S2W11Disord

Question 1

Cognitive disorders vs. disorders with cog. features

Answer 1

Cognitive Disorders (learning, memory, perception, problem solving)

Amnesia
Delirium
Dementia
Parkinson’s

Disorders with cognitive features (cognitive problems not primary feature):

Schizophrenia
Depression
Addiction

Question 2

Parkinson’s hallucinations

Answer 2

16-40%

Result of medication that stimulates dopamine in Substantia Nigra

Also believed to be intrinsic to the disease through impairments of sensory processing.

Question 3

Parkinson’s depression

Answer 3

25-50%

Understandable reaction.

Can occur 3 years prior to onset (potential predictor?)

Contributed to thinking that depression is accompanied by an allostatic state (biological state of stress) that accelerates disease in the brain

Question 4

Parkinson’s & Dopamine

Answer 4

Parkinson’s results in dopamine deficiency.

Dopamine pills developed.

L-dopa – first drug developed taken as pill and converted to dopamine by neurons.

L-dopa increases dopamine release in all axons (those deteriorated and normal ones).

Alternates between high and low levels of release.

Doesn’t replace other depleted transmitters.

Doesn’t slow the continuing loss of neurons.

Side effects: restlessness, low blood pressure, repetitive movements and hallucinations and delusions

Question 5

Parkinson’s & Schizophrenia

Answer 5

Drugs that increase dopamine help Parkinson’s but can cause psychosis.

Drugs that decrease dopamine should help psychosis.

Side effects similar to Parkinsons (motor problems)

High doses of recreational drugs over long periods cause psychosis (raise dopamine)

Anti-psychotic drugs developed that alleviate psychosis by blocking dopamine receptors

Question 6

Dopamine Hypothesis

Answer 6

Dopamine receptors too sensitive – messages sent too often and too easily

Parkinson’s patients – not often enough.

Antipsychotics block dopamine receptors

Question 7

Schizophrenia and Cogniton DSM

Answer 7

No explicit mention of cognitive deficits.

Two present for 1-month:

1) Delusions
2) Hallucinations
3) Disorganised Speech

Disorganised or catatonic behaviour

Negative symptoms (e.g. avolition)

Question 8

Features of Schizophrenia

Answer 8

Positive symptoms (excess of normal functions)

Delusions, hallucinations, disorganised speech, disorganised or catatonic behaviour

Negative symptoms (reduced normal functions)

Flattened affect, alogia (poverty of speech), avolition (apathy)

Question 9

Cognitive problems are related to schizophrenia

Answer 9

Some memory

Attention

Perceptual-motor

Executive Functioning

Language

Hallucinations

Delusions

Question 10

Cognitive Theories

Answer 10

Theories centre around:

Attentional processes

Attributional/Information Processing

Theory of Mind

Question 11

Attentional Processes Schizophrenia

Answer 11

Inability to associate relevant events or irrelevant associations.

Reflect inability to focus on relevant environmental aspects (underattention)

Or overattend to irrelevant aspects.

Deficits in orienting response (response to environmental change)

Skin Conductance to simple tones – schizophrenics less sensitive.

Highly distractible on cognitive tasks:

Sustained Attention, Selective Attention, Divided Attention.

Question 12

Attributional and Information Processing Schizophrenia

Answer 12

Attribute negative events to external causes.

Excessively stable and global attributions to negative life events.

Attribute positive events to internal causes.

Explains reports of persecution in sufferers

Question 13

Bentall & Kaney (1989) Stroop Schizophrenia

Answer 13

Emotional Stroop Task

Name the colours of words

Words related to negative affect, paranoia or neutral

Response times for Paranoid words slower

Question 14

Processing bias schizophrenia Morrison (2001)

Answer 14

Bias labelling cognitive intrusion as threatening

Leads to negative mood and arousal that cause more intrusions.

Question 15

Freeman et al (2002) Persecutory Delusions (Formation)

Answer 15

Hallucination/delusion with no obvious explanation

Arousal

Search for meaning

Incooperates belief about self and the world (biased)

Selection ofexplanation

Threat belief

Question 16

Freeman et al (2002) Persecutory Delusions (Maintenance)

Answer 16

Delusional distress

Anxiety, depression create bias toward negative thinking

Discard disconfirmatory evidence

Obtain confirmatory evidence

Reinforcement of threat belief

Social factors such as isolation

Question 17

Jumping to conclusions bias

Answer 17

Red and blue beads in a jar.

300 in each.

One with more red one with more blue.

Schizophrenics jump to conclusions earlier on and get it wrong.

Question 18

Theory of Mind Schizophrenia

Answer 18

Deficits in Theories of Mind

Ability to understand our own and others mental states.

