Unit 3 Notes03/25/14 Schizophreniao Symptoms - Hallucinations - Delusions- Disorganized Speech- Flat Mood and Apathy- Decline in Functioning- Stimulus Overloado Positive vs. Negative Symptomso Positive Symptoms:- Hallucinations, Delusions, - Rapid onset in adolescence or adulthood- Relatively good prognosiso Negative Symptoms:- Flat mood, - Slow onset beginning early- Poor prognosiso Diagnosis has to be made by exclusion- There cant be any other explanation for the symptomso Gender differences- Men diagnosed with the disorder at a younger age Possibly because men are more likely to have negative symptoms - Estrogen may protect women from the symptomso Social class differences- More likely to be diagnosed if you are in the lower class Downward social drift Bias in making the diagnosis Poorer treatment (no healthy insurance) Problems during pregnancy and birtho Ethnicity - Rates appear to be the same across cultures- Differences appear to be due to differences in definitions of symptoms “Ghost Sickness”o Early Psychological Explanations- Bad/Inconsistent mothering “Schizophrenogenic Mothers”- Learning of symptoms Can not use a cognitive approach to change an individuals symptomso Physiological Approaches- Due to high levels of dopamine in the nerve tracts that carry activity to the brain- High brain activity - Positive symptoms- Electrical activity for the brain- High levels of activity in the cortexo How was the role of dopamine discovered?- The accidental discovery that Thorazine (Cholorapromazine) reduced the symptoms of schizophrenia - Reduced levels of dopamine- Antihistamines o Evidence for the dopamine explanation- Drugs that reduce dopamine activity reduce symptoms- Drugs that increase dopamine activity increase symptomso Role of brain activity in hallucinations- Stimulation of cell assemblies that contain memories or thoughts- The Case of the Woman Who Heard The Choir Singing White Christmaso Other explanation for schizophrenia- Brain damage (cortex and ventricles)- Damages reduces brain activity which leads to negative symptomso Hippocampus Memory- Emptyo Amygdala Emotions- Flat moodo The Role of Genetics- 1% in the population- 2% to 6% among cousins- 8% to 14% among siblings- Almost 70% if both parents suffer from the disordero Evidence based on rates in adopted children- The likelihood of your developing schizophrenia is determined by who gave you your genes, not who raised youo The role of biological traumas- The “Season of Birth Effect” If there is an epidemic of influenza that occurs in late fall/early winter, the individual that gets pregnant at that time is more likely to give birth to a child that is more likely to suffer from schizophrenia if the mother has the flu- Inadequate diet during pregnancy- The polio virus- Maybe insufficient levels of vitamin A Problems during pregnancy Prolonged or difficult labor Mother’s high blood pressure Reduced oxygen during birth Use of forceps- More traumas lead to earlier onset of schizophrenia and more severe symptoms Evidence for traumas comes from physical abnormalities Malformed ears Webbed toes and fingers Unusual eye folds- Blows to the head during childhood Why is the onset of the disorder delayed? Takes awhile for the traumas to set ino The role of psychological stress in positive symptoms- Stress increases the activity of the limbic system- Stress is most likely to influence individuals who already have a predispositiono Treatmentso Physiological - Neuroleptic Drugs Block dopamine receptors - Effective for treating positive symptoms Original neuroleptics Thorazine and Haldol The problem of tardive dyskinesia Atypical Neuroleptics Clozaril*, Risperidal, Zyprexia, Seroquel, Geodon, Abilify Block more receport sites in nerve tracts leading to the cortex but fewer in the motor control area Disorders appearing first in infancy, childhood or adolescence o Attention-Deficit Hyperactivity Disorder (ADHD)- Occurrence: 5% of school age children- Three to ten times more common in males than females- Occurs in adults as wello Symptoms: - Inattention - Hyperactivity/impulsiveness- Other problems such as lack of friends, drug abuse, school drop out, criminal behavior, depression, poor intellectual functioningo Making the diagnosis- Self diagnosis- “I’m doing poorly” Questionnaires and rating scales Computerized tests The Holmes test: try medso Causes and Treatments- The learning approach Failure to learn control Behavior therapy Effects to not generalize - The physiological approach Underactivity in the brain Prefrontal cortex (attention controlled) Premotor cortex (motor behavior controlled)- Low levels of dopamine Low dopamine reduces brain activity Link to depression- Why low dopamine? Genetics (dopamine transporter gene) Biological vs. adopted children- About 80% of cases are due to genetic factors- Other 20% comes from Biological traumas: Mothers who smoked, had infections, used alcohol or were exposed to high stress during pregnancy - ADHD and food additives Coloring of food does NOT - Medication: Stimulants: Ritalin and Concerta (methylphenidates) Adderall and Dexedrine (dextroamphetimes) These drugs increase dopamine levelso Autistic Disorder- Symptoms: Impairments in social interactions Restricted, repetitive and stereotyped behaviors Impairments in communication Language functioning by age five usually determines whether they have autism - The debate over the incidence of Autism 1994: 0.04% of children Recent: 0.60% of children Debated that there was an epidemic of Autism - Reasons for the apparent increase: The definition of the disorder was greatly widened Prior to 1994, each of eight symptoms was necessary. After 1994, six of 14 symptoms were necessary There is increased public and professional attention to the disorder- The causes: Bad parenting “Refrigerator Mothers” so the children turned away and withdrew into themselves for comfort and stimulation (Bettelheim school- was FAKE) Problems with brain development and damage Brain size: too small and then too big Cerebellum: problems there may be linked to problems with muscle control and speech problems The temporal lobes: right lobe larger and dominant. Boys with language problems had right lobes that were 27% larger Problems
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