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Chapter 14: Neurocognitive Disorders Multiple-Choice Questions 1. Which of the following statements about the brain is true? a. The skull is designed to support as much as 3 tons of weight. b. The brain is protected only by the skull. c. The human brain typically weights about 5 pounds. d. Brain damage rarely results in cognitive changes. Answer: a. The skull is designed to support as much as 3 tons of weight. 2. It is important that mental health professionals have an understanding of the effects of brain damage because a. most of their patients will have brain damage. b. brain damage can result in symptoms that look like psychological conditions. c. many of the medications used to treat psychopathology cause brain damage. d. the effects of most forms of brain damage are reversible. Answer: b. brain damage can result in symptoms that look like psychological conditions. 3. All of the following are reasons why cognitive disorders are addressed in an abnormal text EXCEPT a. these disorders are considered to be psychopathological conditions. b. some brain disorders cause symptoms that look like mood and anxiety disorders. c. psychological conditions can signal the onset of brain damage. d. brain damage can lead to psychological symptoms. Answer: c. psychological conditions can signal the onset of brain damage. 4. According to your text, what can double the risk of acquiring Alzheimer’s Disease? a. anxiety. b. psychosis. c. blindness d. depression. Answer: d. depression. 5. In the DSM-5, the disorders now known as “Delirium, Dementia, and Amnestic and Other Cognitive Disorders” will be part of a newly proposed category called __________. a. Delirium and Dementia Disorders b. Cognitive Disorders c. Neurological Disorders d. Neurocognitive Disorders Answer: d. Neurocognitive Disorders 6. The extent of the deficits seen after brain damage are determined in part by a. genetic factors. b. how one is functioning before the damage occurs. c. chemical imbalances in the brain. d. the drugs a person was on. Answer: b. how one is functioning before the damage occurs. 7. Major brain damage a. causes major changes. b. causes minor changes. c. causes changes to personality only. d. sometimes causes minor changes and sometimes major ones. Answer: d. sometimes causes minor changes and sometimes major ones. 8. A person who has experienced destruction of brain tissue may have widespread or limited behavioral deficits. The outcome depends upon which of the following? a. Gender b. Ethnicity c. Predisorder intellectual competence d. Income Answer: c. Predisorder intellectual competence 9. Which of the following could occur as a result of exposure to formaldehyde? a. high blood pressure b. epilepsy c. asthma. d. attention deficits Answer: d. attention deficits 10. When Mrs. Thomason experienced a stroke, a small area of her brain was deprived of oxygenated blood. This resulted in a a. diffuse brain injury. b. focal brain lesion. c. psychopathological dementia. d. diffuse lesion. Answer: b. focal brain lesion. 11. Mild to moderate diffuse brain damage is most likely to result in a. mood disturbance. b. attention deficits. c. visual distortions. d. altered sleep patterns. Answer: b. attention deficits. 12. Focal brain damage is most likely to be a consequence of a. stroke. b. oxygen deprivation. c. poison ingestion. d. malnutrition. Answer: a. stroke. 13. Someone with focal brain damage in his or her left hemisphere a. will have anterograde amnesia. b. will have problems with processing language. c. will have problems with nonverbal reasoning. d. will have problems with understanding new situations. Answer: b. will have problems with processing language. 14. Damage to the temporal lobes of the brain is most likely to result in a. passivity. b. impulsivity. c. blindness. d. forgetfulness. Answer: d. forgetfulness. 15. Damage to the ___________ lobes of the brain is most associated with memory loss; damage to the ___________ lobes of the brain is most associated with passivity or impulsiveness. a. temporal; frontal b. parietal; occipital c. frontal; temporal d. parietal; temporal Answer: a. temporal; frontal 16. Ruth experienced a stroke that severely damaged her occipital lobe. We can expect that she has an impairment in her ability to a. think and talk using good judgment. b. walk in a coordinated fashion. c. understand what she sees. d. do mathematical and word problems. Answer: c. understand what she sees. 17. Which of the following is a good example of a person with an impairment of orientation? a. Joe, who