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Mizzou PSYCH 2510 - Chapter 14

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Psych 2510 1nd Edition Lecture 19 Outline of Last Lecture I. Developmental DisordersII. Features and Epidemiology of Developmental DisordersIII. Causes and Prevention of Developmental DisordersIV. Assessment and Treatment of Developmental DisordersV. Disruptive Behavior DisordersVI. Features and Epidemiology of Disruptive Behavior DisordersVII. Causes and Prevention of Disruptive Behavior DisordersVIII. Assessment and Treatment of Disruptive Behavior DisordersOutline of Current Lecture I. What are cognitive disorders? II. Features and EpidemiologyIII. Causes and PreventionIV. Assessment and TreatmentCurrent LectureI. What are Cognitive Disorders?A. Normal memory and cognitive changes occur with age and do not interfere with daily functioning. B. These changes may progress to more serious cognitive disorders such as deliriumand dementia. These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.II. Features and EpidemiologyA. Delirium i. Often temporary and reversible condition where a person is disoriented and has trouble with attention, concentration, and memory. ii. Delirium may result from substance intoxication or medical situations such as anesthesia. B. Dementiai. More serious cognitive disorder that includes chronic and irreversible declines in memory and other cognitive processes.C. The most common form of dementia is Alzheimer’s diseasei. A progressive condition marked by cognitive deficits such as aphasia, apraxia, and agnosia and deficits in executive functioning.D. Video: Tom, a profile of Alzheimer’s disease.E. Vascular dementia i. Dementia caused by a blood vessel problem, especially a stroke.ii. People with this dementia often face a more abrupt and acute onset of symptoms but less cognitive impairment than people with Alzheimer’s disease.F. Dementia may be due to Parkinson’s disease i. A progressive neurological disorder involving severe problems in motor functioning. ii. Not all cases of Parkinson’s progress to dementia however, such as with Michael J. Fox.G. Dementia due to Pick’s disease i. The most well known of the frontotemporal dementias, meaning deterioration occurs in the frontal and temporal brain lobes, as indicated in the large gaps seen in this image.H. Amnestic disorders i. Refer to memory impairments caused by substances or medical conditions. ii. Korsakoff ’s syndrome is an amnestic disorder resulting from long-term thiamine deficiency.I. Dementia occurs in about 5 to 8 percent of older persons, and many people with one form of dementia also have another form of dementiaV. Causes and PreventionA. Biological risk factors for cognitive disorders include genetics;i. Identical twins display more concordance for Alzheimer’s disease than nonidentical twins.B. Genetic changes in cognitive disorders include chromosome 21 and amyloid precursor protein, chromosome 19 and apolipoprotein E, and chromosomes 14 and 1 and presenilin 1 and 2.C. Neurochemical changes in cognitive disorders include low levels of acetylcholine,serotonin, norepinephrine, and dopamine and high levels of L-glutamate.D. Brain changes in cognitive disorders often include neurofibrillary tangles, senile plaques, Lewy bodies, atrophy, and oxidative stress and free radicals. E. Environmental factors may also influence cognitive disorders, especially diets high in antioxidants and fish and low in fat and cholesterol.F. Moderate alcohol use may be related to less dementia, but aluminum intake mayrelate to more dementia. G. The amyloid cascade hypothesis refers to various brain changes cascading from genetic and environmental factors to produce cognitive disorder. H. Prevention of cognitive disorder will likely hinge on diet, exercise, cognitive stimulation, medications, and perhaps gene therapy. VI. Assessment and TreatmentA. Interviews i. Commonly used to assess people with dementia and their caregivers, andtopics often include recent changes in behavior, thinking, memory, and longterm skills such as language or ability to recognize others.B. Questionnaires i. Used to screen for delirium and dementia and typically cover orientation, verbal and written comprehension, concentration, learning, writing and copying, and memory.C. Cognitive tests such as neuropsychological and intelligence tests also evaluate strengths and weaknesses of people with dementia.D. Medical and laboratory tests, including neuroimaging techniques, can often be used to spot the development and progression of dementia.E. Biological treatments for people with dementia often include:i. Cholinesterase inhibitors to increase acetylcholine in the brain, memantine to control L-glutamate activity, and L-dopa to quell symptoms of Parkinson’s disease.F. Gene therapy will likely be a key future way of treating people with dementia.G. Many biological treatments for people with dementia are conducted in hospice or nursing home settings. H. Psychological treatments for people with dementia include:i. Reminiscence therapy, reality orientation, memory training, and behavior therapy.I. Psychological treatments for caregivers of people with dementia include:i. Education about dementia and providing support and respite care to prevent caregiver burnout and improve quality of life. J. The long-term outcome for people with dementia is bleak; most die within 3-9 years of onset of the cognitive


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