Sufferers have deficit in ability to infer beliefs/intentions of others

Jokes involving inferring the mental state of others more difficult to understand

Question 19

Frith & Corcoran (1996)

TOM

Answer 19

Six stories to schizophrenics.

First order (character has false belief about world)

Second order (character has a false belief about the belief of another character)

Types of story (circumstantial, deception)

Asked one memory question and one question about inferring mental state of others.

Patientes with paranoid delusions impaired on mental state questions.

Patients with behavioural signs impaired on mental state questions, but difficulty associated with memory impairment.

Question 20

CBT schizophrenia

Answer 20

Challenging negative beliefs and biases that maintain psychotic thinking.

interpretation bias leads to safety behaviours that lead to more hallucinations

CBT aims to generate acceptable explanations.

Good outcomes.

Reduction in positive symptoms that are long-lasting.

Question 21

Reattribution Therapy

Answer 21

Help patients reattribute paranoid symptoms to normal daily events.

Patients challenged by:

Monitoring frequency of delusional beliefs

Generating alternative explanations

Creating behavioural experiments that allow for reality testing.

Verbal challenge often enough

Question 22

Addiction

Answer 22

Produces dopamine that leads to people wanting to do it again.

Behavioural or chemical based.

Interference with everyday functioning: Substance Abuse Disorder.

Behavioural (e.g. gambling)

Neurochemical (e.g. drugs)

Both increase dopamine activity.

Also direct effect on dopamine in some drugs

Question 23

Twin studies and addiction

Answer 23

Strong influence of genetics.

Few genes specific to addiction, but number associated with different disorders.

One gene controls variation in types of dopamine receptor (short or long).

Long less sensitive so substances are less reinforcing.

Stronger craving to make up for short fall in reinforcement.

Another gene controls COMT (breaks down dopamine).

If this gene is active it breaks down dopamine more quickly so r

Leads to impulsivity and risk-taking.

Question 24

Cognitive Deficits of Addiction

Answer 24

Impulsivity and risk-taking involve decision-making.

Direct effects of particular substances on cognition:

Language, memory and perceptual motor: alcohol/drugs

Hallucinations/delusions caused by drugs.

May also be cognitive problems that facilitate and maintain the addictive behaviour indirectly (false beliefs about effects)

Question 25

Major Depressive Disorder DSM

Answer 25

5+ for 2 weeks.

Depressed mood

Loss of pleasure.

Weight loss/gain

Insomnia/Hypersomnia

Fatigue

Restlessness/slowed down

Worthlessness or guilt (may be delusional)

Inability to concentrate

Recurrent thoughts of death.

Question 26

Features of Depression

Answer 26

Emotional
Sadness,
Close to tears
Anxiety

Motivational
Loss of interest
Lack of initiative

Behavioural
Slow speech/behaviour
Decreased energy

Physical
Sleep disturbance
Dizziness
Pain

Question 27

Cognitive Features of Depression

Answer 27

Negative view of the self/world/future: pessimism

Inability to concentrate or make decisions

Worthlessness and guilt

Question 28

Neurochemical Factors Depression

Answer 28

Blood pressure meds in 1950’s caused depression.

Decreased serotonin.

Depression caused by low Serotonin/Norepinephrine

Inhibits neuron communication (brain activity)

Drugs inhibit reuptake leaving more in synapse

Facilitates communication.

Serotonin in MDD
Norepinephrine BD

Recent research argues for interaction

Question 29

Beck’s Cognitive theory of depression

Answer 29

Bias in thinking and information processing.

Negative schemas

Effects selection, encoding and evaluation of events.

Originates in childhood.

Event reactivates schema.

Negative Triad – self, future, world.

Self-fulfilling prophecy

Question 30

Evidence for Beck

Answer 30

Attentional bias to negative stimuli.

Stroop: slower at naming colours of negative words

Dichotic listening: difficulty ignoring negative words.

Memory tasks: remember negative words, negative info about self.

Interpretational bias: associated with critical self-judgement

Question 31

Attribution Theory Depression

Answer 31

Negative life events attributed to factors that are difficult to change.

Internal/External (Personality/Environment)

Stable/Unstable (Unchangeable/Changeable)

Global/Specific (Effect many areas/Specific area)

Global-Stable = depression

Question 32

Hopelessness Theory

Depression

Answer 32

Account for interaction between attribution and other factors.

Diathesis – stress.

Attribution style represents diathesis and stress is negative event.

Combination of low self-esteem, negative attributional style and negative life events predict depression.

Negative attributional style linked to difficulty making decisions and lethargy.

Question 33

Depression treatment

Answer 33

CBT:

Challenge thoughts
Correct negative bias
Monitor automatic thoughts

Mindfulness:

Recognise negative feelings and view them for what they are.

Alter relationship with behaviour and thoughts.

ACT:

Feel fear do it anyway.