Chapter 16 - Disorders & Treatments Flashcards

(47 cards)

1
Q

Disorders & Treatments

  • (2) perspectives
A

Neurological

Psychiatric

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2
Q

Neurological Disorders

A

organic brain/NS disorders

→ symptoms due to brain dysfunction

  • stroke, TBI, Alzheimers
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3
Q

Psychiatric Treatments & Disorders

A

behavioral disorders

  • schizophrenia, depression, anxiety
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4
Q

Neurological vs. Psychiatric Disorders → Causes

  • difficulties
A

Neurological disorders: causes = largely known

Psychiatric disorders: causes = less known

difficult to identify cause since most disorders do NOT involve a single genetic abnormality

cognitive, behavioral & social symptoms = observable

→ BUT do not necessarily indicate underlying cause

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5
Q

Brain & Behavior Abnormalities

  • result from? (5)
A
  • genetic errors
  • epigenetics mechanisms
  • rapid cell death
  • progressive cell death
  • loss of neural connections & functions
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6
Q

Neurobiology of Abnormal Behavior

→extremely difficult to find because of?

A

complexity of NS

abnormal behavior not always clearly related to brain damage

brain damage doesn’t always produce obvious abnormal behaviors

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7
Q

Diagnosing Behavioral Disorders

  • ease/difficulty?
    • Explain.
A

difficult

  • behavioral observations usually from family or individual
    • biased
    • don’t know what to look for
  • skilled evaluators have own conceptual perspectives
    • ​influences Qs asked & info gathered
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8
Q

Anosognosia

A

lack of self-awareness about a certain disability/disorder one suffers from

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9
Q

Define: EPIDEMIOLOGY

A

study of distribution & causes of diseases in human popn

  • helps define & assess behavioral disorders
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10
Q

Identifying & Classifying Psychiatric Disorders

  • (2) sets of criteria for diagnosis
A

1) Diagnostic & Statistical Manual of Mental Disorders (DSM-5)
2) International Classification of Diseases (ICD-10)

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11
Q

Diagnosing Psychiatric Disorders

1) Diagnostic & Statistical Manual of Mental Disorders (DSM-5)

  • author?
  • provides/lists? (2)
  • limitations? (2)
A

American Psychiatric Association (APA)

→ lists symptoms & criteria (inclusion/exclusion) for diagnosis

→ provides statistical info (avg age of onset, prevalence, sex ratio etc.)

  • arbitrary
  • depends on prevailing cultural views
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12
Q

Diagnosing Psychiatric Disorders

2) International Classification of Diseases (ICD-10)

  • author?
A

World Health Organization

  • neurobiological & psychiatric disorders
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13
Q

some psychiatric disorders are to some extent arbitrary & depend on prevailing cultural views

→ based on? NOT?

A

based on consensus not empirical evidence

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14
Q

Identifying & Classifying Mental/Psychiatric Disorders

Role of NEUROIMAGING

  • present vs. future
    • must be?
    • limitation/problem?
A

brain imaging techniques NOT currently used for diagnosis

→ may be used in future in tandem with behavioral diagnoses to make diagnoses more objective

  • must be
    • sensitive enough to detect unique features of brain disorders
    • specific enough to rule out similar conditions
      • problematic: many behavioral disorders display similar abnormalities
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15
Q

Neurological Disorders → TREATMENTS

A

→ causes largely known

treatment fairly primitive

  • provide relief from symptoms, NOT cure
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16
Q

Psychiatric Disorders → TREATMENTS

A

causes largely unknown & complex

existing treatments = relatively effective

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17
Q

(4) Main Types of Treatments

A

a) Neurosurgical
b) Electrophysiological
c) Pharmacological
d) Behavioral

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18
Q

Treatment

a) Neurosurgical

  • goal? (4)
A
  • very invasive
  • goal = treat dysfunction by:
    • removing abnormal tissue
    • repairing abnormality
    • damaging dysfunctional area
    • implanting stem cells or electrode
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19
Q

Neurosurgical Treatments

  • goal = treat dysfunction by:
    1. removing abnormal tissue
    2. repairing abnormality
    3. damaging dysfunctional area
    4. implanting stem cells or electrode
A

1) epilepsy, tumor
2) hydrocephalus → shunt
3) Parkinson’s → lesion part of BG (neurons)
4) Stroke, Parkinsons → electrode - disrupts BG functioning

20
Q

Treatments

b) Electrophysiological (2)

A

non-invasive

1) Electroconvulsive Therapy (ECT)
* electrical stimulation to treat severe depression
2) Transcranial Magnetic Stimulation (TMS)
* alternative to ECT for depression treatment

21
Q

Electrophysiological Treatments

  • ECT vs. TMS
A

ECT

  • anticonvulsants & muscle relaxants
  • memory impairments may follow

TMS

  • more focused
  • shorter-term effects
22
Q

Electrophysiological Treatments → ECT & TMS

  • significance of BDNF
A

ECT & TMS

→stimulate production of BDNF (Brain-derived Neurotrophic Factor)

  • protein that promotes neural health, neurogenesis & synaptogenesis
23
Q

c) Pharmacological Treatments

  • (4)
  • limitations (2)
A

common drugs for neurological/behavioral disorders:

  • neuroleptics (antipsychotics) →schizophrenia
  • anxiolytics (antianxiety agents)
  • SSRIs → depression
  • L-dopa → Parkinson’s

→ alleviate symptoms (NOT a cure)

→ many disorders not reducible to single chemical abnormality

“a pill is not a skill”

24
Q

Pharmacological Treatments

  • “a pill is not a skill”
    • implications?
A

drugs = “bandaids”

