Chapter Sixteen

Chapter Sixteen

Psychological Disorders

CHAPTER 16PSYCHOLOGICAL DISORDERS

Schizophrenia

• Hallucinations• Delusions• Positive symptoms• Negative symptoms

Figure 16.2 Outcomes of Schizophrenia Takes Several Forms

Schizophrenia

• Genetics of Schizophrenia– Concordance rates– Genetic marker– Saccades

• Environmental Contributions to Schizophrenia– Urban environment

• Poverty, poor nutrition, and stress related to racism

– Prenatal environment– Maternal exposure to famine or viral infection

Figure 16.3 The Influence of Genetics on Schizophrenia

Figure 16.4 A Possible Genetic Marker for Schizophrenia

Schizophrenia

• Brain Structure and Function in Schizophrenia– Enlarged ventricles– Hippocampus organization– Hypofrontality– Adolescent loss of gray matter

• Biochemistry of Schizophrenia– Dopamine hypothesis– Glutamate

Figure 16.5 Schizophrenia Is Associated with Enlarged Ventricles

Figure 16.6 Cell Arrangements in the Hippocampus Appear to be Disorganized in

Cases of Schizophrenia

Figure 16.7 Hypofrontality

Figure 16.8 Schizophrenia is Associated with Larger Losses of Gray Matter in Adolescence

Figure 16.9 Correlations Between Dopamine Activity Levels and Behavior

Schizophrenia

• Treatments of Schizophrenia– Phenothiazines

• Tardive dyskinesia• Newer antipsychotic drugs

– Psychosocial rehabilitation

Figure 16.10 The Introduction of Typical Antipsychotic Medications Reduced the Number

of Institutionalized Patients

Figure 16.11 Tardive Dyskinesia Can Occur as a Side Effect of Treatment with Typical

Antipsychotic Medications

Figure 16.12 Repeated Transcranial Magnetic Stimulation Reduces Auditory Hallucinations

Mood Disorders

• Major Depressive Disorder– Genetics of Depression

• Moderate role – heritability 33%

– Environmental Factors and Depression• “Dutch Hunger Winter”• Significant stressors

– Brain Structure and Function of MDD• Reduced volumes in the hippocampus and orbitofrontal cortex• Sleep patterns reflect circadian rhythm disturbances

Figure 16.14 Depression is Associated with Abnormal Patterns of Sleep

Figure 16.15 The Hypothalamus-Pituitary-Adrenal (HPA) Axis Plays an Important Role in

Stress and Depression

Mood Disorders

• Major Depressive Disorder– Biochemistry of Depression

• Monoamine activity and serotonin activity• Cortisol level

– Treatment of Depression• 30-35 % treated with SSRIs show complete remission• Electroconvulsive shock therapy (ECT)

Figure 16.16 Electroconvulsive Shock Therapy

Mood Disorders

• Bipolar Disorder– Causes of Bipolar Disorder

• Genes play significant role• Dietary influence

– Brain Structure and Function in Bipolar Disorder• Hippocampal volume• Enlargement of amygdala

– Biochemistry and Treatment of Bipolar Disorder• Lithium

Anxiety Disorders

• Obsessive-Compulsive Disorder– Intrusive Thoughts and Repetitive Behaviors

• Germs and disease, fear for safety, moral concerns• Hand washing, checking, counting, touching

– Causes• 63-87% concordance rates• Abnormalities in circuits connecting thalamus, basal ganglia, and

orbitofrontal cortex

– Treatments• Antidepressant medications and SSRIs• Deep brain stimulation

Figure 16.19 OCD and Behavioral Treatment

Anxiety Disorders

• Panic Disorder– Strong sympathetic arousal – Repeated panic attacks– Role of sodium lactate

Anxiety Disorders

• Post-traumatic Stress Disorder– “Shell shock” or “battle fatigue”– Triggered by explores to combat, natural disasters,

accidents, assaults, and abuse– Hippocampus– Decrease in benzodiazepine receptor binding in frontal

cortex

Autism

• Deficits in behavioral domains, communications, and social relatedness

• Causes of Autism– Strong genetic role (90 % concordance)– Multiple environmental factors

• Brain Structures and Function in Autism– Abnormal acceleration then deceleration in growth– Minicolumns– Cerebellum and amygdala– Mirror neurons

Autism

• Biochemistry and Treatment of Autism– Serotonin– GABA– Glutamate– Excess peptides from gluten and casein– Treated with intensive, early childhood learning

experiences

Attention Deficit/Hyperactivity Disorder

• Genetics of ADHD– Significant role – 80 % concordance rate

• Brain Structures and Function in ADHD– Prefrontal cortex, basal ganglia

• Biochemistry and Treatment of ADHD– Stimulant medication– Behavioral therapy

Antisocial Personality Disorder

• “Pervasive pattern of disregard for and violation of the rights of others”

• Genetics of Antisocial Personality Disorder– MAOA gene– Twin studies

• Brain Structure and Function Antisocial Personality Disorder– Limbic structures– Damage to orbitofrontal cortex

Figure 16.20 The Orbitofrontal Cortex

Figure 16.21 Brain Activity Among Murderers

Antisocial Personality Disorder

• Treatment of Antisocial Personality Disorder– Complicated by classification procedure– Learning models

• Anger control• Social skills• Moral reasoning