Richard P.

Halgin
Susan Krauss Whitbourne
University of Massachusetts at Amherst

slides by Travis Langley
Henderson State University
Abnormal
Psychology
Clinical Perspectives on Psychological Disorders 5e
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Aging-Related
and Cognitive
Disorders
Processing of thoughts

Capacity to store memory

The ability to be attentive
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Cognitive Function
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NATURE OF COGNITIVE
DISORDERS
DSM-IV diagnoses include:
Impairment of thought, memory, attention
(cognitive impairment) arising from brain
trauma, disease, or exposure to toxic
substances.
Delirium
Dementia
Amnesia
Can cause a set of presumably
psychological symptoms.

Various physically based syndromes
mimic schizophrenia, mood disorders
and personality disorders.
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Attributes of Physical
Abnormalities
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Differential Diagnosis
Differentiating symptoms associated with a
psychological disorder from those arising
in response to a physical disorder can be
difficult.
Example:
EPILEPSY, especially the form called
TEMPORAL LOBE EPILEPSY, can be
mistaken for a psychological disorder.
Assessment of Cognitive
Disorders
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Neuropsychological Testing
Neuroimaging Techniques
Delirium
A temporary state in which individuals
experience a clouding of consciousness, they
are unaware of what is happening around
them and are unable to focus or pay attention.
In a state of delirium, people
experience cognitive changes in which
their memory is foggy and they are
disoriented.
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delirium
Caused by a change in brain
metabolism due to factors such as:
substance intoxication
substance withdrawal
head injury
high fever
vitamin deficiency
Delirium
Amnestic Disorder
Cognitive disorders involving inability to
(a)recall previously learned information or
(b)register new memories.

This inability can be very disturbing,
because the individual loses a sense of
personal identity.
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Amnestic
disorders due
to medical
conditions.
chronic
transient

Substance-
induced
persisting
amnestic
disorders.
Categories of
Amnestic Disorder
Amnestic Disorders due to
Medical condition
Resulting in wide variety of medical
problems including the ff.
- Head Trauma
- Loss of Oxygen
-Herpes Complex
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Substances That Induce
Amnestic Disorder
Medications
Illicit drugs
Industrial solvents
Mercury
Lead
Insecticides
The most common
cause:
Chronic alcohol
use

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Traumatic Brain Injury (TBI)
Damage to the brain caused by
exposure to trauma.

Increasingly being recognized as an
important cause of mental and physical
dysfunction.
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Our brain tissue is highly sensitive to damage
caused by intense pressure to the head.

Automobile accident
A fall
An injury sustained in contact to sports or
combat.
Causes of TBI
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Headaches
Sleep disturbances
Sensitivity to light and noise
Diminished cognitive
performance(L,M,A,RA)
Depression, anxiety and emotional
outbursts.
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Post-concussion Syndrome
A disorder in which a constellation of
physical, cognitive, emotional symptoms
persists from weeks to years.

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Concussions are milder
forms of TBI that is caused by a blow
to the head.
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Dementia
Generalized progressive deficits in
memory, learning, communication,
judgment, and motor coordination.

The first sign of dementia is memory
loss.
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Dementia: Other Prominent
Symptoms
Aphasia
Wernickes
Brocas
Apraxia
Agnosia
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Dementia: Other Prominent
Symptoms
Disturbance in Executive Functioning
Executive functioning: Cognitive
abilities such as abstract thinking,
planning, organizing, and carrying out of
behaviors.
Relatively simple everyday tasks may be
forgotten or confused.

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Traumatic Brain Injury (TBI)
Damage to the brain
caused by exposure
to trauma is
increasingly
recognized as an
important cause of
mental and physical
dysfunction.
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ALZHEIMERS DEMENTIA
Multiple cognitive deficits associated
with dementia, probably caused by
biological abnormalities involving the
nervous system.
Subtypes
With delirium
With delusions
With depressed mood
Uncomplicated
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ALZHEIMERS DEMENTIA
Stages
Forgetfulness
Early confusional
Late confusional
Early dementia
Middle dementia
Late dementia
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BIOLOGICAL FEATURES
Neurofibrillary tangles
Amyloid plaques
Deficits in neurotransmitter acetylcholine
40 to 50 percent twin concordance rate


ALZHEIMERS DEMENTIA
ENVIRONMENTAL factors must play a role;
otherwise, concordance would be higher, but
specific factors are not yet confirmed.

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Parkinsons Disease
Involves neuronal degeneration of
subcortical structures controlling
movements.
Dementia occurs in up to 60% of
Parkinsons patients.
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Parkinsons Disease
Symptoms
Hands, ankles, or head may shake involuntarily.
Bradykinesia: General slowing of motor activity.
Akinesia: Muscular rigidity, difficulty initiating
movement.
Loss of fine motor coordination.
Slowed, shuffling gait.
Difficulty starting or stopping movement like
walking.
Expressionless appearance.
Loss of normal rhythmic speech quality.
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VARIOUS DEMENTIAS
Substance-Induced
Persisting Dementia
Picks Disease
Lewy Body Dementia
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VARIOUS DEMENTIAS
Frontotemporal
Dementias
Huntingtons Disease
Creutzfeldt-Jakob
Disease
Vascular Dementia
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Pseudodementia:
False dementia, symptoms
caused by depression that
mimic those apparent in early
stages of Alzheimer's.
Pseudodementia
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ALZHEIMERS TREATMENT
BEHAVIORAL MANAGEMENT
Target both patient and caregiver to:
Increase patient independence.
Eliminate wandering and aggression.
Provide social support for caregivers.
MEDICATION
Slow breakdown of acetylcholine.
Antioxidants target free radicals that may
damage neurons.
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