Chapter Sixteen
Psychological Disorders
CHAPTER 16
PSYCHOLOGICAL DISORDERS
Schizophrenia
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Hallucinations
Delusions
Positive symptoms
Negative symptoms
Figure 16.2 Outcomes of Schizophrenia Takes
Several Forms
Schizophrenia
• Genetics of Schizophrenia
– Concordance rates
– Genetic marker
– Saccades
• Environmental Contributions to Schizophrenia
– Urban environment
• Poverty, poor nutrition, and stress related to racism
– Prenatal environment
– Maternal exposure to famine or viral infection
Figure 16.3 The Influence of Genetics on
Schizophrenia
Figure 16.4 A Possible Genetic Marker for
Schizophrenia
Schizophrenia
• Brain Structure and Function in Schizophrenia
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Enlarged ventricles
Hippocampus organization
Hypofrontality
Adolescent loss of gray matter
• Biochemistry of Schizophrenia
– Dopamine hypothesis
– Glutamate
Figure 16.5 Schizophrenia Is Associated with
Enlarged Ventricles
Figure 16.6 Cell Arrangements in the
Hippocampus Appear to be Disorganized in
Cases of Schizophrenia
Figure 16.7 Hypofrontality
Figure 16.8 Schizophrenia is Associated with
Larger Losses of Gray Matter in Adolescence
Figure 16.9 Correlations Between Dopamine
Activity Levels and Behavior
Schizophrenia
• Treatments of Schizophrenia
– Phenothiazines
• Tardive dyskinesia
• Newer antipsychotic drugs
– Psychosocial rehabilitation
Figure 16.10 The Introduction of Typical
Antipsychotic Medications Reduced the Number
of Institutionalized Patients
Figure 16.11 Tardive Dyskinesia Can Occur as a
Side Effect of Treatment with Typical
Antipsychotic Medications
Figure 16.12 Repeated Transcranial Magnetic
Stimulation Reduces Auditory Hallucinations
Mood Disorders
• Major Depressive Disorder
– Genetics of Depression
• Moderate role – heritability 33%
– Environmental Factors and Depression
• “Dutch Hunger Winter”
• Significant stressors
– Brain Structure and Function of MDD
• Reduced volumes in the hippocampus and orbitofrontal cortex
• Sleep patterns reflect circadian rhythm disturbances
Figure 16.14 Depression is Associated with
Abnormal Patterns of Sleep
Figure 16.15 The Hypothalamus-PituitaryAdrenal (HPA) Axis Plays an Important Role in
Stress and Depression
Mood Disorders
• Major Depressive Disorder
– Biochemistry of Depression
• Monoamine activity and serotonin activity
• Cortisol level
– Treatment of Depression
• 30-35 % treated with SSRIs show complete remission
• Electroconvulsive shock therapy (ECT)
Figure 16.16 Electroconvulsive Shock Therapy
Mood Disorders
• Bipolar Disorder
– Causes of Bipolar Disorder
• Genes play significant role
• Dietary influence
– Brain Structure and Function in Bipolar Disorder
• Hippocampal volume
• Enlargement of amygdala
– Biochemistry and Treatment of Bipolar Disorder
• Lithium
Anxiety Disorders
• Obsessive-Compulsive Disorder
– Intrusive Thoughts and Repetitive Behaviors
• Germs and disease, fear for safety, moral concerns
• Hand washing, checking, counting, touching
– Causes
• 63-87% concordance rates
• Abnormalities in circuits connecting thalamus, basal ganglia, and
orbitofrontal cortex
– Treatments
• Antidepressant medications and SSRIs
• Deep brain stimulation
Figure 16.19 OCD and Behavioral Treatment
Anxiety Disorders
• Panic Disorder
– Strong sympathetic arousal
– Repeated panic attacks
– Role of sodium lactate
Anxiety Disorders
• Post-traumatic Stress Disorder
– “Shell shock” or “battle fatigue”
– Triggered by explores to combat, natural disasters,
accidents, assaults, and abuse
– Hippocampus
– Decrease in benzodiazepine receptor binding in frontal
cortex
Autism
• Deficits in behavioral domains,
communications, and social relatedness
• Causes of Autism
– Strong genetic role (90 % concordance)
– Multiple environmental factors
• Brain Structures and Function in Autism
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Abnormal acceleration then deceleration in growth
Minicolumns
Cerebellum and amygdala
Mirror neurons
Autism
• Biochemistry and Treatment of Autism
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Serotonin
GABA
Glutamate
Excess peptides from gluten and casein
Treated with intensive, early childhood learning
experiences
Attention Deficit/Hyperactivity Disorder
• Genetics of ADHD
– Significant role – 80 % concordance rate
• Brain Structures and Function in ADHD
– Prefrontal cortex, basal ganglia
• Biochemistry and Treatment of ADHD
– Stimulant medication
– Behavioral therapy
Antisocial Personality Disorder
• “Pervasive pattern of disregard for and
violation of the rights of others”
• Genetics of Antisocial Personality Disorder
– MAOA gene
– Twin studies
• Brain Structure and Function Antisocial
Personality Disorder
– Limbic structures
– Damage to orbitofrontal cortex
Figure 16.20 The Orbitofrontal Cortex
Figure 16.21 Brain Activity Among Murderers
Antisocial Personality Disorder
• Treatment of Antisocial Personality Disorder
– Complicated by classification procedure
– Learning models
• Anger control
• Social skills
• Moral reasoning