once thought he was a homosexual but now thinks he is heterosexual. b. Karla, who cannot accurately draw objects or copy designs on a piece of paper. c. Lois, who must constantly be reminded of what to do next when she is getting dressed. d. Marlon, who is not sure where he is or what month or year it is. Answer: d. Marlon, who is not sure where he is or what month or year it is. 18. Jerry had a stroke several months ago. Among the changes his family has noticed is that he now blows up over little things, cries over minor problems, and laughs at anything, no matter how silly. Jerry is showing a. focal brain damage. b. impairment of receptive and expressive communication. c. impairment of emotional modulation. d. affective blunting. Answer: c. impairment of emotional modulation. 19. An individual with neuropsychological damage a. will almost always evidence moderate to severe psychopathology, including hallucinations and delusions. b. may or may not have psychopathological symptoms. c. usually manifests symptoms of psychopathology that are the opposite of the person's pre disorder personality. d. will develop psychopathological symptoms only when areas of the frontal cortex have been damaged. Answer: b. may or may not have psychopathological symptoms. 20. Which of the following psychopathological symptoms is commonly seen in neuropsychological disorders? a. Cognitive deficits b. Delusions c. Dissociative episodes d. Panic attacks Answer: a. Cognitive deficits 21. Delirium a. develops slowly. b. affects awareness. c. can occur in a person of any age. d. reflects severe brain damage. Answer: b. affects awareness. 22. Delirium is thought to be more common in the elderly due to a. their weakened immune systems. b. their relative lack of physical and mental activity. c. chemical imbalances. d. normal age-related changes in the brain. Answer: d. normal age-related changes in the brain. 23. Suddenly, Lavinia is unable to remember what she was doing. She screams that bugs are crawling all over the walls. She begins to wildly swing her arms around. She can't fall asleep at night, but finally falls asleep at daylight. Lavinia most likely has a. dementia. b. focal brain damage. c. depression. d. delirium. Answer: d. delirium. 24. The most common cause of delirium is a. disease. b. drugs. c. electrolytic imbalance. d. stroke. Answer: b. drugs. 25. Delirium a. is usually permanent. b. is usually reversible. c. rarely is a medical emergency. d. is characterized by a decline from a previously attained level of functioning. Answer: b. is usually reversible. 26. Delirium is to dementia as ___________ is to ___________. a. acute; chronic b. diffuse; focal c. biological; psychological d. old; young Answer: a. acute; chronic 27. Delirium has a ___________ onset and dementia has a ___________ onset. a. rapid; gradual b. extensive brain damage; localized brain damage c. slow recovery; rapid recovery d. interference with complex processing; interference with simple processing Answer: a. rapid; gradual 28. The first sign of neurocognitive disorder in older adults is typically a. lack of alertness. b. lack of attention to the environment. c. motor control problems. d. memory problems. Answer: d. memory problems. 29. The most common cause of neurocognitive disorder is a. intracranial tumors. b. severe or repeated head injury. c. degenerative brain disease. d. drug toxicity. Answer: c. degenerative brain disease. 30. Which of the following disorders is characterized by motor symptoms such as resting tremors or rigid movements? a. AIDS b. Alzheimer’s disease c. Huntington’s disease d. Parkinson’s disease Answer: d. Parkinson’s disease. 31. Which of the following disorders affects men and women in equal numbers and is characterized by a chronic, progressive chorea? a. AIDS b. Alzheimer’s disease c. Huntington’s disease d. Parkinson’s disease Answer: c. Huntington’s disease 32. The particular disease that most commonly causes dementia is a. AIDS b. Alzheimer's disease. c. Huntington's disease. d. Parkinson's disease. Answer: b. Alzheimer's disease. 33. In order for a diagnosis of Alzheimer's disease to be definitively made a. brain tissue must be examined. b. symptoms must be present for over two years. c. the afflicted individual must exhibit delirium at least 50 percent of the time. d. plaques and tangles must be visible on an MRI. Answer: a. brain tissue must be examined. 