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OCD and Mental Disorders

by: Jenna Schwenk

OCD and Mental Disorders 046

Marketplace > Dartmouth College > Psychlogy > 046 > OCD and Mental Disorders
Jenna Schwenk
GPA 3.0

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About this Document

These notes cover the mental diseases discussed and their impact on the amygdala.
Paul Whalen
Class Notes
25 ?




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This 11 page Class Notes was uploaded by Jenna Schwenk on Tuesday March 1, 2016. The Class Notes belongs to 046 at Dartmouth College taught by Paul Whalen in Winter 2016. Since its upload, it has received 36 views. For similar materials see Emotions in Psychlogy at Dartmouth College.


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Date Created: 03/01/16
OCD & Disorders 02/18/2016 ▯ OCD ▯ ▯ “Everything has to feel just right” “Everything has it’s place”  Anxiety soothing behaviors o Often debilitating o Repetitive, counting  Likely resets striatum & anxiety reducing properties o Striatum knows how to drive but put a cop in your rearview & suddenly other cortical areas are trying to drive that don’t know how b/c they’re anxious about cop o Bringing in other cortical systems block the striatum ability to do what it knows how to do (repetitive motor learning) ▯  Disorder is a part of you: egosyntonic  Soothing yourself from within – ventral striatum ▯  Everybody has motor methods to soothe themselves // anxiety o Test taking, etc ▯ ▯ Define  Obsessive: recurrent thoughts or images that are inappropriate & distressing o It’s about making yourself feel better o Contamination issues (germaphobes) o Doubting // checking-rechecking behaviors  Real pre-frontal memory issues  Don’t strategize like others  SEND ARTICLE o Symmetry issues o QUIRKS DO NOT RUIN YOUR DAY  Compulsions: behavioral (or mental) acts that patients feel compelled to perform to reduce distress or to prevent some dreaded situation o Washing o Checking o Repeating o Counting (children) o Ordering (children) o Hoarding  DSM IV definition o Obsessions & compulsions o Excessive, unreasonable, taking too much time o Interferes w/life  Understanding not helpful is causing the distress ▯ ▯ Striatum  Procedural memory o H.M. Mirror Tracing Performance  SRT: sequence (90s), random (90s) o Serial reaction time test o Implicit motor test o Sequence: a 14 item sequence (most don’t figure it out) for 90s o Random: actually random//no sequence for 90s o BRAIN LEARNS IT & GOES FASTER subconsciously  Type “gate”, type “t”  faster when typing “gate” b/c it’s a program  SEQUENCE V. RANDOM  OCD PEOPLE DO NOT HAVE AN ACTIVE STRIATUM o No normal striatum activity o BUT they were just as fast in reaction time o Activity in the hippocampus correlated w/reaction time  **Striatum is implicit circuitry & hippocampus is explicit circuitry o Using explicit circuitry to do an implicit task! Workaround  How do you catch them in the act? o 1 possibility: change the pattern or stop giving the pattern see if it changes reaction time o What they did: run another SRT  Run implicit task but make them do something explicit at the same time to keep hippocampus occupied  OCD people show deficit in striatum b/c w/o the hippocampus to do the implicit task, it screws up reaction time  Q: IS THEIR STRIATUM OFF//BROKEN? o No o Their striatum is hyper active o Not a broken striatum, inefficient system/circuit o Cognitions that get you into trouble o Striatum has hold of cortex ▯ ▯ OC Spectrum Disorders  OCD  Trichotillomania o Specific motor version of type of OCD o Obsession drives you to compulsion of pulling hair  Excoriation: skin picking  BDD: body dysmorphic disorder o Nothing is perfect, not symmetric o Deficit is striatum  Structural study: striatum white matter is wrong & it’s larger than normal  Hoarding o Driven by neuroscience o Brain imaging studies prove  **Tourettes is listed as a movement disorder o Motor tick o After performing it, they feel better  this makes it similar to OCD o They can stop the ticks but they will fill in the space by picking up frequency after they’re done repressing ▯ ▯  b/c most brain systems overlap and many of these disorders are neurodevelopmental – is that the reason so many of them are comorbid? ▯ ▯ —Missed notes—(10 min) ▯ Dorsolateral PFC ▯ ▯ Study  Put grape on one well (2 wells)  Cover wells o Pick one  Delayed match to sample v. non-delayed match to sample ▯ ▯ Mobilizing plans/strategies  Memory drawing test  People w/o OCD gravitate towards drawing organization factors first o “Big picture” then