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final Flashcards

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1
Q

neurocognitive disorders- category of various forms of dementia and amnestic disorders

A

major and mild

neurodegenerative disorder: the effects are irreversible, accumulating until cognitive functions are obviously impaired

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2
Q

rates of cognitive disability increase after the age of

A

65

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3
Q

symptoms of neurocognitive disorders include

A

paranoia, agitation and aggression

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4
Q

clinical description of delirium

A

impaired consciousness and cognition during the course of several hours or days (confusion, disorientation, inability to focus)
10-30% of patients in acute care facilities
older adults and patients on medication
usually subsides quickly

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5
Q

what else is delirium trigged by

A

sleep deprivation, immobility, excessive stress

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6
Q

delirium environmental factors for hospitalized seniors

A

number of room changes, absence of a clock, watch, reading glasses

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7
Q

delirium treatment

A

attention to precipitating medical problems
pharmacological, antipsychotics
psychosocial, reassurance, presence of personal objects, inclusion of a family member for support

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8
Q

major neurocognitive disorder

A

gradual deterioration of brain functioning

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9
Q

mild neurocognitive disorder

A

early stages of cognitive decline

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10
Q

major and mild neurocognitive disorders clinical descriptions

A

initial stages: memory and visuospatial skills impaired
agnosia
facial agnosia
older adults
8% of Canadians over age 65 are affected
survival rates alter outcomes

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11
Q

major and mild neurocognitive disorders ethology

A 
Alzheimers disease 
vascular dement 
frontotemporal degeneration 
dramatic brain injury
Lewy body disease 
parkinsons 
HIV 
substance use 
hungingtons disease 
the medical conditions
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12
Q

alzhemiers description

A

multiple cognitive deficits that develop gradually and steadily
cognitive impairments (aphasia, apraxia, agnosia, anomia)
mini mental state examination
clock test

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13
Q

neurocognitive disorder: alzhemiers type

A

early detection can lead to early intervention
cognitive deterioration slow in early and later stages
survival rate 4-8 years, may be more
onset 60s or 70s
poor education, intellectual dysfunction, cognitive reserve hypothesis

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14
Q

problem with highly educated people and alzhimers

A

hard to see the early signs

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15
Q

who is alzhemiers most prevalent in

A

women (possibly diminishing estrogen)

lower incidence in low and middle income countries

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16
Q

ways to reduce risk of alzhemiers

A

exercise and healthy diet

social network

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17
Q

vascular neurocognitive disorder

A

strokes
cognitive disturbances
location of brain damage
4.7% among men, 3.8% women

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18
Q

cognitive disturbances

A

declines in speed of information processing and executive functioning

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19
Q

Substance/Medication-Induced Neurocognitive Disorder

A

prolonged drug use, poor diet
memory impairment
cognitive disturbances

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20
Q

alcohol dependance effect on neurocognitive disorders

A

50-70% cognitive impairment

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21
Q

mild and neurocognitive disorders causes. psych and social influences

A

do not cause dementia, but may influence its onset and course
lifestyle factors

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22
Q

Major and Mild
Neurocognitive Disorders
goals of treatment

A

prevent
delay onset
and attempt to help these individuals and their caregivers to cope with advancing deterioration

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23
Q

Major and Mild
Neurocognitive Disorders
biological treatments

A

no effective treatments
depression, nutritional deficiencies can be treated if detected early
steam cell research
medication to develop cognitive abilities being developed, negative side effects
vitamin E, exercise and healthy lifestyle

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24
Q

Major and Mild
Neurocognitive Disorders
psych treatments

A

delay (not stop) the onset of cognitive decline
coping skills effective in earlier stages of disorder
teaching caregivers
cognitive stimulation

