Mental Disorder and Congruent Memory Symptoms Essay
Mental Disorder and Congruent Memory Symptoms Essay
People who suffer from antisocial personality disorder lack omniscience for wrongdoing which Is also supported by frontal lobe damage; thus, they exhibit marked deficits In frontal lobe cognitive functions. The diagnosis and treatment of psychological disorders Involves concepts and research from other areas of psychology.
In this way, the diagnosis and treatment of psychological disorders Is an example of applied psychology.
Identify some of the symptoms of the psychological disorders listed below and explain how the accompanying concept relates to the symptoms or treatment of the disorder. Each pairing is worth 6 points 3 for the shortstops and 3 for the explanation about the related concept). Mental Disorder and Congruent Memory Symptoms Essay.Before answering review the textbook and your notes. 1. C] Dissociation identity disorder (DID): constructive memory Dissociation identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over a person’s behavior.
There’s also an inability to recall key personal information and high distinct memory variations, which fluctuate with the person’s split personality. Constructive memory is the use of knowledge to organize ewe information and fill in gaps in information that was encoded and retrieved. We remember only a small fraction of what we experience so our memories are constructed from our thoughts, dreams, and intentions in addition to “real” experiences.
Mood disorders are common psychiatric illnesses that represent a major cause of disability and mortality worldwide. It is estimated that 8% to 20% of the population will experience a depressive episode at some point in their lives [1]. Of those individuals with symptoms so severe as to require hospitalization, 15% will go on to commit suicide.
Mood disorders are characterized by conspicuous disturbances in emotional disposition (ie, extreme lows [depression] or highs [mania]). The lack of inability to enjoy what once was pleasurable (anhedonia) is also a primary symptom and may occur during major depression in place of depressed mood. Expansive mood can present in bipolar disorder, often accompanied or replaced by irritability. Boxes 1 and 2 show Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) [2] diagnostic criteria for these two disorders. Patients with major depression need to experience symptoms for 2 or more weeks to meet criteria; remission may be obtained spontaneously or with antidepressant medication often combined with psychotherapy. Some patients, however, develop a chronic course despite medication treatment. Patients with bipolar disorder type I experience periods of heightened energy, elevated mood, or irritability for a period of at least 1 week (or shorter if hospitalized during this time). Treatment is often somatic, consisting of neuroleptics, mood stabilizers, or electroconvulsive therapy. Mental Disorder and Congruent Memory Symptoms Essay.
Other symptoms accompany these mood disturbances, such as disruptions in normal sleep, appetite, and psychomotor functions. Delusions and hallucinations may be present, especially in relation to depressive thoughts (eg, pertaining to worthlessness or excessive guilt). Neurocognitive changes also occur. Measurable decreases in attention, executive function, and recall memory have been observed in patients with mood disorders. In major depression, cognitive impairment can be severe and global, sometimes meeting criteria for dementia [3].Mental Disorder and Congruent Memory Symptoms Essay. In the acute phase of bipolar disorder, impairment of cognition may progress to a stuporous state. Other symptoms include motor impairments, which cover a wide range of symptoms. They can manifest themselves as abnormal involuntary disturbances that interrupt a patient’s daily activities. They can escalate to a level of extreme psychomotor retardation (retarded catatonia) or, alternatively, agitation (agitated catatonia). The latter can be life-threatening if not treated in time because of elevated creatinine levels (secondary to muscle breakdown) and subsequent acute renal failure. Within these broad descriptions of deficits, symptoms of mood disorders can be divided into three primary domains: psychological and vegetative signs and symptoms, neurocognitive deficits, and neurological abnormalities.
Research has shown that the relationships between mood and cognition, as that between mood and movement, are dynamic ones, with components that are trait-dependent and others that are state-dependent. This article discusses state- and trait-related changes in cognitive and neurological function that have been associated with depressed, manic, and euthymic phases of mood disorders. Because of their relatively static nature, trait characteristics of cognitive and neurological manifestations may provide insights into core brain abnormalities that give rise to severe mood disorders. The article also reviews evidence from brain imaging studies that point to specific neural systems that may underlie cognitive deficits seen in unipolar and bipolar disorders. Mental Disorder and Congruent Memory Symptoms Essay.
