118 terms

Psych test #3

Chapters 13, 14, & 15
Definition of Developmental Psychology
studies how humans develop & change over time
2 Core Issues with Developmental Psychology
Nature (biological changes that occur) vs. Nurture (learned experiences that change us).

Assessing whether maturing is constant or in stages
Critical Periods
periods of special sensitivity to specific types of learning & sensory stimulation that shape the capacity for future development
Wild Boy of Aveyron & Genie
never picked up the language even though he learned social skills
Sensitive Periods
times that are very important, but not definitive, for subsequent development
Continuous Change
gradual alteration of behavior ----> Slow process
Discontinuous Change
qualitatively different stages of growth that are ordered in a fixed sequence
Definition of Attachment
an enduring emotional tie between a child and his/her caretaker
3 Elements Associated With Attachment
1. Desire of the child to be close to the caretaker ---> physical proximity

2. A sense of safety around the caretaker

3. Feelings of distress when the caretaker is absent (ex. when mom drops child off at school child may get upset)
Harlow's Studies of Contact Comfort
Infant monkeys could choose between a wire-mesh "mother" that provided food or a terrycloth "mother" that did not provide food

-Results supported the idea that perceived security ("contact comfort"), not food, is the crucial element in forming attachment relationships
Mary Ainsworth's Strange Situation Paradigm
developed the "strange situation" paradigm to assess attachment in human children
Strange Situation Paradigm
-a mother leaves her child (12-18 months of age) alone in a room of toy with a friendly stranger
-the stranger leaves the room after the mother
-then the mother rejoins her child
-measure of attachment: the reaction of the child to the mother upon her leaving & returning
The Strange Situation reveals 4 patterns
1. Secure: child welcomes the mother's return and seeks closeness to her
-most commonly observed pattern
2. Avoidant: child ignores the mother
3. Anxious-ambivalent: child exhibits anger at the mother while seeking to be close to her
4. Disorganized: child may approach the mother but gaze away from her; also, child may show dazed facial expressions and odd motor behavior
-found in high-risk samples
Adult Attachment
Researchers have found evidence of childhood attachment in patterns of adulthood
-secure: ~60% of adults
-avoidant: ~25% of adults
-anxious: ~10% of adults
Adult attachment patterns predict:
-how people cope w/ stressful events
-whether people want to have children
-the attachment patterns of their children
-how people balance the needs of their children with the needs of their work
Piaget's Theory of Cognitive Development
Interested in epistemology
-He proposed that children develop knowledge by constructing reality out of their own experience
-He argued that cognitive development involves the modification of schemas as a child seeks to understand his/her world

Schemas: integrated patterns of knowledge stored in memory that organize information and guide that acquisition of new information
the branch of philosophy concerned w/ the acquisition of knowledge
Piaget Proposed 2 Intellectual Processes
1. Assimilation: interpreting new information in terms of one's present schemas
-any 4-legged animal is viewed as a "dog"

2. Accommodation: process by which old schemas are modified to fit reality
-a horse is not a 'dog'
-According to Piaget, equilibration (balancing assimilation and accommodation) is the driving force behind cognitive development
Piaget's Terms
Egocentrism: children understand the world to have only their own point of view & they have great difficulty in understanding the views of others

Operations: mental actions a child uses to manipulate, transform, and then return an object to its original state

Object permanence: realization that an object continues to exist in time and pace even if it cannot be seen

Conservation: understanding that the basic properties of an object are constant even if the object changes shape---> indicative of mathematical skills
Piaget's Stage of Cognitive Development
Sensorimotor: (ages 0-2) Limited to sensor input; egocentric; object permanence develops

Pre-operational: (ages 2-7) Object permanence is firmly established; symbolic thought and language develops

Concrete Operational: (age 7-12) Uses principle of conservation; child can apply logic to concrete situations

Formal Operational: (ages 12+) Mature adult thinking in terms of hypotheses (i.e cause and effect)
Cognition and Aging: 5 Findings
1. Processing speed: slows w/ age