34. You are convinced that your grandmother has Alzheimer's. How can your doctor confirm your diagnosis? a. By conducting a blood test b. By determining if she has enlarged ventricles that indicate brain atrophy c. By looking to see if she has a decrease in frontal lobe function d. By ruling out all other potential causes of dementia Answer: d. By ruling out all other potential causes of dementia 35. Which of the following statements about Alzheimer's disease is true? a. Multiple cognitive deficits exist, not just problems with memory. b. Changes in mood are rarely seen. c. Deterioration into a vegetative state occurs in two years or less. d. The first symptoms involve delusions and assaultive behavior. Answer: a. Multiple cognitive deficits exist, not just problems with memory. 36. It is suspected that June is in the early stages of Alzheimer's disease. Which of the following symptoms would suggest this? a. persistent delusions b. loss of contact with reality c. difficulty recalling recent events d. excessive neatness and an intrusive interest in others' affairs Answer: c. difficulty recalling recent events 37. Which of the following is the most typical example of the onset of Alzheimer's disease? a. After Bill's death, Carol was never the same again. b. When Yula's dementia became obvious, her family looked back on her behavior and realized that she had been exhibiting memory deficits. c. Rachel have always suffered from mood disorders. When she descended into a state of dementia after her last manic episode, no one was surprised. d. Christa began showing signs of forgetfulness after her last surgery. Answer: b. When Yula's dementia became obvious, her family looked back on her behavior and realized that she had been exhibiting memory deficits. 38. The text presented a case study of a retired man who was hospitalized by his wife and son. He was typical of many patients in that a. he had become violent toward family members. b. he never lost his orientation for time and person. c. he had good memory for remote events but no memory for events that just occurred. d. he became hypochondriacal and performed repetitive, meaningless rituals. Answer: c. he had good memory for remote events but no memory for events that just occurred. 39. What types of delusions are most commonly seen in Alzheimer's disease? a. Delusions of grandeur b. Delusions of persecution c. Delusions of reference d. Delusions of bodily changes Answer: b. Delusions of persecution 40. Which of the following is most likely to be characteristic of a physically aggressive Alzheimer's disease patient? a. History of violent behavior b. Multiple psychotic breaks c. Delusions of reference d. Delusions of persecution Answer: d. Delusions of persecution 41. The brain begins to decrease in size at age a. 18. b. 35. c. 55. d. 65. Answer: a. 18. 42. Which of the following is a risk factor for developing Alzheimer's disease? a. Being a woman b. Having a family history of Parkinson's disease c. Living in a non-Western developed nation d. Being highly educated Answer: a. Being a woman 43. Early-onset Alzheimer's disease differs from late-onset in that a. it appears to be caused by rare genetic mutations. b. symptoms invariably involve delusions and assaultive behavior. c. genetics play little or no causal role. d. environmental factors have no impact on the onset or the progression of the disorder. Answer: a. it appears to be caused by rare genetic mutations. 44. Early-onset Alzheimer's disease affects people in their a. teens. b. 20s. c. 30s. d. 40s. Answer: d. 40s. 45. Most cases of early-onset Alzheimer's disease appear to be caused by a. environmental exposure to toxins. b. one of several rare genetic mutations. c. HIV or some other autoimmune disease. d. a combination of psychoactive drug abuse and poor nutrition. Answer: b. one of several rare genetic mutations. 46. Which of the following is associated with an increased risk of developing Alzheimer's disease? a. Having a family history of vascular dementia b. Giving birth to a child with Down syndrome before age 35 c. Living in a non-Western developed nation d. Excessive use of nonsteroidal anti-inflammatory drugs Answer: b. Giving birth to a child with Down syndrome before age 35 47. It has been observed that if a woman gives birth to a child with Down syndrome before the age of 35, she has an increased risk of developing Alzheimer's disease. Which of the following best explains this observation? a. The same gene underlies both Down syndrome and Alzheimer's disease. b. Women under 35 are not emotionally mature enough to manage a child with mental retardation. c. Multiple copies of the APOE-4 allele increase the likelihood of both conditions. d. A genetic mutation that increases susceptibility to Alzheimer's disease also increases the likelihood of passing on chromosomal abnormalities. Answer: d. A genetic mutation that increases susceptibility to Alzheimer's disease also increases the likelihood of passing on chromosomal abnormalities. 