Halgin6e ppt ch12

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  • Cognitive functions include thought processes, memory capacity, and ability to be attentive. In this chapter’s disorders, cognitive impairment is the central characteristic. In DSM-IV-TR , this set of disorders is titled delirium, dementia, amnestic, and other cognitive disorders.
  • People with temporal lobe epilepsy may experience a number of symptoms, such as increased fear, mood swings, inappropriate affect, bursts of anger, illusions or hallucinations, altered thought processes, and bizarre behavior.
  • They may also experience delusions, illusions, or hallucinations, as well as emotional disturbances like anxiety, euphoria, or irritability.
  • People of any age can experience delirium, but it is more common among medically or psychiatrically hospitalized older adult patients.
  • In other words, this is amnesia with biological causes.
  • Those due to medical conditions can be chronic (lasting a month or more) or transient (temporary). Such medical conditions include head trauma, loss of oxygen, herpes simplex.
  • Note the word persisting , to distinguish this from passing effects of substance intoxication or substance withdrawal.
  • Dementia: A form of cognitive impairment involving generalized progressive deficits in a person's memory and learning of new information, ability to communicate, judgment, and motor coordination. Most people who fear they are developing the dementia known as Alzheimer’s are likely to be wrong. For those with Alzheimer’s, though, memory loss becomes more pronounced.
  • Aphasia: A loss of the ability to use language caused by damage to the brain’s speech and language centers. Wernicke’s aphasia: The individual is able to produce words but has lost ability to comprehend them. The person with Broca’s aphasia has a disturbance of language production, but comprehension abilities are intact.
  • The odds that a person will develop Alzheimer’s disease later in life are actually low. It is NOT an inevitable part of the aging process. Uncomplicated: Cases for which none of the other characteristics apply.
  • Neurofibrillary tangles: A characteristic of Alzheimer's disease in which the material within the cell bodies of neurons becomes filled with densely packed, twisted protein microfibrils, or tiny strands. Amyloid plaques: A characteristic of Alzheimer's disease in which clusters of dead or dying neurons become mixed together with fragments of protein molecules.
  • Pictured: Actor Michael J. Fox, who has struggled for years with Parkinson’s Disease.
  • AIDS dementia: Subtle deterioration in cognitive functioning is sometimes the first clue that a person has AIDS, for individuals for whom dementia precedes other AIDS symptoms. Pick's disease: A relatively rare degenerative disease that affects the frontal and temporal lobes of the cerebral cortex and that can cause dementia. Parkinson's disease: A disease that involves degeneration of neurons in subcortical structures that control motor movements, and can cause dementia in up to 60% of Parkinson’s patients. Lewy body dementia: A form of dementia similar to Alzheimer's disease with progressive loss of memory, language, calculation, and reasoning, as well as other higher mental functions. Diagnosed when Lewy bodies (deposits of protein found in dying nerves) are found more diffusely throughout the brain.
  • Frontotemporal dementias involve the frontal lobes of the brain. Rather than involving a decline in memory, this is reflected in personality changes such as apathy, lack of inhibition, obsessiveness, or loss of judgment. Eventually, motivation and communication are lost. Huntington's disease: A hereditary condition causing dementia that involves a widespread deterioration of the subcortical brain structures and parts of the frontal cortex that control motor movements. Creutzfeldt-Jakob disease: A neurological disease transmitted from animals to humans that leads to dementia and death resulting from abnormal protein accumulations in the brain. Vascular dementia: A form of dementia resulting from a vascular disease that causes deprivation of the blood supply to the brain.
  • Although people with Alzheimer’s disease may also have depression, particularly during the early to middle phases, simply being depressed may interfere with thought, memory, and motivation in ways that resemble early stages of Alzheimer’s.
  • As of this writing, there is no cure. Treatments are aimed at (1) slowing progression of the disorder, and (2) managing the patient’s behavior and quality of life.
  • Halgin6e ppt ch12

