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Lecture 9

Lecture 9 - Psychological Disorders

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University of Toronto Mississauga
Ayesha Khan

PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 Chapter 16 – Psychological Disorders Diagnostic and Statistical Manual of Mental Disorders (DSM) - Known as ―the DSM‖ o The DMS is a diagnostic manual to help psychologist make a classification o There is no definitive way for us to be able to say there is a particular - Gold standard for defining o Debate in the literature about the diagnostic manual th - Currently in the 5 edition - The DSM definition does not specifically refer to the causes of mental disorders o The DSM is not so much explaining the cause, it just defines whether you have a disorder or not - Also rules out behaviours that are culturally sanctioned o Culturally sanctioned – such as going into depression after a death in the family - Published by the American Psychiatric Association - Covers all mental health disorders for both children and adults o Once upon a time, it was thought that children don’t have mental health issues - Statistics in terms of: o Gender o Age at onset o Prognosis o Some research concerning the optimal treatment approaches Schizophrenia - Hallucinations o Are false perceptions o It is difficult for the person to figure out what is real and what is not - Delusions - Positive symptoms o Appearance of something - Negative symptoms o Removal of something Positive and Negative Symptoms of Schizophrenia - Positive Symptoms o Hallucinations o Delusions o Derailment o Inappropriate affect - Negative Symptoms o Social Withdrawal o Apathy o Loss of motivation o Lack of goal-directed behaviour PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 o Very limited speech o Slow movements o Poor hygiene o Poor problem-solving o Distorted sense of time - Affects results in emotionality o Appearance of sudden depression or heightened mania - Do not need to memorize this list. As long as you know one symptom of each Outcomes of Schizophrenia Takes Several Forms - Impairment is losing your job, relationships, etc. - Schizophrenia is on a spectrum where you can have varied episodes Schizophrenia - Genetics of Schizophrenia o Concordance rates  The incidence (occurrence) of this disorder (whatever it may be) within a group of closely related individuals  Presented in the form of percentages o Genetic marker o Saccades  Eye movement - Environmental Contributions to Schizophrenia o Urban environment  Poverty, poor nutrition, and stress  In urban environments, the rates of schizophrenia are higher  The levels of environmental stress are higher, may be related to the impact of rates in schizophrenia  Social economic status = SES  poverty has also an impact o Prenatal environment  In the womb  Birth complications can lead to the increased rate of schizophrenia o Maternal exposure to famine or viral infection PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013  Pregnant mothers were deprived fro food because of war or whatever (famine)  rate for schizophrenia increases - Brain Structure and Function in Schizophrenia o Enlarged ventricles o Hippocampus organization o Hypofrontality o Adolescent loss of gray matter The Influence of Genetics on Schizophrenia - Concordance rate – usually the data is plotted in a general population - This data on the graph gives us a concordance rate of what it could be - Identical twins =50% - Two parents = 40-50% - Concordance rates are fairly high for these two. This is when we start looking at genetic markers A Possible Genetic Marker for Schizophrenia - When you follow tennis, you watch the eyes of the players, they follow the ball with eye movements that are fairly smooth - But when you watch the eye movements of people who read a book, their eye movements are jerky known as saccades PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 - In the case of individuals that have schizophrenia in their family (not necessarily diagnosed as having schizophrenia) but have the genetic marker, it is displayed with the abnormal eye movement Schizophrenia is Associated with Enlarged Ventricles - The ventricles are larger – meaning that tissue is located around these ventricles have decreased - It is thought that the hippocampus is smaller in SOME individuals with schizophrenia - To do this kind of analysis with all individuals that have schizophrenia will be different for each person Cell Arrangements in the Hippocampus Appear to be Disorganized in Cases of Schizophrenia - Left photo = normal - Right photo = person with schizophrenia o Not neatly organized, very chaotic PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 Hypofrontality - Hypo = meaning low - Hypofrontality = low activity in the frontal lobe - The red represents activity - There is higher activity in a normal healthy individual - Possibly the organization of thought are disrupted by this lower activity Schizophrenia is Associated with Larger Losses of Gray Matter in Adolescence - Loss of gray matter - More loss of tissue in the schizophrenic brain Schizophrenia - Physiologically and anatomically there is a huge difference normal and schizophrenic individuals - Brain Structure and Function in Schizophrenia o Enlarged ventricles o Hippocampus organization o Hypofrontality o Adolescent loss of gray matter - Biochemistry of Schizophrenia o Dopamine hypothesis  Rests on observation PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 o Glutamate  Is another attractive mate with what is happening in schizophrenic brain o Phencyclidine (PCP)  Increasing the amount of PCP in the system – produces schizophrenic symptoms  It is a model where we combine the effects of dopamine and block the glutamate receptors Correlations Between Dopamine Activity Levels and Behaviour - When there’s a healthy individual, if there’s an increased exposure of cocaine r methamphetamine in their system, they start to show symptoms of phychosis = hallucinations etc. - A lot of medications that decrease the amount of dopamine in the system is given to schizophrenic individuals - If you start to decrease the amount of dopamine in any brain, it may trigger Parkinson’s disease - The challenge is that the individual could show motor disturbances which is a side effect of the medication The Introduction of Typical Antipsychotic Medications Reduced the Number of Institutionalized Patients - Antipsychotic drugs have decreased amount of individuals that were institutionalized PSY290H5S – Introduction to Physiological Psychology Lecture 9 – August 15, 2013 Tardive Dyskinesia Can Occur as a Side Effect of Treatment with Typical Antipscychotic Medication - Tardive dyskinesia – don’t have control of the movement, particularly around the face - Involuntary movements - This is a horrible side effect of the antipsychotic drugs Mood Disorders - Major Depressive Disorder (MDD) o Person feels overwhelming sadness, despair, and hopelessness, and they usually lose their ability to experience pleasure - Bipolar disorder o Person exhibits two radically different moods—extreme highs called manic episodes (or mania) and the extreme lows of a major depression— usually with relatively normal periods in between Mood Disorder: Major Depressive Disorder - Genetics of Depression o Moderate role – heritability 33% - Environmental Factors and Depression o ―Dutch Hunger Winter‖ o Significant stressors o Showed not only schizophrenia, but these individuals were more likely to be hospitalized from major depressive disorder  Therefore there is a relationship between these stress disorders and environmental factors - Brain Structure and Function of MDD o Reduced volumes in the hippocampus and orbitofrontal cortex o Sleep patterns reflect circadian rhythm disturbances - Biochemistry of Depression o Monoamine activity and serotonin activity o Selective serotonin reuptake inhibitors (SSRIs)  Exercise has been determined to help decrease depression as much as the medication that a patient takes o Cortisol level (dexame
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