Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Chapter 15: Psychological Disorders


Published on

Looking at problematic behaviors that interfere with life.

Published in: Education, Health & Medicine
  • Fioricet is often prescribed for tension headaches caused by contractions of the muscles in the neck and shoulder area. Buy now from and make a deal for you.
    Are you sure you want to  Yes  No
    Your message goes here

Chapter 15: Psychological Disorders

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