Cognitive deficits
Cognitive deficits within mood disorders have been studied extensively. Although results have not always been consistent, an overall pattern of specific impairments has become evident. In general, unipolar and bipolar patients have shown impaired performance in tests of attention, executive function, and memory. Increased cognitive dysfunction often is associated with greater symptom severity. Nevertheless, cognitive deficits persist during the euthymic/remitted states, indicating that some types of cognitive processing deficits represent fundamental trait characteristics. Examining deficits during remission allows researchers to better characterize the nature and course of nonaffective symptoms associated with mood disorders.
The study of the relation between impaired cognition and mood is complicated by the subset of patients who present for the first time to a practitioner with complaints of mood (often depression) and then go on to develop Alzheimer’s Disease (AD) [3]. Evidence that cognitive decline might develop in conjunction with mood disorders recently has been confirmed. A 7-year study followed more than 600 healthy elderly (greater than 64 years old) clergy on measures of mood and cognition [4]. Participants with no depressive symptoms at study intake presented mild, yet progressive, cognitive decline annually, presumably due to the natural effects of aging. With each additional depressive symptom presented at intake, however, the annual rate of cognitive decline increased by 24%. Thus, the number of depressive symptoms at baseline was associated with increased risk of developing AD.
Attention and working memory
An impairment in attention or immediate memory can interfere with almost every facet of daily life. Sustained attention, vigilance, and impulse control has often been assessed using Continuous Performance Tests (CPTs) [5]. These tests require a participant to respond to a specified target when it is presented spontaneously within a stream of interfering visual stimuli. In such tests, euthymic patients do not show significant impairment [6]. In contrast, depressed and manic patients in the acute phase of their illness produce more errors of attention compared with matched controls [7–8], and performance deficits worsen with severity of illness [7].
Performance of patient groups across mood states in a variety of tasks has been summarized in Table 1. As can be seen in the table, other tests of attention show a slightly different pattern of results. The Trail Making Test, Part A (TMT-A) [9] and the Digit Symbol Substitution Test (DSST) [10] involve attentional and working memory components. Mental Disorder and Congruent Memory Symptoms Essay. Unipolar depressed patients when acutely ill or when euthymic show deficits in both of these tasks [11–13]. In contrast, bipolar patients are unimpaired on the TMT-A [14–15]. As with the CPT, performance on these measures of attention correlates to symptom severity [13]. Taken together, these reports indicate that patients with mood disorders can experience measurable deficits of attention during euthymic and disturbed mood states. Because attention and working memory are cognitive functions that are integral to many types of neuropsychological tests, the interpretation of studies showing deficits in a broad range of cognitive abilities should take into account the role of poor attentional/working memory capacity in these patients.
Table 1
Cognitive deficits across mood states
| Cognitive domain | Cognitive task | Euthymic state | Depressed state | Manic state | Deficits increase with symptom severity |
|---|---|---|---|---|---|
| Attention | Continuous Performance Test (CPT) | X | Yes | Yes | Yes |
| Trails Making Test Part A (TMT-A) | Yes | Yes | X | ||
| Digit Symbol Substitution (DSST) | Yes | Yes | ? | ||
| Executive function | Wisconsin Card Sort Test (WCST) | Yes | ? | Yes | Yes |
| Stroop test | Yes | ? | Yes | ||
| Trail Making Test, Part B (TMT-B) | Yes | Yes | ? | ||
| Memory | Verbal recall | Yes | Yes | Yes | Yes |
| Non verbal recall | X | Yes | ? | ? | |
| Implicit memory | ? | X | ? | ? |
Executive function
Executive function describes a broad range of cognitive processes that contribute to decision-making and higher-level thinking, such as initiation, planning, execution, and flexibility in response to changing contingencies. Researchers typically have used tests such as the Wisconsin Card Sorting Test (WCST) [16], Stroop Test [17], or the Trail Making Test, Part B (TMT-B) to assess executive abilities. Each test requires the suppression of a prepotent response to respond in accordance with an imposed task rule. To examine the stability of executive function in bipolar mood disorder, patients were tested on the WCST during their acute manic phase and then again when symptoms had attenuated [14]. Compared with healthy controls, bipolar patients were impaired while acutely ill, but they showed improvements beyond normal practice when tested again during the subacute phase of their illness, suggesting that some degree of improvement was related to the alleviation of mood symptoms. Still, a separate study showed that patients with a history of bipolar disorder who were euthymic when tested on the WCST committed more errors than did healthy controls [6]. Similarly, patients in either acute manic or euthymic mood states have demonstrated significant impairments on the Stroop Test [6,12,14]. Austin et al [13] showed that performance on the TMT-B was impaired for depressed patients and worsened with a patient’s level of depression. Mental Disorder and Congruent Memory Symptoms Essay.
