PSYCHIATRIC- MENTAL HEALTH NURSING ●​ Tolerance of uncertainty

INTRODUCTION ●​ self- esteem

UNIT I. FOUNDATIONS OF PSYCHIATRIC MENTAL- HEALTH NURSING ●​ reality orientation

Difference Between Psychiatric and Medical-Surgical Nursing ●​ mastery of environment

●​ Physical efforts prove to students that they are working and ●​ stress management

accomplishing something. In psychiatric nursing, one has to be INFLUENCES ON MENTAL HEALTH

psychologically active ,but physically passive much of the time. Biological factors

●​ It takes some time to realize that LISTENING to what aches in the ●​ Biological makeup

hearts of patients may touch them more profoundly than back rub. ●​ Sense of harmony in life

DEFINITION OF HEALTH ●​ Emotional resilience/ hardiness

●​ A state of complete physical, mental, and social well-being without the ●​ Spirituality

absence of disease or infirmity” - WHO ●​ Positive identity

DEFINITION OF MENTAL HEALTH Social and Cultural factors

●​ The successful performance of mental function, resulting in ●​ Sense of community

productive activities, fulfilling relationships, and the ability to ●​ Access to adequate resources

adapt to change and cope with adversity” - USDHHS, 1999 ●​ Intolerance of violence

DEFINITION OF MENTAL HEALTH ●​ Support of diversity among people

●​ A state of emotional, psychological, and social wellness evidence by Interpersonal factors

satisfying interpersonal relationships, effective behavior, and ●​ Effective communication

coping, positive self-concept, and emotional stability. ●​ Ability to help others

ELEMENTS OF MENTAL HEALTH ●​ Intimacy

●​ Self-governance ●​ Balance of separateness and connection

●​ Progress toward growth or self-realization

Psychopathology
➔​ Witches were in league with the Devil
●​ Psychopathology examines the nature and development of abnormal
➔​ Torture was required to elicit “confessions” of witchcraft;
Behavior, Thoughts, and feelings
death by fire was required to drive out supposed demons
●​ Definitions of abnormality vary widely and may not capture all aspects
Asylums
of psychopathology

●​ Psychopathological aspect (causes, mechanisms) ●​ Asylums were created in the 15th century for the care/treatment of

the mentally ill.

●​ Clinical aspect (assessment, treatment)

➔​ Asylums were meant to be a place of refuge

Early Views of Psychopathology
➔​ Care and treatment within an asylum were not always
●​ Demonology (Supernaturalism) is the view that abnormal mental
humane or effective
function is due the occupation by an evil being of the mind of a
●​ Pinel (1793) advocated for humane treatment of patients in asylums
person
(moral treatment”
➔​ Treatment requires exorcism
➔​ Removed shackles, improved diet, better treatment
●​ Somatogenesis is the view that disturbed body function produces
MODERN APPROACHES TO MENTAL ILLNESS
mental abnormality

●​ Psychogenesis is the belief that mental disturbances has ●​ Systems of classification were developed, which argue that mental

psychological origins illness has a biological cause

DEMONOLOGY DURING THE DARK AGES ➔​ Kraepelin suggested that clusters of symptoms form a

syndrome
●​ The Dark Ages were marked by a decline in Greek and Roman
➔​ Each syndrome has its own unique cause, course,
civilizations and by an increase in the influence of churches
symptoms, treatment, and outcome.
●​ Church authorities came to view witchcraft as an explanation of

abnormality
 ●​ “A Mind That Found Itself”, which chronicled his struggle with mental

illness and the hepatic encephalopathy and other conditions he and

millions of others ensured in mental institutions

●​ Created the National Committee for Mental Hygiene, later the National

Mental Health Association

Sigmund Freud

●​ An Austrian neurologist

●​ The founder of Psychoanalysis, a clinical method for treating

psychopathology through dialogue between a patient

Emil Kraepelin

●​ A German psychiatrist

●​ Founder of modern scientific psychiatry, psychopharmacology, and

psychiatric genetics

●​ Believed the chief origin of psychiatric disease to be biological and

genetic malfuntion.

Hildegard Peplau

●​ The “mother of psychiatric nursing”

Who’s who in Psychiatry?
●​ Introduced the “nurse-patient relationship.”
Benjamin Rush
●​ Pioneer in the development of the theory and practice of psychiatric
●​ The father of American Psychiatry was the first to believe that mental
and mental health nursing
illness is a disease of the mind and not a “possession of demons.”
➔​ Therapeutic communication
Clifford Beers

●​ Sparked the mental health reform movement in 1908

PROBLEMS IN TREATING MENTAL ILLNESS Awareness of Environment

●​ Cost-related issues ●​ Includes recognition of client needs, beliefs, systems, and

●​ Stigma behaviors, identification of the factors that contribute to health

●​ Revolving door treatment and illness in the client, and assessment of resources available to

●​ Lack of parity the client.

