Abnormal Psychology

Chapter 14: Neuro-Cognitive Disorders

Key Terms
*Definition of a Cognitive Disorder
Transient or permanent damage to the brain that results in behavior disturbances
For example:
May walk with a shuffle
Exp. Occasional lapses of memory which can become more pervasive over time
Difficulty speaking
Exp. Hand tremor, etc.
*According to DSM, Cognitive Disorder effects
Thinking
Memory
Consciousness
Perception
The problems above result from brain dysfunction
*Cognitive Disorders classified into 4 major categories
Dementia
Delirium
Amnestic disorders
Cognitive disorders, NOS

1. Dementia characterized by:
Memory impairment
Cognitive disturbances
For e.g., Aphasia=language disturbance)
Apraxia-inability to carry out meaningful movements
Agnosia-inability to name or recognize objects (you previously knew)
Disturbances in planning
Problems with Abstract thinking
Symptoms severe enough to hinder social or occupational functioning
Symptoms represent significant decline from previous level of functioning
People with Dementia may forget to finish tasks, the names of significant others and forget
about significant past events
-Other problems with Dementia, include:
Disrobing in public
Sexual advances to strangers
Course: -Dementia involves gradual, but progressive onset of memory loss and should not be
confused with age related memory loss as people with age related memory loss maintain global
intellectual functioning. May take 8 to 12 years to experience full symptomology leading to death.
-Statistics on Dementia, include:
1.5% million Americans suffer from severe dementia
1 to 5 million (additional) have mild to moderate forms of the disorder
Among people over 65, 5 to 7% have dementia and 2% to 4% have dementia of the Alzheimers type
Dementia rates are about 20% of people over age 85
2. Delirium
-characterized by disturbances of consciousness and changes in cognition
e.g., memory deficit, disorientation, language and perceptual disturbances
-Delirium course = hours to days (rapid onset)
-Patients with delirium symptoms show:
Decreased ability to focus, sustain or shift attention
Disorganized patterns of thinking (rambling, irrelevant & or incoherent speech
Disturbed sleep cycle
10% hospitalized patients exhibit delirium upon admission
-Groups at risk for developing delirium are:
* Elderly
* Individuals recovering from surgery
* patients with existing brain problems
* withdrawal of drugs, etc.

3. Amnestic disorder
Characterized by memory impairment
e.g., inability to learn (remember) new info and inability to recall previously
learned info or past eventsConfusion and disorientation can occur
* Memory problems causes major problems in social and or occupational functioning
* Usually caused by some insult or damage to the CNS. Eg. head trauma, stroke or
Wernicke encephalopathy (Alcohol induced organic mental disorder involving Thiamine
deficiency.
-Specific diseases of the brain, include:
* Alzheimers
* Parkinsons
* AIDS
* Neruosyphyllis
* Encephalitis
* Huntingtons Disease
* Cerebral tumors
* Epilepsy

1. Alzheimers disease
Brain tissue atrophy
Marked deterioration of intellectual & emotional functioning
Accounts for almost 80% of dementia in older people and risk increases with age
Early symptoms, include:
o Memory dysfunction
o Irritability
o Cognitive impairment
o Other symptoms like social withdrawal, depression, apathy, delusions,
impulsive behavior, neglect of personal hygiene: All onset Later
-Death is due to the disorder: 4
th
leading cause of death in US
-True etiology unknown
-Research suggest that causes may include:
* reduced ACH
* repeated head injuries
* Infections and viruses
* decreased blood flow to the brain
* Effects of plaque in the brain

2. Parkinsons Disease
Progressively worsening disorder

Characterized by muscle tremors
Shuffling gait
Lack of facial expression
Social withdrawal
Dementia and depression
Affects 1 of 1000
Affects slightly more men than women
First diagnosed in people age 50-60
1 to 2 percent over age 65.

-Causes, include:
* brain infections
* brain trauma
* poisoning with carbon monoxide
* some genetic predisposition
* death generally occurs after several years
-Treated with LDOPA

3. Encephalitis
-Brain inflammation caused by viral infection. Course is rapid
-Symptoms, include:
Lethargy
Fever
Delirium
Long periods of stupor and sleep
Feeling of need to lie down
Epileptic seizures (most common symptom, especially in kids)
Children may also become restless, irritable, cruel and antisocial
Can recover with no residual or have profound brain damage














4. Huntingtons Disease
Rare, genetically transmitted disease characterized by involuntary twitching and
Eventual dementia
50% of off-springs of person with disorder develop it
Gene detected by scientist
No known treatment (do genetic counseling)
5 to 7 per 100,000 (prevalence rate)
Early symptoms, include:
o Twitching in fingers
o Facial grimaces
o Changes in personality
o Increase moodiness and quarrelsome
o Peculiar walk and problems speaking
o Always ends in death
o Misdiagnosed as schizophrenia, sometimes


MENTAL RETARDATION

Not a cognitive disorder
Significant sub-average intellectual functioning with IQ score of 70 or less
Concurrent deficiencies in adaptive behavior (social, daily living skills, and degree of
independence lower than would be expected by age or cultural group.
Onset before age 18
-Common characteristics (APA, 2000), include:
* Dependency
* Passivity
* Low Self Esteem
* Low tolerance frustration
* Depression
* Self injurious behavior
* increase risk of suffering from psychological problems

Severe cases of MR, include symptoms of:
Speech problems
Neurological problems
Cerebral palsey
Vision & hearing problems





4 Categories of MR

1) Mild
IQ = 50-55 to 70
Can perform tasks at a 6
th
grade level
2) Moderate
IQ 35-40 to 50-55
Can perform tasks at a 2
nd
grade level
3) Profound
Below IQ 20 to 25
4) Severe
IQ below 20
-Etiology (causes)
* Poor living conditions (e.g., decreased socioeconomic stats SES)
* Biological factors or both
* Injury
* Disease
* Brain abnormality
* Lack of Health Care
* Poor Nutrition

DOWN SYNDROME
Extra chromosome (trisomy 21)
MR
Distinctive physical characteristics
Short, Curving fingers
Short broad hands
Slanted Eyes
Furrowed protruding tongue
Flat, broad face
Harsh Voice
Incomplete or delayed sexual development
Increase Risk of developing early onset of Alzheimers dementia (after age 40)
Congenital heart abnormalities
-Prenatal screening possible thru amniocentesis
_Living conditions
Move away from institutions to group homes----least restrictive environment
But some folks with MR cant live even there due to violence and or level of need for
Increase structure and care