Lecture notes - Review for test 3 PDF

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Schizophrenia 

Nora, Iris, Myra and Hester were all developed from a single fertilized egg and genetically identical. All four developed symptoms of schizophrenia.

Schizophrenia: a psychological disorder characterized by psychotic symptoms that significantly affect emotions, behavior, and mental processes and mental contents. Psychosis: break with reality, specifically hallucinations or delusions. Kraeplin & Bleuler: Typical age of onset: symptoms usually begin in adolescence or early adulthood (late teens to early 30s, most common in 20s) DSM-5 Criteria  Two (or more) of the following active for 1 month (persist for at least 6 months)! - Delusions* - Hallucinations* - Disorganized speech* - Grossly disorganized (or catatonic) behavior - Negative symptoms  Social or occupational dysfunction  If prodromal or residual – may see just negative symptoms or 1-4 less severe *(One of the symptoms must be one of the first 3 in list) Positive symptoms: delusions, hallucinations, disorganized speech and behavior. (presence of abnormal) Negative symptoms: absence or reduction of normal mental processes, mental contents, feelings, or behaviors, including speech, emotional expressiveness, and/or movement.  Affect flattening - lack of emotional expression (facial & voice)  Alogia - poverty of speech  Avolition - apathy, lack of energy, lack of goal directed behavior, inattention to self-care  Anhedonia - lack of ‘anticipatory’ pleasure  Asociality- severely impaired social relationships. Few friends, poor social skills, prefer to be alone Delusions: persistent false beliefs that are held despite evidence that the beliefs are incorrect or exaggerate reality.  Persecutory delusions: involve the theme of being persecuted by others.  Delusions of control (thought insertions): revolve around the belief that the person is being controlled by other people who literally put thoughts into his or her head.

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Grandiose delusions: believing oneself to be significantly more powerful, knowledgeable, or capable than. May also include that the mistaken belief that the person is a different person. Referential delusions: belief that external events have special meaning for the person.

Hallucinations: sensations that are so vivid that the percevied objects or events seem real, although they are not.  Auditory hallucinations, specifically hearing voices, are the most common type in people with schizophrenia Disorganized speech/thoughts:  Disorganized: problems organizing ideas & speech  Ideas not logically related; ‘Loose associations’ » fragmented, disconnected » Trouble sticking to one topic » gets off track, derailment  Disturbed content » but the patient does not think it unusual Word salad: a random stream of seemingly unconnected words. Disorganized psychomotor behavior: -catatonia: occurs when a person does not respond to the environment or remains in an odd posture or position, with rigid muscles, for hours. Cognitive deficits: -deficits in attention -deficits in working memory -deficits in executive functioning (mental processes involved in planning, organizing, problem solving, abstract thinking, and exercising good judgment) *for many people, cognitive deficits exist in childhood well before the first episode of schizophrenia. 

Mood disorders, substance-related disorders, schizophreniform, brief psychotic disorder, schizoaffective disorder, delusional disorder, and schizotypal personality disorder are additional psychotic disorders.

"folie a deaux": means "paired madness" in French; a shared delusion among two or more people 

Prevalence of schizophrenia worldwide is > men (about 10:1) o Anorexia in men is similar to that in women o Life-time prevalence is NOREPINEPHRINE & DOPAMINE 

AMPHETAMINE stimulates the release of DOPAMINE  somatic effects = high energy, lots of talking, appetite suppression, heart rate quickens, rise in body temperature (higher doses may produce nervousness, paranoia, confusion, headache, heart palpitations, heart attack, hypertension or stroke)  long term abuse = psychosis, crash withdrawal

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COCAINE blocks the reuptake of DOPAMINE  somatic effects = local anesthetic and vasoconstrictor, symptoms are similar to amphetamines, may have nasal rebound if snorted  crystalline form (crack), much more potent and smoke-able; high in 10 seconds rather than minutes

Opiates/Narcotics  Primary medical use: pain relief, but can be used for pain, cough, diarrhea and CHF  Types of opiates/narcotics: heroin, morphine, codeine, demerol, darvon, hydrocodone, oxycodone and china white effects of opiate withdrawal o o

after 8 hours: muscle pain, sneezing, sweating, yawns and tearful after 36 hours: uncontrollable twitching, cramps, sweats and chills, increased heart rate and blood pressure, unable to sleep, vomiting and diarrhea o 1/3 of user deaths due to overdose Effects of opiate overdose:  mental depression - coma  respiratory depression  hypotension  pinpoint pupils  antidote

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Narcan: competitive antagonist; taken used to counter the effects of narcotics/opiates