2. Memory changes w/ age:
-Older adults have problems w/ complex working memory tasks (ex. repeating digits backwards or keeping track of cars at a 4 way intersection)

-while storage in LTM is not an issue w/ aging, retrieving information from LTM is more difficult for older adults

3. Fluid intelligence declines w/ age while Crystallized intelligence increases w/ age

4. Language skills generally are preserved
-vocabulary skills and factual knowledge remain relatively stable w/ age

5. Aging can take a toll on specific cognitive abilities (ex. mental flexibility, new problem solving), especially if those abilities are unused ('use it or lose it')
Definition of Dementia
progressive & incurable disorder marked by memory loss & deterioration of mental functions, usually diagnosed in older adults
3 Criteria For a Diagnosis of Dementia
1. A noticeable decline from social or occupational functioning (which cannot be accounted for by psychiatric or acute medical conditions)

2. Significant Impairment in memory function

3. At least one of the following cognitive disturbances:
a. Aphasia (impairment in language)
b. Apraxia (decline in motor-shifts)
c. Agnosia (inability to identify familiar objects/people)
d. Executive Dysfunction (difficulty planning, organizing, sequencing, abstracting, etc.)
Dementia Statistics
Only 5% of older adults have dementia
-80% retain sharp mental function

Over 50% of all dementia cases are caused by Alzheimer's disease (AD)
Alzheimer's Disease
Neurological disorder associated w/ protein deposits, tangled neurons, and loss of acetylcholine (a neurotransmitter critical for learning and memory)

Direct correlation btw the extent of damage in the temporal lobes (especially the hippocampus) and the degree of cognitive impairment in persons w/ AD
Definition of Language
A system of symbols, sounds, meanings, and rules that allows for communication among humans
4 Dimensions of Language
1. Semantics: the words of a language & their meanings (nouns, verbs, adjectives, articles, etc.)

2. Syntactics: the grammar (rules) of language

3. Pragmatics: the way meaning is conveyed (ex. Vagueness, using clichés)

4. Prosody: rhythm and intonation used to convey meaning (linguistic prosody) or emotion (affective prosody)
4 Elements of Language
1. Phonemes: smalles units of sound that constitute speech (ex. th, s, a) Critical period

2. Morphemes: smallest units of meaning (ex. anti-, the, -ing)

3. Phrases: Groups of words that act as a unit and convey a meaning (ex. in the den, ate the candy)

4. Sentences: Organized sequence of words that express a though or intention (ex. The house is old. Did you get milk?)
Critical Period
Children learn language very rapidly, often with minimal assistance
-best period to learn a language is birth to 3 years
Segmenting Speech
Children 1st learn to segment speech
-they have an innate sensitivity to phonemes
>at birth, infants can detect difference btw the speech sounds of any human language, but by 10-12 months they lose sensitivity to the sound contrasts in languages to which they are not exposed

Next, they learn to classify words into syntactic categories- nouns, verbs, etc.
Language Development
6-12 months: babbling --> 12-18 months: one words speech --> 18-20 months: two word phrases --> 24-48 months: telegraphic speech --> by age 4: complete sentences
Nonverbal Communication
Nonverbal communication is just as important in interpersonal relationships as understanding verbal language

Nonverbal Communication includes:
-Body Language
-Vocal Intonation
-Physical Distance
-Facial Expressions
the rules people use to balance the conflicting interests of themselves & others
Kohlberg's Theory on Moral Development
-Changes in moral reasoning reflect changes in cognitive structures

-Moral Judgement Interview: 9 moral dilemmas (ex. Heinz and the drug) are presented to determine the level (stage) or moral development
3 Levels of Moral Development
1. Pre-conventional: Morality centers on avoiding punishment and obtaining rewards

2.Conventional: Morality centers on meeting moral standards learned from others, avoiding their disapproval, and maintaining law and order.

