Overview
I & C is associated with many_________ disorders to which makes it more challenging to diagnose.
Name overlapping DXs (3) ?
psychiatric disorders
Mania, ADHD, and Dementia
Habits associated with Comp are responses triggered by __________ stimuli, controlled by ________.
In contrast to GOAL directed Behavior, individual has knowledge of and desire for consequences
(healthy habits are good)
environmental , external
With imp & comp the brain has a had time saying? ______
No
What is the flow of the Comp & Motor response Inhibition Loop?
Examples of disorders associated?
Dorsal Striatum-->thalamus-->Orbitofrontal Cortex (OFC)-->Dorsal Striatum
Autism
Tourettes
body dysmorphia
skin picking
trichotillomania
OCD
somatization
hypochondriasia
compulsive shopping
gambling
internet
paraphilias
hypersexual
drug addiction
obesity/binge eating
The bottom up circuit that drives comp can be over come by activity from the top down _________ response.
If the top down response is inadequate it results in?
inhibition
Compulsion
Impulsivity is the _______, _____ reactions to internal or external stimuli regardless to ________ consequences.
rapid, unplanned
negative
Drug seeking and drug taking behaviors are _________ responses to __________ stimuli
condition, condition
The circuitry is mediated by neurons ________ & ________ which are parallel components of ____________-______ circuitry
anatomically and chemically cortico-subcortico
What is the flow of the Imp Circuit Loop?
Examples of disorders associated?
Ventral Striatum_>thalamus->Ventromedial PRC (VMPFC)-->Anterior Cingulate Cortex (ACC)--> Ventral Striatum
Pryromania
Kleptomania
Intermitt, Explosive Disorder
Mania
ADHD
Impulsive Violence
Borderline Personality Disorder
Antisocial Disorders
Drug Addiction
Gambling
Obesity/binge eating
Often times there is overlap resulting in
Obsessive Compulsive Disorder
Compulsivity is the performance of _________ ________ in a habitual stereotypical fashion, either according to ridged rules or as a means of avoiding negative consequences
repetitive behaviors
What is associated with drug use? (AA)
What other factors are associated with addiction?
Ppl, places, and things
cravings and withdrawal
Imp & Comp networks become __________ and the individual experiences a ______ ___ _______ with thoughts and behaviors
dysfunctional
lack of control
Imp & agitation in AD is caused by ___________ of top down controls
neurodegeneration
Substance use begins as pleasurable with increased _________ release in the _______ ______
And enhanced _____ ______ _____ activity is associated with reward
DA, Ventral striatum
Anterior Cingulate Cortex
Psychopharmacology treats particular Sxs which offer additional _____________
Guidelines
When addicted, drug using and drug seeking are __________ thoughtless responses
automatic
Imp & Comp result from:
too much "bottom up" from the ___________ drive
too little "top down" from the ____________drive
limbic emotional
cortical inhibition
Imp in ADHD is caused by ________________ delay or absent top down
neurodevelopmental
Substance use becomes ________ & _________ with powerful compulsive drive to obtain the substance that is irresistible
mindless and automatic
The PMHNP knows that Imp has the following features: (4)
1. action without forethought
2. lack of reflection on consequences
3. limit ability to not give into temptation
4. needs immediate gratification over delayed reward (inability to postpone reward)
The PMHNP knows that Comp has the following features: (4)
1. action that is inappropriate for situation, but persist
2. Results in undesirable consequences
3. Not able to adapt behavior after negative feedback
The habit Circuit includes what 2 loops?
Imp & reward loop
&
Comp & Motor response inhibition loop
Bottom up circuit that drives imp is modulated by ______ ______ from the PFC.
If the top down response inhibition system is inadequate or overcome by activity in the Ventral Striatum it results in ___________?
top down
Impulsivity
Once addicted the brain no longer achieves the same reward which results in _______ _______ _______ behaviors that are themselves rewarding.
compulsive drug seeking