Behavior Science - Block 3 - Part 2

davidwurbel7's version from 2015-11-17 14:20

Neurocognitive Disorders

Question Answer
Disturbance in attention and awareness. Develops over a short period of time (hours to a few days). Refers to a rapid change from a baseline. Additional disturbance in cognition (e.g., memory, language). Disturbances are not better explained by another preexisting, established, or an evolving NCD. Evidence that the condition is a direct consequence of another medical conditionDelirium
Can be caused by substance intoxication (alcohol, drugs), substance withdrawal, medication induced, another medical condition or cause be due to multiple causesDelirium
Delirium that is rapid onset of severe confusion and disorientation, with fluctuating intensityHyperactive
Delirium that is sudden withdrawal from interaction with outside worldHypoactive
Delirium that alternates between hyperactive and hypoactiveMixed
Treatment is to remove the underlying causeDelirium
Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains based on - concerns from a knowledgeable informant or clinician of a significant decline in cognitive function; and Substantial impairment preferably documented by testing or at least another quantified clinical assessment. Cognitive deficits interfere with independence in everyday activities. Cognitive deficits do not occur exclusively in the context of delirium. Cognitive deficits are not better explained by another mental disorderMajor NCD
Evidence of modest cognitive decline from a previous level of performance in one or more area of cognitive domains based on - concerns from a knowledgeable informant or clinician of a significant decline in cognitive function; and Modest impairment preferably documented by testing or at least another quantified clinical assessment. Deficits do not interfere with a capacity for independent living, but greater effort, compensatory strategies, or accommodation may be requiredMild NCD
Loss of the ability to produce or understand languageAphasia
Inability to perform particular purposive actionsApraxia
Problems recognizing familiar persons and objectsAgnosia
Inability to plan, organize or reasonExecutive Dysfunction
Condition characterized by - neurofibrillary tangles. Plaques (clusters of beta-amyloid). Behavioral changes before cognitive decline. Decline in IQ. Insidious onset and gradual impairment. Onset aged 80-100. Early onset starts aged 50-70. F > MAlzheimer’s Disease
Symptom onset similar to ALZ, but presents only with atrophy to the frontal and temporal lobes. Learning and memory only minimally affectedFrontotemporal Lobar Degeneration
Frontotemporal Lobar Degeneration is also known asPick's Disease
Symptoms include the follow behavioral disinhibition. Apathy. Loss of the following Sympathy/empathy. Perseveration. Stereotypical behaviors. Decline in executive function. Possible decline in language abilityFrontotemporal Lobar Degeneration
Multiple small strokes resulting in cognitive impairment (especially memory loss). Sudden onset of cognitive dysfunction. Stepwise loss of some function with each infarctVascular Dementia
The second most common cause of dementiaVascular Dementia
Condition characterized by Fluctuating alertness and attention. Hallucinations. Problems with movement and posture. Parkinson like symptoms. Tremor. BradykinesiaLewy Body Disease
Onset of dementia less than 1 year from the onset of the motor symptoms. Lewy bodies found cortically.Lewy Body Disease
Condition characterized by slowness (Bradykinesia). Rigidity. Difficulty initiating movements. Pill rolling tremor. Postural instability. Falling (later on). Speech changes (slurring). Small writing. Mask like expression. Reduced blinkingParkinson’s Disease
Onset of dementia greater than 1 year from the onset after motor deficits. Lewy bodies are found in the basal gangliaParkinson's Disease
Condition characterized by positive HIV test. At least two cognitive deficits. At least one motor deficit or personality changes Apathy, Emotional lability or Behavioral disinhibitionHIV Associated Dementia
Condition characterized by - Emotional lability, Dysarthria and Impulsivity. Condition is due to traumatic injury to the headTraumatic Brain Injury
Substance abuse as a disorder that extends beyond the influence of the substance causing Apathy, Emotional lability or Behavioral disinhibitionSubstance Induced (Persisting) Dementia
Depression in elderly that mimics dementia. Memory problems less severe than ALZ, IQ not affectedPseudodementia
Cannot form any new long term memoriesAnterograde Amnesia
Cannot recall any past memories or identityRetrograde Amnesia
Resulting from trauma to the head. Can result in varying degrees of memory deficits, from transient loss of most recent events to the preceding slide. Prognosis relates to extent of trauma or damagePost Traumatic Amnesia
Transient condition resolving in < 24hrs. Patient cannot form new recent memories, but sense of identity is intact. Most common in middle age to elderly. Prognosis goodTransient Global Amnesia
Partial loss of anterograde memories due to excessive alcohol consumption. Can’t recall events from the intoxicated period. Prognosis goodBlackout Phenomenon
Permanent amnesia with more severe retrograde deficits. First is encephalopathy. Then if untreated, Difficulty learning new information. Lack of insight into their condition. Confabulation (especially early on)Wernicke-Korsakoff’s Syndrome
Persistent memory loss, but with confabulationKorsakoff’s Syndrome
An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Most often consists of localized or selective amnesia for a specific event or events; or generalized amnesia for identity and life historyDissociative Amnesia (Psychogenic Amnesia)
Failure to recall events during a circumscribed period of timeLocalized Amnesia
Individual can recall some but not all of the events during a circumscribed period of timeSelective Amnesia
Complete loss of memory for one’s life history. Can also include loss of personal identityGeneralized Amnesia
Stress or depression induced loss of identity, lasting hours to days. Very rare, prognosis goodGlobal Transient Amnesia
Memory loss of a particularly stressful event, (war, rape). Prognosis more variable and often requires long term therapySituation-specific Amnesia
Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information. When the person suddenly leaves and creates a new identity elsewhere, often going back to an age’ before the traumatic or stressful life events occurred that precipitated the fugue. Very rareDissociative Fugue