3. Post-conventional: Morality centers on abstract, carefully considered principles (5% of adults)
Information Processing Model
when people make decisions about whether an act is immoral & whether it deserves punishment, they make a series of sequential judgements:
>Did the person cause the event?
>Was the person morally responsible?
>Is the person blameworthy?
>Does the person deserve punishment?
Definition of Psychopathology
Literally means sickness of the mind

-problematic patterns of thoughts, feelings, & behaviors
>these problematic patterns disrupt a person's sense of well being and they negatively impact social, academic, and/or occupational functioning
Psychodynamic Perspective of Psychopathology
3 Broad Classes of Psychopathology:
1. Neuroses: minor problems that cause anxiety and mild interpersonal conflict

2. Personality Disorders: chronic disturbances that impair interpersonal and occupational functioning

3. Psychoses: severe disturbances of contact with reality -->inability to distinguish between reality and not reality

>the 3 classes form a continuum of functioning from minimal disturbance (neuroses) to serious disturbance (psychoses)
Cognitive-Behavioral Perspective of Psychopathology
Integration of classical conditioning and operant conditioning within a cognitive-social perspective
-Focus is on discrete processes
>Assess the conditions under which symptoms (ex. depression and anxiety) arise and the environmental stimuli that elicit them
-ex. conditioned emotional responses

-Psychopathology also reflects dysfunctional cognitions (ex. negative views of the self)
Biological Perspective of Psychopathology
Psychopathology is a disease of the brain
1.Disturbance of neurotransmitters
-schizophrenia: too much dopamine
-depression: too little serotonin
2. Neural circuits
-anxiety disorders are associated with heightened activation of an "anxiety circuit" in the amygdala & frontal lobe
3. Gross Pathology of the Brain
-atrophy (waste) of the frontal and temporal lobes is associated with schizophrenia
Biological Perspective: Diathesis-Stress Model
An individual develops a disorder when he/she has:
1. Some biological vulnerability (diathesis) AND

2. When he/she experiences some psychological or environmental disturbance (stress)
Systems Perspective of Psychopathology
Seeks the roots of psychopathology in the broader social context
-explains an individual's behavior in the context of a social group (ex. a family)
-the group functions as a system with interdependent parts --> a change in one member influences other members

ex. a mother's depressions influences her children
-->son arrested for DUI, daughter runs away from home:
-the mother may be the primary symptom bearer (identified patient), but the problem lies in the family
The Nature of Descriptive Diagnosis
Descriptive diagnosis is atheoretical (not connected to any theoretical perspective) and is based on a disease (medical) model
-Psychopathology is reflected in discrete symptoms
-As in physical illness, symptoms fall into discrete clusters called syndromes
-Syndromes are assumed to have discrete causes (etiologies) and are to be treated using different therapies
DSM-IV: "The Diagnostic Bible"
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)
Definition of Mental Disorder
A behavioral or psychological pattern that distresses or disables an individual in one or more significant areas of functioning
Organization of the DSM-IV
-provides specific and operational diagnostic criteria for each mental disorder
-organized into classes (ex. mood disorders)
-uses a multi-axial system of diagnosis, which places symptoms in their biological and social context by evaluating individuals along five axis
5 Axes of the DSM-IV
I. Symptoms that cause distress or significantly impair social or occupational functioning (state disorder)

II. Personality disorders and mental retardation- chronic and enduring problems that impair interpersonal or occupational functioning (trait)

III. Medical conditions that may be relevant to understanding or treating a psychological disorder (seizure disorder)

IV. Psychosocial and environmental problems (such as negative life events and interpersonal stressors) that may affect the diagnosis treatment, and prognosis of psychological disorders (unemployment)

V. Global assessment of functioning- the individual's overall level of functioning in social, occupational, and leisure activities (global assessment functioning, 0-100)
Childhood Disorders
Autism, ADHD, Conduct Disorder
Diagnostic Criteria of Autism
Children with Autism display:
1. Impairments in 'social interactions'
-essential feature: lack of an ability to respond to others before age 3
2. Stereotyped behaviors & a need for constancy (being faithful and dependable)
3. Impairments in communication
Theory of Mind Deficits
A primary deficit in autism is lack of theory of mind (ToM)