48. Late-onset Alzheimer's disease has been linked to a gene on chromosome a. 7. b. 14. c. 19. d. 21. Answer: c. 19. 49. Research suggests that the use of ___________ may decrease the risk of developing Alzheimer's disease. a. aspirin b. codeine c. ibuprofen d. valium Answer: c. ibuprofen 50. The protein called tau a. is a sticky substance at the core of a plaque. b. is a neurotoxic substance that occurs in the brains of people with Alzheimer's disease. c. is caused by amyloid in the brain d. is a neurotransmitter important in the mediation of memory. Answer: c. is caused by amyloid in the brain 51. What type of drugs is most likely to be used to inhibit the progression of Alzheimer's disease? a. Nonsteroidal anti-inflammatories b. Antidepressants c. Antipsychotics d. Cholinesterase inhibitors Answer: d. Cholinesterase inhibitors 52. Consistent with its established role in memory, neurons in the ___________ suffer much damage in Alzheimer's disease. a. hippocampus b. hypothalamus c. thalamus d. amygdala Answer: a. hippocampus 53. The first neurons to be affected in Alzheimer's disease are cells that release a. serotonin. b. dopamine. c. beta amyloid. d. acetylcholine. Answer: d. acetylcholine. 54. A hypothetical drug that might improve the cognitive functioning of Alzheimer's patients would probably a. decrease levels of acetylcholine. b. increase levels of acetylcholine. c. increase levels of beta amyloid. d. decrease the activity of all genes that produce ApoE. Answer: b. increase levels of acetylcholine. 55. The most promising development in the treatment of Alzheimer's involves a. finding drugs that counteract the processes associated with inheriting high-risk ApoE allele patterns. b. preventing the degeneration of dopamine-producing cells. c. increasing the intake of vitamins and minerals known to enhance memory function. d. vaccines that might clear away any accumulated plaques. Answer: d. vaccines that might clear away any accumulated plaques. 56. The best avenue of research for effective treatment of Alzheimer's disease involves a. medications to remove plaques, because they cause the symptoms in Alzheimer's disease. b. prevention or treatment at the first sign of illness because lost neurons cannot be regained. c. regenerating neurons in the brain to replace those lost or damaged by the disorder. d. behavioral therapy to help improve memory and living skills. Answer: b. prevention or treatment at the first sign of illness because lost neurons cannot be regained. 57. Caregivers of patients with Alzheimer's disease a. experience "social death." b. are at extraordinarily high risk for depression. c. show high levels of ApoE, even if they do not show any outward anxiety symptoms. d. are likely to show signs of cognitive deterioration. Answer: b. are at extraordinarily high risk for depression. 58. What is the relationship between the HIV-1 virus and brain damage? a. The virus itself never causes brain damage, only peripheral damage to the skin. b. The virus may work indirectly: It allows infections to occur that cause brain damage. c. The virus does not lead to brain damage, but the disease so affects patients that their psychotic reactions mimic those of brain damage. d. The virus is more likely to multiply in a brain that has already been damaged by brain trauma or some other cause of tissue loss. Answer: b. The virus may work indirectly: It allows infections to occur that cause brain damage. 59. Dementia in HIV a. is always due to secondary infections that attack the brain. b. is a common side effect of antiviral therapy. c. results from acute damage to temporal lobe structures. d. may be due to the HIV virus directly attacking brain cells. Answer: d. may be due to the HIV virus directly attacking brain cells. 60. The neuropathology in AIDS-related dementia a. involves the formation of plaques and tangles in the brain. b. tends to result in focal damage in the brain. c. includes generalized atrophy in the brain. d. preferentially affects the frontal and temporal lobes in the brain. Answer: c. includes generalized atrophy in the brain. 61. The only neuropsychological syndrome for which antiretroviral therapy is likely to be helpful is a. AIDS-related dementia. b. multi-infarct dementia. c. vascular dementia. d. amnestic disorder. Answer: a. AIDS-related dementia. 