Psyc 188 - Impulse Control

Front 1

Gating

Back 1

allows you to pick and choose what to focus on

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Huntington's Disease

Back 2

inability to shut off unwanted movements, thoughts, images, or sensations; you can see the symptoms

Caused by the death of a neuron that is being replaced by spinal fluid (that is in the caudate)

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Obsession

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an unwanted, irrelevant, often distressing thought or image (or impulse) that people cannot shut out from their consciousness; "feeling of anxiety"

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OCD

Back 4

an anxiety disorder; internal experience: an inability to gate unwanted, distressing information

obsessions > anxiety > compulsion

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Tourette's Syndrome

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like a sneeze; inability to shut off unwanted sensations

Premonitory urge > discomfort > tic

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Contamination Obsessions

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thoughts of being contaminated by germs causing you to get sick or ill and die

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Compulsion

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rituals designed to minimize the anxiety created by the obsession

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The Gating System for the Brain

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Information leaves cerebral cortex 'brain' > information descends into lower structures 'basal ganglia' > basal ganglia takes info from motor 'or cognitive' cortex, filters info and decides what gets through or not. By changing the gate you can shift the balance and create movement 'or consciousness'

Gate control can be involuntary or voluntary (preconscious or conscious)

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4 determinants of gating capacity

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genetic, developmental, environmental, pathological

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CSPT

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Cortex > Striatum > Pallidum > Thalamus

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Lateral Orbital Cortex Pathway

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Lateral orbital cortex > Caudate > Globus pallidus > Thalamus > (back to LOC)

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Anterior Cingulate Cortex Pathway

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Anterior Cingulate Cortex > Nucleus accumbens > Globus pallidus > Thalamus > (back to ACC)

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What happens when a loop is damaged?

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When one loop is damaged, the other healthy loops must engage to compensate for the areas that are problematic

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What is the process of dopamine through the brain?

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ii. Dopamine regulates basal ganglia and frontal cortex > sends info to caudate nucleus > then into globus pallidus. Info ends on dendrites > dopamine input comes up from midbrain > terminates on neck > determines what info actually gets through

Front 15

OCD shows a decrease in the ________ _______ by __%.

Back 15

Caudate nucelus, 15

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Resting FDG-PET scan:

Normal Control show:

OCD Patients show:

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how sugar is being burned by different parts of the brain as a measure of how much energy it's using; red = activity

resting shows little to no activity

resting shows hyper metabolism in OFC, ACC, and head of nucleus

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Sweaty Sock Experiment

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OCD patients: CSPT circuitry is activated

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OCD
Prevalence:
Onset:
Comorbidities:

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1.5-2.5%, 1:1 male:female
18 years; symptoms begin at 13
Major Depression, phobias, panic

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OCD
Treatments:

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SSRI's, Fluoxetine (Prozac), CBT, stimulating electrode (extreme cases)

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Quality of life with OCD

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Relationships
1) Low self-esteem
2) Interfered with family relationships
3) Fewer friends or difficulty in maintaining friendships

Education
1) Lowered academic achievements

Work
1) Lowered career aspirations
2) Interfered with work
3) Unable to work; average loss of 2years)

Suicide attempts
1) Suicide attempts secondary to OCD symptoms

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Automatic learning

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happens in basal ganglia

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Primary obsessions/compulsions

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contamination/checking

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PANDAS

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Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep

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A brain with TS has a small _______, too little ______, & too much __________.

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caudate, ventral striatal, dopamine

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TS
Prevalence:
Onset:
Comorbitities:

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.05-1%
7 years; symptoms begin at 7
ADHD, Rage, SIB

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TS
Treatment:

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DA antagonist
Habit reversal

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Motor Tic

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Simple:eye blinks, shoulder shrugs
Complex: lip picking, finger drumming, head rolling

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Vocal Tics

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Simple: sniffs, grunts
Complex: corprolalia

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Driving Mechanisms of OCD & TS

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a. Compulsivity: reduction in anxiety or discomfort
b. Impulsivity: obtaining arousal or satisfaction
c. Both have an inability to delay repetitive behaviors

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C-S-P-T

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Cortex, striatum, pallidum, thalamus

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Striatum

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Nucleus accumbens, caudate & putamen

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Basal ganglia

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Globus pallidus & Striatum

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Nucleus Accumbens

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Sit in from of globus pallidus

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Caudate nucleus =

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Corpus Striadal

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Amygdala

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essential for memory, links emotions with sensory inputs from environment

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Anterior cingulate cortex

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relays information from right to left hemispheres

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6 main types of emotions

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1) Good into bad
2) Good out of bad
3) Good prolong bad

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Venting

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an unrestrained expression of emotions ranging from the mere discloser of emotional states to outrages or wildly inappropriate behavior stimulated by emotions

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Catharsis view

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therapy technique, not effective; emotionally purging

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Emotionally expressive effect

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when one expresses an emotion one is likely to experience that emotion

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Silent seething

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holding one's anger in which increases arousal

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Cognitive suppression

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suppressing or avoiding unwanted thoughts or feelings; may cause rebound effect

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Distracters

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has to be appropriate, or can backfire

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Type A personalities

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well established

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Autonomic Nervous System

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sympathetic system: fight or flight; parasympathetic system: couch potato system

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Sensitization

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venting makes the emotion larger because it is sensitizing

Front 47

Movie (Falling Down, starring Michael Douglas)

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"Throughout the film, his efforts at emotional control meet with frustration and failure, and it is only through violent and aggressive outbursts that he ever gets what he wants."

