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Amnestic Disorders Part 2-Abnormal Psycology-Lecture Handout, Exercises of Abnormal Psychology

Dayalbagh Educational InstituteAbnormal Psychology

This course points out abnormal behavior reasons and its form. Mostly it talks about amnestic disorder, mood disorder, developmental disorder, genetics, personality disorder, problems in childhood, psychological model, stress, substance disorder. This lecture includes: Dementia, Delirium, Amnesia, Cognitive, Rehabilitation, Neuropsychologists, Frequency, Treatment, Management, Medication

Typology: Exercises

2011/2012

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Abnormal Psychology – PSY404 VU
©Copyright Virtual University of Pakistan
196
LESSON 41
DEMENTIA DELIRIUM AND AMNESTIC DISORDERS II
Recap lecture no 40
• Formerly called organic mental disorders now the new name according to DSM-IV-TR is cognitive
disorders or cognitive impairment disorders.
• It includes Delirium, Dementia and Amnesia.
Dementia
Dementia is a gradual worsening loss of memory and related cognitive functions, including the use of
language, as well as reasoning and decision making.
Delirium
Delirium is a state of confusion and disorientation that develops over a short period of time and is often
associated with agitation and hyperactivity.
Amnesia
People with Amnesia disorders experience memory impairments that are more limited than those seen in
dementia or delirium.
Research on brain and its role on psychopathology have increased in recent years. The term organic mental
disorder was dropped and the term cognitive mental disorder was adopted.
Cognitive disorders signify the impairment of cognitive abilities such as
• memory
• attention
• perception
• thinking
Cognitive disorders generally first appear during the patient’s 50’s or 60’s and accelerate after the age of 70.
Cognitive impairment disorders include
• Dementia
• Delirium
• Amnesia
Some degenerative brain diseases include
1. Alzheimer’s dementia
2. Parkinson’s disease
3. Huntington’s disease
4. Pick’s disease
Causes of Cognitive Impairment Disorders
1. old age
2. improper use of medications
3. head injuries
4. Various types of brain traumas.
Treatment of Cognitive Impairment Disorders
1. Treatment of the Patient
a. Psychotropic Medications
b. Behavioral Programs
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LESSON 41

DEMENTIA DELIRIUM AND AMNESTIC DISORDERS II

Recap lecture no 40

  • Formerly called organic mental disorders now the new name according to DSM-IV-TR is cognitive disorders or cognitive impairment disorders.
  • It includes Delirium, Dementia and Amnesia.

Dementia Dementia is a gradual worsening loss of memory and related cognitive functions, including the use of language, as well as reasoning and decision making.

Delirium Delirium is a state of confusion and disorientation that develops over a short period of time and is often associated with agitation and hyperactivity.

Amnesia People with Amnesia disorders experience memory impairments that are more limited than those seen in dementia or delirium.

Research on brain and its role on psychopathology have increased in recent years. The term organic mental disorder was dropped and the term cognitive mental disorder was adopted.

Cognitive disorders signify the impairment of cognitive abilities such as

  • memory
  • attention
  • perception
  • thinking

Cognitive disorders generally first appear during the patient’s 50’s or 60’s and accelerate after the age of 70.

Cognitive impairment disorders include

  • Dementia
  • Delirium
  • Amnesia

Some degenerative brain diseases include

  1. Alzheimer’s dementia
  2. Parkinson’s disease
  3. Huntington’s disease
  4. Pick’s disease

Causes of Cognitive Impairment Disorders

  1. old age
  2. improper use of medications
  3. head injuries
  4. Various types of brain traumas. Treatment of Cognitive Impairment Disorders
  5. Treatment of the Patient a. Psychotropic Medications

b. Behavioral Programs docsity.com

c. Cognitive Rehabilitation

  1. Treatment of Caregivers
    • Because of the close link between cognitive disorders and brain disease, patients with these problems are often diagnosed and treated by neurologists, physicians who deal primarily with diseases of the brain and the nervous system.
    • Multidisciplinary clinical teams study and provide care for people with dementia and amnestic disorders.
    • Direct care to patients and their families is usually provided by nurses and social workers.
    • Neuropsychologists have particular expertise in the assessment of specific types of cognitive impairment.
    • Changes in emotional responsiveness and personality typically accompany the onset of memory impairment in dementia.
    • In some cases, personality changes may be evident before the development of full-blown cognitive symptoms.

Assessment of Cognitive Impairment There are many ways to measure a person’s level of cognitive impairment. a. One is the Mini-Mental State Examination.