62. Vascular dementia a. is a result of many small strokes. b. is what was once called amnestic infarct dementia. c. responds to the same treatments as Alzheimer's disease. d. affects more women than men. Answer: a. is a result of many small strokes. 63. How does vascular dementia differ from Alzheimer's disease? a. It is not progressive. b. It occurs at an earlier age. c. The early clinical picture is more homogeneous than that seen in Alzheimer's disease. d. Accompanying mood disorders are more common. Answer: d. Accompanying mood disorders are more common. 64. Vascular dementia is less common than Alzheimer's disease because a. it develops later in life. b. the patient is vulnerable to sudden death from stroke or cardiovascular disease. c. it can be cured. d. spontaneous remission is common. Answer: b. the patient is vulnerable to sudden death from stroke or cardiovascular disease. 65. Which of the following best explains why mood disorders are more characteristic of vascular dementia (VAD) than of Alzheimer's disease? a. VAD preferentially affects serotonergic cells. b. Medical treatments are less effective in the treatment of VAD. c. VAD is more prevalent in women. d. Subcortical areas are more affected in VAD. Answer: d. Subcortical areas are more affected in VAD. 66. What is affected in amnestic disorder? a. The ability to recall something that happened seconds ago b. The ability to recall something that happened minutes ago c. The ability to recall something that happened hours ago d. The ability to recall something that happened years ago Answer: b. The ability to recall something that happened minutes ago 67. An individuals with amnestic disorder is likely to be unable to ____________. a. tell you whom he or she met 5 minutes ago b. describe the house he or she grew up in c. repeat an address he or she was just told d. demonstrate how to ride a bike Answer: a. tell you whom he or she met 5 minutes ago 68. Procedural memory often is intact in patients with amnestic disorder. This means a. they will eventually recover their short-term memory. b. they will eventually recover their memory for the most important personal events in their lives, but will still have problems with short-term memory. c. they can still learn routines and skills and may be able to be taught tasks that will enable them to work. d. the memory pathways in the brain are still intact, so patients can be retaught how to remember things. Answer: c. they can still learn routines and skills and may be able to be taught tasks that will enable them to work. 69. Of the choices listed below, the most common cause of traumatic brain injury is a. stroke. b. motor vehicle accidents. c. drug abuse. d. Alzheimer's disease. Answer: b. motor vehicle accidents. 70. Which of the following is not a cause of traumatic brain injury? a. Car accidents b. Assaults c. Sports d. Vitamin deficiency Answer: d. Vitamin deficiency 71. When a closed-head injury occurs, a. the damage is localized. b. the damage is a result of the brain colliding with the skull. c. post-trauma epilepsy is common. d. the skull is bruised. Answer: b. the damage is a result of the brain colliding with the skull. 72. A bullet is most likely to cause a. a closed-head injury. b. a penetrating head injury. c. amnestic disorder. d. multi-infarct dementia. Answer: b. a penetrating head injury. 73. The damage that might be caused to the brain by riding a violently fast roller coaster is similar to that seen with a. a closed-head injury. b. a penetrating head injury. c. vascular dementia. d. a series of circumscribed cerebral infarcts. Answer: a. a closed-head injury. 74. Mild brain injuries a. usually produce no problems. b. usually produce short-lived, major problems. c. are likely to occur in athletes. d. usually produce long-term, major problems, particularly in older people. Answer: c. are likely to occur in athletes. 75. The occurrence of which of the following after a head injury suggests a poor prognosis? a. Concussion b. Retrograde amnesia c. Contusion d. Anterograde amnesia Answer: d. Anterograde amnesia 76. After being hit on the head, Bob experienced some retrograde amnesia. Those who were there knew this because he a. was unconscious. b. had a concussion. c. could not remember his name. d. did not know what happened. Answer: d. did not know what happened. 77. The effects of head trauma on memory suggest that a. short-term memory is not affected by physical trauma. b. the process of memory consolidation can be interrupted. c. semantic memory is usually affected when an injury is severe enough to produce a loss of consciousness. d. rarely are episodic memories affected by head trauma. Answer: b. the process of memory consolidation can be interrupted. 