Psychopathology and the Brain

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Psychopathology and the Brain
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Schizophrenia

• Comes from Greek words meaning split and mind
• People with schizophrenia do NOT have split
  personalities
• split mind refers to the fact that people with
  schizophrenia are split off from reality and
  cant distinguish what is real from what is not
  real

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Demographics

• One of the most common mental illnesses
• Affects 1 of the population
• Men show first signs in early 20s while women in
  late 20s
• US spends 32.5 billion per year

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Symptoms

• psychosis psychotic element state in which
  people cannot tell what is real and what is not
• Delusions bizarre, false beliefs paranoia,
  grandiosity
• Hallucinations unreal perceptions of
  environment auditory, visual, olfactory, tactile

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More Symptoms

• Disorganized Thinking/Speech
• Negative Symptoms the absence of normal
  behavior
• Catatonia immobility and waxy flexibility

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Types of Schizophrenia

• Disorganized Schizophrenia
• Catatonic Schizophrenia
• Paranoid Schizophrenia

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Brain and Schizophrenia

• Larger than normal lateral ventricles part of
  the ventricular system contain cerebrospinal
  fluid

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Causes of Schizophrenia Genetics

• Twin studies have shown that tendency for both
  monozygotic twins to develop schizophrenia is
  between 30 to 50 the tendency for dizygotic
  twins and siblings to develop schizophrenia is
  15
• Adoption Studies 13 of biological relatives of
  adoptees with schizophrenia had the disease, but
  only 2 of biological relatives of normal
  adoptees had schizophrenia

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Causes of Schizophrenia Environment

• Family Stress
• Poor social interactions
• Infections or viruses at an early age
• Trauma at an early age
• Genetic makeup combines with non-genetic factors
  to cause schizophrenia

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Causes of Schizophrenia Neurotransmitters

• Dopamine Theory schizophrenia caused by an
  overactive dopamine system in the brain dopamine
  is a neurotransmitter that allows nerve cells in
  the brain to send messages to each other
  dopamine imbalance may affect the way a persons
  brain can react to stimuli
• Many drugs for schizophrenia block dopamine
  receptors

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Schizophrenia Medication

• Antipsychotic medications drugs do not cure
  disease, but reduce symptoms
• Some drugs have Parkinsons Disease-like side
  effects
• Counseling also helps

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Bipolar Disorder

• Characterized by changes in mood, behavior, and
  energy levels
• Affects approximately 1.2 of the population
• First episode often occurs in adolescence and can
  be triggered by a traumatic event some people
  are symptom-free in between episodes

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Symptoms Mania phase

• Abnormally elevated mood
• Inflated self-esteem
• Reduced need for sleep
• Excessive talkativeness
• Racing thoughts
• Distractibility
• Activities done to excess
• Pursuit of risky behavior or activities

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Symptoms Depression Phase

• Mania can quickly and without warning change to
  depression/sadness
• Loss of interest
• Changes in appetite weight gain/loss
• Changes in sleep patterns
• Agitation
• Loss of energy
• Trouble concentrating/thinking
• Repeated thoughts of suicide/death

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Accompanying Symptoms

• Psychosis
• Delusions

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Bipolar Disorder and the Brain

• Examination of brain tissue after people with BD
  have died
• Brain imaging
• New theory mitochondrial malfunction
• Mitochondria vital organelle for energy
  production
• 2000 Kato, University of Tokyo based on
  abnormal brain energy metabolism in bipolar
  patients measured by brain scans and
  mitochondrial depletion in autopsied bipolar
  brains searched for mutant mitochondrial DNA
  two suspect genes
• March 2004, Archives of General Psychiatry,
  Christine Konradi - Harvard and McLean Hospital
  - studied brain tissue in hippocampus and found
  expression of genes that coded for mitochondrial
  proteins in bipolar patients decreased

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Famous People with BD

• Abraham Lincoln and Theodore Roosevelt
• George Handel, Robert Schumann, Ludwig van
  Beethoven
• Leo Tolstoy, Virginia Woolf, Ernest Hemingway,
  Charles Dickens
• Sir Isaac Newton
• Patty Duke, Linda Hamilton, Jean-Claude van Damme

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Multiple Personality Disorder

• Presence of two or more distinct identities, each
  with its own unique, and enduring way of relating
  to the world or self
• At least two of these identities recurrently take
  control of the persons behavior
• An inability to recall important personal
  information to an extent that is more than
  ordinary forgetfulness

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History of MPD

• Virtually unknown 30 years ago became more
  common about 10 years ago
• Why?
• W. S. Taylor and Mabel Martin in 1944 fewer
  than 100 documented cases
• 1985 to 1995 abuot 40,000 new cases

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Why More Common?

• previously not diagnosed
• does mind choose pathology from options presented
  by culture?
• was called something different in the past came
  in form of dead relative possession in 19th
  century European culture

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Causes

• Childhood trauma usually sexual abuse before
  age 5
• Experts believe alter arises to protect person
  from overwhelming memories and protect secrets
  from outsiders

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Case Study Eve

• Thigpen and Cleckley, 1953
• Rooted from traumatic events witnessed growing up
  in South during Depression
• Eve White wife and mother Eve Black party
  girl Jane mature intellectual
• Total of 22 personalities

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Case Study Sybil

• True name Shirley Mason
• Set the standard for MPD as a syndrome rooted in
  child abuse
• 16 separate personalities all having unique
  talents and characteristics, such as piano
  playing or having British accent some were male
• Dr. Wilbur Freudian psychologist
• 1998 several publications exposed Sybil case as
  scam
• Dr. Herbert Spiegel - only multiple personality
  in psychoanalytic setting just extremely
  suggestible hysteric
• To ensure the book deal, Sybil had to be
  multiple Dr. Wilburs archives will be opened in
  2005

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MPD in Court

• Billy Mulligan accused of robberies and rapes
  at OSU by the time faced trial, 10 of 23
  personalities surfaced one with British accent,
  one could write fluent in Arabic, one was 16, one
  was 8
• Juanita Maxwell bludgeoned elderly woman to
  death with a lamp but had no memory of crime
  went to trial and violent alter came out
• Critics say that vast majority of patients
  misdiagnosed, faked, or unconsciously created by
  clinician who makes diagnosis
• Problem when evidence overwhelming against
  defendant, only way attorney can mitigate
  sentence is insanity defense
• Often very hard to identify whether truly have
  disorder

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Resources

• http//www.mcmanweb.com
• http//www.crimelibrary.com/criminal_mind/psycholo
  gy/multiples
• http//faculty.washington.edu/chudler/neurok.html