q

Correlation between antipsychotic dose and its affinity for D2 receptors

A

The more affinity an antipsychotic has for D2 receptors, the lower dose you need

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18
Q

What effect does PCP have on NMDA receptors

A

It’s a non competitive antagonist. When PCP is bound, no other ligand can activate the NMDA receptor

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19
Q

Psychomimetic

A

A drug that induces a state resembling schizophrenia, such as PCP

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20
Q

What is observed when amphetamines are taken for a long time

A

When taken in high doses for a long time, positive symptoms like the ones seen in schizophrenia are exhibited

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21
Q

What causes the emergence of positive symptoms when taking amphetamines

A

Vesicles containing dopamine leak, increasing the concentration of dopamine leading to positive symptoms

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22
Q

How do major tranquilizers such as Haloperidol affect schizophrenia symptoms

A

They decrease positive symptoms by antagonizing dopamine receptors

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23
Q

What side effects do dopamine antagonists cause

A

Tardive dyskinesia (involuntary facial tics) and Parkinsons.
Too low dopamine levels lead to tremors seen in these disorders.

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24
Q

What is the glutamate hypothesis of schizophrenia

A

Schizophrenia results from an underactivation of glutamate receptors, which may be what causes hypofrontality

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25
Q

Explain the side effects of antipsychotics

A
  • People not on drugs went longer without a relapse
  • People never on antipsychotics worked more than people always prescribed antipsychotics
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26
Q

Second-generation antipsychotics

A

Antipsychotics that act on other receptors as well as dopamine receptors

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27
Q

Name 2 symptoms of depression

A
  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies
    or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or
    suicide
  • Unexplained physical problems, such as back pain or headaches
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28
Q

What is the cognitive cycle of depression

A

Negative thoughts -> Low mood (feeling worthless and discouraged) -> reduced behavior

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29
Q

What changes occur in nREM sleep in people with depression

A
  • They have difficulty falling asleep and staying asleep
  • Reduction in SWS
  • Increase in Stage 1 and 2 sleep
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30
Q

What changes occur in REM sleep in people with depression

A
  • Enter REM sleep after sleep onset much earlier
  • ## Have unusually vigorous REM sleep
31
Q

Depriving depressed people of _______ sleep is an effective treatment

A

REM

32
Q

Functional polymorphisms in depression

A

Depression is associated with DNA sequence variations linked to the metabolism or synthesis of serotonin and dopamine

33
Q

Where is hyperactivity seen in people with depression

A

The amygdala and prefrontal cortex

34
Q

Monoamine oxidase (MAO) inhibitors

A

Inhibit the breakdown of serotonin, norepinephrine, and dopamine
- Marplan, Nardil, Parnate

35
Q

Tricyclics and heterocyclics

A

Inhibits the reuptake of serotonin, norepinephrine, and dopamine
- Wellbutrin, Elavil, Norpramin

36
Q

Selective serotonin reuptake inhibitors (SSRIs)

A

Block the reuptake of only serotonin
- Prozac, Paxil, Zoloft

37
Q

Relationship between cortisol and depression

A

People with high levels of cortisol often have depression

38
Q

Hypothalamic-pituitary-adrenal axis

A

The anterior pituitary causes the adrenal gland to release cortisol, which is sensed by the hypothalamus

39
Q

Dexamethasone

A

A potent synthetic glucocorticoid that suppresses the early morning rise of adrenocorticotropic hormone (ACTH, a cortisol)

40
Q

Dexamethasone suppression test

A

Dexamethasone given late at night fools the hypothalamus into believing there’s a high level of circulating cortisol. In people with depression, dexamethasone fails to suppress cortisol release the next day

41
Q

What changes in brain activity occur during a manic episode

A

More brain activity is seen

42
Q

What structural changes are seen in the brain in bipolar disorder

A

Enlarged ventricles, and probable changes in subcortical limbic structures

43
Q

What gene affects the probability of developing bipolar disorder

A

BDNF, which deals with regulation of synapse connectivity

44
Q

Cyclothymia

A

Cycling of mania and depression

45
Q

How does mania manifest in Type 2 bipolar disorder

A

Hypomania with a less impaired manic phase is seen

46
Q

What jobs do people with schizophrenia or bipolar disorder usually have?

A

They are more likely to work in a creative field

47
Q

Name 2 symptoms of generalized anxiety disorder

A
  • Restlessness or feeling wound-up or on edge
  • Being easily fatigued
  • Difficulty concentrating or having their minds go blank
  • Irritability
  • Muscle tension
  • Difficulty controlling the worry
  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)
48
Q

What is panic disorder?

