Psychopathology Flashcards
1
Q
What are psychiatric disorders?
A
- disturbance in throught, mood, and/or behavior that impairs function or causes distress
- Diagnosed by behavioral symptoms
2
Q
What is the DSM?
A
- Diagnostic and Statistical Manual of Mental Disorders
- Scales based on presence of various amounts of symptoms
- One of the goals is to have objective information
3
Q
Prevalence of psychiatric disorders
A
- more than 1/3 of the US population reported at some point symptoms matching psychiatric disorders
4
Q
Who is at greater risk for developing psychiatric disorders?
A
- Females are at greater risk than males
- 18-25 year olds are at much greater risk than other ages
- people who are mixed-racial have greater prevalence of developing mental illness- often has to do with identity “issues”
5
Q
Social behavior dysfunction in mental illness
A
- hypo- or a-sociality (reduced or lack of healthy social function)
- can included impaired motivation to elicit social interactions (schizoid personality disorder- cold, detached, aloof)
- Social avoidance: social anxiety disorder- find social interactions aversive
- Impaired social cognition: autism spectrum disorders- difficulty understanding others’ emotions and thoughs
6
Q
Psychopathy and sociopathy symptoms
A
- pattern of antisocial behavior and/or attitudes
- disregard for and violation of the rights and feelings of others
- deviates noticeable from expectations of individual’s culture
- pervasive and inflexible
- leads to personal distress or impairment
7
Q
Sociopathy vs psychopathy
A
- Sociopathy- having a sense of morality and a well-developed conscience, but the sense of right and wrong is not that of the parent culture- can show remorse for actions (cannot make a decision of what’s right or wrong in the moment but can reflect back)
- Psychopathy- no empathy or sense of morality, dishonest, manipulativeness- shows no remorse (takes pride in crimes and hurting others)
8
Q
What causes reduced emotional empathy and sets the stage of psychopathy?
A
- amygdala dysfunction
- boys with conduct disorders and psychopathy have both hemispheres of the amygdala reduced in size
someone with a hyper functioning amygdala will have anxiety and intense fear
9
Q
Emotional empathy in healthy people
A
- viewing people experiencing fear, sadness, or pain evokes emotional empathy in healthy people (we experience their emotions)
- activates the amygdala, anterior cingulate, and insula
10
Q
Psychopathy and the reward system
A
- reward/reinfocement system (striatum) dysfunction causes impaired action-outcome (instrumental learning), particularly for punishment
- Research found decreased signal change in the left caudate when recieving rewarding feedback, and increased signal change when recieving punishing feedback (opposite of healthy controls) in people with disruptive behavioral disorder
11
Q
Psychopaths and frontal lobe
A
- Gage: after frontal lobe legion had no inhibitions or desire for appropriate social behavior
- murderers have a largely inactive frontal lobe
12
Q
Schizophrenia morphemes
A
- Schizo- to split
- phren- mind (not personality); thought, mood, affect, and behavior are splintered
- Spectrum of disorders: psychosis= disconnection from reality
13
Q
Schizophrenia prevalence and age of onset
A
- 1-3% of US population
- peak in diagnoses around age 20
14
Q
Schizophrenia positive symptoms
A
- psychosis, including:
- Hallucinations, delusions, disorganized thought and speech, bizarre behaviors
15
Q
Schizophrenia negative symptoms
A
- Emotional dysregulation : lack of emotional expression, reduced facial expression (flat affect), inability to experience pleasure in everyday activities (anhedonia)
- Impaired motivation: reduced conversation (alogia), diminished ability to begin or sustain activities, social withdrawal
16
Q
Schizophrenia cognitive symptoms
refers to problems with processing and acting on external information
A
- Neurocognitive impairment: memory problems, poor attention span, difficulty making plans, reduced decision-making capacity, poor social cognition, abnormal movement patterns
17
Q
What may promote psychosis?
A
- Psychotropic substances: stimulant drugs of abuse, high potency cannabis and psychedelics (PCP/angel dust)
- Inflammation, injury, illness (things are changing in your brain, making neurons incapable of proper function): meningitis and encephalitis, tumore, strokes, parkinson’s and alzheimer’s
- Stress/trauma susceptibility
18
Q
Genetic susceptibility: twin studies
A
- If a monozygotic twin has schizophrenia there is a 50% risk of the other twin developing schizophrenia!
- Dizygotic and siblings have 2nd highest risk rate if one has schizophrenia (birth weight, early psychological stress, motor coordination for symptomatic twin)
19
Q
Eyes and schizophrenia
A
people with schizophreniz have more erratic eye movements, less precise… are also unable to fixate gaze on a single point
20
Q
Which genes are known to be associated with schizophrenia?
A
- Neuregulin 1: Gaba, NMDA, ACh receptors
- Dysbindin: synaptic plasticity
- COMT: dopamine metabolism
- DISC1: brain synapse development
21
Q
Schizophrenia and stress
A
- Appears in transition from child to adult when physical, emotional, and lifestyle changes occur
- Prenatal stress such as flu (first semester increases risk by 7x), incompatible blood type, and gestational diabetes
22
Q
Schizophrenia and ventricle volume
A
- ventricular size and CSF increases, which can only happen if brain volume shrinks
- Men w schizphrenia have larger ventricle to brain matter raio than controls
- has no relationship to illness length or hospitaliztion period, but does predic responsiveness to antipsychotic drugs
23
Q
What is the disc 1 gene cause?
A
- people with this gene are more susceptible to getting schizophrenia
- if this gene is mutated, the ventricles enlarge, and the brain has to shrink to still fit in the skull
24
Q
Limbic system (subcortical structures) and schizophrenia
A
- both hippocampus and amygdala are smaller in SCZ- discordant twin
- Disorganization of hippocampal pyramidal cells, are all jumbled an unorganized leading to loss of synaptic connections and organized thought
- Entorhinal cortex, parahippocampal cortex, cingulate cortex abnormalities
- Unsure if this happens during development or lifespan neurogenesis
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Cortical changes: Schizophrenia
* thinning of grey matter- loss and shrinkage of neurons, shorter stubbier fewer dendrites
* hypofrontality- less cortical activation in SCZ- discordant twin at rest and during task
26
Schizophrenia and brain volume loss
changes get worse over time, much faster whole-brain volume decline than healthy individuals
27
Chlorpromazine
| antipsychotic drug for schizophrenia
* anesthetic
* lessened psychosis symtpoms
* dramatically impaired/slowed voluntary movement
* D2 antagonist effects in extrapyramidal motor system
* l-dopa can evoke/worsen psychosis in Parkinson's patients
28
D2 affinity and antipsychotc drugs
The effective dose of antipsychotics correlates with their affinity for dopamine D2 receptors
29
Measurements of dopamine release in schizophrenia patients
* SCZ people have a lot more dopamine than healthy individuals
* The more dopamine, the more positive the symptoms
30
Dopamine Hypothesis
* In a normal individual, there is an equal balance of brain stem DA projections from the prefrontal cortex and limbic sites
* In schizophrenic person, brain stem DA neurons are overactive in limbic sites and weakend in the prefrontal cortex... causes complications for treatment
31
Limitations of the dopamine hypothesis
* Not all symptoms are treated well by dopamine antagonists
* not all patients will respond to a dopamine antagonist
* even if they do respond, their delay to efficacy is prolonged, and the associated adverse effects are substantial
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