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Richard P. HalginSusan Krauss Whitbourne
University of Massachusetts at Amherst
slides by Travis LangleyHenderson State University
Abnormal Psychology
Clinical Perspectives on Psychological Disorders 5e
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Aging-Relatedand CognitiveDisorders
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NATURE OF COGNITIVE DISORDERS
DSM-IV diagnoses include:
Impairment of thought, memory, attention (cognitive impairment) arising from brain trauma, disease, or exposure to toxic substances.
Delirium Dementia Amnesia
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Differential Diagnosis
Differentiating symptoms associated with a psychological disorder from those arising in response to a physical disorder can be difficult.
Example:EPILEPSY, especially the form called TEMPORAL LOBE EPILEPSY, can be mistaken for a psychological disorder.
Delirium A temporary state in which individuals
experience a clouding of consciousness, they are unaware of what is happening around them and are unable to focus or pay attention.
In a state of delirium, people experience cognitive changes in which their memory is foggy and they are disoriented.
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delirium
Caused by a change in brain metabolism due to factors such as:
substance intoxication substance withdrawal head injury high fever vitamin deficiency
Delirium
Amnestic Disorder
Cognitive disorders involving inability to (a)recall previously learned information or(b)register new memories.
This inability can be very disturbing, because the individual loses a sense of personal identity.
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Amnestic disorders due to medical conditions.
• chronic• transient
Substance-induced
persisting amnestic disorders.
Categories ofAmnestic Disorder
Substances That InduceAmnestic Disorder Medications Illicit drugs Industrial solvents Mercury Lead Insecticides
The most common cause:
Chronic alcohol use
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Dementia
Generalized progressive deficits in memory, learning, communication, judgment, and motor coordination.
The first sign of dementia is memory loss.
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Dementia: Other Prominent Symptoms Aphasia
Wernicke’s Broca’s
Apraxia Agnosia
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Dementia: Other Prominent Symptoms
Disturbance in Executive Functioning• Executive functioning: Cognitive
abilities such as abstract thinking, planning, organizing, and carrying out of behaviors.
Relatively simple everyday tasks may be forgotten or confused.
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Traumatic Brain Injury (TBI)
Damage to the brain caused by exposure to trauma is increasingly recognized as an important cause of mental and physical dysfunction.
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ALZHEIMER’S DEMENTIA
Multiple cognitive deficits associated with dementia, probably caused by biological abnormalities involving the nervous system.
Subtypes With delirium With delusions With depressed mood Uncomplicated
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ALZHEIMER’S DEMENTIA
Stages Forgetfulness Early confusional Late confusional Early dementia Middle dementia Late dementia
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BIOLOGICAL FEATURES Neurofibrillary tangles Amyloid plaques Deficits in neurotransmitter acetylcholine 40 to 50 percent twin concordance rate
ALZHEIMER’S DEMENTIA
ENVIRONMENTAL factors must play a role; otherwise, concordance would be higher, but specific factors are not yet confirmed.
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Parkinson’s Disease Involves neuronal degeneration of
subcortical structures controlling movements.
Dementia occurs in up to 60% of Parkinson’s patients.
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Parkinson’s Disease Symptoms Hands, ankles, or head may shake involuntarily. Bradykinesia: General slowing of motor activity. Akinesia: Muscular rigidity, difficulty initiating
movement. Loss of fine motor coordination. Slowed, shuffling gait. Difficulty starting or stopping movement like
walking. Expressionless appearance. Loss of normal rhythmic speech quality.
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VARIOUS DEMENTIAS
Substance-Induced Persisting Dementia
Pick’s Disease Lewy Body Dementia
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VARIOUS DEMENTIAS
Frontotemporal Dementias
Huntington’s Disease Creutzfeldt-Jakob
Disease Vascular Dementia
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Pseudodementia: False dementia, symptoms caused by depression that mimic those apparent in early stages of Alzheimer's.
Pseudodementia
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ALZHEIMER’S TREATMENT
BEHAVIORAL MANAGEMENTTarget both patient and caregiver
to: Increase patient independence. Eliminate wandering and aggression. Provide social support for
caregivers.
MEDICATION Slow breakdown of acetylcholine. Antioxidants target free radicals
that may damage neurons.
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