Psychological disorders

Question 1

Drug Mechanisms

Answer 1

3. Drugs either facilitate or inhibit transmission at synapses.
   a. Antagonists block receptors, while agonists mimic or increase effects of a neurotransmitter.
   b. A drug has an affinity for a receptor if it binds to it (like a key in a lock).
   c. A drug’s efficacy is its tendency to activate the receptor.

Question 2

Similarities and Differences Among Addictive Substances

Answer 2

Nearly all abused drugs increase activity at dopamine and norepinephrine synapses.
b. Discovery of neuroanatomy of addiction occurred by accident, when Olds & Milner missed a target for implanting an electrode in rats. The rats’ self- stimulation of the brain increased when electrodes were in areas that increased the release of dopamine or norepinephrine in the nucleus accumbens.

Question 3

c. Nucleus accumbens

Answer 3

reinforces experiences of all types; drugs work to increase dopamine in that area via direct (stimulants) or indirect (opiates) means.
- All abused drugs and even non-drug addictions such as gambling have much in common

Question 4

A craving

Answer 4

is an insistent search for an activity.

Question 5

Tolerance

Answer 5

occurs when the effects of a drug (especially the pleasurable effects) decrease over time.

b. Tolerance is in part learned; when rats are given a drug in a location, their tolerance is increased in that location.
c. When the body reacts to the absence of a drug, it is called withdrawal.

Question 6

Type II (or Type B) alcoholism

Answer 6

has a rapid onset, usually before 25. Most are men with a family history of alcoholism

Question 7

Type I (or Type A) alcoholism

Answer 7

develop alcohol problems gradually, after 25. The late-onset type depends more on stressful life and less on genetics and is generally less severe and more responsive to treatment

Question 8

Antabuse

Answer 8

makes it harder to metabolize acetaldehyde, which causes a person to feel sick after drinking alcohol.

Question 9

Methadone and LAAM

Answer 9

are used to reduce withdrawal and avoid the “high” of heroin and morphine. They do not end opiate addiction, but satisfy the craving in a less dangerous way.

Question 10

Major Depression:

Answer 10

People with major depression feel sad, helpless, and lacking in energy and pleasure for weeks at a time. Individuals with major depression also feel worthless, have trouble sleeping, cannot concentrate, get little pleasure from sex or food, may contemplate suicide, and in many cases, can hardly imagine being happy.

Question 11

Types of Antidepressants

Answer 11

a. Tricyclics
b. Selective serotonin reuptake inhibitors (SSRIs)
c. Serotonin norepinephrine reuptake inhibitors (SNRIs)
d. Monoamine oxidase inhibitors (MAOIs
e. Atypical antidepressants

Question 12

Tricyclics:

Answer 12

Prevent the presynaptic neuron from reabsorbing serotonin, dopamine and norepinephrine after releasing them (this allows the neurotransmitter to remain longer in the synaptic cleft thus stimulating postsynaptic receptors). But causes side-effects such as drowsiness (because it also blocks histamine), dry mouth, difficulty urinating and heart irregularities (and blocks acetylcholine)

Question 13

Selective serotonin reuptake inhibitors (SSRIs):

Answer 13

These drugs are similar to tricyclics, but are specific to the neurotransmitter serotonin. The most popular drug in this class is fluoxetine (Prozac). Produce fewer side effects than tricyclics

Question 14

Serotonin norepinephrine reuptake inhibitors (SNRIs):

Answer 14

Block the reuptake of serotonin and norepinephrine. Produce fewer side effects than tricyclics

Question 15

Monoamine oxidase inhibitors (MAOIs):

Answer 15

Block the enzyme monoamine oxidase (MAO) from metabolizing catecholamines and serotonin into inactive forms. Was the earliest antidepressants, but now is only used when tricyclics or SSRIs do not work because people need to avoid foods containing tyramine (cheese, raisins and many others)

Question 16

Atypical antidepressants:

Answer 16

A miscellaneous group of drugs with antidepressant actions and mild side effects, including bupropion (Wellbutrin), which inhibits reuptake of dopamine and to some extent norepinephrine.

Question 17

Why are Antidepressants Effective?

