Khan Notes on Neurological Disorders PDF

Located 171 inside neurons. Develop proteins normally in the brain, but changed so it's abnormal and causes them to clump together). o Not clear if they're what's killing neurons, or if they're a by-product.  Group of neurons at base of cerebrum, called the **nucleus basalis** is often lost ea...

Located 171 inside neurons. Develop proteins normally in the brain, but changed so it's abnormal and causes them to clump together). o Not clear if they're what's killing neurons, or if they're a by-product.  Group of neurons at base of cerebrum, called the **nucleus basalis** is often lost early in course of Alzheimer's. Important for cognitive functions -- send long axons to cerebral cortex and through cerebrum, and release **acetylcholine**. Contribute to cognitive functions of disease.  Synapses appear to not function clearly long before disease.  Also **genetic mutations**, many involved in processing of amyloid protein.  Also **ApoE4** involved in metabolism of fats is strongly related to AD.  Also, **high blood pressure** increases risk of disorder too.  Things that decrease it -- higher education, challenging jobs with difficult thinking. Biological Basis of Parkinson's Disease  Progressive neurological disorder involving motor abnormalities and mental dysfunction (neural) too. Most common neurological problems are slowed movements, a type of tremor, increased muscle tone, abnormal walking, and poor balance (leading to falls). Muscles are stiffer and slow with tremor. Later in disease when motor abnormalities are severe, patients may not be able to care for themselves and have abnormalities of cognitive, emotional, and autonomic functions.  Brains of patients have abnormalities visible to naked eye -- in brainstem, the **substantia** **nigra** (means black substance, usually darker than surrounding black tissue in normal patients) is less dark or not dark at all in Parkinson's disease patients. Suggests only one type of neuron is involved. These cells/neurons lost are **ONLY dopaminergic neurons** (NT dopamine releasing). Motor abnormalities related to loss of dopaminergic neurons lost at the substantia nigra. o Dopaminergic neurons in other areas are lost as well. o Substantia nigra is one part of the **basal ganglia.** If we section a brain from top to bottom, and we look at deep area of cerebrum, near the center there will be a collection of structures called the basal ganglia. One part of this is the substantia nigra. Basal ganglia is located at the base of the forebrain. § Basal ganglia plays a role in motor functions and some mental functions. Receives info from many places in nervous system, particularly the outermost layer of the cerebrum (cerebral cortex). § Basal ganglia processes that info and sends it back to areas of cerebral cortex to influence areas of activity such as motor cortex. o Substantia Nigra also projects to area of basal ganglia called the **striatum**, and loss of Dopamine neurons protecting from substantia nigra to the striatum causes most of motor abnormalities of Parkinson's. o Under the microscope, we see "diseases neurons" which are degenerating in the substantia nigra. Often contains **Lewy** bodies - abnormal structures inside Dopaminergic neurons of Substantia Nigra. The Lewy bodies contain a protein 172 **alpha synuclein**, a normal protein present in brain cells under normal conditions are clumped together in Parkinson's disease. § Area of research: Do Lewy bodies kill the dopaminergic neurons? Or is something else killing these dopaminergic neurons and the Lewy bodies are formed in the process? o In more-advanced stages of Parkinson's Disease - there are wide spread neuronal loss and Lewy body depositions throughout cerebral cortex. This disease also includes cognitive dysfunction. o **Lewy body disease** - less motor abnormalities from basal ganglia dysfunction and more cognitive dysfunction from loss of function from cerebral cortex. Separate from Parkinson's.  Risk factors: genetic mutations have been found in some families with inherited form of disease, rural living with exposure to agricultural chemicals can be a risk factor. o unclear how these factors cause or contribute to the disorder.  Leading candidate for treatment with stem cells since only 1 type of cell affected. Depression and Major Depressive Disorder  **Depression/Major Depressive Disorder** - characterized by prolonged feeling of helplessness and discouragement about the future. Individuals with this disorder have the following: o Has physical and emotional component. **Sadness + SIG: E CAPS**: (Acronym) § **S**uicidal thoughts: low self-esteem, low mood § **I**nterests decreased: lack of interest (anhedonia) § **G**uilt: § **E**nergy decreased -- lethargy (feeling fatigued) § **C**oncentration decreased -- trouble making decisions § **A**ppetite disturbance (increased or decreased) § **P**sychomotor changes/symptoms (agitation or retardation) § **S**leep disturbances (increased or decreased) § + Weight gain or loss. o \#1 reason people reach out for mental health services -- § "common cold". Good term because it captures the pervasiveness of disorder. 13% of men, 22% of women meet criteria for depression at least once in their life. 31% of college students might experience this disorder. Not a good term because it implies depression isn't that bad, which it is. o Can be triggered by a life event (loss/break up) but doesn't have to me. o Common for people to have anxiety disorders with it. o Three factors: Biological, psychological, sociocultural/environmental factors. All three play a role. Called the **BioPyschoSocial model of depression** § Biological factors --  genetic component (from family/twin studies) 173 o Depression is super complicated though: 5-HTTLPR Gene associated with depression, but ONLY if individual is in a stressful environment. If someone is in a low stress environment, they have a decreased risk for depression.  