Psychosis and Neurological Disorders Flashcards
(116 cards)
1
Q
Moms sue Pop Warner over dead kids’ brain injuries
A
- Growing evidence that playing football can result in Chronic Traumatic Encephalopathy (CTE) found in those playing Pop Warner through high school
- The evidence also moved the NFL in 2015 to settle legal claims up to 20,000 former players before discovery in that case began
- In the California case against Pop Warner, the biggest youth football league in the US with roughly 200,000 participants
- Archie’s son, Paul Bright, died at the age of 24 in a motorcycle accident in 2014 after playing youth football for eight years
- An autopsy on Bright discovered he suffered from CTE. Bright’s erratic and dangerous behavior on his motorcycle were caused by CTE, Archie claims in court papers
2
Q
Alzheimer’s may be preventable in a decade
A
- Roughly 5 1/2 million Americans are living with Alzheimer’s - a disease that impacts memory and, ultimately, stops their bodies from performing basic functions
- Scientists at USC predict that a five-year delay “would effectively halve the globe’s 46 million [dementia] sufferers, saving health care services approximately $600 billion a year”
- “[The idea is to push] the disease back, by developing a drug that we can give to someone years before they start experiencing symptoms,” Jebelli tells The Post. Researchers can use biomarkers - certain signs of the disease visible in the spinal fluid and blood - to determine who may need early treatment
3
Q
Schizophrenia Spectrum “Split mind”
A
A group of psychoses in which deterioration of functioning is marked by severe distortion of thought, perception, and mood, by bizarre behavior
- 1 to 2 percent of population
- Half the beds in psychiatric hospitals
- 1/3 of homeless people
- Onset 20 to 24 for men, 25 to 29 for women
4
Q
Emil Kraeplin
A
- Originated the description of schizophrenia. He called it Dementia Praecox (Premature Madness)
- The father of modern psychiatry
5
Q
Eugen Bleuler
A
- Coined the term schizophrenia
6
Q
Schizophrenia is defined by abnormalities in the following domains:
A
- Delusions
- Hallucinations
- Disorganized thinking
- Abnormal Motor Behavior
- Negative Symptoms
- 2 or more of above criteria for diagnosis
7
Q
Delusions
A
- Fixed beliefs that are not amenable to change in light of conflicting evidence
8
Q
Hallucinations
A
Perceptions that occur in the absence of any appropriate external stimuli
- Auditory (most common)
- Visual
- Tactile
- Olfactory (least common)
9
Q
Negative symptoms
A
- Catatonia
- Flat affect
- Anhedonia
- Apathy
10
Q
Postive vs. Negative Symptoms
A
- Positive symptoms better prognosis, medications better at getting rid of behaviors
11
Q
Brief Psychotic Disorder
A
First 30 days
12
Q
Schizophreniform
A
First 6 months
13
Q
Schizophrenogenic Mother
A
Mother brought out symptoms - smothered or mommy dearest
14
Q
Schizoaffective Disorder
A
Schizophrenia occurs at the same time as MDD or Bipolar
15
Q
Differential Diagnosis of Schizophrenia
A
- Drugs
- Off medication
- Extreme Trauma
- Neurological disorder (tumor)
- Just had a baby
- 50% of women have depression post partum
- 15% clinically significant
16
Q
The Three Christ of Ypsilanti
A
Put three Christs together, thought it would break delusion - they were all Christ
17
Q
Delusions of Persecution
A
Being plotted against
- #1 symptom paranoia
18
Q
Delusions of Control
A
Delusions of influence - others controlling you
19
Q
Delusions of Reference
A
Being referred to in things that have noting to do with the person (e.g., TV)
20
Q
Erotomanic Delusion
A
Believing someone (of higher status) is in love with you, typically stalking cases
21
Q
Delusions of Grandeur
A
A false impression of one’s own importance
22
Q
Delusions of Sin and Guilt
A
God and devil
23
Q
Hypochondriacal Delusions
A
Believing one is ill
24
Q
Nihilistic Delusions (non-existence)
A
Believing world is dead
25
Thought broadcasting
that your thoughts are outside your head being broadcast
26
Thought insertion
others are inserting thoughts in your head
27
Thought withdrawal
others are removing thoughts
28
Loosening of Associations (loose associations)
Ideas jump from one subject to another in a completely unrelated way
29
Flight of ideas
Rapid, continuous verbalizations or play on words, constant shift from one idea to another, ideas tend to be connected
30
Circumstantial v. Tangential
Circle back v. off on tanger
31
Poverty of Content
Poor communication despite correct grammar and adequate vocabulary - they convey very little
32
Neologisms
The use of new words or phrases, often formed by combining parts of two or more regular words that have little if any translation. Made up words.
