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Psyc 211 > Lecture 23 — OCD, ADD, Addiction > Flashcards

Lecture 23 — OCD, ADD, Addiction Flashcards

1
Q

What is Obsessive-compulsive disorder?

A

Characterized by
- Repeatedly having certain thoughts (obsessions)
- A need to repeatedly check things, perform certain routines

Causes distress and impairs general functioning taken to the extreme.

4 groups of symptoms:
- symmetry
- cleaning
- hoarding
- forbidden thoughts

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2
Q

What are the 4 groups of symptoms of obsessive-compulsive disorder?

A

Symmetry
- Think have to have a certain number or you have to check things a certain amount of times. Things have to be perfectly symmetrical and placed

Cleaning
- Everything has to be clean, there are germs everywhere and it’s obsessively wanting things to be clean, mostly associated with thoughts of getting sick

Hoarding
- Not being able to throw things away and feeling a need to keep absolutely everything

Forbidden thoughts
- intrusive thoughts that can disgust or scare a person, but they seem to be insistent and repetitive and refuse to leave

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3
Q

What are forbidden thoughts in obsessive-compulsive disorder?

A

Intrusive and distressing thoughts of a violent, religious, or sexual nature.

Even if they know it won’t happen. The what if? Consumes them. They feel this incredible need to control these thoughts

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4
Q

What are the kind of things that people do to control their intrusive thoughts in OCD?

A

Obsessive hand washing, cleaning, counting, checking on things, difficulty throwing things out.

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5
Q

What drives the need of obsessive behaviours in OCD?

A

They are often performed to seek relief from obsession-related anxiety, driven by a fear that something bad will happen if the ritualistic behaviour is not done properly or a belief that life cannot proceed as normal while the imbalance remains.

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6
Q

What is the prevalence for OCD?

A

Less than 2%.

  • Females diagnosed typically later (after 18) than males (before 18)
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7
Q

When do symptoms usually start for OCD?

A

Before age 25

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8
Q

What are the causes of OCD?

A

Combination of genetic and environmental factors.

Heritability is about 50%

Damage to the frontal lobe is associated with OCD

Environmental risk factors
- History of child abuse
- Other adverse events
- Sometimes infections

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9
Q

What are the environmental risk factors of OCD?

A

History of child abuse
Other adverse events
Infections

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10
Q

Where in the brain does damage increases the risks of OCD?

A

Frontal lobe

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11
Q

What are the treatments for OCD?

A

1) Counseling —> a version of cognitive behavioural therapy
- Exposure and response prevention which involves increasing exposure to what causes the problems while not allowing the repetitive behaviour to occur

2) Medication
- Antidepressants such as selective serotonin reuptake inhibitors

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12
Q

Damage to which areas of the brain can cause symptoms of OCD?

A

Brain damage to the basal ganglia, cingulate gyrus or the prefrontal cortex

  • Increased activity in the frontal lobes and striatum
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13
Q

What is cingulotomy?

A

It’s a treatment for severe cases of OCD that includes a brain lesion, which is cutting a fibre bundle between the prefrontal cortex and anterior cingulate.

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14
Q

What is ADHD characterized by?

A

Mental disorder characterized by problems paying attention, hyperactivity or difficulty controlling behaviour in an age-appropriate manner.

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15
Q

When do symptoms of ADHD usually appear?

A

Before a person is 12 years old. Symptoms have to be present for more than 6 months and cause problems in school, home or elsewhere.

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16
Q

What are the symptoms of ADHD?

A

Recklessness and impetuous behaviour
- Acting without reflecting
- Let interfering activities intrude into ongoing tasks
- Have difficulty withholding a response
- Easily distracted

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17
Q

Why is ADHD diagnoses difficult ?

A

The symptoms are not well defined.

Many children with ADHD can have good attention for tasks they find interesting

+ some hyperactivity, inattention and impulsivity are within the range of normative behaviours for children.

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18
Q

What is the prevalence of ADHD and the difference between sexes?

A

Prevalence varies a lot on places depending going from 1% to 10%

Boys are diagnosed 3x more than girls.

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19
Q

What is ADHD comorbid with?

