Your SlideShare is downloading. ×
Chapter 17 Anxiety Disorders, Autistic Disorder, Attention ...
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Chapter 17 Anxiety Disorders, Autistic Disorder, Attention ...


Published on

  • Be the first to comment

  • Be the first to like this

No Downloads
Total Views
On Slideshare
From Embeds
Number of Embeds
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

No notes for slide


  • 1. Chapter 17 Anxiety Disorders, Autistic Disorder, Attention-Deficit/Hyperactivity Disorder, and Stress Disorder
  • 2.
    • Anxiety Disorders
      • Panic Disorder
      • Anxiety disorder:
        • A psychological disorder characterized by unrealistic fear and anxiety. 1. Panic disorder
        • 2. obsessive compulsive behavior
      • Panic Disorder:
        • A disorder characterized by episodes of intense fear accompanied by symptoms such as shortness of breath and irregularities in heartbeat.
  • 3. Copyright © 2004 Allyn and Bacon
  • 4.
    • Anxiety Disorders
      • Panic Disorder
      • Anticipatory anxiety:
        • A fear of having a panic attack; may lead to the development of agoraphobia.
      • Agoraphobia:
        • An unrealistic and intense fear of being away from home or other protected places.
        • In severe cases people will not leave home!
  • 5.
    • Anxiety Disorders
      • Panic Disorder Possible Causes:
      • Genetic origins:
        • Evidence supports some anxiety disorders may be inherited. Associated with joint hypermobility.
      • Neurotransmitters:
        • Serotonin and central benzodiazepine receptors may be involved in anxiety disorders.
        • Treated with benzodiazepines and occasionally SSRIs
      • Brain Structures:
        • Imaging studies suggest that the cingulate gyrus, prefrontal, and anterior temporal cortices are involved in panic attack.
  • 6.
    • Anxiety Disorders
      • Obsessive-Compulsive Disorder
      • Obsessive-compulsive disorder:
        • A mental disorder characterized by obsessions and compulsions.
      • Obsession:
        • An unwanted thought or idea with which a person is preoccupied.
      • Compulsion:
        • The feeling that one is obliged to perform a behavior, even if one prefers not to do so.
  • 7.
    • Anxiety Disorders
    • Examples of obsessions:
      • Concern for order
      • Cleanliness, germs
      • Forbidden sexual thoughts
    • Examples of compulsions:
      • Hand washing
      • Checking
      • Collecting
      • Repeating behaviors (in and out of a door)
  • 8.
    • Anxiety Disorders
      • Obsessive-Compulsive Disorder
      • Possible Causes:
      • Genetic Origin:
        • Evidence is beginning to accumulate suggesting that OCD might have a genetic origin.
      • Family studies:
        • Some research suggests OCD is associated with Tourette’s; a neurological disorder that appears during childhood.
      • Treatment:
        • SSRIs , tricyclic antidepressants (desipramine, clomipramine)
  • 9. Copyright © 2004 Allyn and Bacon
  • 10.
    • Anxiety Disorders
      • Obsessive-Compulsive Disorder
      • Possible Causes:
      • Tourette’s syndrome:
        • A neurological disorder characterized by tics and involuntary vocalizations and sometimes by compulsive uttering of obscenities and repetition of the utterances of others.
        • Treatment with antipsycolics (dopamine antagonists, D2)
  • 11.
    • Anxiety Disorders
      • Obsessive-Compulsive Disorder
      • Possible Causes:
      • Cingulotomy:
        • The surgical destruction of the cingulum bundle, which connects the prefrontal cortex with the limbic system; helps to reduce intense anxiety and the symptoms of obsessive-compulsive disorder.
        • Only used on patients who are unresponsive to drug treatment.
  • 12.
    • Autistic Disorder
      • Description:
      • Autistic Disorder:
        • A chronic disorder whose symptoms include failure to develop normal social relations with other people, impaired development of communicative ability, lack of imaginative ability, and repetitive, stereotypical movements.
  • 13.
    • Autistic Disorder
      • Possible Causes:
      • Biological:
        • Research and mental health professionals are convinced autism is caused by biological factors.
        • Between 2 and 3 percent of siblings of people with autism are themselves autistic.
        • There is a 70 percent concordance rate for monozygotic twins.
  • 14. Copyright © 2004 Allyn and Bacon
  • 15.
    • Autistic Disorder
      • Possible Causes:
      • Phenylketonuria (PKU):
        • A hereditary disorder caused by the absence of an enzyme that converts the amino acid phenylalanine to tyrosine; causes brain damage unless a special diet is implemented soon after birth.
  • 16.
    • Autistic Disorder
      • Possible Causes:
      • Brain pathology:
        • Heritable aspect of autism suggests the disorder is a result of structural or biochemical abnormalities in the brain.
        • Researchers have found evidence for structural abnormalities in the brains of autistics, but so far we cannot point to any single abnormality as the cause of the disorder.
  • 17.
    • Attention-Deficit/Hyperactivity Disorder
      • Attention-deficit/hyperactivity disorder (ADHD):
        • The principal characteristics of ADHD are inattention , hyperactivity , and impulsivity . These symptoms appear early in a child's life.
        • There are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive. Or, they may show all three types of behavior.
  • 18.
    • Attention-Deficit/Hyperactivity Disorder
      • Inattention
        • Often becoming easily distracted by irrelevant sights and sounds (hyper vigilant)