Schizophrenia and Psychotic Disorders

Question Answer
Symptoms seen in a diseased condition not present in a healthy personPositive
Symptoms seen in a healthy person not present in a diseased conditionNegative
Misperception of real stimuliIllusion
False belief not shared by cultureDelusion
Sensory impression or activation without actual stimuliHallucination
Two (or more) of the following, each present for a significant portion of time during a 1 -month period (or less if successfully treated). At least one of these must be (1 ), (2), or (3) - 1. Delusions 2. Hallucinations 3. Disorganized speech, Grossly disorganized or catatonic behavior, Negative symptoms. Social and or occupational dysfunction present throughout the active phase of the illness. Duration greater than six months. No diagnosis of schizoaffective disorder or mood disorder. Not due to drugs or another medical conditionSchizophrenia
Difficulty in serial learning, Executive functioning, Vigilance, Motor speed or Verbal Fluency suggestsSevere Impairments
Difficulty in delayed recall, Working memory, Distractibility suggestsModerate Impairments
Symptoms present for more than 1 month but less than 6 months. Long term prognosis generally good. Patients tend to have more affective symptoms (i.e. mania), so condition may be more similar to mood disorder. Treatment strategy is essentially the same as for schizophreniaSchizophreniform Disorder
More than a day but less than 1 month. Patients show full remission. Onset is abrupt. Typically follows major life stressorsBrief Psychotic Disorder
Schizophrenia and manic or depressive syndrome. Must have both conditions for the duration of illnessSchizoaffective Disorder
Condition with uninterrupted period during which there is a major depressive or manic mood disorder concurrent with Criterion-A of schizophrenia. Delusions or hallucinations for 2 or more weeks in the absence of a mood episode during the lifetime of the illness. Symptoms of a major mood episode are present for the majority of the total duration of the active and residual illness. The disturbance is not better explained by substance abuse, medication, or another medical conditionSchizoaffective Disorder
One (or more) delusions with a duration of 1 month or longer. Criterion-A for schizophrenia has never been met. Hallucinations, if present, are not prominent. Hallucination follow delusional theme. Impact of the delusion aside, functioning is not markedly impaired. Behavior is not obviously bizarre or odd. If manic/depressive episodes are brief relative (delusional periods). Not substance abuse, medication, other illness or mental disorderDelusional Disorder
Characteristics of this condition include Bizarre fantasies around a central theme; Unusual perceptual experiences; Not withdrawn; Insignificant functional impairmentDelusional Disorder
Belief that the partner is being unfaithful. Can have a very sudden onset with no prior psychiatric historyJealous
Someone important is in love with the person. These patients often show ‘paradoxical conduct’, i.e. any denials or negative reactions from the ‘love’ are interpreted as positive.Erotomanic
Delusion of inflated worth, power, knowledge. ‘Megalomania’.Grandiose
Being attacked, cheated, harassed, harmed, etc. Persons with this delusion sometimes become obsessed with pursuing litigation against their supposed harassersPersecutory