A
  • Aggression
  • Conduct disorder
  • Learning disabilities
  • Depression
  • Anxiety
  • Low self-esteem
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20
Q

What are the causes of ADHD?

A

Environmental and genetic factors.
Heritability = 75% to 91%

Certain causes are related to previous infection of or trauma to the brain

Drug and alcohol use and infections during pregnancy are associated with increased risk for the child to be born as low birth weight.

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21
Q

What are the treatments for ADHD?

A
  • Counseling
    Medications
  • Stimulants that raise dopamine levels by blocking or reversing the dopamine reuptake transporter.
  • Antidepressants may also be helpful
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22
Q

What do the stimulants given for ADHD do?

A

They raise dopamine levels by blocking or reversing the dopamine reuptake transporter.

Basically, they raise the dopamine level, which scientists think is telling the brain that “this is an important task we should be focusing on” which would make it more willing to exert mental physical effort and make people able to focus very intensely on everyday tasks that they would usually not care about.

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23
Q

What does stress refer to ?

A

It refers to the physiological reaction caused by the perception of aversive or threatening situations.

24
Q

What do the physiological responses of stress do for people?

A

It prepares people for fight or flight situations.

It includes autonomic and endocrine responses that help mobilize the body’s energy resources and support vigorous activity

25
Q

What does stress activate in the body? Which systems, which body parts?

A

It activates the sympathetic autonomic nervous system.

It also activates the adrenal glands to release the hormones into the blood, including epinephrine, norepinephrine and glucocorticoids such as cortisol.

26
Q

What do the autonomic and hormone responses related to stress produce in the body?

A

They increase heart rate, blood pressure and blood flow to make the nutrients stored become available

27
Q

What are glucocorticoids?

A

A group of hormones that are important in protein and carbohydrate metabolism.

They are secreted especially in times of stress.

28
Q

What is cortisol?

A

A specific glucocorticoid secreted by the adrenal cortex in response to stress.

29
Q

What part of the brain controls the secretion of glucocorticoids?

A

The hypothalamus

30
Q

How are glucocorticoids produced and secreted in times of stress? Explain the process in order of what part is activated, etc.

A

1) In responses to stress, hypothalamus releases CRH (corticotropin-releasing hormone)

2) CRH stimulates the pituitary gland to secrete ACTH (adrenocorticotropic)

3) ACTH stimulates the adrenal gland to produce glucocorticoids.

31
Q

What are the purpose of glucocorticoids?

A

They help break down and convert proteins into glucose, make fats available for energy, increase blood flow, suppress secretion of sex hormones and stimulate behavioural responsiveness.

Almost every cell in the body contains glucocorticoids.

Short-term effect are essential for survival.

32
Q

What are the effects of long-term exposure to glucocorticoids?

A
  • increased blood pressure
  • Damage to muscle tissue
  • Steroid diabeties
  • Infertility
  • inhibition of growth
  • inhibition of the inflammatory responses
  • Suppression of the immune system
33
Q

How does stress affect the healing of wounds and infections?

A

Stress kind of turns off the immune system.

People tend to get sick after intense stress. Because their body was so focused on the stress that it could not work as well in protecting the body physically. It will also slow down the healing of wounds

34
Q

What did examinations post-morgen of monkeys in low social status showed?

A

They experienced a lot of stress. The examinations found them to have signs of chronic stress, such as gastric ulcers, enlarged adrenal glands and damaged hippocampi.

35
Q

What is associated with children that have very emotional childhoods and traumatic lives?

A

A small reduction in volume of the dorsomedial prefrontal cortex

36
Q

What is PTSD?

A

Post traumatic stress disorder.

Mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions or other threats to a person’s life.

Multiple emotions (guilt, shame, anger) that is not seen in a normal anxiety disorder.

Symptoms include:
- Disturbing thoughts, feelings, or dreams related to the events.
- Mental or physical distress to trauma-related cues and efforts to avoid them
- Increased fight-or-flight response

Symptoms cans interfere with social activities, cause feelings of hopelessness and increase risk for suicide.

37
Q

What are the symptoms of PTSD?