Answer 17

One theory is that most people with depression have lower than average levels of a neurotrophin called brain-derived neurotrophic factor (BDNF) that is important for synaptic plasticity, learning and the proliferation of new neurons in the hippocampus. Many studies suggest antidepressants increase BDNF over the course of weeks (consistent with the course for antidepressants to take effect). The capacity to make new neurons makes it easier to learn new ways of coping.

Question 18

Exercise as therapy:

Answer 18

Regular, non-strenuous exercise increases blood flow to the brain and provides other benefits that are especially helpful to people with depression such as increases in levels of serotonin and BDNF.

Question 19

Electroconvulsive therapy (ECT):

Answer 19

Inducing seizures with an electric shock to the head. ECT is usually applied every other day for about two weeks.

Question 20

Deep brain stimulation

Answer 20

consists of a device implanted into the brain to delivery periodic stimulation to certain brain areas.
ii. Research is still in the experimental phase, but results are promising.

Question 21

unipolar disorder :

Answer 21

Depression can be unipolar or bipolar. People with unipolar disorder vary between depression and normality.

Question 22

People with bipolar disorder (formerly known as manic-depression disorder):

Answer 22

alternate between episodes of depression and mania (characterized by restless activity, excitement, laughter, self-confidence, rambling speech, and loss of inhibitions).

Question 23

Bipolar I disorder:

Answer 23

A type of bipolar disorder where the person has full-blown episodes of mania.

Question 24

Bipolar II disorder:

Answer 24

A type of bipolar disorder where the person has much milder manic phases, called hypomania.

Question 25

Lithium salts

Answer 25

are the most effective therapy for bipolar disorder, but how it works remains unknown. Other drug treatments include anticonvulsant drugs such as valproate and carbamazepine. Encouraging bipolar patients to keep a consistent sleep schedule may reduce the intensity of the mood swings

Question 26

Seasonal affective disorder (SAD):

Answer 26

Depression that reoccurs seasonally, usually in the winter.

2. SAD is most common in regions closest to the poles, where the nights are very long in winter and very short in summer.
3. It is possible to treat SAD by exposing the person to very bright lights for about an hour either early in the morning or in the evening.

Question 27

2. Schizophrenia:

Answer 27

A disorder characterized both by deteriorating ability to function in everyday life and by some combination of the following:

• Delusions: Unjustifiable beliefs, such as “beings from outer space are controlling my actions”
• Hallucinations: False sensory experiences, such as hearing voices when alone
• Disorganized speech: rambling or incoherent
• Grossly disorganized behavior
• Weak or absent signs of emotion, speech, and socialization

Question 28

Positive symptoms:

Answer 28

Behaviors that are present that should be absent (all of the list above except for last)

Question 29

Negative symptoms:

Answer 29

Behaviors that are absent that should be present, such as deficits of social interaction and emotional expression (last on the list above)

Question 30

Cognitive symptoms:

Answer 30

Limitations of thought and reasoning that are common in schizophrenia.

Question 31

Twin Studies of schizophrenia:

Answer 31

a. For monozygotic schizophrenic twins, there is about a 50% concordance (agreement), and a 15% concordance for dizygotic twins.

Question 32

Adopted Children Who Develop Schizophrenia

Answer 32

a. One study found that 12.5% of the immediate biological relatives and none of the adopting relatives had schizophrenia.
b. These results suggest a genetic basis for schizophrenia. There is also the possibility of a prenatal influence. For example, many women with schizophrenia drink and smoke during pregnancy.

Question 33

The Neurodevelopmental Hypothesis:

Answer 33

Schizophrenia is caused in large part by abnormalities to the nervous system during the prenatal or neonatal periods.

1. Prenatal and Neonatal Environment
   a. Having a father over 55 is a risk factor, as is living in a crowded city (presumably for environmental reasons) and prenatal or childhood infection with the parasite Toxoplasma gondii (that only reproduces in cats)
   b. Several factors could have affected the infant’s brain development, including poor nutrition of the mother during pregnancy, premature birth, low birth weight, and complications during delivery.
   c. If a mother is Rh-negative and her baby is Rh-positive, the baby’s Rh-positive blood may trigger an immunological rejection by the mother. The result is hearing deficits, mental retardation, and twice the usual probability of schizophrenia.

