An Analysis of Psychological Disorders. Anxiety and Drug Abuse - Essay Example

?Psychological Disorders Part A. Schizophrenia Schizophrenia can be defined as a severe, lifelong mental/brain disorder characterized by poor emotional responsiveness and a breakdown of thought processes. Although the major effect of the disorder is cognition, it also contributes to chronic behavioral and emotional problems. Generally, the condition makes it hard for the affected people to think logically, tell the difference between unreal and real experiences, have normal emotional responses and behave normally socially. The thought problems associated with this mental disorder are described as psychosis because there are times in which the individual’s thinking is completely out of touch with/disconnected from reality. Areas of the Brain Affected The parts of the brain affected by schizophrenia are limbic system, the forebrain and the hindbrain. The forebrain is the largest and topmost part of the brain and is divided into four lobes namely the thalamus, hypothalamus, corpus callosum and the limbic system. As a whole, the forefront controls cognition (the process of knowing, thinking, learning and judging), motor and sensory function, emotional expression, hunger, temperature regulation and sleep cycle. Skewed thought organization occurs within the frontal lobe creating the delusional ideations that are a more frequent positive symptom of schizophrenia. In addition, the temporal lobe regulates object, facial and hearing recognition and the presence of schizophrenia makes its processes skewed. The result of this is visual and auditory hallucinations. The limbic system is a composition of brain systems including amygdala and hippocampus. This system regulates memories, emotions, learning and sexual behavior. When affected by schizophrenia, the result is affective flattening, an effect considered as a negative symptom of schizophrenia. In addition, impairment in this part of the brain leads to the development of disorganized behaviors that hinder normal social connecting, preoccupation with undesirable sexual content and bizarre actions. The hindbrain includes the medulla, cerebrum and pons. Together, they function in managing motor activity, balance, posture and blood circulation. When schizophrenia is present, an effect on the hindbrain is indicated by negative symptoms of undesirable body language signals and blunted movement. In severe schizophrenia catatonic behaviors result and these are characterized by aimless motor activity, rigid posture and decreased reaction to environmental stimuli/cues. Causal Factors Although mental experts have not come up with a clear cause of schizophrenia, it has been widely agreed that a combination of environmental and genetic factors play a role in the development of the disorder. These experts have stated that an individual is likely to develop the disorder if they happen to have a family member with the disorder. Picchioni and Murray (2007) also agree to this and state that a person is at the greatest risk of developing schizophrenia if they have a first-degree relative with the disease. This risk is 6. 5%. In addition, it has been found that among people who are monozygotic twins, and are affected by schizophrenia, 40% of their twin sisters or brothers are affected. Kapur (2009) mentions drug use, living environment and prenatal stressors as the environmental factors that have been found to be associated with the development of schizophrenia. Picchioni and Murray (2007) and Kapur (2009) both agree that living in an urban environment consistently increases the risk of developing schizophrenia by a factor of two. In support of this, Van Os (2004) explains that after taking into account ethnicity, social group size and drug use, the risk of schizophrenia among urban dwellers is higher compared to rural dwellers. In addition to the genetic and environmental factors, the development of schizophrenia can also be linked to an imbalance in the concentrations of neurotransmitters like glutamatergic and dopaminergic in the brain. Other contributory transmitters include serotonin, acetylcholine and gamma aminobutyric acid. Associated Symptoms There are five types of schizophrenia namely paranoid, disorganized, undifferentiated, residual and catatonic schizophrenia and symptoms can vary among these. The general symptoms associated with schizophrenia are disorganized thinking and speech, delusions and hallucinations were the patient reports hearing voices, believing that others are controlling or reading their minds or seeing things that do not exist (Picchioni and Murray, 2007). Severe cases of speech and thought disorganization manifest as sentences that are not connected well in meaning to incoherent sentences and loss of brain thought. Other symptoms include