    1. 1. Richard P. Halgin Susan Krauss Whitbourne University of Massachusetts at Amherst slides by Travis Langley Henderson State University Abnormal Psychology Clinical Perspectives on Psychological Disorders 5e Clinical Perspectives on Psychological Disorders 6e Richard P. Halgin Susan Krauss Whitbourne slides by Travis Langley Henderson State University Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    2. 2. Aging-Related and Cognitive Disorders Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 12
    3. 3. NATURE OF COGNITIVE DISORDERS <ul><li>DSM-IV diagnoses include: </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Impairment of thought, memory, attention (cognitive impairment) arising from brain trauma, disease, or exposure to toxic substances. <ul><ul><li>Delirium </li></ul></ul><ul><ul><li>Dementia </li></ul></ul><ul><ul><li>Amnesia </li></ul></ul>
    4. 4. Differential Diagnosis <ul><li>Differentiating symptoms associated with a psychological disorder from those arising in response to a physical disorder can be difficult. </li></ul><ul><li>Example: </li></ul><ul><li>EPILEPSY , especially the form called TEMPORAL LOBE EPILEPSY , can be mistaken for a psychological disorder. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    5. 5. Delirium <ul><li>A temporary state in which individuals experience a clouding of consciousness, they are unaware of what is happening around them and are unable to focus or pay attention. </li></ul><ul><li>In a state of delirium , people experience cognitive changes in which their memory is foggy and they are disoriented. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    6. 6. delirium <ul><li>Caused by a change in brain metabolism due to factors such as: </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>substance intoxication </li></ul><ul><li>substance withdrawal </li></ul><ul><li>head injury </li></ul><ul><li>high fever </li></ul><ul><li>vitamin deficiency </li></ul>Delirium
    7. 7. Amnestic Disorder <ul><li>Cognitive disorders involving inability to </li></ul><ul><li>recall previously learned information or </li></ul><ul><li>register new memories. </li></ul><ul><li>This inability can be very disturbing, because the individual loses a sense of personal identity. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    8. 8. Categories of Amnestic Disorder Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>Amnestic disorders due to medical conditions. </li></ul><ul><li>chronic </li></ul><ul><li>transient </li></ul>Substance-induced persisting amnestic disorders.
    9. 10. Substances That Induce Amnestic Disorder <ul><li>Medications </li></ul><ul><li>Illicit drugs </li></ul><ul><li>Industrial solvents </li></ul><ul><li>Mercury </li></ul><ul><li>Lead </li></ul><ul><li>Insecticides </li></ul><ul><li>The most common cause: </li></ul><ul><li>Chronic alcohol use </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    10. 11. Dementia <ul><li>Generalized progressive deficits in memory, learning, communication, judgment, and motor coordination. </li></ul><ul><li>The first sign of dementia is memory loss. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    11. 12. Dementia: Other Prominent Symptoms <ul><li>Aphasia </li></ul><ul><ul><li>Wernicke’s </li></ul></ul><ul><ul><li>Broca’s </li></ul></ul><ul><li>Apraxia </li></ul><ul><li>Agnosia </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    12. 13. Dementia: Other Prominent Symptoms <ul><li>Disturbance in Executive Functioning </li></ul><ul><li>Executive functioning: Cognitive abilities such as abstract thinking, planning, organizing, and carrying out of behaviors. </li></ul><ul><li>Relatively simple everyday tasks may be forgotten or confused. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    13. 14. Traumatic Brain Injury (TBI) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Damage to the brain caused by exposure to trauma is increasingly recognized as an important cause of mental and physical dysfunction.
    14. 15. ALZHEIMER’S DEMENTIA <ul><li>Multiple cognitive deficits associated with dementia, probably caused by biological abnormalities involving the nervous system. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>Subtypes </li></ul><ul><li>With delirium </li></ul><ul><li>With delusions </li></ul><ul><li>With depressed mood </li></ul><ul><li>Uncomplicated </li></ul>
    15. 16. ALZHEIMER’S DEMENTIA Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>Stages </li></ul><ul><li>Forgetfulness </li></ul><ul><li>Early confusional </li></ul><ul><li>Late confusional </li></ul><ul><li>Early dementia </li></ul><ul><li>Middle dementia </li></ul><ul><li>Late dementia </li></ul>
    16. 17. <ul><li>BIOLOGICAL FEATURES </li></ul><ul><ul><li>Neurofibrillary tangles </li></ul></ul><ul><ul><li>Amyloid plaques </li></ul></ul><ul><ul><li>Deficits in neurotransmitter acetylcholine </li></ul></ul><ul><ul><li>40 to 50 percent twin concordance rate </li></ul></ul>ALZHEIMER’S DEMENTIA Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>ENVIRONMENTAL factors must play a role; otherwise, concordance would be higher, but specific factors are not yet confirmed . </li></ul>
    17. 18. Parkinson’s Disease <ul><li>Involves neuronal degeneration of subcortical structures controlling movements. </li></ul><ul><li>Dementia occurs in up to 60% of Parkinson’s patients. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    18. 19. Parkinson’s Disease Symptoms <ul><li>Hands, ankles, or head may shake involuntarily. </li></ul><ul><li>Bradykinesia: General slowing of motor activity. </li></ul><ul><li>Akinesia: Muscular rigidity, difficulty initiating movement. </li></ul><ul><li>Loss of fine motor coordination. </li></ul><ul><li>Slowed, shuffling gait. </li></ul><ul><li>Difficulty starting or stopping movement like walking. </li></ul><ul><li>Expressionless appearance. </li></ul><ul><li>Loss of normal rhythmic speech quality. </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    19. 20. VARIOUS DEMENTIAS <ul><li>Substance-Induced Persisting Dementia </li></ul><ul><li>Pick’s Disease </li></ul><ul><li>Lewy Body Dementia </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    20. 21. VARIOUS DEMENTIAS <ul><li>Frontotemporal Dementias </li></ul><ul><li>Huntington’s Disease </li></ul><ul><li>Creutzfeldt-Jakob Disease </li></ul><ul><li>Vascular Dementia </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
    21. 22. Pseudodementia Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Pseudodementia: False dementia, symptoms caused by depression that mimic those apparent in early stages of Alzheimer's.
    22. 23. ALZHEIMER’S TREATMENT <ul><li>BEHAVIORAL MANAGEMENT </li></ul><ul><li>Target both patient and caregiver to: </li></ul><ul><ul><li>Increase patient independence. </li></ul></ul><ul><ul><li>Eliminate wandering and aggression. </li></ul></ul><ul><ul><li>Provide social support for caregivers. </li></ul></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. <ul><li>MEDICATION </li></ul><ul><ul><li>Slow breakdown of acetylcholine. </li></ul></ul><ul><ul><li>Antioxidants target free radicals that may damage neurons. </li></ul></ul>
    23. 24. <ul><li>For more information on material covered in this chapter, visit our Web site: </li></ul>Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. http:/ www.mhhe.com/halgin6e

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