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25
Major and Mild Neurocognitive Disorders prevention
controlling risk factors, blood pressure control, smoking cessation protective factors, physical and social activity
26
Emil Kraepelin (1899): distinct disorders from combining several symptoms of insanity:
catatonia hebepherina paranoia dementia praecox
27
Eugen Bleuler (1908)
schizophrenia associative splitting "breaking of associative threads"
28
Schizophrenia spectrum disorder:
group of diagnoses recognized by those in the field of schizophrenia
29
Positive Symptoms
50-70% people with schizophrenia experience hallucinations, delusions or both
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delusions
a disorder of thought content - delusions of grandeur - delusions of persecution
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Hallucinations
Experience of sensory events without input from surrounding environment Auditory hallucinations: hearing things that aren’t there
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Negative Symptoms
Absence or insufficiency of normal behaviour Seen in approximately 25% with schizophrenia Avolition: inability to initiate/persist in activities Alogia: absence of speech; brief replies Anhedonia: lack of pleasure experienced Asociality: lack of interest in social interactions Affective flattening: no open reaction to emotional situations
33
Disorganized Symptoms
Disorganized speech: communication problems Inappropriate affect and Disorganized behaviour: laughing or crying at inappropriate times Catatonic immobility: keeping body and limbs in the position they are put in by someone else
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Schizophreniform disorder
Symptoms of schizophrenia for <6 months
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Schizoaffective disorder
Symptoms of schizophrenia + mood disorders
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Delusional disorder
Persistent belief that is contrary to reality & no other symptoms of schizophrenia
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Brief psychotic disorder
≥1 positive symptoms (delusions, hallucinations, or disorganized speech) over ≤1 month
38
Attenuated psychosis syndrome
Proposed new disorder: Patient is aware that SCZ symptoms are pathological
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Schizophrenia Development
Age of onset, early adulthood | Early brain damage
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Schizophrenia cultural factors
``` Cultural norms Cultural variations Stereotypes and bias: misdiagnoses? BR: Black > White Treatment outcomes are better in poorer countries ```
41
Schizophrenia genetic influences
Multiple gene variances combine to produce vulnerability Family Studies Children of schizophrenic parents likely to have it too Seen within families Predisposition may be inherited
42
Schizophrenia dopamine
Clues to the role of dopamine in schizophrenia: Neuroleptics (dopamine antagonists) effective in treating Neuroleptics produce negative side effects L-dopa (agonist) produces schizophrenia-like symptoms Amphetamines, which activate dopamine, can worsen some symptoms in schizophrenia
43
Schizophrenia brain structure
Abnormally large lateral and third ventricles in people with schizophrenia Hypofrontality (less active frontal lobe) Associated with negative symptoms Brain damage
44
Schizophrenia stress
Retrospective and prospective approaches to examine impact of stress Tendency for people with schizophrenia to be found in lower social classes Sociogenic hypothesis: extreme stress can produce psychotic-like symptoms in otherwise normal persons or trigger relapse by hostile environments
45
Schizophrenia Biological Interventions
Neuroleptics: dopamine antagonists When effective, neuroleptics help people think more clearly Reduce or eliminate delusions and hallucinations Effective for 60%–70% of patients Newer antipsychotics have fewer side effects (TD) Involuntary movements of the tongue, face, mouth, or jaw Helps improve cognitive functioning Psychosocial interventions include medication-taking compliance Transcranial magnetic stimulation (TMS) treatment for hallucinations TMS also improves auditory hallucinations: effect is brief Cannabis and psychosis: short- and long-term effects
46
Schizophrenia psych interventions
