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7 Pages

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Sam Sommers

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04/15/2014 Anorexia Nervosa Failure to maintain normal body weight (less than 85% of normal body weight for a given height Intense fear of gaining weight even though underweight Undue influence of body/weight/shape on self­evaluation or denial of severity of low weight In women: amenorrhea (missing 3 consecutive menstrual periods), but possible that cases can be just as  severe without this symptom Subtypes Restricting ▯ restrict diet or don’t eat at all (most common) Binge­eating/purging ▯ may not eat that much but feel need to purge or take laxatives Statistics Lifetime prevalence = 0.5% Onset = adolescence 90% female Physical signs Abnormally slow heart rate Abnormally low blood pressure Low body temperature Dry, cracked skin Brittle hair, hair loss, or Lanugo hair on body Brittle nails  Medical complications Cardiac  Slow heart rate EKG abnormalities due to low electrolytes (need water, sodium, potassium) Ipecac (drug used to throw up) can destroy heart muscle Gastrointestinal (due to continual, consistent purging) Tearing of esophagus Decreased gastric motility of stomach and intestines (pain, discomfort, constipation) ▯ can lead to laxative  abuse Pulmonary Aspiration with repeated forceful vomiting Skeletal Bone density loss  Could be to point of osteoporosis  May not fully reverse with weight gain  Brain structure Ventricle size may be increased and may not normalize after weight gain  Antisocial Personality Disorder  A pervasive pattern of disregard for and violation of the rights of others since age 15 Three or more of the following symptoms: Failure to conform to social norms (repeatedly breaking laws) Deceitfulness, lying, conning Impulsivity, failure to plan ahead Irritability and aggression Reckless disregard for safety of self or others Consistent irresponsibility (failure to maintain work or obligations) Lack of remorse Must be at least 18 years old ▯ when under 18, prescribed as “conduct disorder” Statistics Lifetime prevalence = 3% in men, 1% in women Higher rates in forensic samples Both genetic and environmental contributions Relationship with the construct of psychopathy Lack of empathy, superficial charm, inflated self­appraisal Biological responses Reduced gray matter volume in medial frontal cortex  Area involved in thinking about perspective of others (empathic processing, theory of mind) Decreased modulation of startle response to aversive pictures Lower skin conductance responses to CS+ in Pavlovian fear conditioning paradigms at age 4 predicated  antisocial behavior 20 years later Treatments in schizophrenia, depression, and OCD Medications Electroconvulsive therapy (ECT) Neurosurgery Transcranial magnetic stimulation (TMS) Cognitive­behavioral therapy (CBT) Schizophrenia Treatment Medications  Antipsychotic medications Old antipsychotics (“neuroleptics”) ▯ reduce hallucinations and delusions but with side affects  Chlorpromazine (Thorazine) Haloperidol (HALDOL) New atypical antipsychotics ▯ fewer motor side affects than old antipsychotics but different side affects,  might be better at treating negative symptoms  Clozapine (Clozaril) How do these medications work? Antipsychotics block dopamine receptors Sometimes make negative symptoms worse  Side effects Motor side effects Parkinsonian symptoms (rigidity, tremor) Tardive dyskinesia  Weight gain Agranulocytosis – decrease Major Depression & Depression Treatment Antidepressants  Tricyclics (e.g., imipramine) Serotonin reuptake inhibi
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