Delusion pertaining to the appearance or functioning of the body. (Ex: Delusional Parisitosis, in which the person is convinced their body is infested with parasites)Somatic
When no one delusional theme predominatesMixed Type
When the dominant delusional belief cannot be clearly determined or is not described in the specific typesUnspecified Type
One's feelings, thoughts, actions are under someone else’s control.Of Being Controlled
Thoughts are being broadcast out loud, or inserted into the patient’s mind.Thought broadcasting/insertion
The idea is that events/things etc in the person’s immediate vicinity have some sort of unusual significance.Of Reference
One person begins to believe/share another person’s delusion. Patients have known each other a long time and usually live together. The secondary person is typically gullible, less intelligent, with low self esteemShared Psychotic Disorder
A dream like state in which the patient exists almost exclusively in their hallucinatory state, not well oriented to time and place, seem very confusedOneiroid
Dopamine (DA) - Over-activity in DA systems, Correlates with positive symptoms, DA agonists activity can cause schizophrenia-like symptoms, Anti-psychotic drugs are D2 antagonists; Serotonin (5-HT) - Excess 5-HT correlates with +/- symptoms, Clozapine is an atypical antipsychotic, Interacts with both 5-HT and DA; GABA - May also be involve; Glutamate - Phencyclidine (antagonist) can cause schizo-like symptoms; Acetylcholine - Decreased nicotinic receptors can possibly be a neuropathological cause of thisSchizophrenia
Neuroanatomical correlates with changes in quantity (reduced volume) and disorganized neuronal arrangement in the Temporal lobe; Decreased neuronal density, Reduced volume and Decreased activity in the Frontal lobe; Disorganized pyramidal arrangement in the Hippocampus; Ventricles Enlarged. Reduced volume of the Limbic systemSchizophrenia
This phase of Schizophrenia disease progression may involve - Decreased social activity. New or changing interests, for example, Religion or the occult. Philosophy. Possibly seeking answers due to changing cognition. No psychotic episodes at the stage. May last weeks or months. Occasionally, these symptoms plateau and do not develop furtherProdromal Phase
This phase of Schizophrenia disease progression involve the manifestation of psychotic episodes - Mostly positive and cognitive symptoms predominateActive Phase
This phase of Schizophrenia disease progression in which there is a period between psychotic episodes - usually negative symptoms. Residual symptoms may increase after each active phaseResidual Phase
Significant social and occupational dysfunction. Educational and employment are frequently impaired (avolition). Even when the cognitive skills are sufficient. Employed at a lower level than their parents. Many do not marrySchizophrenia Functional Consequences
The clinical picture is dominated by three (or more) of the following - Stupor (no psychomotor activity), Catalepsy (trance/seizure with loss of sensation and consciousness), Waxy flexibility (resistance to positioning by examiner), Mutism, Negativism (opposition or no response to instructions), Posturing (rigidity), Mannerism (odd caricature of normal actions), Stereotypy (repetitive, frequent, non-goal-directed movements), Agitation (not evoked by external stimuli), Grimacing, echolalia, or echopraxiaCatatonia

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