fill in  People w/OCD focus on small details o Start w/internal  Organization abilities are muddled  Can’t remember entire image well ▯ ▯ California Verbal Learning Test  Remembering list of words that lie in organization structure o Metals, electronics, plants/trees, furniture  Individual w/OCD perform worse on test (remember less words) o Not clustering  aren’t doing well o Don’t spontaneously organize memory  Attacking problem haphazardly rather than controlled ▯ ▯ Wisconsin Sorting Task  Get feedback that it’s not working & trying to adapt  Some disorders can’t/won’t adapt ▯ **See slides for factual information** ▯ ▯ Anxious Coping = “worry”  The good: better prepared for the future  The bad: infinite # of negative scenarios o Iatrogenic ▯ ▯ Depressed Coping = “rumination”  maintaining focus on negative situation  The good: could lead to problem solving  The bad: takes time & energy ▯ ▯ Little Albert  Fear of rabbit got there from Pavlovian conditioning  Your fear may not actually be the object ▯ ▯ An animal model of anxiety  Two factor model of emotional learning o 1 Pavlovian conditioning  Rat associates buzzer w/shock  S-S o Then, instrumental conditioning (operant)  Rate learns that avoidant behavior decreases anxiety  S-R o Will be more likely to perform that behavior in the future  Habit  Behaviors associated w/decreasing anxiety can get quite complex o Get a jumping rat o Rat jumps – buzzer of o Now: rat jumps, leave buzzer on until he presses a lever (no shock)  Rat eventually learns how to turn of buzzer  Can continually “chain” numerous behaviors together in order to turn of the buzzer  **What was originally all about the shock is now all about the buzzer o turning of buzzer is reinforcing  AVOIDANCE CONDITIONING ▯ ▯ Learned helplessness in the human ▯ Depressogenic Explanatory Style  Tendency to attribute negative events to internal, stable, non- specific o  Tendency to attribute positive events to external, unstable, specific factors o External: about someone or something else o Unstable: it won’t happen again o Specific: I’m only good at this  PROTECTS YOU FROM MAJOR DEPRESSION ▯ **NEVER SAY NEVER OR ALWAYS**  Too global  Really care what you say about you ▯ ▯ ▯ Major Depression or (more properly) Major Depressive Disorder (MDD)  Severely depressed mood that lasts at least 2 weeks  Periods of depression may occur as discrete events (major depression) or as recurrent over lifespan (persistent depression) ▯ ▯ Cognitive Behavioral Therapy (CBT)  Focuses on present & future w/historical exploration as needed  Outcomes tend to be concrete & measurable  Usually time-limited  Patients leave w/new skills to prevent relapse  Thought Record o Find the things they say & change the automatic thoughts ▯ ▯ SSRIs in the synapse  Autoreceptors have a baseline & will try to get to the baseline always  SSRI: blocks transporter o Directly block reuptake o Leaves serotonin in the synapse o Don’t increase serotonin production, they make synapse more efficient to use all the serotonin that’s there already o Takes 2-4 weeks to work & symptoms get worse  Autoreceptors are trying to get back to baseline  Release less serotonin so you’re the same or worse ▯ ▯ **GAD group Anxiety (slide 65): SNRI ▯ Exposure to event or events that involved actual or threatened death or serious injury  Combat  Prisoners of War (PoW)  Violent crime (e.g. assault)  Terrorist acts  Natural disasters  Motor vehicle accidents ▯ ▯ General  Lifetime prevalence: 8% of general population o ~25% of war veterans o ~35% of sexual abuse survivors o ~ % firefighters  Predictors of PTSD o Event variables  Severity of trauma  Duration of trauma  Proximity to trauma o Person variables  Previous trauma  Low perceived control over aversive events in general  Previous psychological disorders  Lack of social support after trauma o Environmental variables  Family history of psychological disorders  Lower SES  Lower IQ (poor coping skills?)   less mental disorder education? ▯ ▯ Brain Response  Subjects w/PTSD show exaggerated amygdala responses to fearful faces o PTSD group > control group  Subjects w/PTSD show lower prefrontal responses to fearful faces o PTSD group < control group o LOWER RESPONSE PREDICTS SEVERITY OF PTSD ▯ ▯ Rat Study  Infralimbic (IL) = ventromedial PFC in humans  Trials: freezing ▯ ▯ ▯ Subjects w/PTSD do not retain their extinction training as well as trauma-exposed non-PTSD (TENP) subjects  Higher ERI values = lower SCR responses on Day 2 (i.e. they are remember their Day 1 extinction training better)


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