disorders of movement, unusual thoughts or perceptions, problems with memory, attention and organization and difficulty expressing emotion and speaking. Specific symptoms for paranoid schizophrenia include preoccupation with one or more delusions or experiencing many auditory hallucinations. Disorganized schizophrenia is mainly characterized by disorganized speech and behavior. A person with catatonic schizophrenia primarily manifests at least two of the following symptoms: excessive movement, resistance to movement, difficulty moving, abnormal movements and/or difficulty in repeating what other people do or say. Undifferentiated schizophrenia is marked by episodes of one or more of the following signs: hallucinations, delusions, catatonic behavior, disorganized speech or negative symptoms, however the person does not qualify for diagnosis of catatonic, disorganized or paranoid schizophrenia. Residual schizophrenia is a less severe form of schizophrenia and is mainly characterized by negative symptoms/decrease in function such as disinterest, withdrawal and not speaking. Positive symptoms like excessive abnormal behavior, delusions, and hallucinations are at their lowest level (American Psychiatric Association DSM-5 Work Groups, 2010). The Neural Basis The neural basis of schizophrenia could involve abnormal brain structures and imbalance of neurotransmitters. This includes structural abnormality of the limbic system, fore and hind brain. A reduction in the density of the grey matter causes symptoms of speech, thought and behavioral abnormalities. Neurotransmitters facilitate communication among nerves and between the nerves and other tissues, organs and muscles of the body and thus an imbalance in their amounts has a direct effect in the development of schizophrenia. Appropriate Drug Therapies There are a number of helpful treatment options for schizophrenia, but medical therapies remain the cornerstone of treating schizophrenia. These medications are referred to as antipsychotics, named so because they function by reducing the intensity of psychotic symptoms among people with schizophrenia. Medications that are particularly effective in dealing with the positive symptoms of schizophrenia include risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), paliperidone (Invega), lurasidone (Latuda), asenapine (Saphis), and lloperidone (Fanapt). These are the newer group of antipsychotics, also referred to as second-generation antipsychotics. They work faster compared to other psychotics and can lower positive symptoms of psychosis within a period of 7-14 days. One of these medications can be prescribed in combination with one or more psychiatric medications to maximize their benefit on the patient (National Collaborating Centre for Mental Health, 2011). However, antipsychotics have failed to significantly reduce cognitive dysfunction and negative symptoms of schizophrenia despite their effectiveness in reducing psychotic symptoms. Psychotherapy should, therefore, be used as an alternative for treating the negative symptoms. Depression is one of the conditions that can often accompany schizophrenia and antidepressants are used as the primary medical treatment for this associate problem. References American Psychiatric Association DSM-5 Work Groups (2010). Proposed Revisions – Schizophrenia and Other Psychotic Disorders. Retrieved from http://www. dsm5. org/ProposedRevisions/Pages/SchizophreniaandOtherPsychoticDisorders. aspx. Kapur, S., (2009). Schizophrenia. Lancet. 374(9690), 635–645. National Collaborating Centre for Mental Health. (2011). Gaskell and the British Psychological Society. Schizophrenia: Full national clinical guideline on core interventions in primary and secondary care. Retrieved from http://www. nice. org. uk/nicemedia/pdf/CG82FullGuideline. pdf Picchioni, M. and Murray, R. (2007). Schizophrenia. BMJ. 335(7610), 91–105. Van Os, J., (2004). Does the urban environment cause psychosis? British Journal of Psychiatry. 184(4), 287–288. Part B: Anxiety and Drug Abuse Biopsychologist Perspective From a biopyschologist perspective, Tom’s anxiety may be considered a mental illness with one or more physical causes. The problem is due to the body’s inability to properly regulate chemical serotonin levels in the brain. The chemical which acts as a neurotransmitter moderates the individual’s mood as noted by Hockenbury and Sandy (2004). When the chemical level goes too high or too low, Tom experiences anxiety. In order to treat Tom’s condition, his doctor could prescribe him an antidepressant in the form of SSRIs selective serotonin reuptake inhibitors. The antidepressant prevents some of the released serotonin from getting reabsorbed. Tom’s problem could also be genetic. Genetic anomalies have also been known to cause anxiety in people as noted by Brune, Brune-Cohrs, McGrew