Chapter 15: Psychological Disorders
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Chapter 15: Psychological Disorders

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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