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Chapter 16
Aging and Psychological
Disorders
Abnormal Psychology, Eighth Edition
by
Gerald C. Davison and John M. Neale
Lecture notes created by Paul J. Wellman, Texas A&M University
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16
Issues in Aging
• Cultural view of the aged in the U.S.A. is typically
negative
• Aging may have a greater negative impact for
– Women
– Minorities
• Ageism refers to discrimination against any
person based on age
– Can be young or old person
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.1
Diversity in Aging
• Levels of “old”
– Young-old: ages 65-74
– Old-old:
ages 75-84
– Oldest-old: over age 85
• The one aspect that the elderly have in common
is age
– The elderly differ from one another as well as from
other age groups
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.2
Measurement Issues in Aging
Research
• Age effects are the consequences of being a
given chronological age
• Cohort effects are the consequences of having
been born in a particular year and having grown
up during a particular period of time
• Time-of-measurement effects are confounds that
arise because particular historic events have
specific effects
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.3
Brain Disorders in Old Age
• Dementia refers to a gradual deterioration of
intellectual ability that Interferes with social and
occupational function
• Dementia can involve problems in
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–
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–
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Memory
Poor hygiene
Language disorder
Faulty judgement
Delirium (state of mental confusion)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.4
Causes of Dementia
• Alzheimer’s Disease involves a progressive
deterioration of the cerebral cortex and
hippocampus leading to difficulty in concentration
and memory loss
• Alzheimer’s disease involves
– Loss of nerve cells within brain due to plaque formation
and neurofibrillary tangles
– Reduced activity of the neurotransmitter acetylcholine
(ACh)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.5
Genetics of Alzheimer’s Disease
• Chromosome 21 contains a gene that controls the
formation of amyloid which forms plaques
– The chromosome 21 gene accounts for 5% of early
onset Alzheimer’s cases and no person with this gene
has made it past the age of 65 without developing
Alzheimer’s disease
• Chromosome 19 contains a gene allele that
controls the likelihood of developing Alzheimer’s
(1=50%, 2=90%)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.6
Frontal-Lobe Dementias
• Frontal-Temporal dementia involves
– Cognitive impairments of memory
– Apathy
– Loss of serotonin neurons in brain (rather than
Ach)
• Frontal-Subcortical dementias include:
– Parkinson’s disease (muscle tremors)
– Huntington’s chorea (muscle writhing)
– Vascular dementia (muscle weakness-stroke)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.7
Treatment of Dementia
• Alzheimer’s Disease has no treatment to
halt or reverse the disease
– Drug studies seek to boost remaining ACh
function in brain using
• Drugs that block the breakdown of ACh
• Drugs that block the formation of B-amyloid
– Drugs are used to treat the specific symptoms
of Alzheimer’s disease (depression, anxiety,
sleep disorder)
• Psychological therapy is to be supportive
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.8
Delirium
• Delirium is a clouded state of consciousness
involving
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–
–
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–
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Difficulty in concentration
Disruption of the sleep-waking cycle
Incoherent speech
Memory impairment for recent events
Perceptual disturbances (delusions and hallucinations)
Mood/activity swings
• Mortality rate for delirium is about 40%
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.9
Causes of Delirium
• Causes of delirium include
– Drug intoxications and drug-withdrawal
reactions
– Metabolic/nutritional imbalances (diabetes)
– Infections (fevers)
– Stress (environmental change)
– Major surgery
– Brain damage
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.10
Depression in the Elderly
• The prevalence of mood disorders is less
in the elderly (< 3 %) than in young people
(20 %).
– Bipolar depression is rare in the elderly
– Symptoms of depression are similar in the
elderly expect that feelings of guilt are less
common and somatic/memory complaints are
more common
– Suicide attempts and completions increase for
men as they age
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.11
Causes of Depression in the
Elderly
• Depression in the elderly is associated with
– Poor physical health
– Medications that aggravate existing depression
•
•
•
•
Antihypertensive medications
Hormones
Corticosteroids
Antiparkinsonism medications
– Stressors
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.12
Anxiety Disorders in the Elderly
• Anxiety disorders are more common than
depression in the elderly
– Anxiety per se is quite common in the elderly
• Anxiety is associated with
– Medical illness or anticipation of illness
– Medication reactions
– Delirium accompanying illness
– Cardiovascular conditions (angina)
– Caffeine consumption
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.13
Schizophrenia in the Elderly
• Prevalence of schizophrenia is lower in the elderly
than in the young
– Schizophrenics die young
– Some schizophrenics show remission of their
symptoms as they enter old age
– Schizophrenia rarely has an onset after age 60
• Paraphrenia is the term used to characterize the
onset of schizophrenic symptoms in an older
person (more hallucinations and delusions)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.14
Substance-Related Disorders
• Substance abuse is less prevalent among
the elderly than the young
– Alcohol abuse can have onset in the elderly
• Tolerance for alcohol is reduced in old age
• Older people metabolize alcohol more slowly
– Illegal drug abuse is expected to increase
among the elderly
– Medication misuse occurs in the elderly
• The elderly are 13% of the population but receive
33% of the legal prescriptions
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.15
Sleep Disorders
• Insomnia is a common (25%) sleep problem
in the elderly
• Other common sleep problems include
– Frequent awakenings at night
– Early morning awakenings
– Difficulty following asleep
– Daytime fatigue
• Elderly show reduced sleep time and less
time spent in REM sleep
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.16
Treatment of Sleep Disorders
• Older adults use a variety of medications to
treat sleep disorder and each have
associated problems:
– Sleeping pills lose their effectiveness and
cause sleep disorder (REM rebound sleep)
– Tranquilizers have adverse side effects such as
disruption of learning and reduced thought
clarity during the following day
– Alcohol reduces REM sleep
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.17
Suicide
• Older people are more likely to experience suicide
risk factors such as illness, social isolation, loss of
loved ones and financial pressure
• Suicide rates increase for men as they age and
decrease slightly for women
• Older people are less likely to communicate
suicidal intent and are more successful in their
suicide attempts
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.18
Sexuality
• Older people can maintain an active sex life
• Changes in sexuality in the elderly include
– Older men require longer to acquire an erection
• Erections fade more quickly after ejaculation
• Refractory period lengthens in elderly men
– Older women require more time to become
sexually aroused
• Vaginal lubrication is less in older women
• Older women return more quickly to a non-aroused
state
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.19
Copyright
Copyright 2000 by John Wiley & Sons, New York, NY. All
rights reserved. No part of the material protected by this
copyright may be reproduced or utilized in any form or by
any means, electronic or mechanical, including
photocopying, recording or by any information storage
and retrieval system, without written permission of the
copyright owner.
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e