PSYCH 2011.11 Day 16 Notes - 11/24/15 (Thanksgiving break)
PSYCH 2011.11 Day 16 Notes - 11/24/15 (Thanksgiving break) PSYC 2011
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This 6 page Class Notes was uploaded by Oona Intemann on Tuesday December 1, 2015. The Class Notes belongs to PSYC 2011 at George Washington University taught by Woodruff, P in Fall 2015. Since its upload, it has received 57 views. For similar materials see Abnormal Psychology in Psychlogy at George Washington University.
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Date Created: 12/01/15
NOTES TUESDAY 112415 Reading for this week Chapter 18 Disorders of Aging and Cognition Chapter 19 Mental Health and the Law Page 35 Intellectual development disorder intellectual disability mental retardation IQ test Mental retardation term applied to a lot of different situations Recently intellectual disability has been used clinical settings 0 Almost 3 of ever 100 people meet the criteria for the diagnosis Intellectual functioning is below average Poor adaptive behavior Symptoms appear before age 18 can measure this Test not necessarily 100 accurate depends on socioeconomic status sometimes Some children are not as used to seeing exam language etc Would be more accurate to observe child in their home everyday environment rather than test in order to diagnose mental retardation 0 8085 of people who are mentally retarded are mildly so 0 Children with mild mental retardation might need help when they re stressed but seem to play with others well 0 Jobs tend to be unskilled or semiskilled Mental retardation itself linked to sociocultural and psychological causes 0 Poor unstimulating environments Moderate retardation o Diagnosed earlier in life 0 Most can function well later if they are supervised Severe retardation 0 During infancy 0 Increased risk for brain seizure disorder 0 Rarely able to live independently Profound retardation 0 During birth or early infancy o Often symptoms can be related to a physical disorder as well 0 Extremely low intellectual functioning basic things walking talking feeding 0 Can be fatal 1Q Mild 5070 85 Moron Moderate 35 49 10 Cretin Severe 2034 34 Imbecile Profound Below 20 12 Idiot Causes Chromosomal 0 Down syndrome I Most common chromosomal disorder I Less than 1 of every 1000 births I Mother over 35 increased risk I Small head at face slanted eyes high cheekbones I Close with family but similar in personality to most in the general population Caused by chromosome 21 Can cause early dementia Metabolic o PKU phenylketonuria I l of every 14000 children I Cannot break down phenylalanine I Chemical builds up causes retardation o TaySachs disease I Progressively lose mental functioning vision and motor ability and eventually die I Lipid storage disorder very fatal I Very common in Eastern European Jewish ancestry Prenatal 0 Mother has too little iodine in diet cretinism problem with thyroid 0 Fetal alcohol syndrome previously covered in class I Level of alcohol consumption during pregnancy 0 Some infections syphilis rubella etc can also cause mental retardation in the child Birthrelated 0 Lack of oxygen for a certain amount of time anoxia very dangerous and can cause brain damage Following the birth childhood 0 Some injuriesaccidents can cause mental retardationintellectual dysfunction I Head injuries exposure to Xrays drugs I Lead poisoning I Mercury radiation also I Some can be diagnosed and treated but if it is too late it can lead to mental retardation Chapter 18 Disorders of Aging and Cognition Disorders of later life 0 Depression I Very common among elderly people I Low selfesteem guilt pessimism loss of appetite sleep I If the individual has recently experienced a trauma this can also affect I More likely to commit suicide than younger people I More than half improve with various treatments cognitivebehavioral therapy antidepressants combinations etc I BUT antidepressants can cause cognitive impairment in this population Anxiety I 6 of elderly men 11 of elderly women I Increases throughout old age I Many things can increase anxiety Medical illnesses Overall health I Usually treated with drugs but have to be careful with the elderly population Substance abuse I Majority of older adults do not have an alcohol or substance problem I 4 to 7 of older people have alcoholrelated disorders I Difference between having had alcoholism before their old age and having lateonset alcoholism I With substances most often unintentional most often prescription drugs Psychotic disorders I Higher rate of psychotic disorders than young people I Usually related to delirium or dementia I Some suffer from schizophrenia but less common in older people than in younger people I Very rare that schizophrenia comes up in old age but women outnumber men in this at least 2 to l Disorders of cognition I Common by age 60 or 70 I Delirium Awareness of environment is less clear Difficulty focusing thinking interpreting Sometimes hallucinations occur 60 of patients older than 75 in a nursing home have this Can be caused by infectiondisease injury stroke stress and poor nutrition Memory 0 Sensory memory I Shortest of memory extremely shortterm I Retains sensory images and information I Lasts a very short time o Shortterm memory working memory I