Memory
Subjective complaints of memory loss are often reported by patients with mood disorders and have been confirmed during neuropsychological assessment of declarative memory. Impairments have been reported during the depressed, manic, and euthymic phases of illness in tests of verbal memory, such as story recitation [6] and word list recall [12–13,15,18]. One study comparing depressed and euthymic patients versus healthy controls found an additional impairment for nonverbal memory, but only in acutely depressed patients, whereas the nonverbal memory performance for euthymic patients was comparable to that of controls [19]. As with other cognitive processes, memory function worsens with mood severity [13].
In contrast to recall deficits, performance on implicit (ie, non-declarative) memory tasks, such as primed word stem completion, has been found to be normal for depressed patients compared with that of matched controls [11]. Preserved implicit memory in the presence of impaired recall memory is consistent with a similar performance dissociation in other psychiatric and neurologic disorders, such as schizophrenia and amnesia [20,21].
Structural and functional abnormalities of the brain in mood disorders
Combined with cognitive assessment, more recent advances in neuropathological and neuroimaging studies have begun to delineate the neural substrates of mood disorders. Neuroanatomical findings help to not only gain insight into the underlying neural systems of mood regulation, but also to provide a basis for understanding the cognitive features associated with mood disorders. Neuroanatomical abnormalities have been found in limbic regions associated with identification of emotion, social cognition, and homeostatic regulation [22,23]. Specific limbic and paralimbic regions include the subgenual and rostral cingulate gyrus, orbital frontal cortex, entorhinal cortex, anterior insula, ventral striatum, and amygdala [24–28]. The general findings in functional neuroimaging studies have reported increased activity in ventral limbic regions (the genu of the cingulate gyrus, the amygdala, and the ventral striatum). Functional abnormalities in these limbic regions are thought to reflect the emotional and autonomic symptoms of mood disorders [29].
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Studies have found abnormalities in other regions that also are thought to be important for the regulation of emotional behavior, such as in the prefrontal cortices, hippocampus, and caudate/putamen nuclei [30]. Reductions in brain volume and blood flow in the dorsal medial and dorsal lateral prefrontal cortices in unipolar and bipolar disorders have been among the most consistent findings [31–37]. In both disorders, reductions in the size of the hippocampus also have been reported [38–44], whereas reductions in the caudate/putamen volumes have been found only in unipolar depression [45,46].
Localized structural and functional abnormalities in the mood-disordered brain are consistent with the kind of cognitive deficits that would be expected based on putative functions of the affected neuroanatomical regions.Mental Disorder and Congruent Memory Symptoms Essay. Specifically, disruptions in the dorsal lateral prefrontal cortex (DLPFC), striatum, and hippocampus potentially can impair several cognitive domains that often are symptomatic in mood disorders, namely, attention/working memory, executive function, and recall memory.
Tables 2 and and33 summarize the neural systems that have been implicated in mood disorders and may underlie certain types of mood-associated cognitive deficits. As shown in the tables, one brain area named across cognitive domains is the DLPFC, and it appears to play a role in unipolar depression and bipolar disorder [47]. The pattern of cognitive impairment in these two disorders is similar, perhaps differing only in severity [12,48]. Therefore, it makes sense that these two disorders might share a common substrate in neurocognition, even though the two populations otherwise present very different clinical profiles. The two disorders differentially affect the hippocampus. Unipolar patients often show reduced hippocampal volume, but results have been mixed in bipolar patients, who show volumetric reductions, no difference, or increases compared with controls [30]. Differences across studies related to the patients’ duration of illness, age, and stress may be responsible for these discrepancies. Mental Disorder and Congruent Memory Symptoms Essay.