-ToM: the understanding that other have beliefs, desires, & intentions that are different from one's own

-before age 4, children have trouble understanding that people can hold false beliefs
>ToM is measured by the false belief task

Failure to develop ToM is devastating to social relationships because the behavior of others can't be predicted
>understanding of intentionality is transmitted linguistically; thus, ToM deficits in autism may be a result of limitations in discourse experience
Joint Attention & Imitation Deficits
Autistic children also lack joint attention (shared attention directed at specific objects) and the ability to imitate others
>joint attention & imitation are the foundation of social awareness and social behavior
Diagnostic Criteria of ADHD
Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention, impulsivity, & hyperactivity inappropriate for the child's age
-inattention: non-responsiveness to task demands (ex. is easily distracted by extraneous stimuli)
-impulsivity: failure to inhibit behavior in accord w/ conditions & demands (ex. waiting one's turn)
-hyperactivity: movement greater than require for accomplishing task demands (ex. fidgets)

The inattentive or hyperactive-impulsive symptoms must be present before age 7

Symptoms must be present in 2 or more settings (ex. at school and at home)
-symptoms cause clinically significant impairment in social, academic, or occupational functioning
Prevalence of ADHD
~5% of school-aged children

-4 to 9 times more prevalent in males
Risk Factors of ADHD
Low SES, severe martial discord, maternal psychopathology, paternal criminality
-the more risk factors a child experiences, the more like he/she is to develop the disorder
Under-arousal Hypothesis
Children with ADHD have insufficient inhibitory control over sensory input & motor output
Treatment of ADHD
treatment of choice: stimulant medication (ex. Ritalin): 75-85% improve
-Controversy regarding its use

As many children with ADHD mature, their hyperactivity behavior tends to decrease
Future Problems w/ ADHD
Children w/ ADHD are at risk for other problems in adolescence and adulthood
-ex. substance abuse & anti-social behavior
Diagnostic Criteria of Conduct Disorder
Conduct Disorder (CD): persistent violation of societal norms & the rights of others

-destruction of property (ex. fire setting)
-deceitfulness or theft (ex. shoplifts; often lies to obtain goods or favors or to avoid obligations)
-aggression to people/animals (ex. bullies, threatens, or intimidates others; physically cruel to people/animals)
-serious violations of rules (ex. often stays out at night despite parental prohibitions; truant from school before age 13)

Causes clinically significant impairment in social academic, and/or occupational functioning
Prevalence of Conduct Disorder
6-16% of boys, 2-9% of girls
Etiology (Cause) of Conduct Disorder
-environmental: excessively punitive or ineffectively lax parenting can lead to delinquency
-biological: they have reduced physiological arousal (ex. much lower resting heart rates) and are less emotionally aroused and, thus, ar eless responsive to conditioning (ex. rewards & punishment)
>as a result, they experience less anxiety (discomfort) when they violate social norms
Comorbidity btw ADHD and CD
Many children diagnosed with ADHD also are diagnosed with CD (comorbid disorders)