Gathers the new information I Must be transformed into longterm memory to store it I Prefrontal lobe 0 Longterm memory I Information we ve stored over the years I Retrieval remembering information in this memory system I Temporal lobe hippocampus amygdala diencephalon mammillary bodies thalamus hypothalamus I Declarative memory type of longterm memory can be consciously recalled Episodic experiences and speci c events Semantic facts knowledge and meaning I Procedural memory knowing how to do things tasks and skills Part of longterm memory Motor skills etc Organic disorders that effect memory and identity Alzheimer s disease and other neurocognitive disorders 0 Alzheimer s disease I Most common form of dementia I Gradually progressive I Vast majority occurs in age 65 I Time between onset and death is 8 to 10 years I Memory loss poor judgment I Late stages require constant care I Has to do with brain structure problems with shortterm and longterm memory 0 Pick s disease I Very rare I Affects the frontal and temporal lobes I Clinical picture very similar to Alzheimer s distinguishing characteristics can be seen after death CreutzfeldtJakob disease I Another source of dementia I Also often includes spasms etc I Disease has a very rapid course Huntington s disease I Genetic inherited progressive disease I Memory problems worsen over time I Severe spasms personality and mood changes Children of Huntington s parents have 50 chance I Ultimately can be fatal 0 Parkinson s disease I Tremors spasms unsteadiness and dementia I Michael J Fox and Muhammad Ali As all rivers ow to the same home the sea all lives reach the same end death 0 0 Chapter 19 Law Society and the Mental Health Profession Insanity Obviously affects a person s state of mind Comes into question when we talk about law and mental health Insane people can cause crimes but then where is the fault Mens rea guilty mind Mental state an individual must be in in order to be guilty of a crime Basically the person must be in this state of mind sanity in order for the crime to have been intentional Criminal commitment People accused of a crime are deemed mentally unstable and un t for trial and are sent to a mental hospital etc for treatment Two forms NGRI and mentally un t for trial 0 Mentally un t for trial means they cannot understand the trial at the time it happens don t know court proceedings etc and cannot then defend themselves Not guilty by reason of insanity NGRI Innocent of crime because of state of mental health Must then get treatment or therapy 0 M Naghten rule 1843 I Experiencing a mental disorder at time of crime does not mean the person was insane person might not have a conscience I Might not know right from wrong I Led to the adoption of a different test 0 Irresistible impulse test 1834 I Emphasizes inability to control actions I Fit of passion I Not guilty under this test 0 Durham test 1954 I Later became popular among these other two I Meant to offer more exibility for court decisions but too exible I Under this test alcoholism could deem someone not guilty etc o ALI test 1955 American Law Institute Test I People can t be held accountable if they had a mental disorder that kept them from knowing right from wrong I Also cannot be held accountable if they weren t able to control themselves I So it accounts for both I APA later recommended that only the rst right from wrong was an accurate measure and that people unable to control themselves wasn t a valid reason for insanity I Called for return of M Naghten test I Often schizophrenia is part of the diagnosis for these criminals Guilty but mentally ill GBMI o Verdict defendants are guilty of committing a crime but are also mentally ill but it doesn t have any bearing on their innocence they are treated in prison Diminished responsibility defense guilty with diminished capacity 0 Some states allow this 0 Mental dysfunction is an extenuating circumstance o The person may not have intended to kill someone but they did 0 This would be manslaughter without intent Competence to stand trial 0 Individual can t understand the charges they face 0 Thus they can t adequately defend themselves or testify Civil commitment 0 Individual can be forced to undergo mental health treatment 0 They might not be aware of the problems they have 0 Then the legal system has to take responsibility Voluntary hospitalization 0 Person decides for themself Patient s rights 0 Right to treatment I States are obliged to provide treatment to those who need it who have been committed involuntarily I They can t force people in and then mistreat them 0 Right to refuse treatment I Too many different kinds of treatment that could have negative effects I These are mostly on biological treatments not therapies etc 0 Legal limits to confidentiality therapist con dentiality I Tarasoff case Prosenj it Podder Tarasoff v Regents of the University of California Outpatient at UC hospital Told a therapist he wanted to harm his girlfriend and then when he was released he killed her Confidentiality should have been broken in this case The girlfriend wasn t warned I Duty to warn and to protect principle Responsibility to break confidentiality This is only if it is necessary in order to protect the client or other people Must be in danger or potential danger