and Preuschoft (2006). If this is the case with Tom, then there probably must be an event that triggers his anxiety. Anxiety in Relation to Nature and Nurture Anxiety has a relation to the nature-nurture issue in that the occurrence of anxiety is affected by both biological and environmental factors. Important biological contributors to include genetics, chemistry, brain and the body's fight-or-flight response. Through many studies, researchers have come to know the genes linked to anxiety. According to an article that appeared on the ScienceDaily website in 2008, researchers in Finland examined people with specific anxiety disorders and compared them with normal people. They identified specific differences in gene between the two groups. In addition, they realized that different anxiety disorders have different genetic expressions (Thompson, 2010). In regard to the brain chemistry, anxiety results when neurotransmitters fail to function properly, for example, GABA. This neurotransmitter is responsible for slowing down the brain and when it fails as a result of anxiety, it leads to overreaction, or feelings of vigilance. Other neurotransmitters include norepinephrine and serotonin. According to Thompson (2010), there is a high activation of the sympathetic nervous system (SNS) during a fight-or-flight response as a result of sensing danger. The person either takes flight to escape or stays to fight. For people with anxiety, the hypothalamus and amygdala may become overactivated due to misinterpretation or misperception of sensory signals, thus over-activating the SNS into a fight-or-flight response. The environmental factors that contribute to the development of anxiety include stress from job, family or financial instability or worry about them, dramatic life changes and uncertainty especially resulting from transitions. Anxiety could also result from traumatic experiences, for example, post-traumatic stress disorder (PTSD, poor child-rearing practices and school environment and, unstable families Craig et al, 2000). Helpful Drug Interventions or Solutions One of the helpful drug interventions for anxiety is an antianxiety medication called benzodiazepines. One of them is Alprazolam (Xanax), which functions by increasing GABA activity and thus it suppresses brain activation. Antidepressants that target serotonin are also helpful. Other medications include Wellbutrin, flurazepam (Dalmane), Zoloft, diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin) and Lithium. Lithium could work by itself so that it might not be necessary to combine it with anti-anxiety medications. In order to deal with sleeplessness, the patient could be put on Clonazepam to increase their ability to sleep. Acceptance and Commitment Therapy (ACT) can be used to deal with avoidance tendencies and to ensure that the anxiety does not interfere with the patient’s general life. Physical activities can also help to a great extend in the regulation of moods because it channels time and energy to something constructive and reduces the time for sitting and worrying. Positive or Negative Aspects of the Drug Interventions or Solutions Some of the solutions for anxiety like ACT and physical activities do not have any side effect. Instead, they present added advantages like keeping the body fit and maintaining good social and work relations. Some Benzodiazepines like alprazolam are good for counteracting panic attacks that appear either in certain situations like when driving or unexpectedly but they require higher dosages of alprazolam. However, some of the drug therapies have negative aspects. Benzodiazepines, for example, can cause fetal abnormalities, and thus they cannot be used by expectant mothers suffering from anxiety as well as nursing mothers. When taken in low doses, they can cause drowsiness or lightheadedness, and if taken in high doses, they can cause speech problems, memory problems and constipation. They can also lead to dependency when taken in high does for a long time. Alprazolam has drug interactions which increases its blood concentration, and thus its side effects. These include Ketoconazole (Nizoral), nefazodone (Serzone), itraconazole (Sporanox) fluvoxamine (Luvox and cimetidine (Tagamet). Drug Abuse in the Perspective of a Biopsychologist Susceptibility to drug abuse is related to a variety of factors including environmental situations, one’s biological response to drugs and the individual’s psychological make-up (U.S. Congress, Mice of Technology Assessment, 1993). According to biopsychologists, there are two main factors that may contribute to Ron’s behavior; his biological status and the effects that the drugs exert on him. The drugs’ mechanisms of action on the brain and their long term effects encompass the first factor while the second factor relates to Ron’s biological