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Chapter 16
Aging and Psychological
Disorders
Abnormal Psychology, Eighth Edition
by
Gerald C. Davison and John M. Neale
Lecture notes created by Paul J. Wellman, Texas A&M University
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16
Issues in Aging
• Cultural view of the aged in the U.S.A. is typically
negative
• Aging may have a greater negative impact for
– Women
– Minorities
• Ageism refers to discrimination against any
person based on age
– Can be young or old person
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.1
Diversity in Aging
• Levels of “old”
– Young-old: ages 65-74
– Old-old:
ages 75-84
– Oldest-old: over age 85
• The one aspect that the elderly have in common
is age
– The elderly differ from one another as well as from
other age groups
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.2
Measurement Issues in Aging
Research
• Age effects are the consequences of being a
given chronological age
• Cohort effects are the consequences of having
been born in a particular year and having grown
up during a particular period of time
• Time-of-measurement effects are confounds that
arise because particular historic events have
specific effects
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.3
Brain Disorders in Old Age
• Dementia refers to a gradual deterioration of
intellectual ability that Interferes with social and
occupational function
• Dementia can involve problems in
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Memory
Poor hygiene
Language disorder
Faulty judgement
Delirium (state of mental confusion)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.4
Causes of Dementia
• Alzheimer’s Disease involves a progressive
deterioration of the cerebral cortex and
hippocampus leading to difficulty in concentration
and memory loss
• Alzheimer’s disease involves
– Loss of nerve cells within brain due to plaque formation
and neurofibrillary tangles
– Reduced activity of the neurotransmitter acetylcholine
(ACh)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.5
Genetics of Alzheimer’s Disease
• Chromosome 21 contains a gene that controls the
formation of amyloid which forms plaques
– The chromosome 21 gene accounts for 5% of early
onset Alzheimer’s cases and no person with this gene
has made it past the age of 65 without developing
Alzheimer’s disease
• Chromosome 19 contains a gene allele that
controls the likelihood of developing Alzheimer’s
(1=50%, 2=90%)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.6
Frontal-Lobe Dementias
• Frontal-Temporal dementia involves
– Cognitive impairments of memory
– Apathy
– Loss of serotonin neurons in brain (rather than
Ach)
• Frontal-Subcortical dementias include:
– Parkinson’s disease (muscle tremors)
– Huntington’s chorea (muscle writhing)
– Vascular dementia (muscle weakness-stroke)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.7
Treatment of Dementia
• Alzheimer’s Disease has no treatment to
halt or reverse the disease
– Drug studies seek to boost remaining ACh
function in brain using
• Drugs that block the breakdown of ACh
• Drugs that block the formation of B-amyloid
– Drugs are used to treat the specific symptoms
of Alzheimer’s disease (depression, anxiety,
sleep disorder)
• Psychological therapy is to be supportive
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.8
Delirium
• Delirium is a clouded state of consciousness
involving
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Difficulty in concentration
Disruption of the sleep-waking cycle
Incoherent speech
Memory impairment for recent events
Perceptual disturbances (delusions and hallucinations)
Mood/activity swings
• Mortality rate for delirium is about 40%
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.9
Causes of Delirium
• Causes of delirium include
– Drug intoxications and drug-withdrawal
reactions
– Metabolic/nutritional imbalances (diabetes)
– Infections (fevers)
– Stress (environmental change)
– Major surgery
– Brain damage
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.10
Depression in the Elderly
• The prevalence of mood disorders is less
in the elderly (< 3 %) than in young people
(20 %).
– Bipolar depression is rare in the elderly
– Symptoms of depression are similar in the
elderly expect that feelings of guilt are less
common and somatic/memory complaints are
more common
– Suicide attempts and completions increase for
men as they age
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.11
Causes of Depression in the
Elderly
• Depression in the elderly is associated with
– Poor physical health
– Medications that aggravate existing depression
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•
•
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Antihypertensive medications
Hormones
Corticosteroids
Antiparkinsonism medications
– Stressors
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.12
Anxiety Disorders in the Elderly
• Anxiety disorders are more common than
depression in the elderly
– Anxiety per se is quite common in the elderly
• Anxiety is associated with
– Medical illness or anticipation of illness
– Medication reactions
– Delirium accompanying illness
– Cardiovascular conditions (angina)
– Caffeine consumption
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.13
Schizophrenia in the Elderly
• Prevalence of schizophrenia is lower in the elderly
than in the young
– Schizophrenics die young
– Some schizophrenics show remission of their
symptoms as they enter old age
– Schizophrenia rarely has an onset after age 60
• Paraphrenia is the term used to characterize the
onset of schizophrenic symptoms in an older
person (more hallucinations and delusions)
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.14
Substance-Related Disorders
• Substance abuse is less prevalent among
the elderly than the young
– Alcohol abuse can have onset in the elderly
• Tolerance for alcohol is reduced in old age
• Older people metabolize alcohol more slowly
– Illegal drug abuse is expected to increase
among the elderly
– Medication misuse occurs in the elderly
• The elderly are 13% of the population but receive
33% of the legal prescriptions
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.15
Sleep Disorders
• Insomnia is a common (25%) sleep problem
in the elderly
• Other common sleep problems include
– Frequent awakenings at night
– Early morning awakenings
– Difficulty following asleep
– Daytime fatigue
• Elderly show reduced sleep time and less
time spent in REM sleep
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.16
Treatment of Sleep Disorders
• Older adults use a variety of medications to
treat sleep disorder and each have
associated problems:
– Sleeping pills lose their effectiveness and
cause sleep disorder (REM rebound sleep)
– Tranquilizers have adverse side effects such as
disruption of learning and reduced thought
clarity during the following day
– Alcohol reduces REM sleep
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.17
Suicide
• Older people are more likely to experience suicide
risk factors such as illness, social isolation, loss of
loved ones and financial pressure
• Suicide rates increase for men as they age and
decrease slightly for women
• Older people are less likely to communicate
suicidal intent and are more successful in their
suicide attempts
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.18
Sexuality
• Older people can maintain an active sex life
• Changes in sexuality in the elderly include
– Older men require longer to acquire an erection
• Erections fade more quickly after ejaculation
• Refractory period lengthens in elderly men
– Older women require more time to become
sexually aroused
• Vaginal lubrication is less in older women
• Older women return more quickly to a non-aroused
state
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e
Ch 16.19
Copyright
Copyright 2000 by John Wiley & Sons, New York, NY. All
rights reserved. No part of the material protected by this
copyright may be reproduced or utilized in any form or by
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and retrieval system, without written permission of the
copyright owner.
© 2000 John Wiley & Sons, Inc.
Davison and Neale: Abnormal Psychology, 8e