17 Chapter 15 • Neurocognitive DisordersNormal Cognitive Changes Related to AgingDo Cognitive Abilities Change With Age?How the Brain Changes With AgeDeliriumCharacteristics, Prevalence, and Causes of DeliriumCASE OF BOBBY BALDWIN: DeliriumMild and Major Neurocognitive DisordersCharacteristics, Prevalence, and Diagnosis of Neurocognitive DisordersNeurocognitive Disorder Due to Alzheimer’s DiseaseCharacteristics, Prevalence, and Diagnosis of Alzheimer’s DiseaseUnderstanding Changes in DSM–5: Neurocognitive DisordersNeurofibrillary Tangles and Neuritic PlaquesGenes and Alzheimer’s DiseaseNeuroimaging of Alzheimer’s DiseaseOther Neurocognitive DisordersVascular Neurocognitive DisorderFrontotemporal Neurocognitive DisorderThe Development of Frontotemporal Neurocognitive Disorder in a Scientist and ArtistNeurocognitive Disorder Due to Traumatic Brain InjuryNeurocognitive Disorder Due to Lewy Body DementiaNeurocognitive Disorder Due to Parkinson’s DiseaseNeurocognitive Disorder Due to HIV InfectionSubstance-Induced Neurocognitive DisorderNeurocognitive Disorder Due to Huntington’s DiseaseLENS: The Silent Epidemic of Concussion in SportsNeurocognitive Disorder Due to Prion DiseasePrevention, Treatment, and SupportPrevention of Neurocognitive DisordersCan an Individual’s Activities Be Protective in Brain Changes?Treatment of and Support for Those With Neurocognitive DisordersLENS: Dementia-Friendly CommunitiesSummaryStudy ResourcesReview QuestionsFor Further ReadingKey Terms and ConceptsSAGE edge
18 Chapter 16 • The Law and Mental HealthThe American Legal System and the Insanity DefenseLENS: Mental Health and the Law in the Real World—Failure of a System?Competency to Stand TrialA Public Case: Andrea YatesEthical and Legal Issues in TreatmentThe Ethical and Legal Aspects of the Initial Contract for TreatmentEmergency CommitmentSexual Predator LawsA Public Case: Jeffrey DahmerCultural LENS: Global Mental Health: Prisoners and Mental HealthNeuroscience and Evolutionary Perspectives on the Legal Aspects of PsychopathologyLENS: The Implications of Solitary ConfinementUnderstanding Changes in DSM–5: Legal IssuesSummaryStudy ResourcesReview QuestionsFor Further ReadingKey Terms and ConceptsSAGE edge
19 Glossary
20 References
21 Author Index
Preface
Abnormal psychology books from the middle of the last century largely contained descriptions of particular disorders. However, there would not be much written about the experiences of having a mental disorder. Since that time, society has a new conceptualization of what it means to have a mental disorder. There is also a greater awareness of how many people with a mental illness are able to live full lives and have productive occupations. In this text, I want to introduce some of these individuals and describe their experiences.
Also, in a textbook from the last century, there would not be much written about research studies. The research included would be focused exclusively on studies related directly to abnormal psychology. It would not be connected with the larger human condition and how mental illness is part of our evolutionary history and related to human cognition, emotion, and motor processes. In many ways, the field of abnormal psychology at that time remained disconnected from other areas of psychology as well as the life sciences.
Jumping ahead to the beginning of the 2000s, abnormal psychology textbooks included more research. However, the amount of research related to the neurosciences was limited. There was little in the way of brain imaging and the manner in which different disorders are related to one another on an underlying level. However, there was a realization that mental illness is a complex process and cannot be explained on a single level such as the possibility of mental illness being produced by a single gene or by one type of environmental experience.
Using this broader perspective, the dichotomous positions of nature versus nurture or innate versus learned fuse into the larger question of how aspects of each lead to an understanding of behavior and experience and their relationship to mental illness. Understanding that human behavior and experience take place on a number of different levels replaces the strict dichotomous approach pitting one level against another. On a molecular level, for example, we now know that genes must be turned on and off. What this means is that many significant human processes are directed by the environment. That is, environmental factors are able to influence which genes turn on and off. On a higher level, the “genetics versus culture” debate may be of limited value without understanding the manner in which humans both live within a culture and are influenced by historical environments.
Development of Brain Imaging
As we entered the twenty-first century, questions of importance to psychology were being embraced by the neurosciences. This allowed for both richness and an integration of scientific information concerning important psychological questions. In the past 25 years, we have seen a shift in focus that has included the “Decade of the Brain” of the 1990s as well as a real emergence of the cognitive and affective neurosciences. A number of scientists have also begun to ask how neuroscience approaches can influence psychopathology and inform the diagnosis of different types of mental disorders.
Recent developments in brain imaging have provided important perspectives on psychopathological processes. These developments include functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and magnetoencephalography (MEG), and their basics should be understood by students seeking an overview of psychopathology. The perspectives based on these brain imaging techniques are beginning to emphasize the manner in which underlying cortical networks may reflect particular changes in psychopathological conditions and give us a better understanding of the manner in which normal social and emotional processes may become dysfunctional. For example, we know that there are a variety of basic networks in the brain, some of which are involved in internal processes such as mind wandering when there is no external stimulation, and others that become activated when interaction with the external world is required. A number of researchers have sought to articulate how these so-called default networks as well as other networks are associated with psychopathology. Other researchers have focused on emotional circuits that are either under- or overactivated in particular psychopathologies. One aspect of this emotional expression is the role it has played in our survival, mating, and social relationships from throughout our history. This brings us to the value of an evolutionary perspective.
Development of an Evolutionary Perspective
An evolutionary perspective examines the close interaction of organisms with their environment. In this close connection, the organism seeks ways to solve the fundamental problems or challenges of its existence. In many cases of mental illness, this close connection is no longer functioning in an optimal manner. The environment for humans includes not only nature but also culture. Throughout their evolutionary history, humans have always lived in groups with other people. The manner in which cultures understand and solve problems related to mental illness is one crucial question I will explore in this book. An evolutionary perspective also can give us insight into why some disorders such as schizophrenia are seen in similar proportions around the world, whereas other disorders vary by geographical location.
Implications for Treatment
An integration of research from the neurosciences with traditional psychological research helps clarify the efficacy and mechanisms of psychological treatments. For example, recent brain imaging research concerning treatment suggests that the type of treatment used determines the brain response. On the one hand, research concerning treatment of depression shows that psychotropic medications work