Download Abnormal Psychology Clinical Perspectives on Psychological

Aging-Related
and Cognitive
Disorders
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NATURE OF COGNITIVE
DISORDERS
Impairment of thought, memory, attention
(cognitive impairment) arising from brain
trauma, disease, or exposure to toxic
substances.
DSM-IV diagnoses include:
 Delirium
 Dementia
 Amnesia
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Differential Diagnosis
Differentiating symptoms associated with a
psychological disorder from those arising
in response to a physical disorder can be
difficult.
Example:
EPILEPSY, especially the form called
TEMPORAL LOBE EPILEPSY, can be
mistaken for a psychological disorder.
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Delirium

A temporary state in which individuals
experience a clouding of consciousness, they
are unaware of what is happening around
them and are unable to focus or pay attention.

In a state of delirium, people
experience cognitive changes in which
their memory is foggy and they are
disoriented.
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Delirium
delirium
Caused by a change in brain
metabolism due to factors such as:
substance intoxication
substance withdrawal
head injury
high fever
vitamin deficiency
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Amnestic Disorder
Cognitive disorders involving inability to
(a)recall previously learned information or
(b)register new memories.
This inability can be very disturbing,
because the individual loses a sense of
personal identity.
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Categories of
Amnestic Disorder
Amnestic
disorders due
to medical
conditions.
• chronic
• transient
Substanceinduced
persisting
amnestic
disorders.
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Substances That Induce
Amnestic Disorder
Medications
The most common
cause:
 Illicit drugs
 Industrial solvents  Chronic alcohol
use
 Mercury
 Lead
 Insecticides

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Dementia
Generalized progressive deficits in
memory, learning, communication,
judgment, and motor coordination.

The first sign of dementia is memory
loss.
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Dementia: Other Prominent
Symptoms

Aphasia
 Wernicke’s
 Broca’s
Apraxia
 Agnosia

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Dementia: Other Prominent
Symptoms
Disturbance in Executive Functioning
• Executive functioning: Cognitive
abilities such as abstract thinking,
planning, organizing, and carrying out of
behaviors.
Relatively simple everyday tasks may be
forgotten or confused.
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Traumatic Brain Injury (TBI)
Damage to the brain
caused by exposure
to trauma is
increasingly
recognized as an
important cause of
mental and physical
dysfunction.
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ALZHEIMER’S DEMENTIA
Multiple cognitive deficits associated
with dementia, probably caused by
biological abnormalities involving the
nervous system.
Subtypes

With delirium
 With delusions
 With depressed mood
 Uncomplicated
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ALZHEIMER’S DEMENTIA
Stages






Forgetfulness
Early confusional
Late confusional
Early dementia
Middle dementia
Late dementia
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ALZHEIMER’S DEMENTIA
BIOLOGICAL FEATURES




Neurofibrillary tangles
Amyloid plaques
Deficits in neurotransmitter acetylcholine
40 to 50 percent twin concordance rate
ENVIRONMENTAL factors must play a role;
otherwise, concordance would be higher, but
specific factors are not yet confirmed.
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Parkinson’s Disease
Involves neuronal degeneration of
subcortical structures controlling
movements.
 Dementia occurs in up to 60% of
Parkinson’s patients.

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Parkinson’s Disease
Symptoms








Hands, ankles, or head may shake involuntarily.
Bradykinesia: General slowing of motor activity.
Akinesia: Muscular rigidity, difficulty initiating
movement.
Loss of fine motor coordination.
Slowed, shuffling gait.
Difficulty starting or stopping movement like
walking.
Expressionless appearance.
Loss of normal rhythmic speech quality.
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VARIOUS DEMENTIAS

Substance-Induced
Persisting Dementia
 Pick’s Disease
 Lewy Body Dementia
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VARIOUS DEMENTIAS

Frontotemporal
Dementias
 Huntington’s Disease
 Creutzfeldt-Jakob
Disease
 Vascular Dementia
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Pseudodementia
Pseudodementia:
False dementia, symptoms
caused by depression that
mimic those apparent in early
stages of Alzheimer's.
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ALZHEIMER’S TREATMENT
MEDICATION
 Slow breakdown of acetylcholine.
 Antioxidants target free radicals that may
damage neurons.
BEHAVIORAL MANAGEMENT
Target both patient and caregiver to:
 Increase patient independence.
 Eliminate wandering and aggression.
 Provide social support for caregivers.
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