PSYC 168_Study Guide M2

PSYC 168_Study Guide M2 - PSYC 168 1. Tourettes Syndrome a....

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PSYC 168 1. Tourette’s Syndrome a. Tics i. Characteristics: 1. Brief, repetitive, purposeless, involuntary movement or sound 2. Premonitory urge- sensory/psychic discomfort 3. ADHD- brain area affected, can be co-occurring? 4. Can be suppressed, but associated with a build up of inner tension 5. Diminished during periods of goal-directed behavior {baseball player} 6. Triggering perceptions: a. Urges to perform dangerous, forbidden or senseless acts ii. Course: 1. Early as age 2, must occur before 18 {can be something else} 2. Median age of onset age 6-7, greatest severity between 8-12 a. Some can grow out of it, 50% diminish by 18 b. Some are lifelong {adults are more predictable} iii. Motor: produce movement iv. Vocal or phonic: produce sound v. Simple: one muscle group, one single sound {blinking} 50% vi. Complex: coordinating movement by number of muscles or utterances 1. Echopraxia: copying actions 2. Copropraxia: inappropriate gestures 3. Echolalia: repeating one phrase over and over 4. Coprolalia: inappropriate expressions vii. Sequence of Tic 1. Premonitory or sensory event
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2. Complex state of inner conflict 3. Motor or phonic production 4. Transient sensation of relief b. DSM 4 i. Both motor and vocal tics must be present, not necessarily concurrently ii. Occur many times a day, nearly everyday, never tic free for 3 months iii. Age of onset before age 18 iv. Disturbance not due to physiological effects of substance or a condition 1. (e.g. Huntington’s disease- attacks basal ganglia) c. Prevalence i. ~1 in 100 ii. 4x more likely in boys iii. 19% in regular education classes have tics 1. 4% meet diagnostic criteria or TS d. Co-morbidities i. 50% referred with TS diagnosed with ADHD 1. Frontostriatal Circuit: ii. 40% TS patients experience OCD symptoms e. Causes i. Monozygotic twins rate = 90% !! 1. Highly genetic, too much dopamine in striatum ii. PET studies – reduce glucose uptake 1. Orbitofrontal cortex, caudate, parahippocampus, midbrain regions iii. Enlarged frontal cortex {b/c trying to suppress} f. Treatment i. Alpha-2 agonists: mimics effects of NT [Catapres, Tenex]
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ii. Antipsychotics: reduces dopamine, horrible side effects iii. Surgery: deep brain stimulation [for Parkinson’s too] 2. Conduct Problems a. Definitions i. Conduct problems: antisocial(against) behavior, age inappropriate actions and attitudes that violate expectations, norms and personal rights of others ii. Delinquency: legal term for antisocial behavior, not considered mental disorder iii. Externalizing behavior: mix of impulsive, overactive, aggressive and delinquent acts iv. Internalizing: behavior is focused inward (depression, anxiety) b. ODD (Oppositional Deficit Disorder): i. 12%. Big brat, age inappropriate, negativistic, hostile, defiant behavior, argumentative ii. Deliberate and willful 1. (not like ADHD here, no eat/sleep disturbances, constant energy levels) iii. 4 symptoms must be present in DSM 4 iv. Parents more likely to have mood disorders/ less likely to have problems with the law, do not display
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This note was uploaded on 03/04/2010 for the course PSY 168 taught by Professor Childs during the Winter '09 term at UCSD.

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PSYC 168_Study Guide M2 - PSYC 168 1. Tourettes Syndrome a....

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