A
  • Disturbing thoughts, feelings or dreams related to the events
  • Mental or physical distress to trauma-related cures and efforts to avoid them
  • Increased fight or flight response

They interfere with social activities, cause feelings of hopelessness and increase risks of suicide.

38
Q

What are the emotions associated with PTSD?

A

Shame, guilt, anger, hopelessness, etc.

39
Q

What is the heritability of PTSD?

A

30%

40
Q

What are the treatments for PTSD?

A
  • Cognitive behavioural therapy
  • Group therapy
  • Medication —> selective serotonin reuptake inhibitors
41
Q

What abnormalities are associated with PTSD?

A

Abnormalities in the hypothalamic-pituitary-adrenal axis, which coordinates hormonal response to stress.

Increased activity in the amygdala —> responsible for emotional reactions in people with PTSD.

42
Q

What parts of the brain showed activation when pictures of faces with fearful expressions were shown to people with PTSD?

A

Greater activation of amygdala and smaller activation of prefrontal cortex

43
Q

What are the big players in addictions?

A

Alcohol
Opiates
Cocaine and meth
Nicotine
Barbiturates
Benzos

44
Q

What are the problems with alcohol abuse?

A

-Automobile accidents
- Fetal alcohol syndrome
- Cirrhosis of the liver
- Korsakoff’s syndrome
- Increased rate of heart disease
- Increased rate of intracerebral hemorrhage
- Pancreatitis, diabetes, etc.

45
Q

What is the heritability of alcoholism?

A

40 to 60% are accounted to genetic factors

46
Q

What is reinforcement learning in addiction?

A

Drugs that lead to dependency must first reinforce people’s behaviour

If, in a situation, a behaviour is regularly followed by a reinforcement that behaviour will become more frequent in that situation;

47
Q

What neurotransmitter is released when reinforcement occurs and in which part of the brain?

A

Dopamine is released in the striatum, particularly in the nucleus accumbens

48
Q

What is tolerance?

A

Fact that increasingly large doses of drugs must be taken to achieve a particular effect.

It’s caused by compensatory mechanisms that oppose the effect of the drug. Not all addictive drugs produce tolerance and withdrawal.

49
Q

What are withdrawal symptoms?

A

The appearance of symptoms opposite to those produced by drugs when the drug is suddenly no longer taken.

Caused by the presence of compensatory mechanisms.

50
Q

What is negative reinforcement ?

A

The removal or reduction of an aversive stimulus that is contingent on a particular response, with an attendant increase in the frequency of that response.

Ex: taking the drug or alcohol to get rid of the withdrawal symptoms.

51
Q

How does addiction affect the prefrontal cortex?

A

After a long time of addiction, people show the same deficits on tasks that involved the prefrontal cortex as do people with damage to that region.

They show abnormalities in the prefrontal cortex. Their medial prefrontal cortex is less activated when they perform tasks that normally activate the prefrontal cortex.

52
Q

What is addiction comorbid with?

A

Schizophrenia, ADHA, substance abuse
- 70-90% of schizophrenics smoke cigarettes.

53
Q

What is Naltrexone?

A

A somewhat long-acting, slow onset opioid receptor antagonist that is prescribed to alcoholics and opiate addicts.
- REduces the high produced by opiates, but also tends to reduce drug, alcohol and food cravings in certain people.

54
Q

What is Naloxone?

A

An extremely rapid and short lived opioid receptor antagonist that reverses the effects of an opiate overdose,

An injection can immediately stop the effects of an overdose and even elicit withdrawal symptoms

55
Q

What is methadone maintenance?

A

It’s a potent opiate, similar to morphine or heroin but with a slower onset and offset, which means that it takes a long time to reach the brain, which makes the possibility of addiction less probable.

56
Q

What is Buprenorphine in the treatment of addiction?

A

It’s a high affinity partial opioid receptor agonist

  • It strongly binds to opioid receptors but produces only a weak effect while blocking the effect of other opiates.
  • Commonly mixed with a little naxolone to reduce the potential for abuse.
57
Q

What is varenicline in the treatment of addiction?

A

Approved to treat nicotine addiction.

  • partial agonist at nicotinic (acetylcholine) receptors

Psyc 211 (9 decks)

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