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Underregulation - emotions
(Standards)

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people believe that they should never consciously attempt to control their emotions

Complete lack of standards - (venting sadness and other aversive mood states may parallel the underregulation proposed for anger)

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Underregulation - emotions
(monitoring)

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Disinhibition (silent seethers, when given alcohol may explode with anger)

Renegade Attention (involves focusing on feelings of anger or sadness - attentional failure)

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Underregulation - emotions
(Strength)

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Psychological inertia (distracters that backfire: mood state creates conditions that make it more difficult to escape from that mood)

Rumination (ruminating about a bad mood or brooding about what caused a bad mood is not likely to result in a mood change; reduces time and energy for active problem solving; increases the accessibility of negative cognitions)

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Misregulation - emotions

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Misguided focusing (venting directs attention in the wrong place)

Emotional focusing (venting bad feelings prevents people from distracting themselves)

Transcendence failure (attentional problem with alcohol, including myopia and transcendence failure)

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"Rolling the Snowball" - emotions

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1) Spiraling distress (alcohol may intensify depressive symptoms; vicious cycle)

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How to control anger?

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1) Cool off (calm down; don’t brood; find appropriate distracters)
2) Rational discussion
3) Confront problem
4) Try to change what made you upset to begin with

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T/F When one expresses an emotion, one is likely to experience that emotion.

Back 54

TRUE

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Compulsive buying disorder

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loss of control over buying/shopping preoccupations, impulses or behavior, resulting in impairment in social or occupational functioning

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Underregulation
(Monitoring)

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1) De-individualization (lost in a world of shopping and sometimes do not realize what they are buying)

2) Renegade Attention (reduced monitoring; subjects report being hypnotized by object)

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Underregulation
(Strength)

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1) Temporary weakness (impulse purchase while experiencing negative affective states)
2) Externally-mediated weakness (impulse is extremely strong and there is unlimited access)
3) Chronic weakness (can't control impulses)
5) Ego control (absorption: being self-involved in your experience; lack of ego control)

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Misregulation

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i. Emotional focusing (regulation of emotions is more important to them than any other behavior)
ii. Painful self-awareness (many believe they are expert shoppers; low self esteem, positive interactions with store staff)
iii. Transcendence failure ("cognitive narrowing": focus on immediate, low level, concrete task to avoid feeling bad about themselves, people focus on immediate things)
iv. Overgeneralization (lacks seeing consequences of spending)

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Compulsive Buying
"Rolling the Snowball"

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1) Spiraling distress (shop as means of escaping or in efforts to improve their mood)

a) Preoccupation/ anticipation "craving" (irresistible urges > splurge > tension relief/high > regret/guilt > depression >> *urge*)

b) Binge/intoxication (products associated with physical appearance; items often not used; urge to buy > loss of control > Intoxication > depression)

c) Withdrawal/negative affect (relief after shopping episode short-lived; followed by negative feelings)

2) Acquiescence (unlimited access; making a purchases in a store requires a series of acts that could be restricted; leads to a description of an overwhelming power of the impulse)

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Compulsive Buying
Case Studies

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Debt is seen as a personal weakness, so people judge themselves harshly

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Compulsive Buying
Primary motivation

Back 61

addicts: tension relief;
non-addicts: desire for object

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Compulsive Buying
Prevalence:
Onset:

Back 62

predominately female;
about 2% of population;

onset about 18yrs;
more likely young people

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Maladaptive buying/shopping preoccupation, impulses or behavior

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1) Irresistible, intrusive or senseless
2) Frequently buy more than is affordable
3) Frequently buy unneeded items
4) Shop longer than intended

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Compulsive Buying
Causes

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1) Marked distress
2) Time consuming
3) Interference with social or occupational functioning
4) Financial problems

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Compulsive Buying
Consequences

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1) Submit to criminal activities
2) Suicide

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Characteristics of compulsive shoppers

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1) lack of stable self image (higher levels of depression and anxiety; lower self-esteem)
2) Female purchases (clothes, jewelry, make-up, gifts for others, & home décor; objects of adornment that enhance image, mostly physical; arise when depressed or bored)
3) Male purchases (computers, entertainment, transportation, tools, watches, cameras; things that enhance image; arise when agitated, angry, or elated; likelihood of online auctions)

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Compulsive Buying
Dependence

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1. Tolerance (frequently buy more than they can afford)

2. Withdrawal (preoccupations, impulses or buying behaviors cause marked distress)

3. Large amounts (frequent preoccupation with buying impulses)

4. Impaired control

5. Time spent (shopping longer than intended)

6. Neglect of activities (shopping instead of doing other things)

7. Continued use despite problems (even though they end up with personal and financial problems, they continue doing it)

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carpal tunnel

Back 68

soreness of muscles of thumb by pressure on median nerve

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Underregulation - internet addiction
(monitoring)

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De-individualization (isolate and ignore other aspects of life)

Renegade Attention (hypnotized or mesmerized; lost in world of computing and loses sense of reality; leads to transcendence failure)

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Underregulation - internet addiction
(strength)

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Temporary weakness (low self-esteem; shyness)

Externally-mediated weakness (impulse is extremely strong; access is unlimited; can lead to acquiescence)

Psychological inertia (difficult to stop; behavior become automatic)

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Misregulation - internet addiction

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Painful self-awareness (lowself-esteem or shy; pride in being an "expert")

Front 72

"Rolling the Snowball" - internet addiction
(spiraling distress)

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Preoccupation/anticipation "craving" (thoughts about the computer- constantly making sure you have access)

Binge/intoxication (loss of control over use)

Withdrawal/negative affect (when you don't have access)

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DSM IV- internet addiction

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Tolerance
Withdrawal
Larger amounts
Impaired control

Time spent (Persistent or unsuccessful attempts to cut down or control internet use)

Neglect of activities
Continued use despite problems