Abnormal Psychology Chapter 15

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Abnormal Psychology: Integrative Approach 3rd Canadian Edition Barlow Grant MacEwan University
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cognitive disorders (CD) originally defined as organic mental disorders, indicating brain damage or dysfunction instead focus is on impairment of cognitive abilities such as memory, attention, perception, thinking
3 CD types 1. delirium 2. dementia 3. amnestic disorders
Delirium impaired consciousness and cognition during course of several hours or days: confused, disoriented, out of touch, cannot focus, mostly older people
9 Delirium affects 1. 10-30 % of ppl in facility care 2. immune deficiency 3. usually only last max 2 weeks, sometimes ppl go into acoma and die 4. intoxication of drugs: alcohol, sedative, hypnotics 5. head injury 6. meds abuse: anticholinergic 7. children w/ fevers 8. infection 9. absence of time, room change
4 treatment for delirium 1. haloperidol, antipsychotics 2. medical treatment for tumours, infection, brain injury 3. psychosocial intervention 4. relaxation
prevention for delirium broad spectrum: education, travel, anxiety-reduction, reorientation
Dementia a gradual deterioration of brain functioning: judgement, memory, language, advanced cognitive abilities caused by drug/ alcohol, infection, depression, stroke, syphilis, HIV, head injury, toxins, Parkinsons, Huntington's
visuospatial skills reduction ability to located oneself within an environment
agnosia inability to recognize names, objects
facial agnosia inability to recognize familiar faces
4 Dementia STATS 1. rarely occurs under age of 45 2. 8% of canadian over age of 65 affected 3. 47% over age of 85, 90% show signs 4. 3.9$ billion spent in 1991
5 classes of Dementia 1. alzheimers 2. vascular dementia 3. dementia due to other medical conditions 4. substance abuse 5. multiple etiologies
Alzheimer's disease atypical form of senior dementia, strange disease of cerebral cortex: progressive memory, orientation, judgment, reasoning impairment, suspiciousness, socially isolated, confused, depressed, anxious, combative
5 other symptoms 1. aphasia- language 2. apraxia- motor 3. agonsia 4. planning, organizing, abstracting 5. anomia
2 test for alzheimers includes 1. drawing a clock that is circular, put numbers on the clock 2. idea density, journal reading which shows depth of thought and ideas indicate ALZ
4 stages 1. early: little change 2. middle: great deal of deterioration 3. late: little deterioration 4. death: 8 years from prognosis usually
prevention includes more education: helps cope longer w/ mental deterioration
cerebral reserve hypothesis more synapses a person develops throughout life more neuronal death must take place before signs of symptoms show, education builds up and reserves brain functions
3 Alzheimers 1. highest prevalence in women, live longer 2. estrogen and progesterone increases dementia 3. found in same numbers throughout cultures
vascular dementia progressive brain disorder that is second to Alzheimers as a cause of death: blood vessels in brain are blocked/ damaged, no longer carry oxygen to brain tissue, multiple sights can be damaged, men are at higher risk
11 Dementia due to other medical causes 1. HIV 2. head trauma 3. Parkinsons 4. Huntingtons 5. Picks 6. creutzfeldt-Jakob disease7. hydrocephalus 8. hypothyroidism 9. brain tumour 10. B12 deficiency 11. human immmunodeficiency virus-type-1 (HIV-1)
HIV-1 disease impairment is independent of other infectiolnessns that accompany HIV: cognitive slowness, forgetful, weak, clumsy, tremors, apathetic, socially withdrawn
Parkinsons and Huntingtons subcortical dementia, it affects primarily inner areas of brain below cortex: aphasia or motor skills
head trauma injury to head and brain lead to cognitive impairments in adults, children: memory loss is common
parkinsons disease degenerative brain disorder that affects about 1/1000 pp: motor problems bradykinesia (jerky movements, tremors), monotone, DOPA reduction, muscle weakness
Huntingtons disease genetic disorder that initially affects motor movements, typically in form of chorea, involuntary movements, offspring 50% chances when parent has, deficient on chromosome 4
Picks disease cortical dementia, 5-10years, onset 40-50s, cause is unknown
Creutzfeldt-Jacob disease affect 1/1000000, ten cases linked to bovine spongiform encephalopathy
4 Substance induced Dementia 1. prolonged drug use+poor diet+ damage brain 2. 7% are dependent on alcohol 3. glue/ gasoline inhalant 4. includes memory impairment: aphasia, apraxia, agnosia, disturbance in executive functioning
6 Biological Causes of Dementia 1. smoking causes alzheimers to increase speed in degeneration 2. aluminum hypothesis: exposure 3. neurofibrillary tangles 4. amyloid plagues 5. brain atrophy 6. genes on chromosomes 21, 19 (late onset),14 (early onset), 12, 1
deterministic genes if you have one of these genes you are 100% chance of getting Alzheimers: amyloid beta peptides, Presenilin 1 & 2
susceptibility genes apolipoprotein E4 gene, only slight risk, more common in population
core of plaque is made up of solid wax known as AB, deposits cause cell death
two mechanisms of amyloid protein build up 1. amyloid precursor protein (APP), eventually breaks down into amyloid protein found in plaques, chromosome 21 produces APP= maybe responsable for Downs S & Alzheimers 2. amyloid protein may build up in brain through apolipoprotein E (transports cholesterol), Apo E2, E3,E4: E4 on chromosome 19 responsible for amyloid protein, more then one gene for E4 = earlier onset
2 gene-environment 1. physical exercise 2. african descent w/out E4 gene
dementia pugilistica/ Chronic traumatic encephalopathy (CTE) repeated blows to head, and concussions
5 Psychological & Social influences 1. lifestyle 2. diet/ exercise 3. African/ Asian decent higher rates of hypertension/ stroke - vascular dementia 4.Papua New Guinea - Kuru ritual cannibalism 5. education
5 Treatment 1. regeneration of neurons- plasticity 2. prevent drug use 3. delay onset w/better life quality 4. coping strategies 5. psychotropic meds
8 biological treatments 1. nutrition 2. GNDF = glial cell-derived neurotrophic factor 3. stem cell transplant 4. stroke prevention drugs 5. cholinesterase inhibitors, donepezil, rivastigmine, galantamine, tacrine hydrochloride (prevent breakdown of acetylcholine) 6. drugs that target beta-amyloid plaque breakdown 7. Ginkgo biloba, vitamin E 8. antidepressants, SSRIs
8 Psychosocial Treatments 1. taught skills to compensate for memory lose 2. memory wallets 3. cognitive stimulation 4. skill-building exercise 5. restraint to avoid social stigma 6. smart home technology 7. caregivers for aggressive patients 8. treat family stress
2 Prevention 1. blood pressure control 2. active social and physical life
Amnestic disorder inability to tranfer info into long-term memory due to head trauma or long term drug abuse: Wernicke-Korsakoff syndrome damage to thalamus+ B1 thiamine deficiency; new routes for memory retrieval help- object action pairs
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