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Chapter 15: Psychological Disorders

Chapter 15: Psychological Disorders



Looking at problematic behaviors that interfere with life.

Looking at problematic behaviors that interfere with life.



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    Chapter 15: Psychological Disorders Chapter 15: Psychological Disorders Presentation Transcript

    • Psychological Disorders
    • Substance Abuse
      • Definition:
      • Maladaptive pattern of substance use leading to clinically significant impairment of distress
      • Synapses, Reinforcement, & Drug Use
      • Experiments showed dopamine release in the area of the nucleus accumbens was reinforcing
      • Most abused drugs & ordinary pleasures lead to increased dopamine activity
      • Recent research has dopamine & nucleus accumbens playing role in attention-getting or arousal rather than pleasure
    • Common Drugs & Their Synaptic Effects
      • Stimulants
      • Produce excitement, alertness, elevated mood, decreased fatigue, & sometimes motor activity
      • Highly addictive
      • Amphetamines
      • Increases dopamine release from presynaptic terminals by reversing the direction of dopamine transfer
      • Cocaine
      • Blocks the reuptake of catechola-mines & serotonin at the synapse
      • Behavioral effects are believed to be mediated primarily by dopamine & secondarily by serotonin
      Normal Brain Cocaine Brain
    • Common Drugs & Their Synaptic Effects
      • Effects of Amphetamine & Cocaine
      • Short-lived because of the depletion of dopamine stores & tolerance
      • Methylphenidate
      • Ritalin
      • Prescribed for ADHD
      • Works like cocaine by blocking reuptake of dopamine at presynaptic terminals
      • Repeated use of stimulants can have permanent effects on brain functioning
    • Common Drugs & Their Synaptic Effects
      • Nicotine
      • Stimulates the nicotinic receptor (a type of acetylcholine receptor) in the CNS & neuromuscular junction of skeletal muscles
      • Also increased dopamine release by attaching to neurons that release dopamine in the nucleus accumbens
      • The nicotine in tobacco is 4 ½ times more addicting than heroin
    • Common Drugs & Their Synaptic Effects
      • Opiate Drugs
      • Morphine, heroin & methadone
      • The net effect is of increasing the release of dopamine by stimulating endorphin receptors
      • They decrease the activity in the locus coeruleus resulting in a decreased response to stress & decreased memory storage
    • Common Drugs & Their Synaptic Effects
      • Marijuana
      • Contains  9 -THC which works by attaching to canabinoid receptors
      • Hallucinogenic Drugs
      • Drugs that distort perception
      • Many hallucinogenic drugs resemble serotonin & bind to serotonin type 2A receptors
    • Alcohol & Alcoholism
      • Alcoholism & Alcohol Dependence
      • A common type of substance abuse that produces significant harm to the lives of others & the drinker
      • Alcohol inhibits the Na + ion flow across the neuron membrane
      • It decreases serotonin activity, facilitates the transmission of GABA A receptor & blocks glutamate receptors & increases dopamine activity
      • Types of Alcoholism
      • Type I alcoholism: less dependent on genetic factors, develops gradually over years, affects men & women equally & is less severe
      • Type II alcoholism: has a strong genetic basis, is rapid & has an early onset, primarily affects men, is more severe & is associated with criminality
    • Alcohol & Alcoholism
      • Risk Factors for Alcohol Abuse
      • 1. Less than average intoxication after drinking a small to moderate amount of alcohol
      • 2. Experiencing more than average relief from tension after drinking alcohol
      • 3. Having a smaller than normal amygdala in the right hemisphere
      Alcohol's Addictive Cycle 2. Alcohol High (Stimulating Opioid Receptors) 4. Motivated to Consume More Alcohol (Increased craving & Loss of Control) 1. Alcohol Consumption 3. Alcohol High Diminishes (Desire to stimulate The Opioid Receptors)
    • Major Depression
      • Characteristics:
      • Feeling sad, helpless, lacking energy & pleasure for weeks at a time, feelings of worthlessness, trouble sleeping, can’t concentrate, little pleasure from food or sex, contemplating suicide & can’t imagine being happy
    • Major Depression More Shortness Of Breath Increased Anxiety Less Energy Tiredness More Shortness Of Breath Muscle Tension Shallow Breathing Anxiety Deprsssion
    • Major Depression
      • Evidence of Genetic or Other Prior Predispositions
      • If there were relatives with depression that manifests before the age of 30
      • It tends to be episodic & there were incoming feelings of depression
      • May have normal feelings for weeks, months or years between episodes
      • It is more common among women than men but equally common among children
      • Most experiencing depression have decreased activity in the left hemisphere & increased activity in the right prefrontal cortex
    • Major Depression
      • Borna Disease
      • A viral infection of the nervous system leading to periods of frantic activity alternating with periods of inactivity
      • In 1990 study, 30% of severely depressed persons tested positive for the Borna virus
      • Hypoglycemia
      • Causes: too little food, too much insulin or diabetes or diabetes medication, or extra activity
      • A sudden onset may progress to insulin shock
    • Treatment for Depression
      • Tricyclics
      • Prevent the presynaptic neuron from reuptake of catecholimes or serotonin
      • MOA Inhibitors
      • Block the enzyme monamine oxydase from metabolizing catecholamines & serotonin into active forms
      • SSRIs
      • Similar to tricyclics but are specific to serotonin
      • Atypical Antidepressants
      • A miscellaneous group of drugs with antidepressant actions & mild side effects; they inhibit reuptake of dopamine & to some extent norepinephrine
    • Treatment for Depression
      • Cognitive Therapy
      • Produces effects similar to drugs for many depressed people