→ NOT a fix

→ must also address sources of distress

25
d) **Behavioral** Treatments * **(4)**
* "brain alters behavior & **behavior alters brain"*** 1) Behavioral Modification 2) Cognitive Therapy 3) Neuropsychological Therapy 4) Psychotherapy
26
Behavioral Treatments 1) **Behavioral Modification**
→ mostly for **psychiatric** disorders **change _maladaptive_ behaviors** *to more constructive behavior* * therapists apply principles of operant/classical conditioning * systematic desensitization
27
Behavioral Treatments **2) Cognitive Therapy**
**change _maladaptive_** **thoughts** → depression, brain injury * perspective that thoughts intervene b/w events & emotions* * challenge **self-defeating attitudes/assumptions***
28
Behavioral Treatments 3) **Neuropsychological** Therapy
**_retraining_** **cognitive & behavioral processes lost after injury** → ABIs, stroke *restraint therapy, relearning in novel ways*
29
Behavioral Treatments 4) **Psychotherapy**
Emotional Therapy **_talking_** about **emotional problems** * provides **_insight_ into** & **helps _overcome_ causes** **​**
30
Neurological Disorders → **Traumatic Brain Injury** * **cause** * **factors** that damage brain
result from **blow to head** * bleeding * disrupt blood supply * swelling * infection * scar tissue
31
Neurological Disorders → **Traumatic Brain Injury (TBI)** * **(2)** types of damage
**MOVEMENT** OF BRAIN CAN CAUSE: **(1) widespread** damage → **generalized** impairments * throughout brain **(2) focal** damage → **discrete** impairments * specific region
32
Neurological Disorders → **Traumatic Brain Injury (TBI)** 1) **Focal** Damage * location * **most susceptible** areas * impairment(s)
at **coup** (site of impact) or **countercoup** (opposite side) * anterior **temporal** * inferior pre**frontal** **impairment** of **specific** functions * personality * social functioning
33
Neurological Disorders → **Traumatic Brain Injury (TBI)** 1) **Widespread** Damage * location * impairment(s)
**→ minute lesions** throughout brain _loss of **complex cognitive** functions:_ * **reduced** mental speed * poor **concentration** * **memory** difficulties
34
**Traumatic Brain Injury (TBI)** * diagnosis
Diagnosis of **chronic behavioral problems** resulting from **TBI** can be **difficult** * often **NO obvious damage** visible on **CT/****MRI** scans
35
Traumatic Brain Injury (TBI) → **Widespread** vs. **Focal** Damage * **_recovery_**
most cognitive **recovery** occurs within fist **6-9 months** _**widespread** damage_ → **cognitive** abilities have **good prognosis** **_focal_** _damage_→ **social skills/personality** do not * **quality of life** more challenging to recover
36
**Psychiatric** Disorders → **Symptoms (3)**
lose **touch** with **reality** irrational ideas (**delusions**) distorted perceptions (**hallucinations**)
37
**Psychiatric** Disorders → **SCHIZOPHRENIA** * **diagnostic symptoms (5)**
_**positive** symptoms_ → more responsive to drugs * **delusions** (distorted thoughts) * **hallucinations** (altered sensory/perceptual experiences) * disorganized **speech** * disorganized/**catatonic behavior** _**negative** symptoms_ → poor response to neuroleptics * blunted affect (apathy) → *lack of emotion*
38
Psychiatric Disorders → **SCHIZOPHRENIA** * NEURAL CORRELATES * abnormalities (2)
*family history, 5 abnormal xsomes* ## Footnote thin **frontal** & **medial temporal cortices** **Abnormal** **dendritic fields** in: * **dorsolateral prefrontal** cortex * **hippocampus** * **entorhinal** cortex **Abnormalities** in NT systems: * **DA**, **glutamate,** **GABA**, **seratonin**
39
Psychiatric Disorders → **SCHIZOPHRENIA** * NEURAL CORRELATES * relation to symptoms (3)
**medial temporal cortices** → auditory hallucinations & disorganized speech **dorsolateral prefrontal** cortex → negative symptoms **hippocampus →** memory impairments
40
Psychiatric Disorders → **Mood & Anxiety** Disorders * causes? (2)
genetics early life experiences (negative)
41
Psychiatric Disorders → **Mood** Disorders (2)
**Depression** **Bipolar Disorder** * mania & depression
42
Psychiatric Disorders → **Mood** Disorders * neural correlates * **Depression**
imaging studies show ↑ **activity** in: – **orbitofrontal** cortex → *conscious experience/emotion regulation* – **Anterior cingulate** cortex → " " – **Amygdala** → *primal threat detector* → all 3 involved in **rumination**
43
Psychiatric Disorders → **Anxiety** Disorders (3)
**Generalized Anxiety Disorder (GAD)** **Panic** Disorder **Specific Phobias**
44
Psychiatric Disorders → **Anxiety** Disorder * neural correlates
imaging studies show ↑ **activity** in: **_At Rest:_** * Cingulate cortex * parahippocampal gyrus → *role in turning off stress response* **_Anxiety-provoked:_** * Amygdala * prefrontal cortex
45
Psychiatric Disorders → **Treatments (3)** * **Depression**
**Antidepressants** * SSRIs (mainly) **Cognitive**-**Behavioral** Therapy **Electrophysiological** (ECT/TMS)
46
Psychiatric Disorders → **Treatments** (3) * **Anxiety** Disorders
Benzodiazepines → *acute* SSRIs → *long-term* Cognitive-Behavioral Therapy
47
Mood & Anxiety Disorders → **Antidepressants** * **Drug Mechanism**
Similar to ECT ↑ **BDNF** & stimulate **neurogenesis** in **hippocampus** → presumably result in: * ↑ **brain health** * ↑ **ability** to turn **off** stress response