There's often environmental familial pathology in the homes of children with both ADHD & CD
-ex. poor child management methods, martial discord, maternal depression
Treatment of Conduct Disorder
Treatment of choice: multimodal treatments that combine stimulant medication w/ individual and family psychotherapy
-multimodal treatments are more effective than drug treatments alone in improving delinquency in children w. both ADHD & CD
Schizophrenia (SZ)
Characterized by profound disturbance in thought, perception, behavior, emotion, & communication
-Emerges in late adolescence or early adulthood
-occurs in about 1% of population with rates higher among the poor and unmarried
-Only about 10-20% of people with SZ recover, most relapse within a year
DSM-IV Criteria for SZ
-severe impairment of reality testing
-marked deterioration in a persons functioning
-symptoms last at least 6 months
-not due to effects of a substance or medical condition
2 Primary Symptoms of SZ
1. Delusions: false beliefs that are held even in the face of evidence
2. Hallucinations: a false sensory perception (usually auditory)
Negative Symptoms of SZ
-Reduction in normal behavior/emotions
-Affective flattening: reducing range of emotion
-Alogia: restrictions in the fluency of speech
-Avolition: restrictions in initiation of goal oriented behavior
Positive Symptoms of SZ
-Excess in sensory perceptions or ideas
-Loose associations: thinking is directed along relative line rather than logic
Etiology of SZ
-Genes play a primary role in SZ
-Prenatal and or delivery complications (hypoxia: insufficient air to the brain)
-Increased risk in pregnant women who are stressed or get sick
-Enlarged ventricles and reduction in tissue in surrounding brain
-Dopamine Hypothesis
>Most cases of SZ are treated w/ dopamine blockers
>People w/ Parkinson's who take drugs to increase dopamine have increased chance of SZ
>Some w/ SZ treated w/ antipsychotics develop symptoms similar to Parkinson's
>Postmortem show more dopamine receptors
>Large doses of dopamine can produce SZ like symptoms
>People w/ SZ produce more dopamine
SZ and the Family
Expressed Emotion: family interactions characterized by criticism, hostile comments and emotional over-involvement
-Higher EE leads to quicker relapse
Major Depressive Disorder
Characterized by depressed mood & loss of interest in activities
DSM-IV Criteria
5 or more of the following 9 symptoms have been present and at least one of the first two:
-Depressed mood
-Anhedonia: diminished interest in pleasure
-Weight gain/loss increase/decrease in appetite
-Insomnia or hypersomnia
-Feeling worthless or excessive guilt
-Loss of energy
-Suicide thoughts/attempt
Theories of Depression
-Genetics: heritability estimated between 30-40%
-Neurotransmission: monoamine hypothesis: abnormalities in serotonin and norepinephrine
-Hormones: Low estrogen/testosterone, hypothyroidism, overactive HPA axis
-Brain Regions: hippocampal damage due to too much cortisol, over-activity in right frontal lobe, under-activity in left frontal lobe
Psychological Theories of Depression
-Depressed people are different in content of thought and cognitive process
-Aaron Beck argues those individuals have cognitive distortions which negatively transform neural information
Anxiety Disorder
Intense frequent anxiety which may lead to phobias: Social Phobia & Specific Phobia
Social Phobia
fear of social situations especially those where they may be under scrutiny of others
Specific Phobia
irrational fear of desire to avoid a stimuli
Etiology of Anxiety Disorder
Biological: genetic, neurophysiological (abnormalities in serotonin and dopamine and low GABA levels)

Behavioral: classical conditioning
Dissociative Identity Disorder
2 or more identities in a person

-Each personality can function properly on its own
-95% of cases have history of sexual or physical abuse
Personality Disorders
Repeated display of dysfunctional behaviors

-Disorder of traits that effect how people perceive and think
-DSM-IV Clusters
-A: odd, eccentric ideas/behaviors (paranoid, schizoid, schizotypal)
-B: dramatic, erratic behaviors (antisocial, narcissistic
-C: anxious, fearful behavior (avoidant, dependent, OCD)
The Psychodynamic Approach
Created by Freud
-Mental symptoms reflect unconscious conflicts that induce anxiety
-Emphasis on insight and understanding one's own psychological processes
-Therapeutic change requires an alliance between the patient and therapist
3 Psychodynamic Techniques
1. Free Association
3. Analysis of Transference
Free Association
Patient is encouraged to say whatever comes to mind to reveal associational networks and unconscious processes involved in symptom formation
-Resistance: barriers to free association which the patient creates
therapist interprets the thoughts and feelings of the patient in order to reveal hidden conflicts and motivations
Analysis of Transference
Patients bring into therapy their past troubled relationships which are transferred onto the therapist
2 Psychodynamic Therapies
1. Psychoanalysis
2. Psychodynamic psychotherapy
Patients lie on a couch; analyst sits behind them
-patients usually undergo psychoanalysis 3-5 times a week for several years, making it a very intensive, extensive, & expensive therapy
Psychodynamic psychotherapy
More conversational than psychoanalysis but the goal is still exploration of unconscious processes
-patient & therapist conduct the treatment sitting face-to-face with the patient in a chair rather than on a couch
-takes place 1-3 times/week & can last several years
>however, there are some short-term psychodynamic therapies that last a year or less
Behavioral Approach
There are 2 classical conditioning techniques that can alter emotional responses:
1. Systematic Desensitization
2. Exposure
Systematic Desensitization
the client is encouraged to confront a feared stimulus mentally while in a relaxed state
-client makes an image hierarchy and in a calm state moves through it to their most feared action then conquers it in real life (good for anxiety and phobias)
Clients are exposed to actual stimuli they fear
-Flooding: client confronts all at once
-Graded exposure: slowly exposed to the feared stimulus
-Virtual Reality Exposure: expose patient to virtual image of feared stimulus