●​ Limited access to services Johari’s Window

METHODS OF ACHIEVING OPTIMAL CARE FOR MENTAL ILLNESS

●​ Beyond response to recovery

●​ Reintegration into society

●​ Mental health parity

●​ Culturally competent care Awareness of Interactions with the Environment

●​ Medication adherence Nurses identify their:

PSYCHIATRIC-MENTAL HEALTH NURSING ●​ Specific feelings and thoughts about clients (including feelings of

➔​ “The diagnosis and treatment of human response to actual or potential acceptance or rejection)

mental health problems” ●​ Evaluate the consequences of their actions toward clients

●​ Nursing Process and Standards of Care ●​ Learn to effectively differentiate between their own needs and client's

●​ Levels of Practice needs

●​ Guiding Principles

●​ Role of the Psychiatric Nurse as a Team Member ★​ An interpersonal process

PERSONAL PHILOSOPHY ISSUES ★​ Employing theories of human behavior as its science and purposeful

Self-Awareness use of self as its art

●​ The NURSE gains recognition of his/her own feelings, beliefs, and ★​ The major therapeutic goal is the prevention, detection, and

attitudes. rehabilitation of psychiatric disorders.

 ➔​ Emphasis on the “interpersonal process and relationships.” ●​ View the client’s behavior as designed to meet a need or to

➔​ Most fundamental goals: To help the patient accepts himself, communicate a message

to improve his relationship with other people and to learn to ●​ Potential for establishing relationship with clients

function independently on a realistic basis ●​ Quality of the interaction

●​ View the client’s behavior as the best possible adaptation

NURSING ROLES

●​ Ward Manager

●​ Social Agent

●​ Counselor

●​ Teacher

●​ Mother Surrogate

Other Terms Used For Psychiatric Nursing: ●​ Technical Role

●​ Psychosocial Nursing ESSENTIAL QUALITIES OF THE PSYCHIATRIC-MENTAL HEALTH NURSE

●​ Institutional Nursing ●​ Therapeutic use of Self

●​ Mental Health Nursing ●​ Genuineness and Warmth

Self as a Therapeutic Tool ●​ Empathy

●​ The nurse uses herself in order to affect positive changes in the ●​ Acceptance

patients’ behavior ●​ Maturity and Self-Awareness

PRINCIPLES OF PSYCHIATRIC NURSING THE MENTAL HEALTH TEAM

●​ View the client as a holistic being ●​ Nurse

●​ Focus on the client’s strengths and assets, not on his weaknesses ●​ Social worker

and liabilities ●​ Clinical Psychologist

●​ Accept the client as a human being who has value and worth ●​ Psyhiatrist
●​ Physician

●​ Occupational Therapist

●​ Recreational Therapist

●​ Psychiatric Aide/ Clinical Assistant

LEGAL & ETHICAL ISSUES IN PSYCHIATRIC NURSING Criteria for Court-Ordered Treatment

INTRODUCTION ➔​ Need has been clearly established

●​ Nurses are constantly faced with the challenge of making difficult ➔​ Patient poses danger to himself or others

decisions regarding good and evil or life and death. ➔​ Physician and treatment team demonstrate need for continued

●​ Nurses must know the legal and ethical issues regarding care of the inpatient treatment

mentally ill. Right of Minors

RIGHTS OF THE MENTALLY ILL ●​ Legal responsibility must be established immedaitely (Parent)

Right to treatment ●​ Conservatorship

●​ How treatment must be given Right to Informed Consent

➔​ By adequate staff ●​ Admitting the provider’s responsibility

➔​ In least restrictive setting ●​ The nurse should refuse to participate in procedures for which

➔​ In privacy informed consent hasn’t been obtained.

➔​ In facility that provides a comfortable bed, adequate diet, and Right to Privacy

recreational facilities ​ Circumstances for disclosure of confidential information

➔​ With patient’s informed consent before unsual treatement ●​ Suspected drug abuse

➔​ With payment for work done in facility, outside of program ●​ Criminal cases

activities ●​ Government requests

➔​ According to individual treatment plan ●​ When publich has a right to know

★​ Nurses have a duty to ensure that the patient knows what treatment he ●​ Is the patient at imminent risk to himself or others

needs and how he’ll get it, to help prepare him for eventual discharge. DUTY TO WARN THIRD PARTIES

Right to Refuse Treatment ●​ Is the client dangerous to others?