33
Clanging (clang association)
The pairing of words that have no relation to one another beyond the fact that they rhyme or sound alike "Okay for flump. What is a flump? A flump is a gump."
34
Word Salad
- Words and phrases are combined in what appears to be a completely disorganized fashion
- "It's all over for a squab true tray and there ain't no music, there ain't nothing besides my mother and my father who stand alone upon the island of Capri"
35
A Breakdown of Selective Attention
Inability to confine extraneous data to the edge of consciousness
36
Hynagogic
While falling asleep
37
Hypnopompic
Before waking up
38
Eye Movement Desensitization and Reprocessing
Mimics REM state, consolidating memories
39
Blunted Affect
Patient shows little emotion
40
Flat Affect
Patient shows no emotion
41
Inappropriate Affect
The expression of emotions unsuitable to the situation
42
Stereotypy
The act of engaging in purposeless behaviors repetitively over long periods of time
43
Social Withdrawal
The lack of attention to or interest in the goings-on of the external world
44
Negative Symptoms
- Apathy
- Avolition
- Alogia
- Anhedonia
- Asociality
- Alexithymia
45
Apathy
Lack of interest, enthusiasm, or concern
46
Avolition
Decrease in the motivation to initiate and perform self-directed purposeful activities.
47
Alogia
Diminished speech output
48
Anhedonia
Inability to feel pleasure
49
Asociality
Lack of interest in social interactions
50
Alexithymia
Inability to identify emotions
51
The Course of Schizophrenia: Prodromal Phase
The gradual deterioration of functioning before any clearly psychotic symptoms appear
52
The Course of Schizophrenia: Active Phase
Patient begins showing prominent psychotic symptoms
53
The Course of Schizophrenia: Residual Phase
- Gradual recovery
| - Behavior is similar to that of the prodromal phase
54
Disorganized Schizophrenia (Hebephrenic)
- Pronounced incoherence of speech
- Mood distrubance
- Disorganized behavior, or lack of goal orientation
55
Catatonic Schizophrenia
- Marked Disturbance in motor behavior
- Waxy flexibility
- Catatonic stupor: complete immobility, usually accompanied by mutism
- Echolalia
- Echopraxia
56
Echolalia
Repeated words
57
Echopraxia
Repeated movements
58
Paranoid Schizophrenia
- Delusions and/or hallucinations of a relatively consistent nature, often related to the themes of prosecution and grandeur
- Far more common than disorganized or catatonic type
59
Good-poor Premorbid Dimension
How well the patient was functioning before the onset of the active phase
- Adolescent onset better
60
Positive-negative Symptoms Dimension
Positive Symptoms: the presence of something that is normally absent
Negative Symptoms: the absence of something that is normally present
61
Delusional Disorder
```
The Symptoms of Delusional Disorder (Non-Bizarre):
- Persecutory type
- Grandiose type
- Jealous type
- Erotomanic type - high status
- Somatic type
Delusions are the only symptom
```
62
Genetic Studies
- Family studies
- Twin studies
- Adoption studies
- Mode of transmission
- Genetic high-risk studies
- Genetic markers (DSM-5)
- Behavioral high-risk studies
63
Genetic Studies Results
- Dramatically higher chance of Schizophrenia in monozygotic twins
64
Auditory Hallucinations in Brain
- Superior temporal gyrus
65
Positive Symptoms in Brain
- Medial prefrontal cortex = self awareness
66
Negative Symptoms in Brain
- blunted amygdala responses
67
Prefrontal Cortex
Located at the front of the frontal lobe, implicated in complex behaviors including planning and greatly contributes to personality development
68
The Dopamine Hypothesis