A

Recurrent, unexpected panics which are sudden periods of intense fear

49
Q

Name one symptom of panic disorder

A
  • Sudden and repeated attacks of intense fear
  • Feelings of being out of control during a panic attack
  • Intense worries about when the next attack will happen
  • Fear or avoidance of places where panic attacks have occurred in the past
50
Q

Name 2 symptoms of social anxiety disorder

A
  • Feeling highly anxious about being with other people and having a hard time talking to them
  • Feeling very self-conscious in front of other people and worried about feeling humiliated,
    embarrassed, or rejected, or fearful of offending others
  • Being very afraid that other people will judge them
  • Worrying for days or weeks before an event where other people will be
  • Staying away from places where there are other people
  • Having a hard time making friends and keeping friends
  • Blushing, sweating, or trembling around other people
  • Feeling nauseous or sick to your stomach when other people are around
51
Q

What effect does the projection to the periaqueductal gray from the amygdala have on stress response

A

Avoidance behavior

52
Q

What effect does the diffusion from the amygdala have on stress response

A

Increased vigilance

53
Q

Explain the push-pull regulation of the HPA by the amygdala and hippocampus

A
  • Activation of the amygdala increase HPA activity which increases cortisol
  • Increase in cortisol activates the hippocampus which decreases HPA activity
54
Q

What effect does chronic stress have on the HPA axis?

A

Chronic stress damages hippocampal neurons, which dampens the ability of the hippocampus to decrease cortisol output via the HPA

55
Q

How do benzodiazepines work?

A

They bind to GABAa receptors as agonists to upregulate inhibitory neurotransmitter systems

56
Q

What is the distribution of benzos in the brain?

A

The effect of benzos happen in a wide distribution all over the cortex

57
Q

What is obsessive-compulsive disorder?

A

Recurring, repetitive acts carried out without reason while recognizing the behaviors are abnormal

58
Q

What areas of the brain do OCD patients have increased metabolic rates?

A

Orbitofrontal cortex, cingulate cortex, and caudate (disinhibition of these areas)

59
Q

What role does the caudate play in OCD

A

The caudate which deals with motor and cognitive habits is disinhibited, which could be a reason for repetitive acts

60
Q

What drug does OCD respond to and what does this show?

A

OCD responds to SSRIs in most cases, which suggests a serotonin dysfunction plays a role

61
Q

Overactivity in what circuit might underlie OCD?

A

Prefrontal cortex to striatum to thalamus

62
Q

Name 2 obsessive symptoms of OCD

A
  • Dirt, germs, or environmental toxins
  • Something terrible happening
  • Symmetry, order, or exactness
  • Religious obsession
  • Body waste or secretions
    -Lucky or unlucky numbers
  • Fear of harming self or others
63
Q

Name 2 compulsive symptoms of OCD

A
  • Performing excessive or ritualized cleaning routines
  • Repeating rituals
  • Checking things
  • Engaging in miscellaneous rituals
  • Removing contaminants from contacts
  • Touching
  • Counting
64
Q

What can be lesioned as an intervention for OCD?

A

A lesion of the cingulum

65
Q

Name 2 motor tics of Tourette’s

A
  • Eyes, face, head
  • Shoulder, neck
  • Arms, hands
  • Trunk
  • Legs
66
Q

Name 2 vocal tics of Tourette’s

A
  • Low noises
  • Loud noises
  • Stuttering
  • Obscenities
  • Syllables
  • Words out of context
  • Repeating others
67
Q

Name 2 compulsive actions of Tourettes’s

A
  • Head banging
  • Kissing
  • Touching objects
  • Kicking
  • Tapping
  • Touching self or others
  • Biting self
  • Touching sexual organs
  • Mimicking others
68
Q

What structural change can be seen in people affected with Tourette’s?

A

D2 receptors in the caudate are denser, which may be due to differences in the dopaminergic system

69
Q

What drug can be used to treat Tourette’s?

A

Haloperidol, a dopamine antagonist

70
Q

What is posttraumatic stress disorder?

A

When memories of a traumatic (whether acute or chronic) event repeatedly plague a person, and can be easily reactivated by stressful circumstances

71
Q

What structural change is seen in people with PTSD?

A

Decreased volume in the right hippocampus

72
Q

How does the brainstem sensitize people with PTSD?

A

Norepinephrine, dopamine, endogenous opioids, and corticotropin releases hormones are released as a result of the original trauma, and subsequent stressors lead to a sensitization

73
Q

What role does the amygdala play in in PTSD?

A

Sensory and cognitive associations to the original trauma lead to fear conditioning and a lack of an extinction response.