      • Recovered are less likely to relapse
      • Electroconvulsive Therapy
      • Inducing seizures with an electric shock to the head
      • Application: every other day for about 2 weeks
      • About ½ will relapse within 6 mos.
      • Most depressed people will enter REM sleep within 45 mins. of going to bed
      Thoughts Emotions Behavior
    • Bipolar Disorder
      • Manic-Depressive Disorder
      • Alternates between depression & mania
      • 2 types of bipolar disorder:
      • Bipolar I disorder: Has full-blown episodes of mania
      • Bipolar II disorder: His milder phases of mania (hypomania)
      • Characteristics
      • Mean onset is in the late 20s
      • Brain activity is higher than normal during mania & lower than normal during depression
      • There is a strong hereditary basis but there is no specific gene
      • Lithium salts are the most effective therapy but it isn’t known how they work
      • Drugs used include valproic acid and carbamazepine
    • Seasonal Affective Disorder
      • Usually in the Winter
      • Most common in regions closest to the poles where the nights are very long and there’s a very short summer
      • Treatment is with bright lights in either the morning or evening for about 1 hour
    • Schizophrenia
      • Characteristics
      • Deteriorating ability to function in everyday life, delusions, hallucinations, movement disorders, thought disorders, & inappropriate emotional expression
      • Behavioral Symptoms
      • Positive Symptoms: (behaviors that should be absent) delusions, hallucinations, inappropriate emotional responding, bizarre behavior, & thought disorders
      • Negative Symptoms: (missing behaviors that should be there) deficits in social interaction & emotional expression
      • Can be either acute or chronic
    • Schizophrenia
      • Diagnosing
      • Difficult to diagnose
      • Conditions with similar symptoms:
      • 1. mood disorder with psychotic features
      • 2. substance abuse
      • 3. brain damage
      • 4. undetected hearing loss
      • 5. Huntington’s disease
      • 6. nutritional abnormalities
      • Demographic Data
      • Occurs in all ethnic groups & is about equal in men & women
      • It tends to develop earlier in men
      • Expressed emotions: hostile expressions by a caretaker can aggravate the conditions
      • May be the reason for increased number of cases in the U.S. & Europe compared to 3 rd world countries
      • The older the father at the time of birth, the greater the risk
    • Schizophrenia
      • Genetics
      • There is a 50% concordance for schizophrenia for monozygotic twins & a 15% concordance for dizygotic twins
      • This does not mean that schizophrenia has a purely genetic cause
      • There are no reliable markers for schizophrenia
    • Schizophrenia Hypotheses
      • Neurodevelopmental Hypothesis
      • Caused in large part by abnormalities to the nervous system during the prenatal or neonatal period
      • Many schizophrenics had problems before or shortly after birth that could have affected brain development
      • Rh incompatibility between mother & offspring is associated with increased probability of schizophrenia
      • Season-of-birth effect: tendency for those born in winter months to have a slightly greater probability of schizophrenia
      • Mild Brain Abnormalities
      • Many schizophrenics have slightly smaller prefrontal cortex, temporal cortex, hippocampus & amygdala
      • Have smaller than normal cell bodies & some neurons fail to arrange themselves in a neat, orderly manner
      • Have slightly larger right hemisphere & lower than normal activity in the left hemisphere
      • It appears late if the damage is done early because the damage is in areas that mature slowly producing minor symptoms in childhood, but impairments increase with maturation
    • Schizophrenia Hypotheses
      • Dopamine Hypothesis
      • Schizophrenia is the result of excess activity at certain dopamine synapses
      • Evidence comes from drugs that relieve the symptoms work on dopamine
      • Chlorpromazine: Thorazine was the 1 st drug used successfully
      • Antipsychotic drugs: Block dopamine receptors
      • Phenothaizines: neuroleptic drugs including chlorpromazine
      • Butyrophenones: neuroleptic drugs including haloperidol (Haldol)
      • Substance-induced Psychotic Disorder
      • Characterized by hallucinations & delusions caused by drugs such as cocaine, amphetamine, MDMA & LSD that increase the activity of dopamine synapses
      • Stress increased the symptoms & causes release of dopamine from the prefrontal cortex
      • Excess dopamine is not the only cause
      • Drugs that block dopamine do so almost immediately but behavioral effects over 2 or 3 weeks
      • Recent studies show schizophrenics have2 X as many D 2 as normals
    • Schizophrenia Hypotheses
      • Glutamate Hypothesis
      • Schizophrenia is the result of deficient activity at certain glutamate synapses
      • The brain releases lower than normal amounts of glutamate in the prefrontal cortex & hippocampus & has fewer glutamate receptors
      • Phencyclidine (PCP): blocks glutamate type NDMA receptors & produces a type of psychosis similar to schizophrenia
      • No drugs that treat schizophrenia directly stimulate glutamate activity
    • The Search for Improved Drugs
      • The Mesolimbocortical System
      • A set of neurons that project from the midbrain tegmentum to the limbic system
      • Believed to be the area where antipsychotic drugs have beneficial effects
      • Tardive Dyskinesia
      • Characterized by tremors & other involuntary movements
      • Probably due to denervation sensitivity caused by prolonged blockade of dopamine receptors
      • Atypical Antipsychotic Drugs
      • New drugs that alleviate the symptoms of schizophrenia while seldom producing movement problems
      • They have less effect on D 2 & stronger effect on D 4 & serotonin 5-HT receptors
      • Alleviate both positive & negative symptoms of schizophrenia
      • The side effects include increased risk of diabetes & impairment of the immune system