Abnormal Psychology Clinical Perspectives on Psychological Disorders 5e Richard P. Halgin Susan Krauss Whitbourne University of Massachusetts at Amherst Richard P. Halgin Susan Krauss Whitbourne University of Massachusetts at Amherst slides by Travis Langley Henderson State University slides by Travis Langley Henderson State University Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Gangguan Usila dan Kognitif Chapter 12 Gangguan Usila dan Kognitif Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

GANGGUAN KOGNITIF Gangguan pikiran, memori, atensi (impermen kognitif) timbul karena trauma otak, penyakit, atau paparan dengan zat toksik. Diagnosis DSM-IV dalam : Cognitive functions include thought processes, memory capacity, and ability to be attentive. In this chapter’s disorders, cognitive impairment is the central characteristic. In DSM-IV-TR, this set of disorders is titled delirium, dementia, amnestic, and other cognitive disorders. Delirium Demensia Amnesia Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Diagnosis Banding Simtom yang mirip pada gangguan psikologi dan fisik berbeda mungkin sulit dibedakan. Misal : EPILEPSI, terutama dari EPILEPSI LOBUS TEMPORAL, sering mirip gangguan psikologik. People with temporal lobe epilepsy may experience a number of symptoms, such as increased fear, mood swings, inappropriate affect, bursts of anger, illusions or hallucinations, altered thought processes, and bizarre behavior. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Delirium Keadaan individu dengan kesadaran berkabut, bersifat sementara, mereka tidak menyadari apa yang terjadi disekitar mereka dan tidak mampu fokus atau memperhatikan. Pada keadaan delirium, orang berubah kognitifnya yakni memorinya berkabut dan mereka mengalami disorientasi. They may also experience delusions, illusions, or hallucinations, as well as emotional disturbances like anxiety, euphoria, or irritability. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Delirium delirium Disebabkan adanya perubahan metabolisme karena faktor seperti : intoksikasi zat putus zat trauma kepala demam tinggi defisiensi vitamin People of any age can experience delirium, but it is more common among medically or psychiatrically hospitalized older adult patients. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Gangguan Amnesia Gangguan kognitif meliputi ketidak mampuan recall informasi yang pernah dipelajari register memori baru. Ketidak mampuan dapat sangat mengganggu , karena individu kehilangan sensasi identitas personal nya. In other words, this is amnesia with biological causes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Kategori Gangguan Amnesia Gangguan Amnesia karena kondisi medik. kronik transient Gangguan amnesia persisten diinduksi oleh zat. Those due to medical conditions can be chronic (lasting a month or more) or transient (temporary). Such medical conditions include head trauma, loss of oxygen, herpes simplex. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Zat yang Menginduksi Gangguan Amnesia Medikasi Zat illegal Pelarut Industri Mercuri Timbal Insektisida Penyebab paling umum : Penggunaan alkohol kronis Note the word persisting, to distinguish this from passing effects of substance intoxication or substance withdrawal. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Demensia Defisit generalisata progresif memori, belajar, komunikasi, judgment, dan koordinasi motorik. Tanda pertama demensia hilangnya memori. Dementia: A form of cognitive impairment involving generalized progressive deficits in a person's memory and learning of new information, ability to communicate, judgment, and motor coordination. Most people who fear they are developing the dementia known as Alzheimer’s are likely to be wrong. For those with Alzheimer’s, though, memory loss becomes more pronounced. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Demensia: Simtom Menonjol Lainnya Afasia Wernicke Broca Apraxia Agnosia Aphasia: A loss of the ability to use language caused by damage to the brain’s speech and language centers. Wernicke’s aphasia: The individual is able to produce words but has lost ability to comprehend them. The person with Broca’s aphasia has a disturbance of language production, but comprehension abilities are intact. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Demensia: Simtom Meninjol Lainnya Gangguan Fungsi Eksekutif Fungsi Eksekutif : Kemampuan kognitif seperti berpikir abstrak, berencana, mengorganisasi dan berperilaku Tugas sederhana rutin setiap hari mungkin lupa atau bingung Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Traumatic Brain Injury (TBI) Penting dikenali disfungsi mental dan fisik akibat kerusakan otak sekarang terlihat meningkat Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