78. After the car accident, Sherry was unable to remember what happened from the time of the crash until the following morning. Sherry appears to have experienced a. amnestic disorder. b. anterograde amnesia. c. retrograde amnesia. d. dissociative fugue. Answer: b. anterograde amnesia. 79. The case of Phineas Gage demonstrates a. the role of the brain in determining personality. b. that even the most serious brain injuries need not lead to permanent alteration in behavior. c. the role of the temporal lobe in controlling behavioral impulses. d. the importance of a healthy cerebrovascular system. Answer: a. the role of the brain in determining personality. 80. Emotional dyscontrol and personality alterations are expected with a. amnestic syndrome. b. vascular dementia. c. frontal lobe damage. d. prolonged oxygen deprivation. Answer: c. frontal lobe damage. 81. Phineas Gage had a a. penetrating head injury. b. closed-head injury. c. skull fracture. d. contusion. Answer: a. penetrating head injury. 82. Which of the following is probably the most important factor in determining the functioning of a child who undergoes significant traumatic brain injury? a. Age b. Gender c. Competencies acquired before the injury d. Family environment Answer: c. Competencies acquired before the injury 83. Before the accident, Bob was unemployed and had few friends. Lionel, who suffered comparable head trauma, was a successful businessman and had just married. Which of these men should have the more favorable outcome and why? a. Bob, because his lack of responsibilities will permit him to focus on getting well. b. Bob, because he will benefit from relearning basic social skills. c. Lionel, because he is more likely to be motivated to recover. d. There is no reason to expect that these men will have different outcomes. Answer: c. Lionel, because he is more likely to be motivated to recover. 84. Positive outcomes following a traumatic brain injury are associated with: a. being young. b. having a favorable life situation to return to. c. experiencing severe cognitive impairment. d. later intervention. Answer: b. having a favorable life situation to return to. 85. Which person is least likely to have a good recovery from moderate brain injury? a. Paul, who was severely depressed. b. Wendy, who was a Ph.D. student. c. Danielle, who had a short period of unconsciousness following the injury. d. Art, who received treatment interventions shortly after the injury. Answer: a. Paul, who was severely depressed. Fill-in-the-Blank Questions 1. The type of brain damage that occurs after the brain is jarred in the skull is called __________ brain damage. Answer: diffuse 2. Many people with brain damage resulting in neuropsychological disorders have problems with __________ and self-regulation. Answer: cognitive processing 3. ___________ is the second most common neurodegenerative disease after Alzheimer's disease. Answer: Parkinson's disease 4. Huntington's disease is rare and caused by an autosomal dominant gene on __________. Answer: chromosome 4 5. In Alzheimer's disease, __________ are deposits of sticky protein. Answer: amyloid plaques Short Answer Questions 1. What factors determine the amount of impairment from brain damage? Answer: The nature, location, and extent of the damage, premorbid competence and personality, an individual's life situation and the amount of time since the first appearance of the condition. 2. What effects is damage to the frontal areas of the brain likely to have? Answer: Damage to the frontal parts of the brain that are largely involved in the control and planning of movement may result in a passive apathy or impulsiveness and distractibility. Where the damage is and the extent of the damage will determine the ultimate effect on behavior. 3. What is delirium? Answer: Delirium is a state of confusion that reflects some major change in how the brain is working. The elderly are at high risk for experiencing delirium. The most common cause of delirium is drug intoxication or withdrawal. 4. How can a diagnosis of Alzheimer's disease be definitively made? Answer: A diagnosis of Alzheimer's disease can only be confirmed at autopsy with an examination of brain tissue. The presence of amyloid plaques and neurofibrillary tangles in the brain are the hallmarks of the disease. 