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Psychopathology and the Brain

Psychopathology and the Brain

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Psychopathology and the Brain

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  1. Psychopathology and the Brain

  2. Schizophrenia • 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

  3. Demographics • 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

  4. Symptoms • “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

  5. More Symptoms • Disorganized Thinking/Speech • Negative Symptoms – the absence of normal behavior • Catatonia – immobility and “waxy flexibility”

  6. Types of Schizophrenia • Disorganized Schizophrenia • Catatonic Schizophrenia • Paranoid Schizophrenia

  7. Brain and Schizophrenia • Larger than normal lateral ventricles – part of the ventricular system; contain cerebrospinal fluid

  8. 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

  9. 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

  10. 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

  11. Schizophrenia: Medication • Antipsychotic medications – drugs do not cure disease, but reduce symptoms • Some drugs have Parkinson’s Disease-like side effects • Counseling also helps

  12. 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

  13. 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

  14. 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

  15. Accompanying Symptoms • Psychosis • Delusions

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. Causes • Childhood trauma – usually sexual abuse before age 5 • Experts believe alter arises to protect person from overwhelming memories and protect secrets from outsiders

  22. 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

  23. 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…

  24. 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

  25. Resources • http://www.mcmanweb.com • http://www.crimelibrary.com/criminal_mind/psychology/multiples • http://faculty.washington.edu/chudler/neurok.html