DEMENSIA ALZHEIMER Defisit kognitif multiple terkait demensia, mungkin disebabkan abnormalitas biologik yang mengenai sistem syaraf Subtipe dengan delirium dengan delusi dengan mood depresi tanpa komplikasi The odds that a person will develop Alzheimer’s disease later in life are actually low. It is NOT an inevitable part of the aging process. Uncomplicated: Cases for which none of the other characteristics apply. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

DEMENSIA ALZHEIMER Tahap Pelupa Kebingungan dini Kebingungan Lanjut Demensia dini Demensia pertengahan Demensia lanjut Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

DEMENSIA ALZHEIMER FITUR BIOLOGIK Neurofibrillary tangles Amyloid plaques Defisit neurotransmitter acetylcholine 40 - 50 persen twin concordance rate Neurofibrillary tangles: A characteristic of Alzheimer's disease in which the material within the cell bodies of neurons becomes filled with densely packed, twisted protein microfibrils, or tiny strands. Amyloid plaques: A characteristic of Alzheimer's disease in which clusters of dead or dying neurons become mixed together with fragments of protein molecules. Faktor LINGKUNGAN memainkan peran ; namun, concordance lebih tinggi , faktor spesifiknya belum dapat dikonfirmasi Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Penyakit Parkinson Degenerasi neuronal struktur subcortical yang mengendalikan gerakan Demensia terjadi pada 60% pasien Parkinson. Pictured: Actor Michael J. Fox, who has struggled for years with Parkinson’s Disease. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Simtom Penyakit Parkinson Tangan, tumit, atau kepala dapat bergoyang secara involuntar. Bradykinesia: aktivitas motorik melambat secara menyeluruh. Akinesia: kekakuan otot, kesulitan memulai gerakan. Koordinasi gerak motorik terganggu Gerak lambat, tidak lancar. Sulit memulai atau menghentikan gerak ketika berjalan misalnya Tampilan ekspresi. Kehilangan irama bicara normal dan berkualitas Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

BEBERAPA DEMENSIA Substance-Induced Persisting Dementia Pick’s Disease Lewy Body Dementia AIDS dementia: Subtle deterioration in cognitive functioning is sometimes the first clue that a person has AIDS, for individuals for whom dementia precedes other AIDS symptoms. Pick's disease: A relatively rare degenerative disease that affects the frontal and temporal lobes of the cerebral cortex and that can cause dementia. Parkinson's disease: A disease that involves degeneration of neurons in subcortical structures that control motor movements, and can cause dementia in up to 60% of Parkinson’s patients. Lewy body dementia: A form of dementia similar to Alzheimer's disease with progressive loss of memory, language, calculation, and reasoning, as well as other higher mental functions. Diagnosed when Lewy bodies (deposits of protein found in dying nerves) are found more diffusely throughout the brain. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

BEBERAPA DEMENSIA Frontotemporal Dementias Huntington’s Disease Creutzfeldt-Jakob Disease Vascular Dementia Frontotemporal dementias involve the frontal lobes of the brain. Rather than involving a decline in memory, this is reflected in personality changes such as apathy, lack of inhibition, obsessiveness, or loss of judgment. Eventually, motivation and communication are lost. Huntington's disease: A hereditary condition causing dementia that involves a widespread deterioration of the subcortical brain structures and parts of the frontal cortex that control motor movements. Creutzfeldt-Jakob disease: A neurological disease transmitted from animals to humans that leads to dementia and death resulting from abnormal protein accumulations in the brain. Vascular dementia: A form of dementia resulting from a vascular disease that causes deprivation of the blood supply to the brain. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Pseudodementia Pseudodemensia: False demensia, simtom dipicu oleh depresi yang mirip tampilan ini pada stadium dini Alzheimer. Although people with Alzheimer’s disease may also have depression, particularly during the early to middle phases, simply being depressed may interfere with thought, memory, and motivation in ways that resemble early stages of Alzheimer’s. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

TERAPI ALZHEIMER MEDIKASI MANAJEMEN BEHAVIORAL Melambatkan pemecahan acetylcholine. Antioksidan menarget radikal bebas yang merusak neuron. MANAJEMEN BEHAVIORAL Target pada pasien dan caregiver untuk : Meningkatkan kemandirian pasien Membatasi mondar mandir dan aggresi pasien. Menyediakan dukungan sosial bagi caregivers. As of this writing, there is no cure. Treatments are aimed at (1) slowing progression of the disorder, and (2) managing the patient’s behavior and quality of life. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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