Decreased activation in prefrontal cortex (associated with difficult in generating actions and decreased decision making capacity)  Lower levels of activity in reward circuit in the brain.  Associated with NT -- fewer receptors for serotonin (monoamine) and NE (monoamine/catecholamine). § Psychological factors --In depression the following occur:  Behavioral theory - **"learned helplessness"** -- begin to feel powerless if they have no control over the environment they are in repeatedly. "uncontrollable exposure to an aversive stimulus "independent to intensity of punishment  "Cognitive theory" -- **cognitive distortions** - getting trapped in negative thought pattern. When you continue to think about negative thoughts.  Cognitive theory -- **attribution**. These form a pessimistic /negative attributional style which makes people vulnerable to depression o Individuals with depression link negative experiences to *internal causes*. They think negative experiences will continue to occur in the *future*. They also think negative experiences are *global* § Ex: a friend doesn't call you back, you start thinking it is because you are unlikeable, you start thinking this will happen in the future and also that another friend doesn't like you. o Are pessimistic attribution style individuals more likely to have depression or is it the other way around. Not always clear.  Coping style and self-esteem might have to do with depression. Do these cause depression or are they a result? § Sociocultural/Environment factors  **Co-rumination/Empathy**: having a friend/roommate/partner with depression can increase likelihood of individuals around you getting depression. Might be due to people talking about problems and the negatives of them instead of how to solve them. You also take on the (empathize) with the emotions of those close to you. This empathy might cause depression.  **Low Socioeconomic status** or those who lost a job/struggling to keep a job have a higher risk of developing depression  Social isolation/child abuse 174  Internalization of prejudice = higher likelihood of depression o Ex. You grow up in a household that has negative attitudes toward homosexuality and you start to like people of the same sex. This can lead to depression o **Dependent Stressor** - Depressed person would be expected to experience a greater number of stressful events that he or she influences (i.e., dependent stressors). o An **independent stressor** (i.e., the death of a loved one) occurs without the person's influence. Equal amounts. Depression and Bipolar Disorder  Bipolar disorder is very related to depression  Bipolar disorder *used to be* referred to as "manic depressive disorder"  Bipolar disorder -- A condition where someone swings from *extreme emotional highs to* *extreme emotional lows.*  Individual with bipolar disorder will have periods of depression and periods of mania  Mania is a state of high optimism, high energy, high self-esteem, euphoria, poor judgement, poor decision making (which can cause financial distress), risky behaviors (ex. Driving to quick, or risky sexual behavior), delusions of grandeur (unrealistic thoughts), heart races, people don't sleep, racing thoughts. Followed by a crash (a depressive episode).  Mania acronym: **DIG FAST** (**D**istractibility, **I**nsomnia, **G**randiose, **F**leeting thoughts, **A**gitation, **S**peech (pressured), **T**houghtlessness (risky behavior)  ***Hypomania** -- mild forms of mania* **i**s sometimes not that bad. Lots of energy and don't need to sleep a lot so you get lots of work done. You also feel good. Creativity. Results in mania at times, but sometimes does not develop into a mania.  A hypomanic episode is a period of abnormally elevated mood and abnormally increased energy lasting at least 4 consecutive days; however, the episode is not severe enough to cause impairment in functioning or to require hospitalization.  A manic episode is a period of abnormally elevated mood and abnormally increased energy lasting at least 7 consecutive days; however, the episode is severe enough to cause impairment in functioning or to require hospitalization  **Bipolar I disorder** -- when hypomania becomes manic w/ or w/o major depressive disorder o **An individual diagnosed with bipolar II has never had a manic episode.** o Although it is possible for an individual diagnosed with bipolar I to never experience hypomania, it is extremely unlikely.  **Bipolar II disorder** -- when it remains hypomania + one major depressive episode  **Cyclothymic disorder** -- hypomania + dysthymia 175 Social Psychology Conformity and Groupthink  **Social Psychology** -- how individuals think, feel, and behave in social interactions  People act differently in groups than individually  **Conformity --** "peer pressure", tendency for people to bring behaviour in line with group norms. Powerful in social situations. We use social situations (especially ones with peers) to determine what is acceptable, when to question authorities, and get feedback on behavior. o This is why it is important for people to have positive peers. If group behavior is positive, then there will be peace, harmony, happiness o Negative peers = negative behaviors, which can be catastrophic  When do people conform to group norms even when behaviours negative/wrong? o Ex: Imagine you are part of a group asked to train a dog. Group decides to train it with a shock color and you agree. Why would you agree? o There are two reasons why you would agree/conform with the group: o 1) **Informative influence:** look to group for guidance when you don't know what to do and you assume the group is correct. § Ex: You have never interacted with a dog before and you are uncertain about how to train a dog and you are uncertain if it's an appropriate method to use a shock color. You look for the group for guidance and you assume they are correct. o 2) **Normative influence**: even if you know what's right, do what group's negative actions to to avoid social rejection. § Ex: you are an expert group trainer and you know it's easier to train the dog with treats than treat it with a shock color. Even though you know training the dog with a shock color is incorrect you may still decide to go along with the group to avoid being a social outcast. You fear social rejection that can come with disagreement with the group, so you conform to even a wrongful act.  2 different ways a person can conform **-- publically** or **privately**. o If you **privately conform**- change behaviours and opinions to align with group. § Ex: If you privately conformed to the shock color, you would leave the situation with a genuine belief that the best way to train a dog is with a shock color. o If **publically conform -** you're outwardly changing but inside you maintain core beliefs. You only outwardly agree with the group. § Ex: you agree to the shock color in the group situation but you also know that the treats is a more effective route. You are not convinced. When you are alone you train the dog with a treat. 176  Problem Solving/Decision-making often takes place in groups. Factors that influences an individual's problem solving/decision making -- the group interactions shape the outcome. o **Group polarization is** a phenomenon where group decision-making amplifies the original opinion of group members. A stronger version of the decision is adopted. § For a view point to influence a groups final decision making:  All the view do not have equal influence.  Viewpoint is shared by majority of members of the group  Arguments made tend to favour popular/majority group view  Any criticism is directed towards minority view  **Confirmation bias**: group members seek out information that support the majority view.  **Ex**: majority of the group agrees that training the dog with treats is the best way to go about it. Some people chastise those who say the collar is the best way to train the dog. The individuals leave the discussion that training the dog with treats is amplified  **Groupthink** -- occurs when maintaining harmony among group members is more important than carefully analyzing problem at hand. Happens in very cohesive, insulated groups. Often have important/respected leaders, and in the interest of group "**unity"** individuals suppress/sensor their own opinions. o First suggestion proposed by the leader is adopted. Especially if there is little hope of finding a better solution. Not the most effective way to make a decision and can explain what's wrong with Congress in the US. o Ex: neighborhood people decide to meet to discuss a dog exhibiting bad behavior. Leader says the dog should be put down to avoid damage to the neighborhood. Instead of arguing with the leader and having a conflict, the neighbors agree that the dog should be put down. o To avoid group think: bring in outsiders/experts, have the leader of the group not disclose opinion, discuss what should be done in smaller groups  Recap: Conformity, Group Polarization and Group think are all processes when individuals come together in a group. Can be positive if the group is open minded, positive, and willing to consider more than one opinion. Conformity and Obedience  Conformity and obedience refer to different, but related things.  **Conformity** -- "peer pressure" -- how we adjust our behaviour/thinking (cognition) to match group. o Can be positive. Ex: If you see a bunch of people running out of a building, that you are just about to enter, you would probably conform to this behavior and run away as well 177 o Can lead to negative behavior. Ex. In teenagers peer pressure can lead to negative behaviors. "If your friend jumped of a bridge, would you too"  **Obedience** -- describes how we follow orders/obey authority. No cognitive component. Ex. "I'm just following orders" o Can be positive. Ex: Firefighter tells you to not enter a building because it's on fire -- you would probably acknowledge authority and obey. o Can be negative: ex. normal people committed such negative acts during the Holocaust due to obedience.  Both conformity and obedience can be positive (useful/helpful/important aspects) or negative in their effects on social behavior in society.  We can conform/obey in little ways as well: o Ex: we obey traffic laws or agree that cereal is a breakfast food. We don't question if we should stop at a stop sign.  **Social Anomie --** breakdown of social bonds between an individual and community. A situation in which society does not have the support of a firm collective consciousness. Social anomie can also result in social groups disbanding, and alienation from social groups. **To resolve social anomie, social norms must be strengthened and groups must** **redevelop sets of shared norms.