Psychopathology and the Brain

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

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

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

More Symptoms

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

Types of Schizophrenia

Disorganized Schizophrenia Catatonic Schizophrenia Paranoid Schizophrenia

Brain and Schizophrenia

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

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

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 nongenetic factors to cause schizophrenia

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

Schizophrenia: Medication

Antipsychotic medications drugs do not cure disease, but reduce symptoms Some drugs have Parkinsons Diseaselike side effects Counseling also helps

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

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

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

Accompanying Symptoms

Psychosis Delusions

Bipolar Disorder and the Brain brain tissue after people with BD have died Examination of
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

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, JeanClaude van Damme

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

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

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

Causes

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

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

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

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

Resources

http://www.mcmanweb.com http://www.crimelibrary.com/criminal_ mind/psychology/multiples http://faculty.washington.edu/chudler/ neurok.html