5. What is vascular dementia? Answer: Vascular dementia (VAD) was once known as multi-infarct dementia and results in symptoms that look a lot like Alzheimer's disease. In VAD, however, the problems observed are a consequence of a series of small strokes that kill more and more of the brain. 6. What is anterograde amnesia? Answer: Anterograde amnesia is an inability to form new memories. It is after the traumatic event. 7. What does the case of Phineas Gage suggest about traumatic brain injury? Answer: Gage survived a blasting accident in which an iron bar went through his brain. He had a severe frontal lobe wound that altered his personality. Where once he was efficient and capable he became impulsive and profane. This illustrates a neuropsychological personality syndrome and is characteristic of frontal lobe damage. Further, Gage was no longer able to return to his former occupation, a common outcome of this kind of brain injury. 8. What are the factors that have an impact on the outcome for children with traumatic brain injury? Answer: The younger they are, the more adversely affected. The severity of the damage and the degree to which their environment is accommodating also has an impact. If the injury is mild, most have no lasting effect. Essay Questions 1. Why are cognitive disorders included in abnormal psychology? Answer: 1. They are considered psychopathological conditions. 2. They can cause symptoms very similar to other mental disorders. 3. Brain damage can change behavior, personality, mood, etc. and can help in understanding of biological bases of many problems. 4. Many people with brain disorders react with depression or anxiety and depression may be related to onset. 5. These disorders can have heavy impact on family members, often including anxiety and depression. 2. Your text lists nine types of impairments that are commonly found in neuropsychological disorders. List and describe five of them. Answer: 1. Impairment of memory: Typically recent events are forgotten rather than remote events; there is a tendency to fill in gaps (confabulate). 2. Impairment of orientation: the person cannot accurately locate himself/herself in time or place or in relation to the personality identities of self or others. 3. Impairment of learning, comprehension, and judgment: the person has trouble understanding abstract ideas or is unable to plan actions. 4. Impairment of emotional control: the person overreacts with extreme emotions such as laughter, tears, or rage. 5. Apathy or emotional blunting: This lack of emotionality usually occurs when deterioration is advanced. 6. Impairment of initiating behavior: The person needs to be repeatedly reminded what to do next. 7. Impaired control over ethical conduct: The person shows lowered standards of appearance, language, sexuality, hygiene, and so on. 8. Impaired communication: inability to comprehend or express oral or written language. 9. Impaired visuospatial ability: poor handwriting or ability to assemble things. 3. Describe delirium and dementia. What are the main differences? Answer: Delirium has a relatively rapid onset and is caused by a generalized disturbance in brain metabolism. Causal factors include head trauma, oxygen deprivation, drug withdrawal, and toxic and metabolic disturbances. Attention, perception, and memory are affected. Frequently, the person becomes agitated and has disturbed sleep. Delirium rarely lasts more than one week. Dementia involves a progressive deterioration of brain function that begins with episodic, short-term memory loss and spreads to include impaired emotional control, motor control, learning, abstract thinking, and other functions. It typically affects older individuals and may be caused by strokes, infections, tumors, head injury, and degenerative diseases, particularly Alzheimer's disease. 4. What evidence is there that genes are involved in Alzheimer's disease (AD)? Answer: While the incidence of AD increases with age, there are those who develop AD in their 40s or 50s. This "early-onset" AD appears to have a genetic basis. This form of the disease is usually of rapid onset and course. While early-onset AD appears to run in families, numerous genes have been implicated. Mutations on many different chromosomes have been identified as playing a potential causal role. Genes that code for products that play a role in the development plaques and tangles have been identified. While much has been discovered about this disease, there are many questions that remain unanswered. Test Bank for Abnormal Psychology: DSM 5 James N. Butcher, Jill M. Hooley, Susan M. Mineka 9780205965090, 9780205944286

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