Term
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Definition
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Term
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Definition
| Affect, Association, Autism |
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Term
| Prepulse inhibition (disease,symptoms) |
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Definition
| (schizophrenia) if you make a loud noise people jump, but if you make a slightly lower noise and then a louder noise they don’t jump as much |
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Term
| Hebophrenia (disease,symptoms) |
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Definition
| (schizophrenia) continue to talk but it appears to be word salad. |
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Term
| Features of Schizophrenia (4) |
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Definition
psychotic features e.g. delusions, thought disorder, inappropriately expressed emotion, hallucinations
functional deterioration
onset before the age of 45
the illness lasts for months or years rather than days |
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Term
| Historical Perspective on Etiology and Treatment |
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Definition
Early vitalistic thinking was Possession
Dissipation theory –
Rake’s progress (look up)
Treatment
Warehousing – Bethlehem Hospital
Humane treatment |
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Term
| Pharmacological Revolution of the 1950s |
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Definition
Amphetamine – produced psychosis (taken chronically)
Discovery of the phenothiazines for psychiatric disorders |
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Term
| Schizophrenia is a Developmental Disorder (3) |
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Definition
Characterized by early onset (<40 years)
May be triggered by disease or neuro- toxicological event
The “influenza blip”: about twenty years after a major influenza outbreak there is a rise in schizophrenia cases
Winter births
Prodromal signs begin often in late adolescence (people in this category undergo odd changes, they stop doing well, and they don’t seem to care about hygiene |
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Term
| Physiological symptoms of Schizophrenia |
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Definition
Loss of brain volume associated with the increase in ventricle size
reduced brain activity in the frontal lobes |
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Term
| Genetics and Schizophrenia |
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Definition
Schizophrenia condcordance is about 50% in monozygotic twins, 20% in dyzygotic twins and about 3-4% in siblings (basically the same as the general population)
Schizophrenics appear to have degeneration in the frontal cortex |
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Term
| Disease Progression (prodromal signs)4 |
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Definition
Withdrawal (autism)
Odd or ritualistic behaviors
Flattening of affect
changes in personal hygiene |
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Term
| Disease Progression (psychotic signs)3 |
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Definition
Delusions
Hallucinations (most auditory, some olfactory)
Disordered thought |
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Term
| Evidence for Genetic Involvement |
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Definition
Unrelated individuals – 1% lifetime risk
Third-degree relatives – 2%
Second-degree relatives – 4-6%
First degree relatives – 6-17%
Twins
Dizygotic – 17%
Monozygotic – 50% (concordance)
Conclusion: genes play a role,but 50% results from environmental factors) |
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Term
| Neuroanatomical Sequelae (schizophrenia)4 |
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Definition
Reduced blood flow to Globus Pallidus
Lack of induced blood flow to prefrontal cortex
Reduction in mass of the medial temporal cortex– and hippocampus
Increase in volume of ventricles |
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Term
| GXE and Schizophrenia (3) |
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Definition
Polygenic (complex trait, not a single gene, or gene mix)
Environment (toxin or viral insult?)
Cellular sequelae
Alters migration of NADP – diaphorase neurons? Fewer in layer VI in afflicted individuals?
Cause?
Glycogen synthase kinase 3 signalling pathway |
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Term
| Pharmacotherapy for Schizophrenia (4) |
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Definition
Discovery of the Phenothiazines
May work by inhibiting the receptor, but then this causes the receptors to become hyper sensitized after inhibition
Dopamine strategy for treatment
D1 and D2 receptors vs D3 and D4
Typical vs atypical
Relationship between affinity for the D2 receptor and clinical efficacy
DA systems exert differential manifestations of Schizophrenia |
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Term
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Definition
Gsk-3 beta is constituitively active
Phosphorylation decreases its activity
Decreased Gsk-3B activity is associated with deregulation of DA differentiation |
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Term
| Schizophrenia treatment side effects |
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Definition
* Acute dystonia - uncontrolled movements of face, neck, tongue
* Oculomotor crisis - uncontrollable eye movements
* Akathisia - restlessness & agitation
* Parkinson's disease - slow movement, shuffle, facial tremor
* Tardive dyskinesia
eans "late appearing movement disorder".
