Investigators have shown that two factors are important for stress appraisal:
- predictability
- controllability
Predictability= do you know it is coming
Controllability= can you change the outcome
Children in highly stressful environments have ……
inhibition of normal growth.
Prolonged elevations in CORT in rats cause atrophy in pyramidal neurons and destroy excitatory synapses in the _____ and ________
hippocampus and prefrontal cortex
Schizophrenia Developmental:
as noted – may aggravate symptoms, but not ultimate cause. Examples are: viral infection/ stress/ poor nutrition of mother during pregnancy, nutritional premature birth, low birth weight, complications during delivery, adolescent marijuana use
Post-traumatic stress disorder (PTSD)
occurs in some people after certain crises or terrifying experiences
Symptoms:
Frequent distressing recollections
Nightmares
Avoidance of reminders of the event
Exaggerated arousal in response to noises and other stimuli
psychosurgery –
the use of surgical manipulation to treat severe mental illness (1940s)
Lobotomy -
frontal lobe lesions
During its heyday, 10-50K patients in US were estimated to have had this surgery
Surgery was supposed to induce relaxation and calmness in individuals with severe or intractable mental disorders
Side effects were not so good - among many, mood swings, change in personality
Cushing’s disease
– endocrine syndrome where cortisol levels are chronically elevated; these patients show massive hippocampal shrinkage and cell loss
positive symptoms
Added symptoms
Delusions – thinking things that can not be true, e.g., as being involved in historical events or interacting with famous people
Paranoia
Structured hallucinations – usu. auditory; these have a well-defined structure and content, such as voices
Walter Freeman –
American psychiatrist that performed and aggressively advocated the prefrontal lobotomy; he probably deserves much of the blame for its overuse
negative symptoms
Social withdrawal – abnormal social associations
Absence of affect – dampened emotionality
Schizophrenia Genes:
highly heritable, but hard to link with mechanism –variations genes for MHC, DISC1, and COMT genes have been identified
Risk factors that have been linked to SZ risk:
Poor nutrition of mother during pregnancy
Premature birth
Low birth weight
Complications during delivery
Increased stress in mother early in pregnancy (famine, viral infection)
Schizophrenia Brain abnormalities:
live imaging – decreased frontal cortex activity during memory tasks, ventricular enlargement; some postmortem studies show synapse loss in frontal cortex
Typical antipsychotics
– block D2 receptors (e.g., chlorpromazine)
Neuroleptics (same as the term antipsychotics)
– are drugs that block DA receptors; discovered in 1950s
Atypical antipsychotics –
block D2 but have other effects less well understood (prob some 5-HT receptor antagonism)(e.g., amilsulpiride, clozapine)
LIMITATIONS of meds for SZ -
-slow-acting: biological effects of dopamine anti-psychotic drugs happens in minutes, but the behavioral changes in SZ only occurs 2-3 weeks later (similar to SSRIs in depression)
-only relieves positive symptoms
-they have a variety of side-effects (esp. typical antipsychotics); may produce extrapyramidal motor symptoms
Glutamate hypothesis of schizophrenia –
deficient activity at glutamate synapses in the frontal cortex accounts for SZ – also based on postmortem studies that show synapse loss in frontal cortex of SZ patients
Sekar et al. (2016) showed that one of the gene products –__________in this family is upregulated in SZ patients
C4 protein (“C” means ”complement” as it relates to the innate immune response)
MHC – major histocompatibility complex;
represent a family of genes involved in the immune response to infection
Reactive depression –
due to an adverse life event; contrasted from normal grieving; usually resolves within 6 months with therapy/ meds
Major depressive disorder –
severe, prolonged depression; may be precipitated by trauma, but not necessarily
Major depressive disorder (MDD) –
extreme feelings of sadness and helplessness everyday for weeks on end
Includes (although does not require all) the following characteristics (DSM-V):
Lack of energy
Feelings of worthlessness
Suicidal thoughts
Feelings of hopelessness
