Psychopathology Flashcards
Schizophrenia
> Generally thought to be a disease of the brain, much to be understood
> Considered a: chronic condition (cannot be cured)
> But can be managed
> Schizophrenia amounts to half of all admissions to psychiatric hospitals
> Often manifests in late adolescence/ early adulthood
> Requires clinical management after manifestation
> 1 in 200 people affected in any given time
Symptoms and features of schizophrenia (diagnosis)
- Hallucinations
- Delusions
- Disorganized speech
(one of these must be present for diagnosis)
> Grossly disorganized/ Catatonic behaviour
> Negative symptoms (absence of normal behaviour)
Diagnosis based on observable behaviour and psychological features. At least 2 of the above symptoms must be present for at least one month in duration.
Positive vs. Negative Symptoms
Positive: something is being added, excess or distortion of normal behaviour, presence of symptoms that aren’t normally there
Negative: something is being removed, absence of normal behaviour.
»> apathy, flattened affect, failures of volition or self-directed behaviour
»> associated with a poorer prognosis, less easily treated
Psychopathology
“Mental illness”
- Schizophrenia
- Depression
- Anxiety disorders
- Substance use disorders
Schizophrenia and ventricles
- Enlargement of the lateral and third ventricles is a well-noted piece of evidence for schizophrenia
- Larger ventricles reflect brain atrophy
- Brain atrophy can continue up to 20 years after diagnosis
Approaches in studying schizophrenia
Two main cognitive neuroscience approaches:
1. Comparing cognitive deficits in schizophrenia to deficits in patients with known brain damage
2. Using neuroimaging and brain functioning measurements to identify areas of difference between schizophrenics and control groups
Both demonstrate involvement of the frontal and temporal lobes
Frontal lobe disruption
Affected:
> Working memory
> Self monitoring
> Attention
> Cognitive control
> Behavioural flexibility
___________
Working memory
E.g. Activity is abnormal in the dorsolateral prefrontal cortex when manipulating held information, the ventrolateral prefrontal cortex is underactive during the encoding phase of working memory
Self-monitoring
E.g. Abnormalities in structure and function of medial regions of the frontal lobe including ACC, Abnormal ERN responses to errors
Attention
E.g. Deficient smooth-pursuit eye-movements, fail to activate the frontal eye fields as much as controls
Cognitive control
E.g. frontal lobe mechanisms involved in inhibiting behavior are disrupted
Behavioral flexibility
E.g. impaired on tests of planning and tests of mental flexibility
Hypofrontality
Frontal hypoactivation is evident in schizophrenia when the person is resting and when engaged in tasks that normally activate the frontal lobe
Temporal lobe disruption
Reduced volume of grey matter in the left and right middle temporal gyrus, left posterior superior temporal gyrus, and left angular gyrus
Sensory gating effect for auditory stimuli is absent or substantially reduced
Abnormalities in semantic priming (linked to temporal lobe processing):
»»> ERP component sensitive to the degree of semantic relatedness between items (reduced when the target word is semantically related to the prime) do not differentiate as well between concepts that are highly related versus unrelated.
Genetic link to schizophrenia
Risk depends on relation to someone with the disorder
Linked to schizophrenia
»> Genes relate to synaptic pruning during development, immune function, dopaminergic transmission or glutamate function, and more
Treatment of Schizophrenia
Most common form: antipsychotic drugs that affect the dopamine symptoms of the brain (especially D2 dopamine receptor)
» Effective in reducing positive symptoms
> relatively ineffective at reducing negative symptoms
> can have unwanted side effects
Depression
- One of the most common mental illnesses
» 1 in 10 adults withing any 12-month period
» Twice as common in women than in men - Timing in relation to life stressors
» First episode is often tied to a severe life stress, subsequent episodes may appear to be decoupled from discrete life stressors
Symptoms of Depression
In general, depression is a mood disorder characterized by:
> Chronic feelings of sadness and hopelessness
> Loss of interest or pleasure in once pleasurable activities
Other common symptoms include:
> Change in appetite and/or sleeping patterns
> Low energy
> Low self-esteem
> Poor concentration and difficulty making decisions
> Suicidal thoughts
Subtypes and variations of depression
Major Depression
Dysthymia
Seasonal Depression
Bipolar Disorder
Cognitive characteristics of Depression
Memory and attention are biased toward negative events and interpretations (creating a self-perpetuating cycle)
Poor performance on standard tasks of executive functions
Trouble shifting mental sets (reduced activity in the DLPFC and dorsal anterior cingulate cortex)
Inability to respond adaptively to performance errors or negative feedback (disruption in functional connectivity between cingulate and DLPFC regions)
Poor performance on spatial tasks that depend on the right hemisphere
