[PSYB65H3] - Midterm Exam Guide - Ultimate 36 pages long Study Guide!

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PSYB65H3
MIDTERM EXAM
STUDY GUIDE
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L12: Treating Disordersl
Treating Disorders
- Neurologists treat organic disorders of the nervous system medically
Parkinson Disease & Stroke
- Psychiatrists treat mental disorders with pharmacological & other medical treatments in combination with behavioral
treatments
Schizophrenia & PTSD
Causes of Disordered Behavior
- Evidence for brain abnormalities in organic-neurological disorders is straightforward, the causes are generally known
Genetic errors (e.g. Huntington disease)
Epigenetic mechanisms
Progressive cell death (e.g. Alzheimer Disease)
Rapid cell death (e.g. Stroke, Traumatic Brain Injury)
Loss of neural connections (e.g. MS)
- Far less is known about the causes of behavioral-psychiatric disorders, but there
must be some abnormality in brain structure or activity
Many of these factors interact
Microscopic: Genetic error Tay-Sachs disease & Huntington disease
Intermediate: One-time events Infections, Injuries, Toxins
Macro level Nutrition, Stress
Challenges to Diagnosis
People are seldom objective observers of their own behavior or that of a loved one
The patient and loved ones may be selective in what they notice
- People are seldom specific in identifying symptoms
- Evaluators have their own conceptual biases, which may influence the questions they ask and the information they gather
Treatments for Disorders
- Neurosurgical: Skull is opened and some intervention is performed on the brain
- Electrophysiological: Brain function is modified by stimulation through the skull
- Pharmacological: Chemical that affects the brain is either ingested or injected
- Behavioral: Treatment manipulates the body or the experience, which in turn influences the brain
Neurosurgical Treatments
- Largely reparative, as when tumors are removed, or arteriovenous (AV) malformations corrected Typically successful
- Advances include improved imaging of a target for surgery and methods to destroy diseased tissue without opening the skull
Deep Brain Stimulation (DBS)
- Neurosurgery in which one or more electrodes implanted in the brain stimulate a targeted area with a low-voltage electrical
current to facilitate behavioral change
DBS remains an experimental option of last resort
Its not a permanent cure: When stimulation stops, beneficial effects are reduced
- Electrodes implanted in the brain are well tolerated and remain effective for several years
- Electrical stimulation can relieve depression or compulsive behaviors
- Stimulation may also make brain tissue more plastic and receptive to other treatments
*If a brain region is functioning abnormally or if it is diseased or dead, as occurs in TBI or after stroke, it should be possible to return this
region to the embryonic state and regrow a healthy region Induced stem cells by neurotrophic factors
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Neurosurgical Treatments (CONTD.)
Stem Cell Therapy
- Using appropriate manipulations, any cell can potentially be returned to a stem cell state
- Extract stem cells, place them in special culture medium to generate millions of cells, place these stem cells in the damaged brain
Cells would be instructed to differentiate appropriately and develop the correct connections
Electrophysiological Treatments
Electroconvulsive Therapy (ECT)
- Uses electrical current to produce seizures as a treatment for severe depression
- Stimulates the production of neurotrophic factors (e.g. BDNF) that in turn restore inactive cells to more active mode
Transcranial magnetic stimulation (TMS)
- A magnetic coil placed over the scalp induces an electrical current in underlying brain regions
- Can be applied to local brain regions (focal areas) thought to be implicated in specific disorders
- Manipulation of the magnetic field can stimulate an area of cortex as small as a quarter
The cortical surface only or deeper layers of brain tissue
Studies report positive effects treating depression, but the required duration of treatment and duration of beneficial effects
remain under investigation
Promising studies have extended the possible benefits of TMS to schizophrenic auditory hallucinations, anxiety disorders,
hemiparesis, neurodegenerative diseases, pain syndrome
Pharmacological Treatments
Drugs commonly used for behavioral disorders
- Neuroleptics for Schizophrenia
- Anxiolytic agents for Anxiety
- L-dopa for Parkinson Disease
The central goal is developing drugs that can act as magic bullets to correct the chemical imbalances found in various disorders
- Pharmacological treatments have significant downsides
Acute and Chronic side effect stop the list, and long-term effects may cause new problems
- Drugs do not provide the behavioral tools needed for coping: A pill is NOT a skill
Behavioral Treatments
- Focus on key environment factors that influence how a person acts
As behavior changes in response to treatment, the brain is affected as well
- Since every aspect of behavior is the product of brain activity, behavioral treatments do act by changing brain function
Behavior Modification
- Therapists apply the principles developed from laboratory studies of learning by reinforcement, including operant & classical
conditioning
- Systematic desensitization: Form of habituation that allows an individual to adapt to a repeatedly presented stimulus
(e.g. treatment of phobias)
Cognitive Therapy
- Thoughts intervene between events and emotions
- Challenge a persons self-defeating attitudes and assumptions
- Important for people with brain injuries
Neuropsychological Therapy
- Aim to retrain people in the fundamental cognitive processes they have lost
- Neurocognitive programs are being developed to improve functional outcomes following TBI and stroke
Emotional Therapy
- Talking about emotional problems, enabling people to gain insights into their causes; may also serve as treatment
- Address the unwanted behaviors directly (by acquiring a skill rather than taking a pill)
- Effective treatment for depression / anxiety
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