Question 34

Season-of-birth effect:

Answer 34

the tendency for people born in winter to have a slightly greater possibility of developing schizophrenia. Some reason this may occurs is nutrition during winter, viral infections, fever, and influenza.

Question 35

Mild Brain Abnormalities in schizophrenia:

Answer 35

a. On average, people with schizophrenia have less than average gray matter and white matter, and larger than average ventricles—the fluid-filled spaces within the brain.
b. The strongest deficits are in the left temporal and frontal areas of the cortex.
c. The thalamus is also smaller than normal for people with schizophrenia.
d. The areas with consistent signs of abnormality include some that mature slowly such as the dorsolateral prefrontal cortex. Most people with schizophrenia show deficits in memory and attention because of these deficiencies.
e. Lateralization also differs, with the left hemisphere slightly larger than the right.

Question 36

Antipsychotic Drugs and Dopamine schizophrenia

Answer 36

a. Chlorpromazine (Thorazine): First drug used successfully for the treatment of schizophrenia.
b. Antipsychotic drugs (neuroleptic drugs): Drugs used for the treatment of schizophrenia. These drugs work primarily by blocking dopamine receptors.
i. Phenothiazines: A class of neuroleptic drugs that includes chlorpromazine.
ii. Butyrophenones: A class of neuroleptic drugs that includes haloperidol (Haldol).

Question 37

Dopamine hypothesis of schizophrenia:

Answer 37

According to this hypothesis, schizophrenia results from excess activity at certain dopamine synapses. The primary evidence for this hypothesis is the type of drugs that relieve and aggravate the symptoms of schizophrenia.

Question 38

Substance-induced psychotic disorder:

Answer 38

Disorder characterized by hallucinations and delusions caused by drugs such as cocaine, amphetamine, and LSD, which increase the activity of dopamine synapses.

Question 39

Glutamate hypothesis of schizophrenia:

Answer 39

Idea that schizophrenia results from deficient activity at certain glutamate synapses. Because dopamine inhibits glutamate activity in many parts of the brain, much of the evidence supporting the dopamine hypothesis of schizophrenia also supports the glutamate hypothesis of schizophrenia.

Question 40

Phencyclidine (PCP):

Answer 40

A drug that blocks NMDA glutamate receptors. PCP administration produces a type of psychosis more similar to schizophrenia than drugs like cocaine, as PCP induces both negative and positive symptoms. Moreover, PCP does not produce psychosis in preadolescents and PCP produces a much more severe psychosis in people with a history of schizophrenia.

Question 41

Mesolimbocortical system:

Answer 41

A set of neurons which project from the midbrain tegmentum to the limbic system. The mesolimbocortical system is believed to be the area in which antipsychotics have their beneficial effects.

Question 42

Tardive dyskinesia:

Answer 42

A serious side effect of antipsychotics; this disorder is characterized by tremors and other involuntary movements. Tardive dyskinesia is caused by the prolonged blockade of dopamine receptors in the basal ganglia.

Question 43

Second generation (atypical) antipsychotics:

Answer 43

drugs (e.g., clozapine) that alleviate the symptoms of schizophrenia while seldom, if ever, producing movement problems. These drugs have less intense effects on dopamine type D2 receptors, but stronger effects at D4 and serotonin 5-HT2 receptors.
d. Atypical antipsychotics are more effective than typical antipsychotics at relieving the positive symptoms and, to some extent, the negative symptoms of schizophrenia, but they do not improve overall quality of life more than the typical antipsychotic drugs.

Question 44

Autism spectrum disorder

Answer 44

includes a range of people with varying degrees of difficulty, and encompasses what used to be called Asperger’s Syndrome as well as autism.

2. The primary characteristics are:
   a. Deficits in social and emotional exchange
   b. Deficits in gestures, facial expressions, and other nonverbal communication
   c. Stereotyped behaviors, such as repetitive movements
   d. Resistance to a change in routine
   e. Unusually weak or strong responses to stimuli, such as indifference to pain or a panicked reaction to sound

Question 45

Treatments for autism

Answer 45

1. No medical treatment can help with the social and communication issues of autism, but Risperidone (an antipsychotic drug) can help with stereotyped behavior, though with serious side effects.
2. Behavioral treatments may work on the social aspects of autism, focusing on eliciting the child’s attention and reinforcing favorable behaviors.