Psychoanalytic approach: not beneficial; may be harmful Behavioural family therapy: must be ongoing if patients and families are to benefit from it Multilevel treatments reduce relapses Target of intervention?
47
A Personality disorder is:
Persistent pattern of emotions, cognitions, behaviour resulting in enduring emotional distress for affected person and others Distress may (or not) be subjective Causes difficulties with work and relationships
48
Cluster A:
odd or eccentric
49
Cluster B:
dramatic, emotional, erratic
50
Cluster C:
anxious, fearful
51
Paranoid Personality Disorder description
Suspicious, mistrustful, argumentative, complain, quiet, hostile towards others, suicidal
52
Paranoid Personality Disorder causes
Genetics, relatives with schizophrenia, cultural
53
Paranoid Personality Disorder treatment
Cognitive therapy to change mistaken assumptions about others
54
Schizoid Personality Disorder description
Detachment from social relationships, no desire to enjoy closeness with others, cold, aloof
55
Schizoid Personality Disorder | Causes
Childhood shyness, abuse, neglect, low density dopamine receptors
56
Schizoid Personality Disorder | Treatment
Social skills training
57
Schizotypal Personality Disorder | Clinical Description
Social deficits, psychotic-like symptoms, paranoia, “magical thinking,” hypersensitive to criticism as children
58
Schizotypal Personality Disorder | Causes
Genetics, left hemisphere damage
59
Schizotypal Personality Disorder | Treatment
Antipsychotic medication, CBT
60
Antisocial Personality Disorder | Clinical Description
Aggressive, lying, cheating, no remorse, substance abuse, unnatural death in boys with this disorder
61
Antisocial Personality Disorder | Causes
Gene-environment interaction, underarousal of cortex, fearlessness
62
Antisocial Personality Disorder | Treatment
Multifaceted, CBT, prevention better approach
63
Borderline Personality Disorder | Clinical Description
Turbulent relationships, fear abandonment, self-mutilating behaviours, no control over emotions
64
Borderline Personality Disorder | Causes
Genetics, related to mood disorders, early trauma
65
Borderline Personality Disorder | Treatment
Antipsychotic and antidepressants, dialectical behaviour therapy (DBT)
66
Histrionic Personality Disorder | Clinical Description
Dramatic, theatrical, self-centred, seek constant reassurance
67
Histrionic Personality Disorder | Causes
Co-occurs with antisocial personality disorder
68
Histrionic Personality Disorder | Treatment
Improving problematic interpersonal relationships
69
Narcissistic Personality Disorder | Clinical Description
Unreasonable sense of self-importance, grandiosity, no compassion for others, envious, arrogant
70
Narcissistic Personality Disorder | Causes
Failure of empathetic “mirroring”
71
Narcissistic Personality Disorder | Treatment
Coping strategies, CBT
72
Avoidant Personality Disorder | Clinical Description
Interpersonally anxious, fear rejection, pessimistic about future
73
Avoidant Personality Disorder | Causes
Born with difficult temperament, parental rejection, uncritical love
74
Avoidant Personality Disorder | treatment
CBT, systematic desensitization, exposer
75
Dependent Personality Disorder | Clinical Description
Interpersonally dependent, anxious
76
Dependent Personality Disorder | Causes
Disruptions in early childhood lead to fears of abandonment
77
Dependent Personality Disorder | Treatment
Developing confidence; ensuring patient does not over-depend on therapist
78
Obsessive-Compulsive Personality Disorder | Clinical Description
Rigidity, poor interpersonal relationships, quest for perfectionism
79
Obsessive-Compulsive Personality Disorder | Causes
Genetics
80
Obsessive-Compulsive Personality Disorder | Treatment
Relaxation techniques, CBT
81
Sadistic Personality Disorder:
receiving pleasure by inflicting pain on others
82
Passive-Aggressive Personality Disorder:
people are defiant and refuse to cooperate with requests
83
Levels of involvement
``` Substance use Substance intoxication Substance abuse Substance dependence Substance withdrawal ```
84
Physiological dependence
Tolerance: greater amounts of drug needed to experience same effect Withdrawal: negative physical response when the substance is no longer ingested
85
Psychological dependence:
behavioural reactions to substance dependence
86
Diagnostic Issues (drugs)
Substance use might occur concurrently with other disorders Drug intoxication and withdrawal cause increased risk-taking Mental health disorders cause substance use disorder
