The Soloist and A Beautiful Mind PDF

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Lecture notes on antisocial personality disorders...

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Week #11 11/7 The Soloist and A Beautiful Mind Disorganized speech / incoherent Decline in self-care Notion: the presence of any kind of symptom of psychosis is going to make it more different to perform any cognitive task A lot of evidence = some of the same factors that contribute to impairment of cognitive functioning also contribute to predisposition to mental illness (shared causation) Distribution for people with severe mental illness = skewed Presenting someone like Nathanial (savant capacities) – film is presenting unusual cases that aren’t the norm Film could lead people to expect that individuals w. psychotic disorders are musical geniuses Good job in showing what it can be like for people with serious symptoms of psychosis to be in a group setting with other patients People w. psychosis are more sensitive to stress It is disconcerting for a people w. thought disorder to be around people w. same conditions -

Not a therapeutic treatment

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Individual therapy preferred

Change between being in the stress full of passersby vs. alone in an apartment Ideal approach to getting people w. disorders into better environment -

Gradual progression

Ideal setting for housing people -

Outside of urban areas where patients might be subjected to exploitation

It is true that people w. serious mental illness have records of arrest for disorderly conduct but: -

Are also the victims of crime

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Police arrest them with no valid grounds

*Must respect that they are autonomous people and can decide for themselves = cannot force them into housing Dementia Oracox – early onset dementia (initial name for schizophrenia) People in the field of medicine struggled to understand why individuals had normal cognitive abilities and during adolescence and young adulthood began suffering from thought disorders and deficit in functioning (when psychiatry still formed part of neurology) Healthcare system has reinforced that divide between cognitive impairment and mental disorders Involuntary treatment – notion that people who have severe illnesses that impairs their decision making should be subjected to treatment even if they don’t believe they need it _____________________________________________________________________ A Beautiful Mind – John Nash

Family experiences – 3q19 and 22q11 deletion related to: a. Birth problems b. Autism spectrum disorder c. Anxiety/depression d. Psychosis e. Developmental delays John Nash – mathematician who won the Nobel Prize and was institutionalized at 30 for schizophrenia His youngest son, Johnny, also has his genius abilities and schizophrenia Son – had first symptoms during his teens -

Voices wanted him to stand in the middle of the highway

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Severe

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Angry, withdrawal, isolation make treatment more hard

Inherited genetic vulnerability because of his father Attitude towards his parents: felt neglected by them; immature reaction (kind of like a teenager) -

Felt overshadowed by his father’s accomplishments

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His needs were maybe not met from his point of view

John Nash himself is highly rational

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Residual symptoms: speech disorganization, facial expressions (blunted), monotonic (negative symptoms)

John Nash in his 60’s or 70’s – point in lifespan were typically people w. psychotic disorders see a decline in symptom severity (because dopamine is declining as well) -

Parkinson’s increases when dopamine increases

Drugs that increase dopamine levels or dopamine activity in the brain -

Cocaine

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Meth

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Stress hormones

THC in marihuana increases cortisol release and a heightened sense of stress John Nash speech -

Lost train of thought

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Didn’t know where he was going with his comments

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Speech was barely comprehensible

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Anhedonia

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Murmurs

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Hard to follow

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Conversation went in a circle

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No facial expressions

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No hand gestures or movement

Medication induced abnormalities vs. characteristics of his illness

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Anti-psychotic medication – antagonistic effect on dopamine (decline on its activity on the brain) 

Can produce a reduction in movement and speech

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Changes in facial expressions of emotion

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Effect of this medication: sedating

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Reduction in thought disorder (which would be more present if he didn’t have the medication)

Comorbidity – associated with different part of the lifespans -

In the case of schizophrenia, earlier onset of dementia (especially Alzheimer’s)

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It is possible that he already has some cognitive decline that comes w. his psychotic disorder

Interaction with others / communication...