  • Some of the questions on this exam are directed at the person’s orientation to time and place.
  • Others are concerned with anterograde amnesia, such as the ability to remember the names of objects for a short period of time. b. Neuropsychological assessment can be used as a more precise index of cognitive impairment.
  • This process involves the evaluation of performance on psychological tests to indicate whether a person has a brain disorder.
  • The best-known neuropsychological assessment procedure is the Halstead-Reitan Neuropsychological Test Battery, which includes an extensive series of tests that tap sensorimotor, perceptual, and speech functions.
  • Some neuropsychological tasks require the person to copy simple objects or drawings. c. Personality and Emotion
  • The emotional consequences of dementia are quite varied.
  • Some demented patients appear to be apathetic or emotionally flat.
  • At other times, emotional reactions may become exaggerated and less predictable.
  • Depression is another problem that is frequently found in association with dementia. d. Motor Behaviors
  • Demented persons may become agitated, pacing restlessly or wandering away from familiar surroundings.
  • In the later stages of the disorder, patients may develop problems in the control of the muscles by the central nervous system.
  • Some specific types of dementia are associated with involuntary movements, or dyskinesia—tics, tremors, and jerky movements of the face and limbs called chorea.

Amnesia

  • Some cognitive disorders involve more circumscribed forms of memory impairment than those seen in dementia.
  • In amnestic disorders, a person exhibits a severe impairment of memory while other higher level cognitive abilities are unaffected.
  • The memory disturbance interferes with social and occupational functioning and represents a significant decline from a previous level of adjustment.
  • The most common type of amnestic disorder is alcohol-induced persisting amnestic disorder, also known as Korsakoff’s syndrome.

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  • Alzheimer’s disease appears to be the most common form of dementia, accounting for perhaps half of all cases.
  • Dementia with Lewy bodies may be the second leading cause of dementia; studies report prevalence rates between 12 and 27 percent for DLB among patients with primary dementia.
  • Prevalence rates for vascular dementia are similar to those for DLB.
  • Pick’s disease is much less common than Alzheimer’s disease, vascular dementia, or DLB.
  • Huntington’s disease is rare by comparison.
  • It affects only 1 person in every 20,000.

Cross cultural Comparisons

  • Alzheimer’s disease may be more common in North America and Europe, whereas vascular dementia may be more common in Japan and China.
  • There are also some tentative indications that prevalence rates for dementia may be significantly lower in developing countries than in developed countries.

Treatment and Management

  • When a person clearly suffers from a primary type of dementia, such as dementia of the Alzheimer’s type, a return to previous levels of functioning is extremely unlikely.
  • No form of treatment is presently capable of producing sustained and clinically significant improvement in cognitive functioning for patients with Alzheimer’s disease.
  • Realistic goals include helping the person to maintain his or her level of functioning for as long as possible in spite of cognitive impairment and minimizing the level of distress experienced by the person and the person’s family. 1. Medication
  • Some drugs are designed to relieve cognitive symptoms of dementia by boosting the action of acetylcholine (ACh), a neurotransmitter that is involved in memory and whose level is reduced in patients with Alzheimer’s disease.
  • New drug treatments are being pursued that are aimed more directly at the processes by which neurons are destroyed.
  • Although the cognitive deficits associated with primary dementia cannot be completely reversed with medication, neuroleptic medication can be used to treat some patients who develop psychotic symptoms. 2. Environmental and Behavioral Management
  • Patients with dementia experience fewer emotional problems and are less likely to become agitated if they follow a structured and predictable daily schedule.
  • Severely impaired patients often reside in nursing homes and hospitals.
  • The most effective residential treatment programs combine the use of medication and behavioral interventions with an environment that is specifically designed to maximize the level of functioning and minimize the emotional distress of patients who are cognitively impaired.
  • One important issue related to patient management involves the level of activity expected of the patient.
  • It is useful to help the person remain active and interested in everyday events.
  • Patients who are physically active are less likely to have problems with agitation, and they may sleep better.
  • Social interactions are often troublesome for patients with dementia due to distorted views of reality.
  • Creative problem-solving strategies that accommodate the patient’s distorted view of reality are

sometimes useful in this type of situation. docsity.com

3. Support for Caregivers - In the United States, spouses and other family members provide primary care for more than 80 percent of people who have dementia of the Alzheimer’s type. - Their burdens are often overwhelming, both physically and emotionally. - In addition to the profound loneliness and sadness that caregivers endure, they must also learn to cope with more tangible stressors, such as the patient’s incontinence, functional deficits, and disruptive behavior. - Some treatment programs provide support groups, as well as informal counseling and ad hoc consultation services, for spouses caring for patients with Alzheimer’s disease. - Some treatment programs arrange for direct assistance in addition to social support. - Respite programs provide caregivers with temporary periods of relief away from the patient.

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