87
Alcohol-Related Disorders
``` Delirium tremens (the DTs) Fetal alcohol syndrome (FAS) ```
88
Depressants
alcohol | Sedative-, hypnotic-, and anxiolytic-related disorders
89
Alcohol-Related Disorders | Clinical Description
Depressant, inhibitory centres in the brain are depressed, or slowed Continued drinking depresses more areas of the brain Impaired motor coordination Slower reaction time Confused, poor judgments Vision and hearing affected
90
Alcohol-Related Disorders | Effects
Influences several neuroreceptor systems GABA, inhibitory neurotransmitter, blackouts Releases natural analgesics Delirium Tremens (DTs): frightening hallucinations and body tremors Fetal Alcohol Syndrome (FAS): affects child whose mother drank while she was pregnant
91
Alcohol-Related Disorders | Progression
Fluctuations between heavy drinking and abstinence Gets worse if untreated Early consumption can predict dependence in later years Linked with violent behaviour
92
Sedative-, Hypnotic-, and Anxiolytic-Related Disorders
``` Sedative (calming) Hypnotic (sleep-inducing) Anxiolytic (anxiety-reducing) Include Barbiturates Benzodiazepines ```
93
Sedative-, Hypnotic-, and Anxiolytic-Related Disorders | Clinical Description
``` Barbiturates relax muscles Produce mild feeling of well-being Overdosing is common means of suicide Benzodiazepines: calming, induce sleep Tolerance and dependence with repeated use ```
94
Stimulant-Related Disorders | Amphetamines
``` “Uppers” leading to a “down” and crash Reduce appetite → weight loss Reduce fatigue Stimulate central nervous system Enhance activity of norepinephrine and dopamine ```
95
Stimulant-Related Disorders | Cocaine
Derived from leaves of the coca plant | Coca-Cola contained 60 milligrams of cocaine per 240 ml until 1903
96
Clinical Description
: Increases alertness, blood pressure; causes insomnia
97
Tobacco-Related Disorders
Nicotine in tobacco is a psychoactive substance Produces dependence, tolerance, withdrawal Less than 20% of Canadians smoke Inhaled nicotine enters blood in 7–19 seconds Stimulates pleasure pathways Nicotine and depression interrelated Genetic vulnerability and life stresses combine vulnerability to nicotine use and depression
98
Caffeine-Related Disorders
“Gentle stimulant” found in tea, coffee, many soda drinks, cocoa products Elevates mood, decreases fatigue Causes insomnia Tolerance and dependence with over-use
99
Opioids
Opiate: natural chemicals in opium poppy having a narcotic effect Sleep-inducing, pain-relieving (analgesic) Heroin is most commonly used Emergency room admissions indicate 34% increase between 1995 and 2002 Intravenously taken: risks of HIV & other infections High mortality rates
100
Cannabis
Cannabis (marijuana) most routinely used illicit substance in Canada; past-year cannabis use was 11% in 2013 Alters perceptions; mood swings Impairment of memory, concentration, motivation, self-esteem, relationship with others “reverse tolerance” with repeated use Tetrahydrocannabinols (THC): a variety of marijuana The brain makes its own too!
101
Hallucinogens
LSD (acid; d-lysergic acid diethylamide) | Psilocybin (mushrooms), lysergic acid amide, dimethyltryptamine (DMT), mescaline (peyote), phencyclidine (PCP)
102
drug abuse Causes
``` Biological dimensions Familial/genetic, neurobiological Psychological dimensions Positive and negative reinforcement, cognitive factors Social dimensions Cultural dimensions ```
103
Biological treatments (drugs)
Agonist substitution Methadone Antagonist treatments Aversive treatment
104
Psychosocial treatments (drugs)
``` Inpatient facilities Alcoholics Anonymous (AA) Controlled use Component treatment Relapse prevention ```
105
drug Harm reduction, prevention
Controlled drinking Safe injection sites (SISs) Community-based interventions
106
Gambling Disorder
Lifetime estimate of approximately 2% Americans Job loss, bankruptcy, arrests, suicide Similar to substance use disorders Tolerance and withdrawal DSM-5: Addictive disorders People with gambling disorder: in denial, impulsive, continually optimistic Internet gambling disorder
107
Intermittent Explosive Disorder:
Aggressive impulses resulting in serious assaults, destruction of property
108
Kleptomania:
recurrent failure to resist urges to steal things; stigma associated; illegal
109
Pyromania
: having an irresistible urge to set fires

Abnormal psychology (3 decks)

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