© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Abnormal Psychology, Eighth Edition by Gerald C. Davison and John M. Neale Lecture notes created by Paul J. Wellman, Texas A&M University PowerPoint  Lecture Notes Presentation Chapter 16 Aging and Psychological Disorders Ch 16

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Issues in Aging Cultural view of the aged in the U.S.A. is typically negative Aging may have a greater negative impact for –Women –Minorities Ageism refers to discrimination against any person based on age –Can be young or old person Ch 16.1

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Diversity in Aging Levels of “old” –Young-old: ages –Old-old:ages –Oldest-old:over age 85 The one aspect that the elderly have in common is age –The elderly differ from one another as well as from other age groups Ch 16.2

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Measurement Issues in Aging Research Age effects are the consequences of being a given chronological age Cohort effects are the consequences of having been born in a particular year and having grown up during a particular period of time Time-of-measurement effects are confounds that arise because particular historic events have specific effects Ch 16.3

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Brain Disorders in Old Age Dementia refers to a gradual deterioration of intellectual ability that Interferes with social and occupational function Dementia can involve problems in –Memory –Poor hygiene –Language disorder –Faulty judgement –Delirium (state of mental confusion) Ch 16.4

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Causes of Dementia Alzheimer’s Disease involves a progressive deterioration of the cerebral cortex and hippocampus leading to difficulty in concentration and memory loss Alzheimer’s disease involves –Loss of nerve cells within brain due to plaque formation and neurofibrillary tangles –Reduced activity of the neurotransmitter acetylcholine (ACh) Ch 16.5

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Genetics of Alzheimer’s Disease Chromosome 21 contains a gene that controls the formation of amyloid which forms plaques –The chromosome 21 gene accounts for 5% of early onset Alzheimer’s cases and no person with this gene has made it past the age of 65 without developing Alzheimer’s disease Chromosome 19 contains a gene allele that controls the likelihood of developing Alzheimer’s (1=50%, 2=90%) Ch 16.6

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Frontal-Temporal dementia involves –Cognitive impairments of memory –Apathy –Loss of serotonin neurons in brain (rather than Ach) Frontal-Subcortical dementias include: –Parkinson’s disease (muscle tremors) –Huntington’s chorea (muscle writhing) –Vascular dementia (muscle weakness-stroke) Frontal-Lobe Dementias Ch 16.7

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Treatment of Dementia Alzheimer’s Disease has no treatment to halt or reverse the disease –Drug studies seek to boost remaining ACh function in brain using Drugs that block the breakdown of ACh Drugs that block the formation of B-amyloid –Drugs are used to treat the specific symptoms of Alzheimer’s disease (depression, anxiety, sleep disorder) Psychological therapy is to be supportive Ch 16.8

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Delirium Delirium is a clouded state of consciousness involving –Difficulty in concentration –Disruption of the sleep-waking cycle –Incoherent speech –Memory impairment for recent events –Perceptual disturbances (delusions and hallucinations) –Mood/activity swings Mortality rate for delirium is about 40% Ch 16.9

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Causes of Delirium Causes of delirium include –Drug intoxications and drug-withdrawal reactions –Metabolic/nutritional imbalances (diabetes) –Infections (fevers) –Stress (environmental change) –Major surgery –Brain damage Ch 16.10

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Depression in the Elderly The prevalence of mood disorders is less in the elderly (< 3 %) than in young people (20 %). –Bipolar depression is rare in the elderly –Symptoms of depression are similar in the elderly expect that feelings of guilt are less common and somatic/memory complaints are more common –Suicide attempts and completions increase for men as they age Ch 16.11

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Causes of Depression in the Elderly Depression in the elderly is associated with –Poor physical health –Medications that aggravate existing depression Antihypertensive medications Hormones Corticosteroids Antiparkinsonism medications –Stressors Ch 16.12

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Anxiety Disorders in the Elderly Anxiety disorders are more common than depression in the elderly –Anxiety per se is quite common in the elderly Anxiety is associated with –Medical illness or anticipation of illness –Medication reactions –Delirium accompanying illness –Cardiovascular conditions (angina) –Caffeine consumption Ch 16.13

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Schizophrenia in the Elderly Prevalence of schizophrenia is lower in the elderly than in the young –Schizophrenics die young –Some schizophrenics show remission of their symptoms as they enter old age –Schizophrenia rarely has an onset after age 60 Paraphrenia is the term used to characterize the onset of schizophrenic symptoms in an older person (more hallucinations and delusions) Ch 16.14

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Substance-Related Disorders Substance abuse is less prevalent among the elderly than the young –Alcohol abuse can have onset in the elderly Tolerance for alcohol is reduced in old age Older people metabolize alcohol more slowly –Illegal drug abuse is expected to increase among the elderly –Medication misuse occurs in the elderly The elderly are 13% of the population but receive 33% of the legal prescriptions Ch 16.15

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Sleep Disorders Insomnia is a common (25%) sleep problem in the elderly Other common sleep problems include –Frequent awakenings at night –Early morning awakenings –Difficulty following asleep –Daytime fatigue Elderly show reduced sleep time and less time spent in REM sleep Ch 16.16

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Treatment of Sleep Disorders Older adults use a variety of medications to treat sleep disorder and each have associated problems: –Sleeping pills lose their effectiveness and cause sleep disorder (REM rebound sleep) –Tranquilizers have adverse side effects such as disruption of learning and reduced thought clarity during the following day –Alcohol reduces REM sleep Ch 16.17

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Suicide Older people are more likely to experience suicide risk factors such as illness, social isolation, loss of loved ones and financial pressure Suicide rates increase for men as they age and decrease slightly for women Older people are less likely to communicate suicidal intent and are more successful in their suicide attempts Ch 16.18

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Sexuality Older people can maintain an active sex life Changes in sexuality in the elderly include –Older men require longer to acquire an erection Erections fade more quickly after ejaculation Refractory period lengthens in elderly men –Older women require more time to become sexually aroused Vaginal lubrication is less in older women Older women return more quickly to a non-aroused state Ch 16.19

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