Richard P. Halgin Susan Krauss Whitbourne University of Massachusetts at Amherst slides by Travis Langley Henderson State University Abnormal Psychology Clinical Perspectives on Psychological Disorders 5e Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Aging-Related and Cognitive Disorders

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 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

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 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. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Amnestic disorders due to medical conditions. chronic transient Substance- induced persisting amnestic disorders. Categories of Amnestic Disorder

Substances That Induce Amnestic Disorder Medications Illicit drugs Industrial solvents Mercury Lead Insecticides The most common cause: Chronic alcohol use Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Dementia Generalized progressive deficits in memory, learning, communication, judgment, and motor coordination. The first sign of dementia is memory loss. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Dementia: Other Prominent Symptoms Aphasia  Wernicke’s  Broca’s Apraxia Agnosia Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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.

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 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

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ALZHEIMER’S DEMENTIA Stages Forgetfulness Early confusional Late confusional Early dementia Middle dementia Late dementia

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 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.

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Parkinson’s Disease Involves neuronal degeneration of subcortical structures controlling movements. Dementia occurs in up to 60% of Parkinson’s patients.

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 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.

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. VARIOUS DEMENTIAS Substance-Induced Persisting Dementia Pick’s Disease Lewy Body Dementia

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. VARIOUS DEMENTIAS Frontotemporal Dementias Huntington’s Disease Creutzfeldt-Jakob Disease Vascular Dementia

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Pseudodementia: False dementia, symptoms caused by depression that mimic those apparent in early stages of Alzheimer's. Pseudodementia

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ALZHEIMER’S TREATMENT BEHAVIORAL MANAGEMENT Target 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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