constitution (inherited characteristics in response to drugs). When drugs are abused, they upset the normal balance of the brain and its biochemical activity. The drugs act partly on certain areas of the brain that affect feelings of reward and pleasure (U.S. Congress, Mice of Technology Assessment, 1993). The ability to induce activity in the brain’s reward system makes it possible for drugs to act as reinforcers, thereby provoking and supporting continued abuse and use. When taken for long, the drugs can cause permanent or long term changes in the brain. Alcoholism in Relation to the Nature-Nurture Issue Drug abuse and alcoholism presents a tougher nature-nature debate because the interaction between a person’s biological composition and environment in the development of alcoholism is not outright. However, scientists have already established that alcohol abuse is linked to environmental and biological factors meaning that genetic factors interact with some non-genetic factors to bring up the problem. The exact gene that people inherit to make them become alcoholics has not yet been known. However, there is a high likelihood that alcohol abuse involves multiple genes that control several aspects of the biological response to drug use and alcohol. Evidence of genetic predisposition to alcoholism was obtained through a study which indicated a high rate of alcohol abuse among males and females born as monozygotic twins compared to those born as dizygotic twins. This rate was also higher among siblings of the same parents compared to adopted kids. People with this genetic predisposition are, therefore, likely to experience problems with alcohol despite being raised by non-alcoholic parents and, being shown support and love. Another evidence of genetic predisposition is that people at high risk of alcoholism experience instability in their minds and this situation can be calmed by taking alcohol. In addition, those people who have inherited “familial essential tremor”, a condition in which hands shake, are more likely to become alcoholic and alcohol consumption minimizes or ends the tremor. In regard to the contribution of environmental factors, some people become drug and alcohol abusers because of the adverse or alcohol encouraging situations they go through. These include joblessness, marital problems, financial distress, growing in a close-knit alcoholic family, wanting acceptance by friends and a poor cultural environment that reinforces alcohol use. Any helpful drug interventions or solutions Scientists have not yet come up with a magic pill for curing alcoholism, but there are drugs that reduce cravings for alcohol. So far, 3 medications have been FDA–approved for dealing with alcohol dependence. These are acamprosate, disulfiram and naltrexone. Topiramate has also presented encouraging results during clinical trials. Disulfiram interferes with alcohol degradation leading to accumulation of acetaldehyde. Acetaldehyde produces a strong unpleasant reaction with alcohol including nausea, flushing and palpitations. Naltrexone interferes with opioid receptors that are normally involved in the rewarding effects of alcohol and craving for alcohol. It minimizes relapse to heavy drinking. Due to genetic differences, it could be highly effective or not very effective on the patient. Acamprosate minimizes symptoms of protracted withdrawal like anxiety, insomnia, dysphoria/restlessness, depression and irritability). Just like with anxiety, no single treatment is appropriate for all. In addition to drug use, behavioral therapies are also used to help patients change their behavior and attitude towards alcohol and drugs. Therapy begins with detoxification then relapse prevention (drugabuse. gov, 2009). Positive or Negative Aspects of the Drug Interventions or Solutions Drug interventions like those that produce negative effects on alcohol consumption help to boost the struggle to change behavior and attitude. They also help to minimize withdrawal symptoms and prevent a relapse. References Brune, M., Brune-Cohrs, U., McGrew, W., & Preuschoft, S. (2006). Psychopathology in great apes: concepts, treatment options and possible homologies to human psychiatric disorders. Neurosci Biobehav Rev 30 (8): 1246–59. Drugabuse. gov. (2009). InfoFacts: Treatment Approaches for Drug Addiction. Retrieved from http://www.drugabuse.gov/publications/infofacts/treatment-approaches-drug-addiction Hockenbury, D. & Sandy F. (2004). Discovering Psychology. Worth Publishers.  Thompson, K. (2010). Biological Perspective on Anxiety. Retrieved from http://www. livestrong.com/article/129043-biological-perspectives-anxiety/ U.S. Congress, Mice of Technology Assessment, (September 1993) BioZogicaZ Components of Substance Abuse and Addiction, OTA-BP-BBS-1 17, Washington, DC: U.S. Government Printing Office. Read More