- Schizophrenia is associated with excess activity in the parts of the brain that use dopamine as a neurotransmitter (i.e. increases in dopamine)
- Amphetamine, cocaine and similar increase levels of dopamine in the brain and can cause symptoms which resemble those present in psychosis, particularly after large doses or prolonged use
69
Schizophrenia: Treatment of Choice
- Psychotropic medications
- Haldol, Thorazine, Zyprexa, Abilify, Risperdal, Geodon, Seroquel
- Atypical (newer) vs. Typicals (older)
- Tardive Dyskinesia
- Akathisia
- Extrapyramidal Side Effects (EPS)
70
Akathisia
Characterized by feeling of inner restlessness and compelling need to be in constant motion, as well as by actions such as rocking while standing or sitting
- Can lead to someone being suicidal due to distress
71
Tardive Dyskinesia
Characterized by repetitive, involuntary movements
- Grimacing
- Tongue movements
- Lip smacking
- Pursing of lips
- Excessive eye blinking
72
Neuroleptic malignant syndrome
Die from taking medication, body heats up and kills organs
73
EPS
Similar to Parkinsonian symptoms
74
Schizophrenia & Dead
- Schizophrenics die 10-25 years before gen pop
| - 5% are suicidal, higher suicide rate
75
Psychoeducation
- Social Skills Training
- Assertiveness Training
- Relapse Prevention
- Token Economy
- Privileging System
76
Schizophrenia: The Sociocultural Perspective
- Assertive Community Treatment (ACT)
- Kendra Webdale
- diathesis stress model
77
Neuropsychology
The study of the relationship between brain and behavior
78
DKEFS Trail Making Test
- 8 to 89 years
| - Looks at problems of basic motor and/or visual problems vs. cognitive shifting
79
Tower Test
Executive functioning task - looks at deficits in planning
80
Stroop Test & Rey-Osterrieth
Visual spatial skills
81
Delirium
- A transient, global disorder of cognition and attention
- Acute Confusion
- Remits quickly
- Etiology - Medications, surgery, withdrawal, heart attack
82
Specific Cognitive Impairments
- Impairment of attention and arousal
- Impairment of language function
- Impairment of learning and memory
- Impairment of visual-perception function
- Impairment of motor skills
- Impairment of executive function
- Impairment of higher-order intellectual function
83
Frontal Lobe
Impulse control, judgment, language production, working memory, motor function, sexual behavior, socialization, problem solving initiation, facial movement, planning abilities, coordinating, controlling, and executing behavior
84
Dementia
- The impairment of at least two cognitive functions, resulting in a decline from a higher level of performance that compromises a person's occupational or social functioning
- Progressive deterioration (due to HIV, Syphillie, or progressive deteriorations).
- Precursor for Alzheimer's
- Apraxia - motor
- Agnosia - recognition
- Aphasia (expressive vs. receptive)
- Ataxia - balance
85
Apraxia
Inability to perform particular purposive actions
86
Agnosia
Inability to interpret sensations and hence to recognize things,
87
Broca's Aphasia
Loss of ability to express speech (expressive)
88
Wernicke's Aphasia
Loss of ability to understand speech (receptive)
89
Traumatic Brain Injuries (TBI)
Any trauma that leads to injury of the scalp, skull, or brain
90
Concussion
A blow to the head that jars the brain, momentarily disrupting its functioning (loss of consciousness)
91
Cerebrospinal Fluid (CSF)
The brain floats within the skull surrounded by cerebrospinal fluid (CSF), one of the functions of which is to protect the brain from normal light "trauma", e.g., being jostled in the skull by walking, jumping, etc.