        • Often failing to pay attention to details and making careless mistakes
        • Rarely following instructions carefully and completely losing or forgetting things like toys, or pencils, books, and tools needed for a task
        • Often skipping from one uncompleted activity to another.
  • 19.
    • Attention-Deficit/Hyperactivity Disorder
      • Hyperactivity-Impulsivity
        • Feeling restless, often fidgeting with hands or feet, or squirming while seated
        • Running, climbing, or leaving a seat in situations where sitting or quiet behavior is expected (lack of impulse control)
        • Blurting out answers before hearing the whole question (lack of impulse control)
        • Having difficulty waiting in line or taking turns.
  • 20.
    • Attention-Deficit/Hyperactivity Disorder
      • Possible causes
        • There is strong evidence from family and twin studies for hereditary factors in a person’s likelihood of developing ADHD.
        • Thirty-six percent of all findings were positive (P< 0.05), 17% were trends (0.05 <P < 0.15), and 47% were negative (P > 0.15).
        • Genetic investigations have supported the role of both dopamine D4 receptor gene (DRD4) and dopamine transporter gene (DAT1) in the vulnerability to the disorder.
        • The DRD4 gene has been postulated as a candidate gene for attention-deficit-hyperactivity disorder
          • Lower DA binding in basal ganglia
          • Increased DA transport in frontal lobes
  • 21.
    • Attention-Deficit/Hyperactivity Disorder
    • Other causes
      • Possible correlation between the use of cigarettes and alcohol during pregnancy.
      • Lead paints?
      • Sugar sensitivities?
      • Head injuries?
  • 22.
    • Attention-Deficit/Hyperactivity Disorder
      • Brain structure involvement:
        • Studies of brain structure of people with ADHD do not reveal any localized abnormalities, though the total volume of their brains is approximately 4% smaller than normal.
        • Candidates:
          • Frontal lobes
          • Medial temporal lobes
          • Caudate nucleus
  • 23.
    • Attention-Deficit/Hyperactivity Disorder
      • NIMH Child Psychiatry Branch studied 152 boys and girls with ADHD, matched with 139 age- and gender-matched controls without ADHD. The children were scanned at least twice, some as many as four times over a decade. As a group, the ADHD children showed 3-4 percent smaller brain volumes in all regions—the frontal lobes, temporal gray matter, caudate nucleus, and cerebellum.
  • 24.
    • Attention-Deficit/Hyperactivity Disorder
      • The Reticular Activating System
        • Decreased NE activity in RAS
        • Poor attention, learning difficulties, memory deficits, lack of behavior control
        • Treatment with amphetamines increase RAS activity
        • Increased RAS activity
        • Hyperactivity, restlessness, hyper vigilant
        • Treatment may include Clonadine (NA Antagonist)
  • 25.
    • Attention-Deficit/Hyperactivity Disorder
      • Drug Treatment
        • Adderall amphetamine
        • Concerta methylphenidate
        • Cylert pemoline*
        • Dexedrine dextro-amphetamine
        • Ritalin methylphenidate
        • * DA agonist? Mechanism not well described
  • 26.
    • Stress Disorders
      • Stress:
        • A pattern of physiology common to all stressors
      • Stressor:
        • A stimulus (or situation) that produces a generalized stress response.
  • 27.
    • Stress Disorders
      • Fight-or-flight response:
        • First stage of the stress response where organism is mobilized.
        • Changes in hormonal and sympathetic activity in preparation for response.
  • 28.
    • Stress Disorders
      • Physiology of Stress
      • Glucocorticoid (cortisol)
        • One steroid hormone of the adrenal cortex that is important in protein and carbohydrate metabolism, secreted especially in times of stress.
  • 29.
    • Stress Disorders
      • Physiology of Stress
      • Corticotropin-releasing hormone (CRH):
        • A hypothalamic hormone that stimulates the anterior pituitary gland to secrete ACTH.
      • Adrenocorticotropic hormone (ACTH):
        • A hormone released by the anterior pituitary gland in response to CRH; stimulates the adrenal cortex to produce glucocorticoids.
  • 30. Copyright © 2004 Allyn and Bacon
  • 31. Copyright © 2004 Allyn and Bacon
  • 32.
    • Stress Disorders
      • Psychoneuroimmunology
      • Psychoneuroimmunology:
        • The branch of neuroscience involved with interactions between environmental stimuli, the nervous system, and the immune system.
      • Antigen:
        • A protein present on a microorganism that permits the immune system to recognize the microorganism as an invader.
  • 33.
    • Stress Disorders
      • Psychoneuroimmunology
      • Antibody:
        • A protein produced by a cell of the immune system that recognizes antigens present on invading microorganisms.
      • B-lymphocyte:
        • A white blood cell that originates in the bone marrow; part of the immune system.
  • 34.
    • Stress Disorders
      • Psychoneuroimmunology
      • Immunoglobulin:
        • An antibody released by B-lymphocytes that bind with antigens and help to destroy invading microorganisms.
      • T-lymphocytes:
        • A white blood cell that originates in the thymus gland; part of the immune system.
  • 35.
    • Stress Disorders
      • Psychoneuroimmunology
      • Cytokine:
        • A category of chemicals released by certain white blood cells when they detect the presence of an invading microorganism; causes other white blood cells to proliferate and mount an attack against the invader.