Hallucinogens Marijuana: an exogenous cannabinoid that is obtained from the leaves of the cannabis sativa plant; THC is the most abundant psychoactive substance from cannabis  THC in marijuana binds to CB1 receptors in the hypothalamic eating control areas; this stimulates the appetite (munchies) Some therapeutic effects of marijuana:  relaxed and sociable  cancer pain  treatment nausea from chemotherapy  reduce intra-ocular pressure in glaucoma  multiple sclerosis or other spasticity  increase appetite in late state HIV patients Hashish: a stronger (more potent) form of THC obtained from the resin of cannabis plants Marinol/Cesamet: THC purified in FDA approved pill for medical use in 2.5, 5 or 10mg 

Smoking Benefits/Problems of Marijuana:  User controls amount  Bioavailability thru lungs is rapid and more predictable  30 second time factor, peak effect in few minutes  Short time between administration and effect allows accurate dosing’  Carcinogenic hydrocarbons are produced when burning

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Marijuana, Sleep and Hormones  inhibits stage IV sleep; stage IV rebound produces a “spaced-out” effect where heavy users lack the ability for sustained attention  90% of daily testosterone release is during the last stage IV episode in the early morning THC inhibits testosterone release

Entourage Compounds: produced when smoking; ‘non-psychotropic’ cannabinoids; somehow ‘modulates’ THC effect Cannabidiol (CBD): blunts THC’s unpleasant effects; anti-anxiety, anti-seizure, antiinflammatory and anti-hypertensive effects on its own CBD: THC concentration in plant is a ratio PCP: Phencycline (AKA: Ketamine)  decreases pain perception  hallucinations

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agitated, violent and combative if overdosed increased strength

MDMA: commonly known as, “Ecstasy” or “Molly.” It is a manmade drug that produces energizing effects similar to the stimulant class amphetamines as well as psychedelic effects, similar to the hallucinogen mescaline. Stages of Change: a series of five stages that characterizes how ready a person is to change problematic behaviors: precontemplation, contemplation, preparation, action and maintenance.

Sleep Wake Disorders Etymology of the word "circadian":  Latin  Circa & diem  "about a day" Circadian rhythms: entrained rhythms that have a cycle length of 24 hours Why do organisms have intrinsic time-keeping systems?  Because of the planet's daily rotation on its axis, there is a cyclic variation of light/dark  Organisms have intrinsic time-keeping systems that adjust physiology and behavior to anticipate these cycles of light and dark Do we have physiological body rhythms?  It is believed that most mammalian cells have rhythms, with a hypothalamic clock mechanism that just synchronizes them.  Organs and tissues, individual cells (fibroblasts) and even some bacteria (cyanobacteria) display rhythmic activity.  In the brain, liver, heart and kidney tissue of mammals, 5-10% of the genome is rhythmically transcribed (many of these genes represent key, tissue specific metabolic control points) What is the purpose of coordinating rhythms within tissues or across organs?  A circadian timing system may achieve "internal temporal order" among organs so that organs are prepared to function most efficiently.  Coordinating rhythms within a tissue may optimize organ-level physiological responses. Why do we match behaviors to this light/dark cycle?  We are inactive at a time when moving about would be dangerous (dark)  We efficiently use this time for…  Conserving energy

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Restoring brain glycogen stores Producing proteins and building up tissues Secreting growth hormones and gonadotropins Memory consolidation

Why must we adjust the intrinsic time-keeping system?  In humans, free-running clock is 24.5 hours  The light must shift the animal's clock each day by an amount equal to the difference between their intrinsic free-running period of the lighting cycle. Why not just a set 24 hour rhythm?  There is a seasonal variation in lighting conditions in the natural environment  Most noticeably a change in the length of the light period each day  A time-keeping system that tracks dusk and dawn each day is needed for accurate entrainment. Necessary components of a biological timing system: 1. An intrinsic clock mechanism that measures time 2. An input mechanism that allows clock to be synchronized or reset by changes in environment 3. Output pathways that lead to the generation of overt rhythms Lead brain structure:  The "SCN" (suprachiasmatic nucleus)  In the anterior hypothalamus  A pair of pinhead-size brain structures that sit in the hypothalamus just above the point where the optic nerves cross (optic chiasm)  Bothe oscillator and pacemaker  Gene transcriptional/translational feedback loop is self-sustaining  When isolated, these cells still produce rhythmic activity (oscillator)  Thru outputs, these oscillations regulate rhythms in physiology and behavior (pacemaker) Molecular mechanism involved:  The clock is based on gene expression  The molecular basis for circadian oscillation is a feedback loop involving genes  Alterations in genes that contribute to this loop can cause sleep disorders Retinal detection of light:  Via melanopsin in special retinal ganglion cells  M1 retinal ganglion cells  Mediates the "nonvisual responses to light"  Inhibition of motor activity (ventral subparaventricular zone)  Regulation of nocturnal melatonin secretions (ventrolateral preoptic area)  Constriction of the pupil to light (olivary pretectal nucleus)  Migraine photophobia

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"photo-entertainment" of the SCN

Flower opening and photosynthesis are cyclic and entrained to light!

Zeitgebers- "time givers"...