- Shearing
92
Axonal shearing
This injury involves damage to individual nerve cells (neurons) and loss of connections among neurons which can lead to a breakdown of overall communication among neurons in the brain
93
Concussion & Axons
1. In a normal neuron, the axon, which is protected by a myelin sheath, is not broken or otherwise distorted
2. After a concussive blow, an axon might twist or bend interrupting communication between neurons
3. If a concussion is severe enough, the axon swells and disintegrates. Less severely damaged axons return to normal.
94
Contusion (Bruise)
Trauma is sever enough that the brain is not just jarred; it is actually bruised
95
The Case of Phineas Gage
He survived a rod through his brain but his temperament completely changed - he became nasty
96
Subdural Hematoma
Develops when blood veins that are located between the membranes covering the brain (the meninges) leak blood after an injury to the head
97
Cerebrovascular Accident (CVA): Stroke
- Blockage or breaking of the blood vessels in the brain results in injury to brain tissue
- 3rd leading cause of death
- Between 60 and 80 - risk increases x 8
98
Infarction (e.g., due to heart attack)
- Supply of blood to the brain is somehow cut off, resulting in the death of brain tissue fed by that source
99
Hemorrhage
A blood vessel in the brain ruptures, causing blood to spill out into the brain tissue
100
Types of Acquired Brain Injuries: Degenerative Disorders
General deterioration of intellectual, emotional, and motor functioning as a result of progressive pathological change in the brain
101
Alzheimer's Disease
- Cognitive deficits as a result of neurofibrillary tangles (twisted and distorted nerve fibers) and senile plaques (microscopic lesions in the neurons)
- Characterized by progressive cognitive deterioration together with declining activities of daily living and neuropsychiatric symptoms or behavioral changes. It is the most common type of dementia
102
Vascular Dementia
The cumulative effect of a number of small strokes, eventually impairing many of the brain's faculties
103
Parkinson's Disease
- Damage to the basal ganglia, particularly in the region known as the substantia nigra
- Etiology: unknown
- Primary symptoms
- Tremors
- Expressionless, masklike, countenance
- Mohammad Ali, Michael J. Fox
104
Korsakoff's Psychosis
- Most common among alcoholics
- Deficiency in Vitamin B1 (thiamine)
- Anterograde Amnesia
- The inability to incorporate new memories
- Confabulation
- The tendency to fill in memory gaps with invented stories
105
Epilepsy
Primary symptom is spontaneous seizures caused by a disruption of the electrical and physiological activity of the brain cells
106
Partial Seizures
Originate in one part of the brain rather than in the brain as a whole
107
Simple Partial Seizures
- Cognitive functioning remains intact
108
Complex Partial Seizures
- Interrupts cognitive functioning
109
Generalized Seizures
- Either involve the entire brain at the outset or soon spread from one part of the whole brain
110
Absence Seizures
"petit mal" type
| - Causes lapses in awareness or staring
111
Tonic-clonic Seizures
"grand mal" type
- Have an aura
- Tonic - rigid extension of arms
- Clonic - shaking or jerky movements
112
Aura
- An aura is a perceptual disturbance
- Telltale sensation experienced by some people with epilepsy before a seizure
- It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences
113
Seizure Response Dogs
- Trained to bark when someone has a seizure
- Might lie next to someone having a seizure to keep them from harm
- Might even be trained to activate some kind of pre-programmed device
- The dogs are paired up with people who have frequent seizures and then given a reward every time the person has a seizure. Other dogs seem to develop this skill on their own, just by being in the company of an owner who has seizures
- Nobody knows how the dog is able to detect an oncoming seizure. Some suggest that there may be a change in the owner's behavior or scent before a seizure happens and that is what the dogs are responding to
114
Issues with CTE
1. Rapid Brain Growth - associated with executive functioning and attention deficit, cognitive delays, impaired learning, increased impulsivity and decreased ability to self-regulate
2. Delayed Development
3. Obesity
4. Sleep Deprivation
5. Mental Illness
6. Aggression
7. Exacerbating ADHD
8. Addiction
9. Radiation?
10. Breeding narcissism? Need to work together
115
Indications of Head Injury
- Scalp Wound
- Fracture
- Swelling, bruising
- Loss of consciousness
- Nasal discharge
- Stiff Neck
116
Whiplash
Traumatic, closed head injury
| - coup contrecoup (front and back of brain) injury from neck being bent forward and backwards