** Can lead to uncertainty in social situations. Means that there is a weakened sense of morality and criteria for behavior. o "Associated with functionalist theoretical paradigm in sociology. The concept of anomie describes the alienation that individuals feel when social norms and social bonds are weak. Without attachment to society, people will experience purposelessness, and aimlessness. Periods of rapid social change are often associated with anomie."  \# of types of conformity and obedience: compliance, identification, and internalization o **Compliance** --situations where we do behaviour to get a reward or avoid punishment. Tendency to go along with behaviour without questioning why. Compliance goes away once rewards/punishments removed. § \"Compliance refers to a change in behavior that is *requested* by another person or group; the individual acted in some way because others asked him or her to do so (but it was possible to refuse or decline.)  Compliance is the tendency to agree to do what is requested especially if there are certain factors present: a feeling that there is give and take, believability, likability, limited supply and positive feedback from others. Robert Cialdini studied how successful marketing results in consumer compliance. For example, soft drink labels have long used celebrities to increase compliance. The ordinary consumer would buy the drink because they liked the celebrity, assumed that the celebrity approved of the product, and believed what he had to say about it. 178 § Ex. paying taxes (I will get punished if I don't pay my taxes). TSA screenings (nobody likes them, but you won't be allowed on the plane if you don't) o **Identification** -- when people act/dress a certain way to be like someone they respect. Will do this as long as they maintain respect for that individual. § According to Freud, as children develop, there comes a time in which the child must adopt the characteristics of one of the parents. During this process of identification, the child adopts the characteristics of the samesex parent and begins to associate themselves with and copy the behavior of significant others. In addition, Freud stated that this process also involves the development of the child\'s superego (our moral guide in life - the moral component of personality) which is done by incorporating characteristics of the parents' superegos into the child\'s own. So, a young male child will begin to take on characteristics of the father (act more like his father than his mother in the sense of being a male) and will develop a superego that has similarities to the moral values and guidelines by which the parents live their lives (e.g., if the parents are honest people, the child may come to realize that honesty is important and that lying is wrong). § Ex: football player people admired and bought his jersey, but then he engaged in domestic violence and once it was made public the identification of this player by people dropped significantly. o **Internalization** -- idea/belief/behaviour has been integrated into our own values. We conform to the belief privately. Stronger than other types of conformity. § Internalization refers to the normal process where children learn and absorb (internalize) knowledge and rules about the world from social context, rather than through being specifically told. This is how children learn how to alter their behavior in response to the situation that they are in (home, school, church, playground, etc.) § Ex: start going to gym to comply with friends, but then might internalize that exercise is good for you and continue the behavior  Can conform due to different types of social influence- pressure we feel from those around us o **Normative Social Influence -** If we do something to gain respect/support of peers, we're complying with social norms. Because of this we might go with group outwardly, but internally believe something differently. § Ex: friends are all obsessed with a certain singer. You tell the group you like the singer as well even if you absolutely hate him/her. You continue to say you like it (or even go to the singers concert) o **Informational Social Influence** -- when we conform because we feel others are more knowledgeable than us, because we think they know something we don't. 179 § Ex: when you move to a new place. You would ask people around you (who lived in this place for a longer period) of things to do /places to eat and go along with their suggestions. Asch Conformity Studies (Asch Line Studies)  One of most famous conformity experiments.  **Solomon Asch** (1907) was part of the group known as **Gestalt Psychologists** -- believed not possible to understand human behaviour by breaking down into parts, people must be understood as whole. o "Most social acts have to be understood in their setting, and lose meaning if isolated. No error in thinking about social facts is more serious than the failure to see their place and function." \~Solomon Ash.  Holocaust influenced Ash's studies of conformity (was born in Poland and moved to US at age of 13). Was interested in studying how group behavior can influence behavior of an individual. What aspects of the group behavior is most important.  Ex. Participant in study, many other participants too. The experiment explains a boring experiment to you -- he holds up a card with a target line and 3 comparison lines, and the participants need to figure out which comparison line matches target line. This occurs 18 times (12 trials where the confederates give wrong answer, 6 where they give correct answer). o First trial, each participant everyone gives what is obviously right answer. Second trial, same occurrence. Error rate \