●​ A patient can’t be kept in a hospital against his will, nor can he be ●​ Is the danger the result of mental illness?

denied the right to refuse treatment ●​ Is the danger serious?

 ●​ Are the means to carry out the threat available? Involuntary/ Mandatory Outpatient Treatment

●​ Is the danger targeted at identifiable victims? ●​ Involves treatment mandated by a court order

●​ Is the victim accessible? ●​ This option has been used as DEINSTITUTIONALIZATION has

Reproductive and Sexual Rights progressed.

●​ Right to marry Conditions

●​ Right to have children a.​ Substance-impaired individuals

●​ Right to use contraception or sterilization if desired b.​ Homeless mentally ill persons

●​ Right to follow a lifestyle of their own choosing c.​ Sex offenders

TYPES OF ADMISSION KEY LEGAL CONCEPTS

Voluntary Admission Confidentiality

●​ The client willingly enters and consents to treatment ●​ Client information is considered privileged

●​ Clients retain all of their civil rights and may discontinue treatment Informed Consent

whenever they choose ●​ Ensures that he received adequate information about his care and

●​ If the treatment team disagrees witha client’s decision treatment, the treament prior to his consenting to treatment.

client signs a form acknowledging that he has been discharged AMA, Right to Refuse Treatment

or the treatment team may decide to seek involuntary commitment of ●​ All clients (including those committed involuntarily)

the client. ●​ In emergency situations, a client can be given medication or confined

Involuntary Inpatient Commitment by seclusion or restraints.

●​ The client is institutionalized against his will Client Incompetence

Conditions ●​ The inability to legally make decisions regarding one’s health care,

a.​ Those who pose a threat to self or others finance, and property.

b.​ Those who lack the capacity for meeting basic needs ●​ A legal guardian is appointed by the court to make decisions for him.

c.​ Those who are seriously mentally ill but fail to seek treatment
Seclusion & Restraint ➔​ OFFERING MEDICATIONS

●​ Methods of preventing a client from harming himself or others during a ●​ When initial measures fail or are inappropriate → client may be

violent outburst involuntarily confined (secluded) in a room/ area to prevent him from

●​ Both methods are regulated by specific legal and ethical guidelines physically leaving.

➔​ The guiding principle of managing client acting-out behavior is

the use of LEAST RESTRICTIVE MEAURES M’Naghten Rule (Defense of Insanity)

CRITERIA FOR URING RESTRAINTS ●​ The person accused of the crime is NOT GUILTY because the person

●​ Examination of patient by physician to determine need cannot control his/her actions or cannot understand the wrongfulness

●​ Written physicain’s order that’s place in patient;s medical record before of the act.

restraints are applied ●​ Used only 0.9% (9 in 1000) of all criminal cases and is successful in

●​ Application of restraints for specified duration 20% of those cases.

NURSING IMPLICATIONS ETHICAL PRINCIPLES

●​ Monitored 1:1 for the first hour Autonomy

●​ Monitors & documents the client’s skin condition, blood circulation in ●​ The client’s freedom to make choices about his life.

hands & feet, and emotional well–being ●​ E.g. Making decisions for himself

●​ Monitors for side-effects of medications Beneficence

●​ Implements & documents offers of food, fluids, and also opportunities ●​ Acting in ways that benefit the client

to use the bathroom ●​ “To do the most good for the patient.”

LEAST RESTRICTIVE MEASURES? ●​ E.g., Resuscitating a drowning victim

●​ The nurse attempts to calm the client before advancing to Nonmalificience

interventions that require seclusion or restraint. ●​ Acting in a manner to avoid causing harm to the client. “Do no harm.”

➔​ LIMIT SETTING ●​ E.G., avoiding negligent care of a patient

➔​ VERBAL INTERVENTIONS
Veracity

●​ Nurses must not withhold the whole truth from clients, even when it

may lead to patient distress

Confidentiality

●​ Nondisclosure of information with which one is entrusted

Justice

●​ Acting out in a fair, equitable, and appropriate manner

Fidelity

●​ Faithfulness and the practice of keeping promises

THEORETICAL CONTRIBUTIONS SIGNIFICANT TO ●​ Shaped by experience and environment

PSYCHIATRIC-MENTAL HEALTH NURSING E.g., A boy raised by wolves is NOT human

Personality Nature vs. Nurture

●​ Individual differences STAGES OF PERSONALITY DEVELOPMENT

●​ Consistent and enduring ●​ Personality is determined by what happens to us as we pass through

●​ Formed in childhood (child is father to the man) each stage

●​ Can alter, but usually only due to extreme trauma ●​ Personalities often display traits associated with developmental stages

