LECTURE_17_SLIDES - NPB12 Lecture 17 Attention – Deficit...

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Unformatted text preview: NPB12 Lecture 17 Attention – Deficit / Hyperactivity Disorder 3-5% of American Children 3 boys for every girl 3 cardinal symptoms: Inattention not being able to keep their mind on a single problem for an extended time. They become easily bored within a few minutes. Difficulty in sitting still, will not remain seated for Hyperactivity more than a few minutes if allowed. Fidget in their seats, etc. They appear in adults to be very restless Impulsivity blurting out inappropriate comments, sudden aggressive behavior, not being able to "take turns", etc. Attention – Deficit / Hyperactivity Disorder Have to have all the symptoms starting at 3-4 years of age Have to have all the symptoms all the time. Should rule out other things that look the same (learning disability, stress, abuse etc.) Oppositional Defiant Disorder Approx. ! have this: fighting, punching, etc. Emotional Disorders: Anxiety, Depression It is characterized by aggression and violence, commonly resulting in punching playmates when they get frustrated Oppositional Defiant Disorder Emotional Approx. ! have this: fighting, punching, etc. about 1/4 feel anxious, which is tremendous worry, tension and uneasiness even though there is nothing in their environment to fear. About a similar number will have Disorders: episodes of depression, which goes beyond ordinary sadness. Depression Anxiety What doesn t cause it: Stimulants are an effective treatment for ADHD But that is not without controversy Why in the world would you give this: Impulse control centers in the frontal lobe are not active enough a stimulant? The stimulant increases activity all over, but it increases it in the frontal lobe enough to allow better impulse control. Side effects of Ritalin? Everything that you expect from a stimulant: anxiousness insomnia fast heart rate Behavior modification can also work: Break things into manageable chunks. Obsessive – Compulsive Disorder Obsessive-Compulsive Disorder: You obsess about something, which compels you to do something that you know is irrational. One of the more common things is the obsession about germs Which compels you to wash your hands. 20 or 50 or 200 times a day. That makes it tough to have a normal life. They know that this is irrational behavior, they just can t help themselves. this is different than other addictions: Obsessive-Compulsive Disorder: 2-3% of Americans have it. Likely an underestimate since many will not seek treatment. Treatments are Drugs and Therapy: tricyclic antidepressants: affect the re-uptake of norepinephrine and serotonin selective serotonin re-uptake inhibitor (SSRI) Therapy: Exposure and Response Prevention Manic Depressive Illness (also called bipolar disorder) Depression is by far the more common. If an individual suffers only from depression it is considered unipolar. If the person experiences episodes of both mania and depression, or mania alone, it is considered bipolar. 1-2% of population Manic episodes are often rewarded: William Blake Winston Churchill Virginia Woolf Buzz Aldrin Marlon Brando antidepressants multiple side-effects work best for depressive state Lithium (Li+) works well to control both the mania and depression. How it works is unclear. T his drug is considered a SSRI, or selective serotonin reuptake inhibitor SSRIs also work (Prozac), and seem to work about the best. Many are championing it s virtues, but you must be careful as there is a long history of well-renowned psychologists/psychiatrists that have touted the virtues of drugs we now know are not that good for you. Electroconvulsive Shock Therapy Checkered history Still used today for severely depressed patients with high suicide risk. Now do under anesthesia with paralytics. Works much faster than anti-depressants. It generates a generalized seizure for 30 – 60 seconds, and somehow that helps. Anxiety Nervosa 2 Forms: Generalized and Panic Attacks Generalized anxiety is less severe, but constitutes a continuous feeling of anxiety, fear, and apprehension. This will of course cause irrational behavior making it very difficult to maintain a fulfilling relationship, hold down a job Drug treatments are the benzodiazapams (Valium) Panic Attacks One of the most overprescribed medications of the late 1960s and early 1970s Side effects include: Drowsiness Dizziness Affective Disorders (euphoria) Addiction Benzodiazapams mimic GABA and bind to a specific GABA receptor. Benzodiazepines mimic GABA and cause an increase in the inhibition of neurons in the cortex. The anticonvulsants that are used in the treatment of epilepsy also mimic GABA. However, these anti-convulsants do not work well to alleviate the symptoms of anxiety, and the benzodiazepines do not prevent epileptic seizures. This is because there is more than one type of GABA receptor, and so far the two most common are the GABA-A and GABA-B receptors GABA-B receptor also binds GABA but it activated a G-protein and works via a second messenger. Anti-epileptic drugs work on the GABA-B receptor and don t help with anxiety. Psychoactive Drugs should be able to treat most mental illnesses Patients often don t like the side effects (remember Lecture 16?) so they stop taking the drugs once they feel normal Once they are ill again they don t know to take the medicine, stay mentally ill, with bad consequences. Dissociative Disorders I m not crazy and neither am I These disorders cover a wide range, from perfectly normal to Dissociative Identity Disorder to post-traumatic stress disorder Post-Traumatic Stress Disorder Estimated at 10-15% of the population at one time or another. Is triggered by an extremely stressful event. It could be an acute event. Or a longer period of constant stress Post-Traumatic Stress Disorder has two general types: Flashbacks or Amnesias Flashbacks are when the person experiences the event in a very vivid way. It is much more than a memory, the person feels that they are actually there again. This is the intrusion type as the thoughts of those events continually intrude in your mind. The amnesia type is the opposite, you simply don t remember what happened to you. Which type you get generally depends on what happens after the event. If you have the chance to talk about it ( reporting live from New Orleans I m standing with a man who lost everything " ) you get the intrusion type. If you are told to keep it quiet, which commonly happens to children that are physically or sexually abused, you get the amnesia type. Why did the Vietnam War veterans get PTSD more often that soldiers from previous wars? average age: 19 vs. 26 Three days and a wake-up call More effort is now made to treat people with PTSD, including group therapy, virtual reality, and medications. Dissociative Identity Disorder The person adopts a different personality. Sometimes they know about each other and are able to switch from one personality to the other. The cause is child abuse, either physical, sexual or (in most cases) both. This usually occurs only after repeated incidences of abuse. ...
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This note was uploaded on 12/01/2011 for the course NPB 72965 taught by Professor Recanzone during the Fall '11 term at UC Davis.

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