Assignment: NURS 6501 Week 9 Concepts of Psychological Disorders

Assignment: NURS 6501 Week 9 Concepts of Psychological Disorders

Assignment: NURS 6501 Week 9 Concepts of Psychological Disorders

Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.

Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.

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This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.

Learning Objectives
Students will:

Analyze concepts and principles of pathophysiology across the lifespan
Learning Resources
Required Readings (click to expand/reduce)

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, Anxiety Disorders, and Obsessive-Compulsive Disorder, including Summary Review
Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician, 91(9), 617–624. Retrieved from https://www.aafp.org/afp/2015/0501/p617.html

Credit Line: Diagnosis and management of generalized anxiety disorder and panic disorder in adults by Locke, A. B., Kirst, N., & Shultz, C., in American Family Physician, Vol. 91/Issue 9. Copyright 2015 by American Academy of Family Physicians. Reprinted by permission of American Academy of Family Physicians via the Copyright Clearance Center.

McIntyre, R. S. & Calabrese, J. R. (2019). Bipolar depression: The clinical characteristics and unmet needs of a complex disorder. Current Medical Research and Opinion, 1–14. doi:10.1080/03007995.2019.1636017. Retrieved from https://www.tandfonline.com/doi/full/10.1080/03007995.2019.1636017

Credit Line: Bipolar depression: The clinical characteristics and unmet needs of a complex disorder by McIntyre, R. S. & Calabrese, J. R., in Current Medical Research and Opinion. Copyright 2019 by Librapharm Ltd. Reprinted by permission of Librapharm Ltd via the Copyright Clearance Center.

Required Media (click to expand/reduce)

Module 6 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 6 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check. (1m)

Accessible player
Concepts of Psychological Disorders – Week 9 (12m)

Accessible player
Generalized Anxiety Syndrome
Osmosis.org. (2016, February 29). Generalized anxiety disorder (GAD) – causes, symptoms, & treatment [Video file]. Retrieved from https://www.youtube.com/watch?v=9mPwQTiMSj8

Note: The approximate length of the media program is 5 minutes.

Knowledge Check: Psychological Disorders
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.

Possible topics covered in this Knowledge Check include:

Generalized anxiety disorder
Depression
Bipolar disorders
Schizophrenia
Delirium and dementia
Obsessive compulsive disease

Photo Credit: agsandrew / Adobe Stock

Complete the Knowledge Check By Day 7 of Week 9
To complete this Knowledge Check:

Module 6 Knowledge Check

What’s Coming Up in Module 7?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In Module 7, you will analyze processes related to women’s and men’s health, infections, and hematologic disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.

Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

In the Week 10 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 7. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.

Next Module
To go to the next module:

Module 7

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QUESTION 1

1. Scenario 1: Schizophrenia

A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”.  The boyfriend relates episodes of unexpected rage and crying.

PMH:  noncontributory

FH: positive for a first cousin who “had mental problems”.

SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.

PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed. 

DIAGOSIS: schizophrenia.  

Questions

1. What are known characteristics of schizophrenia and relate those to this patient.  

Schizophrenia symptoms are categorized into four domains: Positive, Negative, Mood, and Cognitive. Positive symptoms are usually psychotic features like hallucinations, delusions, disordered speech, and catatonic/disorganized behavior (Zhao et al., 2018). Negative symptoms include poverty of speech, decreased emotional range, flattened affect, apathy, and loss of interest and drive (Zhao et al., 2018). Cognitive symptoms include deficits in working memory, attention, and executive functions, while mood symptoms include mood changes. The patient presents with symptoms consistent with schizophrenia, including auditory and visual hallucinations, persecutory delusions, poverty of speech, and mood swings evidenced by unexpected rage and crying.

QUESTION 2

1. Scenario 1: Schizophrenia

A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”.  The boyfriend relates episodes of unexpected rage and crying.

PMH:  noncontributory

FH: positive for a first cousin who “had mental problems”.

SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.

PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed. 

DIAGOSIS: schizophrenia.  