●​ Exhibited by behaviour where traumatic incidents occurred

Behaviour is also influenced by: ●​ Can sometime sbe used for rough segmentation

●​ Needs ●​ People often regress to previous stages at times of stress or anxiety

●​ Past experienced Intrapersonal Theory

●​ Attitudes ●​ Focuses on behaviours, feelings, thoughts, and experiences of each

●​ Perception individual

●​ Current situation Sigmund Freud

●​ Social pressures ●​ Aspects of consciousness (Conscious, preconscious, unconscious)

●​ As well as personality ●​ Components of personality (Id, ego, superego)

Hereditary gives ●​ Anxiety as a feeling of tension, distress, and discomfort produced by a

●​ Ability to learn and learn language perceived or threatened loss of inner control

●​ Intelligence ●​ Defense mechanisms- alleviates anxiety by denying, misinterpreting,

●​ Tendency to the production of some hormones or distorting reality; for the most part, these operate at an unconscious

Heredity level

●​ A base built on environmental factors ●​ Psychosexual Theory of Growth & Development

●​ We inherit potential
STRUCTURE OF PERSONALITY ●​ The “over-I” over ego

●​ Perfection principle

URGES BLOCKED BY SUPEREGO

Sublimate - find another outlet for the energy (kick a tree)

Rationalize - find an excuse to do it anyway

Repression - deny but the pressure finds outlet in

●​ Dreams

Id ●​ Slips of the tongue

●​ Basic psychic energy and motivations ●​ Funny hehaviour

●​ Operates to demands of Pleasure Principle- strive to satisfy desires ●​ Mental breakdown

and reduce inner tension Ego Ideal

●​ Locus of instinctual drives ●​ A chold that is consistently rewarded for “good behavior”, the

●​ Impulsive and irrational self-esteem and the behavior becomes part of the ego-ideal.

Ego Conscience

●​ Deals with real world ●​ A child that is consistently punished for “bad behavior”,forms a

●​ Operates to demans of Reality Principle solves problems by planning conscience with can generate a feeling of guilt

and acting ➔​ Important !!! because it assist the ego in the control of id

●​ Begins to develop between 4-6 y.o. impulses

●​ Primary function is mediator to maintain harmony among the external ➔​ Strict supergo → rigid, compulsive, unhappy person

world, the id, and the superego. ➔​ Weak, Defective → antisocial behavior, hostility, anxiety, guilt

Superego

●​ Internalized social norms and moral forces pressing on and

constraining individual action

TOPOGRAPHY OF THE MIND ●​ He emphasized that a child’s personality is formed by the ways which

Conscious his parents managed his sexual and aggressive drives.

●​ Memories that remain within the individual’s awareness, under the ●​ Freud sees people as passive; behvaiors determind by interactions of

control of the ego external reality and internal drives

Preconscious ●​ Psychic Determinism: all behaviors driven by antecedent events,

●​ Not present in the awareness, but can be recalled, under the control of experiences. There are no accidents; nothing happens by chance

the superego ●​ Libidinal (Sexual, aggressive) instincts drive people

➔​ Suppression ➔​ In children “libido” isn’t purely sexual, it’s pleasure thru

Unconscious sensations (oral, anal, gratification, etc.)

●​ Unable to bring to consciousness ●​ Behavior results from conflicts:

➔​ Largest level ➔​ Between instinctual libidinal drives (Aggression, sex) and

➔​ Represson efforts to repress them from consciousness)

➔​ Dreams and incomprehensible behaviour Psychosexual Theory

➔​ Parapraxes- slips of the tongue ●​ Children pass through a series of age-dependent stages during

Psychic Energy development

●​ Each stage has a designated “pleasure zone” and “primary activity”

●​ Each stage requires resolution of a particular conflict/ task

Oral Stage

➔​ Birth to 18 months

●​ Pleasure Zone: Mouth

Sigmund Freud - Psychosexual Theory ●​ Primary Activity: Nursing

●​ Was based on his therapy with troubled adults ●​ Fixation results in difficulties with trust, attachment, and commitment
 ●​ Fixation may also manifest as eating disorders, smoking, drinking ●​ Sophocles' story (5th century B.C., tragedy)

problems ●​ King of Thebes

➔​ Greatest need: Security ●​ Parents: Laius & Jocasta

➔​ Greatest fear: Anger, Anxiety ●​ Freud saw the myth enacted in every family (although on a

Anal Phase less dramatic scale)

➔​ 18 months - 2 years ●​ Oedipus acted out a wish that everyone has in early

●​ Pleasure Zone: Anus childhood.

