Psychopathology and the brain
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Psychopathology and the Brain. Schizophrenia. Comes from Greek words meaning “split” and “mind” People with schizophrenia do NOT have split personalities

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  • Comes from Greek words meaning “split” and “mind”

  • People with schizophrenia do NOT have split personalities

  • “split mind” refers to the fact that people with schizophrenia are split off from reality and can’t distinguish what is real from what is not real

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  • One of the most common mental illnesses

  • Affects 1 % of the population

  • Men show first signs in early 20’s while women in late 20’s

  • US spends $32.5 billion per year

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  • “psychosis” – psychotic element; state in which people cannot tell what is real and what is not

  • Delusions – bizarre, false beliefs; paranoia, grandiosity

  • Hallucinations – unreal perceptions of environment; auditory, visual, olfactory, tactile

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More Symptoms

  • Disorganized Thinking/Speech

  • Negative Symptoms – the absence of normal behavior

  • Catatonia – immobility and “waxy flexibility”

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Types of Schizophrenia

  • Disorganized Schizophrenia

  • Catatonic Schizophrenia

  • Paranoid Schizophrenia

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Brain and Schizophrenia

  • Larger than normal lateral ventricles – part of the ventricular system; contain cerebrospinal fluid

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Causes of Schizophrenia: Genetics

  • Twin studies have shown that tendency for both monozygotic twins to develop schizophrenia is between 30 to 50%; the tendency for dizygotic twins and siblings to develop schizophrenia is 15%

  • Adoption Studies – 13% of biological relatives of adoptees with schizophrenia had the disease, but only 2% of biological relatives of normal adoptees had schizophrenia

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Causes of Schizophrenia: Environment

  • Family Stress

  • Poor social interactions

  • Infections or viruses at an early age

  • Trauma at an early age

  • Genetic makeup combines with non-genetic factors to cause schizophrenia

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Causes of Schizophrenia: Neurotransmitters

  • Dopamine Theory – schizophrenia caused by an overactive dopamine system in the brain; dopamine is a neurotransmitter that allows nerve cells in the brain to send messages to each other; dopamine imbalance may affect the way a person’s brain can react to stimuli

  • Many drugs for schizophrenia block dopamine receptors

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Schizophrenia: Medication

  • Antipsychotic medications – drugs do not cure disease, but reduce symptoms

  • Some drugs have Parkinson’s Disease-like side effects

  • Counseling also helps

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Bipolar Disorder

  • Characterized by changes in mood, behavior, and energy levels

  • Affects approximately 1.2% of the population

  • First episode often occurs in adolescence and can be triggered by a traumatic event; some people are symptom-free in between episodes

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Symptoms: Mania phase

  • Abnormally elevated mood

  • Inflated self-esteem

  • Reduced need for sleep

  • Excessive talkativeness

  • Racing thoughts

  • Distractibility

  • Activities done to excess

  • Pursuit of risky behavior or activities

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Symptoms: Depression Phase

  • Mania can quickly and without warning change to depression/sadness

  • Loss of interest

  • Changes in appetite – weight gain/loss

  • Changes in sleep patterns

  • Agitation

  • Loss of energy

  • Trouble concentrating/thinking

  • Repeated thoughts of suicide/death

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Accompanying Symptoms

  • Psychosis

  • Delusions

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Bipolar Disorder and the Brain

  • Examination of brain tissue after people with BD have died

  • Brain imaging

  • New theory – mitochondrial malfunction

  • Mitochondria – vital organelle for energy production

  • 2000 – Kato, University of Tokyo – based on abnormal brain energy metabolism in bipolar patients measured by brain scans and mitochondrial depletion in autopsied bipolar brains; searched for mutant mitochondrial DNA – two suspect genes

  • March 2004, Archives of General Psychiatry, Christine Konradi - Harvard and McLean Hospital - studied brain tissue in hippocampus and found expression of genes that coded for mitochondrial proteins in bipolar patients decreased

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Famous People with BD

  • Abraham Lincoln and Theodore Roosevelt

  • George Handel, Robert Schumann, Ludwig van Beethoven

  • Leo Tolstoy, Virginia Woolf, Ernest Hemingway, Charles Dickens

  • Sir Isaac Newton

  • Patty Duke, Linda Hamilton, Jean-Claude van Damme

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Multiple Personality Disorder

  • Presence of two or more distinct identities, each with its own unique, and enduring way of relating to the world or self

  • At least two of these identities recurrently take control of the person’s behavior

  • An inability to recall important personal information to an extent that is more than ordinary forgetfulness

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History of MPD

  • Virtually unknown 30 years ago – became more common about 10 years ago

  • Why?

  • W. S. Taylor and Mabel Martin in 1944 – fewer than 100 documented cases

  • 1985 to 1995 – abuot 40,000 new cases

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Why More Common?

  • previously not diagnosed

  • does mind choose pathology from options presented by culture?

  • was called something different in the past – came in form of dead relative possession in 19th century European culture

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  • Childhood trauma – usually sexual abuse before age 5

  • Experts believe alter arises to protect person from overwhelming memories and protect secrets from outsiders

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Case Study: Eve

  • Thigpen and Cleckley, 1953

  • Rooted from traumatic events witnessed growing up in South during Depression

  • Eve White – wife and mother; Eve Black – party girl; Jane – mature intellectual

  • Total of 22 personalities

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Case Study: Sybil

  • True name – Shirley Mason

  • Set the standard for MPD as a syndrome rooted in child abuse

  • 16 separate personalities all having unique talents and characteristics, such as piano playing or having British accent; some were male

  • Dr. Wilbur – Freudian psychologist

  • 1998 – several publications exposed Sybil case as scam

  • Dr. Herbert Spiegel - only multiple personality in psychoanalytic setting; just extremely suggestible hysteric

  • To ensure the book deal, Sybil had to be multiple; Dr. Wilbur’s archives will be opened in 2005…

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MPD in Court

  • Billy Mulligan – accused of robberies and rapes at OSU; by the time faced trial, 10 of 23 personalities surfaced; one with British accent, one could write fluent in Arabic, one was 16, one was 8…

  • Juanita Maxwell – bludgeoned elderly woman to death with a lamp but had no memory of crime; went to trial and violent alter came out

  • Critics say that vast majority of patients misdiagnosed, faked, or unconsciously created by clinician who makes diagnosis

  • Problem: when evidence overwhelming against defendant, only way attorney can mitigate sentence is insanity defense

  • Often very hard to identify whether truly have disorder

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