Question:

1. Genetics are sometimes attached to schizophrenia explain this.

Schizophrenia is a multifactorial condition that involves the interaction of multiple epigenetic processes, susceptibility genes, and environmental factors. According to Trifu et al. (2020), genetic epidemiological studies indicate that the lifetime risk of developing schizophrenia in the general population is 0.5-1%. However, this increases when one has relatives with schizophrenia. Family, twin, and adoption studies have revealed a relative increase in risk for schizophrenia with the degree of genetic relationship to an individual suffering from the condition. The risk is approximately 2% for third-degree relatives, 9% for first-degree relatives, 27% for children with two affected parents, and 50% for monozygotic twins (Trifu et al., 2020). The patient has a first cousin with a mental disorder, which increases her risk of developing a similar disorder.  

QUESTION 3

1. Scenario 1: Schizophrenia

A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”.  The boyfriend relates episodes of unexpected rage and crying.

PMH:  noncontributory

FH: positive for a first cousin who “had mental problems”.

SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.

PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed. 

DIAGOSIS: schizophrenia.  

Question:

What roles do neurotransmitters play in the development of schizophrenia?

Schizophrenia is associated with the dysregulation of serotonin and dopamine. Dopamine is an inhibitory neurotransmitter, and abnormalities in the mesolimbic and prefrontal brain regions are associated with schizophrenia symptoms (McCutcheon et al., 2020). Besides, serotonergic and deviations in serotonin and dopamine activity contribute significantly to the positive and negative symptoms of schizophrenia. The dopamine hypothesis suggests that schizophrenia patients have hyperactive dopamine transmission in the mesolimbic areas and hypoactive transmission in the prefrontal cortex (McCutcheon et al., 2020).

QUESTION 4

1. Scenario 1: Schizophrenia

A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”.  The boyfriend relates episodes of unexpected rage and crying.

PMH:  noncontributory

FH: positive for a first cousin who “had mental problems”.

SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.

PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed. 

DIAGOSIS: schizophrenia.  

Questions:

Explain what structural abnormalities are seen in people with schizophrenia.

Schizophrenic patients are often seen with cingulated, prefrontal, and middle-temporal structural brain abnormalities. Structurally, schizophrenia is linked with reduced gray matter volume in the insula, superior temporal, inferior and medial frontal, anterior cingulate gyri, the thalamus, and amygdala (Zhao et al., 2018). In addition, reduced white matter volume has been found in the tracts connecting the structures within and between the brain hemispheres.  

QUESTION 5

1. Scenario 2: Bipolar Disorder

A 44-year-old female  came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. 

DIAGNOSIS: bipolar type 2 disorder. 

Question

1. How does genetics play in the development of bipolar 2 disorders?  

Family-based studies have established a number of chromosomal regions connected to bipolar disorder. Besides, various candidate genes have shown evidence of a relationship with bipolar disorder. Guzman-Parra et al. (2021) explain that relatives of patients with Bipolar have shown a high risk for the respective BD subtype. However, genetic studies have reported a higher heritability of Bipolar 1 than –Bipolar 2 and a high genetic relationship between Bipolar and Bipolar 2. Thus, a person with a relative with Bipolar 1 has a higher risk of developing the disease than one with a relative with Bipolar 2.

References

Guzman-Parra, J., Streit, F., Forstner, A. J., Strohmaier, J., González, M. J., Gil Flores, S., … & Rietschel, M. (2021). Clinical and genetic differences between bipolar disorder type 1 and 2 in multiplex families. Translational Psychiatry, 11(1), 1-10. https://doi.org/10.1038/s41398-020-01146-0

McCutcheon, R. A., Krystal, J. H., & Howes, O. D. (2020). Dopamine and glutamate in schizophrenia: biology, symptoms and treatment. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 19(1), 15–33. https://doi.org/10.1002/wps.20693

Trifu, S. C., Kohn, B., Vlasie, A., & Patrichi, B. E. (2020). Genetics of schizophrenia. Experimental and Therapeutic Medicine, 20(4), 3462-3468. https://doi.org/10.3892/etm.2020.8973

Zhao, C., Zhu, J., Liu, X., Pu, C., Lai, Y., Chen, L., … & Hong, N. (2018). Structural and functional brain abnormalities in schizophrenia: a cross-sectional study at different stages of the disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 83, 27-32. https://doi.org/10.1016/j.pnpbp.2017.12.017