Response Prevention: exposure techniques prevent the client from producing responses that allow avoidance of the feared stimulus
Operant Techniques
1. Extinction: remove the source of reinforcement

2. Selective Punishment: positively or negatively punish an undesired target behavior in order to decrease the probability of that behavior

3. Selective Reinforcement: positively or negatively reinforce a desired target behavior in order to increase the probability of that behavior
Behavioral Treatment of Autism
Treatment: applied behavioral analysis (ABA)
-Ivar Lovaas was the first researcher to study ABA w/ Autistic children
-Recruited autistic children who were <4 years old w/ IQ's > 36
-For two years, children received either:
>standard treatment - 10 hrs/week (Control)
>intensive treatment - 40 hrs/week

Behavior Modification Procedure (Shaping): shaping produces novel behavior by reinforcing closer and closer approximations to the desired response
-child rewarded for any audible sound and then over time only for complex language
Results of Lovaas study at the age of 7
47% of children given intensive treatment improved
-had IQs in the average range (they gained an avg of 30 IQ points)

Only 2% of the control children who received standard treatment improved
2 Social Learning Techniques
1. Participatory Modeling: the therapist models the desired behavior and gradually induces the client to participate in it

2. Skills Training: teach the behaviors necessary to accomplish relevant goals
Cognitive Approach
What we think influences how we feel and behave
-Goal is to change dysfunctional thought patterns
-2 cognitive therapies
>Ellis' Rational-Emotive Therapy
>Beck's Cognitive Therapy
Ellis' Rational-Emotive Therapy
Clients can rid themselves of most psychological problems by minimizing their irrational thinking and maximizing their rational thinking
Beck's Cognitive Therapy
10-20 highly structured sessions to change cognitive distortions
Cognitive-Behavior Therapy (CBT)
corrects maladaptive thoughts and behaviors in a person through modifying schemas
-Emphasis on present symptoms not the past
-Very direct, do not explore the unconscious
-Therapy is short term (months) starting w/ behavioral analysis then moving into tailor procedures for specific issues
4 Benefit of CBT
1. Brief and inexpensive
2. Units of analysis can be measured
3. Based on empirical research
4. Effective for a variety of disorder
Humanistic Therapies
Aim: to help people 'get in touch' w/ their 'true selves' and w/ a sense of meaning in life
-Gestalt Therapy
-Carl Roger's Person-Centered Approach
Gestalt Therapy
get in touch w/ true self and derive a sense of meaning
-Insist the root of psychopathology is a loss of connection to ones feelings
Empty Chair Technique
Patient is given an empty chair and asked to imagine the object of their emotion in the chair
Roger's Person-Centered Approach
Humans are good and only want to grow and mature
-Ever person has multiple selves
>True Self: core aspect of being
> False Self: distorted creation from interpersonal experience
>Ideal Self: who a person would like to be