It involves erky movement of the tongue and face, eventually entire body affected. |
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Term
| Factors that indicate drug abuse |
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Definition
Socioeconomic Status
Personality types – conduct disorder (high prevelence of drug use in young people with primary conduct disorder)
Environmental conditions
Genetics |
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Term
| Environmental Conditions of abuse |
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Definition
Those that increase risk
Peers
Media
Familial (those families that have problems with alcohol, or those that don’t drink seem to have problems with alcohol)
Those that decrease risk
Familial
Educational |
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Term
Susceptibility to Addiction
Genetic contributions |
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Definition
sensitivity (Schuckit’s work)
Initial sensitivity to alcohol seems to be indicate an increased risk of alcohol dependence later on
toxicity (e.g. ALDH)
People from east Asia may have a problem with acetaldehyde, it is toxic, but most have the capacity to reduce this to aldehyde, these people don’t have this capacity (increases the risk for esophageal cancer)
single vs. multiple genetic effects, the tale of the DRD2 gene (they initially thought that deficiencies in this gene did not allow people to attain the same level of reqard and caused addiction) |
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Term
Susceptibility to Addiction
Environmental effects |
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Definition
cues
environmental situations (environmental stressors)
Genes and Environment – co morbidity? (depression and alcoholism) |
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Term
| Different Types of Addicts |
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Definition
Type I Alcoholic (dependent: late 20’s early 30’s) triggered by bad situations, women are more susceptible to damage from alcohol (less water)
Type II Alcoholic (abuser: early onset, male limited) drinking a lot not caring about the consequences |
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Term
| Short term effects of alcohol |
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Definition
“The superego is that part of the personality that is soluble in alcohol” G.M. White 1973
Frontal cortex is the most susceptible part of the brain to alcohol
Limbic system is the most resistant
Increased risk-taking behaviors
Brain becomes effected at .05 for decision making
The LD50 for humans is about .4 (not alcoholics)
Alterations in behavior
Acute toxicity |
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Term
| Long term effects of alcohol |
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Definition
Alteration in behavior
Functionality (dry drunk: alcoholics who have stopped still appear to have a long term effect)
Corpicus (vitamin deficiency) can be reversed
Organic damage |
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Term
| Corpicus (disease, cause) |
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Definition
| alcoholism (vitamin deficiency) can be reversed |
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Term
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Definition
Response to attractive properties of substance (euphoria, relief from anxiety)
Cocaine is the only drug in which people appear to binge during the first time trying the drug
Repeated usage – frequency and length of exposure to target tissue (brain)
People form southern Europe appear to have a higher control system for knowing their limits, whereas northern Europeans tend to continue to drink
Associated disruption of homeostatic mechanisms
tolerance to attractive effects
setting up of aversive consequences of termination
Abstinence syndrome
shift of self administration based on attractive to avoidance of the aversive effects |
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Term
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Definition
Diminished effect of drug at same dose
Types of tolerance
Acute-functional (rapid change in target tissue)
Pharmacodynamic (change in target tissue)
Down regulates GABA receptors (alcohol)
Up regulate dopamine transporters cocaine:blocked
Dispositional (change in rate of elimination by change in metabolizing enzymes, etc.)
TOLERANCE IS NOT SENSITIVITY BUT A DIMINISHED SENSITIVITY
THC may actually cause an increased sensitivity to the drug (why you don’t get high the first time) |
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Term
| Tolerance and Homeostasis |
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Definition
Brain functions are either excitatory or inhibitory
Drugs that increase excitation (usually) cause downregulation of excitatory processes
Drugs that increase inhibition (usually) cause downregulation of inhibitory processes
Abstinence syndrome follows drug-based tolerance in homeostatic systems
Dependence and addiction are biological |
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Term
| The Insidiousness of Tolerance |
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Definition
Drug makes you feel good
Occasional use leads to tolerance to attractive effects – leads to more drug use
More drug use now alters homeostatic systems – nevertheless you persist to try to get back the good old feeling – long gone
Now when you stop the drug, the effects aren’t so great – anxiety to lethargy to convulsions, depending on the drug -- you take the drug to avoid these effects
Cocaine crash just lethargic and depressed
Opiates depressed, cold sweat, diarheaa
Alcohol, barbituates serious effects (use BZ’s like valium for detox) |
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Term
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Definition
Tolerance
Abstinence syndrome
Drug is taken in large quantities
Unsuccessful attempts to quit or manage
Large effort to acquire drug
Drug use replaces normal activities
Knowledge of problem alone may not help |
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Term
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Definition
Recurrent use of drug coupled with performance problems in other activities
Use in face of possible physical harm
Scrapes with the law
Continued use, sans souci
(Don’t care)
Little or no evidence of Dependence |
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Term
| Dealing With the Problem (3) |
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Definition
Functional Addicts
Alcoholics
Opiate Users (biggest complaint= constipation)
Interventions
Community-based
THE LAW
Voluntary cessation
quitting sedative/hypnotics/alcohol vs.
quitting psychostimulant drugs |
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Term
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Definition
Chemically-based
Treatment with agonists (drugs with similar effects)
Treatment with antagonists (to block drug effects)
Non Chemically-based
Cold-turkey
Weaning
Counseling-Psychotherapy |
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Term
| After Treatment Prevention of Relapse |
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Definition
12-step programs
Counseling and Therapy
Individual
Group
Family
Preventing environmental cueing |
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Term
| Neurobiology of addiction |
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Definition
Dopamine and Reward
Mesolimbic System
Ventral Tegmentum
Nucleus Accumbens
Medial Prefrontal Cortex
Ventral Pallidum
LOOK UP Schulgin (ecstasy)
Makes ecstasy to test on himself
Uses it in married couples
MDMA has been shown to have neurotoxic effects
Don’t mix with alcohol |
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