Abnormal psychology and clinical presentations

Abnormal Psychology

Amnestic syndrome is an abnormal mental state where all cognitive functions are intact except memory and learning. Amnestic disorders can be either transient or persistent and can be caused by accidents, trauma, seizures, alcohol, tumors, encephalitis, carbon monoxide poisoning, and other conditions. There are some fascinating clinical cases on record where after severe brain trauma, an individual was completely unable to lay down new memories at all. There are also popular movies about amnestic syndromes. One of the most interesting is the movie, Memento, in which the main character has to tattoo notes all over his body to help him function because he has lost his memory and cannot retain new memories.

Transient amnesia is characterized by severe memory loss and total disorientation -- except for self-identity -- and resolves within 24 hours. During this time, long-term memories are not laid down. This is often caused by a stroke or by seizures. Post-traumatic amnesia is a different type of amnesia which is caused by trauma, such as an accident or an extremely traumatic event. The poet John Berryman saw his father shoot himself when the poet was a child, but 'forgot' this event until later in life.

Another form of amnesia are alcoholic blackouts. As alcoholism progresses, and when blood alcohol is high, the brain cannot form long-term memories. Thus after an alcoholic blackout, the individual cannot recall what happened while he or she was drinking to excess. It is possible that there is a genetic predisposition to alcoholic blackouts. Low blood sugar may also be a contributing factor.

Korsakoff syndrome is another amnestic syndrome. It can have an acute or a slow and subtle onset. Individuals have a hard time learning new information, and may even have retrograde amnesia that extends back for many years. Usually this type of amnesia lasts for a few onths and then patients slowly begin to recover their memory.

Most amnestic disorders improve over time.

Alzheimer's Disease, in contrast to amnestic disorders, is a tragic, progressive brain disorder that gradually destroys a person's memory, their ability to learn, reason, communicate, and carry out daily activities. Alzheimer's Disease slowly robs the individual of their true self. As Alzheimer's worsens, patients often show personality changes, such as severe anxiety or depression, as well as delusional thinking. A patient with Alzheimer's may no longer recognize his or her loved ones, though usually the patient retains memories from early childhood. In fact, it is sometimes referred to as a second childhood. The late President, Ronald Reagan, suffered from Alzheimer's for many years before he died. New treatments for Alzheimer's are being developed. For instance, the anti-inflammatory antibiotic minocycline has been used in some studies in Alzheimers, and a new study in the Journal of Neuroscience shows that male hormones, or androgens, slow the progression of Alzheimer's in mice.

Mild mental retardation is a pattern of persistently slow learning of basic motor and language skills during childhood. These skills are known as milestones and are expected to occur within certain time frames. Those who suffer from mild mental retardation usually have an IQ of 70 or below. In testing for and diagnosing mild mental retardation, many professionals now use the broad term "developmental delay," as well as "learning disability," which can occur for any number of reasons, such as deafness or dyslexia.

Individuals with mild mental retardation usually learn to sit up, crawl and walk later than other children. They may talk later, have difficulty remembering things, have trouble solving problems and thinking logically. Even so, those with mild mental retardation can learn and function in society. In fact, they may have their own different kinds of gifts. An example of this is Forrest Gump, played by Tom Hanks in the smash hit movie of that name. Forrest often recites his mother's favorite sayings, "Mama always says, 'Life is like a box of chocolates' and 'Stupid is as stupid does.'" In spite of his mental retardation, Forrest leads a fascinating and inspiring life, intersecting with great figures and moments in history and pop culture.

Phenylketonuria (PKU) is a genetic disorder characterized by the inability of the body to utilize the essential amino acid, phenylalanine. In classic PKU, the enzyme that breaks down phenylalanine is deficient. Currently, most symptoms of PKU are avoided by early screening and treatment. Babies with PKU seem normal at birth, and if they are untreated, they develop a range of alarming symptoms, ranging from vomiting to rashes, increased muscle tone, mental retardation and seizures. They have small heads, prominent cheek and jaw bones, widely spaced teeth, and poor tooth enamel. However, every state now screens the phenylalanine level of newborns at 3 days of age. If an infant has PKU, dietary sources of the amino acid are lessened or eliminated. High protein foods such as meat, fish, chicken, eggs, cheese, milk, and peas are avoided. Cereals, starches, fruits and vegetables, along with phenylanine-free baby formulas are given instead. If a proper diet is maintained, these individuals can develop normally.

Functional enuresis and encorpresis are elimination disorders. The first is bedwetting, or urination, during the day or night, in one's clothing or in bed. There are three subsets of this disorder. In one, the individual (usually a child) urinates at night. In the second subtype, the individual urinates only while awake. The third subtype occurs both during the day and the night. In some cases, the child has an uncontrollable urge to urinate and cannot postpone it. In other cases, the child, for emotional reasons or because they are preoccupied with other things, delays urinating until they suddenly have to go to the bathroom and cannot make it in time. Usually these disorders disappear as a child gets older and learns self-control.

Functional encopresis is when an individual passes feces into clothing or other areas. Children over age four have usually learned to control their elimination of feces. This disorder is divided into two subtypes. The first occurs with constipation. When an individual is constipated and not moving his or her bowels regularly, there may be some leakage of stool. If the constipation is treated, this condition disappears. In the second subtype, the soiling occurs without an obvious reason. This may be related to psychological disorders, such as oppositional defiant disorder or conduct disorder.