-Client Centered Therapy: psychological difficulties occur when a person's concept of self is incongruent w/ their experience
>Goal is to create supportive environment w. unconditional positive regard
>Therapist listens empathetically
Group Therapy, Couples Therapy, Family Therapy
Group Therapy
Multiple people work together towards a mutual goal
-Explore the group process to help each other
Couples Therapy
Focus on marital unit
-Use family systems approach, look for problems in communication
-Negative reciprocity: negative responses to each other
Family Therapy
Goal is to change maladaptive behaviors and patterns
-Structural Family Therapy: focuses on organization of the familial system, using intervention to disrupt maladaptive behaviors
-Use of a genogram (map of family) to look at patterns between family members
Psychotherapy integration
the use of multiple therapeutic perspectives
-Eclectic Psychotherapy: clinicians combine techniques from different approache, often to fit a particular case
Evaluation of Psychotherapy
-Meta-Analysis: a statistical technique allowing researchers to combine studies to make comparisons between effective treatment

-All forms of psychotherapy are better than none, those who have psychotherapy are 25% better off than those without
The Medical Model
-Views abnormal behavior as reflecting a biological disorder
-Psychopathology often involves brain damage or disruption of neurotransmitters
-Physical therapies
Psychotropic Medications: drugs that act on mental processes in the brain
-Alter behavior by interacting w/ transmitter sites
>Block postsynaptic receptors
>Block the breakdown of neurotransmitters in synapse
>Block the re-uptake of certain chemicals
>Increase release of certain neurotransmitters
>Activate receptors within a cell's nucleus

-Can also alter behavior due to Placebo effect
>Functions change because people think they're taking a drug that changes them
Antipsychotic Medication
Drugs that treat SZ and other acute psychotic states
-Prior to 1956, SZ was untreatable w/ many people confined to mental hospitals
-Chlorpromazine (thorazine) was found to reduce psychotic thoughts
>newer drugs have helped people who don't respond to thorazine
>after introduction of chlorpromazine mental hospitals populations declined rapidly

-Most are dopamine receptor antagonists and block dopamine

-Positive vs. Negative Symptoms
>Positive symptoms are caused by too much dopamine in the limbic system and basal ganglia
>Negative symptoms reflect enlarged ventricles and too little dopamine from the midbrain to prefrontal cortex
>Thus antipsychotics are more effective for the positive symptoms of SZ
Side Effects of Antipsychotic Medication
Many side effects because Dopamine (DA) exists in multiple regions of the brain
-Blocking dopamine in one areas may inhibit its functions elsewhere
-Most serious side effect is Tardive Dsykinesia: tremors and involuntary movement caused by blocking dopamine in the basal ganglia
-More likely after taking antipsychotics for many years
Antidepressant Medication
Increase Serotonin and Norepinephrine in synapses
-Tricylics block the re-uptake of both
-MAOIs keep an enzyme MAO from degrading neurotansmitters
-SSRI's block the re-uptake of serotonin
-They all require a month to take effect

In a normal person MAO does not effect serotonin or norepinephrine re-uptake or breakdown

In a depressed person there is too much breakdown or re-uptake
Anxiety Medications
Benzodiazepines can be useful for short term treatment
-Increase GABA activity in brain
-Result in psychological dependence
-Preferred treatment is SSRIs due to serotonergic abnormalities in the limbic system
>usually respond to SSRI within a week
Evaluation of Pharmacotherapy
-Long term effectiveness for many conditions
-Issues are side effects and relapse post drugs
-Combinations w/ psychotherapy help resist relapse
-Virtually all untreated patients relapse within 3 years
-Medication helps but nearly half relapse after 5 years
Electroconvulsive Therapy (ECT)
Used for severe depression
-For patients who do not respond to drugs or cannot take them
-Patient is anesthetized and electric currents are run through the brain
-Immediate mood improvement
-Increased reaction to postsynaptic serotonin receptors
-Short Term memory loss and can interfere w/ memory consolidation
-Brain surgery to reduce psychotic behavior
-Lobotomy is most widely practiced procedure
>Removal of cerebral tissue in the frontal lobe
>Calmed patients but cause them to be emotionally blunted and bring back child like behaviors
>Currently a much more limited form is used to help those w/ OCD that don't react to drugs
Prof Alverez's B-Day
August 21st