●​ Primary Activity: Toilet training ​ Oedipal Conflict

●​ Failure to produce on schedule arouses parental disappointment ●​ Boys want to marry mom and kill father, aka Oedipal

➔​ Greatest need: Power Complex, but fear retaliation from father (Castration anxiety);

●​ Parental disappointment, in turn, arouses feelings in child of anger and ultimately resolved through identification with father

aggression towards caregivers, which are defended against ●​ Girls have penis envy, want to marry dad, aka Electra

●​ Fixation may result in either: Complex; identity with mom to try to win dad’s love

➔​ Anal retentiveness: perfectionism, obsessive- compulsive ➔​ Resolution of the Oedipal Conflict results in the formation of the

tendencies Superego

➔​ Anal expulsive: sloppy, messy, disorganized ➔​ Fixation results in attraction to unattainable partners

Phallis (Oedipal) Phase Latency Phase

➔​ Ages 3-6 ➔​ Ages 6-11

●​ Pleasure Zone: Genitals ●​ Pleasure Zone: Sex drive is rerouted into socialization and skills

●​ Primary Activity: Genital fondling development

●​ Must successfully navigate the Oedipal Conflict ●​ Primary Activity: Same sex play; identification of sex roles

Oedipal Complex ●​ Don’t like the opposite sex (has “cooties”)

●​ Greek mythological figure, Oedipus

 ●​ Fixation results ina lack of initiative, low self esteem environmenytal
Intimacy vs. Isolation Young adulthood
incompetence
Generativity vs. Stagnation Middle adulthood
Genital Phase

➔​ Ages 13- young adulthood

Integrity vs. Despair The elderly
●​ Pleasure Zone: Genitals

●​ Primary Activity: Adult sexual relationship

●​ Fixation results in regression to an earlier stage, a lack of sa ense of

self

Erik Erikson

●​ Psychosocial Theory

●​ Expanded on Freud’s theories

●​ Believed that development is life-long

●​ Emphasized that at each stage, the child acquired attitudes and skills

resulting from the successful negotiation of the psychological conflict.

Identifies 8 stages:

Basic trust vs. Mistrust Birth - 1 year

Social - Interpersonal Theory

Autonomy vs. Shame and Doubt Ages 1 - 3
●​ Focus is on relationships and events in the social context
Initiative vs. Guilt Ages 3 - 6
➔​ Harry Stack Sullivan

●​ Personality could not be observed apart from interpersonal relationship

Industry vs. Inferiority Ages 6 - 11
●​ Identified three principal components of the interpersonal sphere:
Identity vs. Identity Confusion Adolescence
Dynamisms, Personifications, and Cognitive Processes
Infancy ➔​ Pre-adolscence (11 - 12)

●​ Self- concept is developed ●​ Intimacy

●​ “Good Me”, “Bad Me” ●​ Chum relationship

●​ Type of play: Solitary ●​ Learns to put other need of his need

Toddlerhood Adolescence (12- 18)

●​ Negativistic ●​ Establish a relationship with the opposite sex

●​ Active, mobile, curious (vulnerable to accidents) ●​ Sexual urges= LUST

●​ Temper tantrums ●​ Heterosexual relationship

●​ Type of play: Parallel Early Adulthood (20 - 40)

Pre-Schooler ●​ Intimacy + Lust = Heterosexual relationship

●​ Love to watch adults and imitate their behaviors Jean Piaget: Cognitive Development

●​ “Why?” ●​ French psychologist, philosopher, naturalist

●​ Tell lies, brag, and boast in order to impress ●​ One of the creators of child psychology, known for his studies on the

●​ Imaginary playmates development of intelligence in children

●​ Offensive language Theory of Cognitive Development

●​ Sex questions ●​ Primarily deals with how the mind, personality, and intelligence from

●​ Associative or Cooperative Play birth to death.

Schooler ●​ Sensorimotor

➔​ Juvenile Era (6-10) ●​ Pre-operational thought

●​ Period of gang loyalties ●​ Concrete operations

●​ Important interpersonal tools ●​ Formal operations

➔​ Ability to complete

➔​ Ability to compromise
 Concrete Operational Period

●​ Ages seven to eleven

●​ Children perform operations only on images of tangible objects and

actual events

●​ Children master

Sensorimotor Period ➔​ Reversibility

●​ Birth to age two ➔​ Decentration

●​ Developing the ability to coordinate sensory input with motor actions Formal Operational Period

●​ Object permanence is key in this transition ●​ Begins at eleven years

●​ Object permanence- recognition that objects exist even when no ●​ Children begin to apply their operations to abstract concepts in

longer visible addition to concrete objects

Assimilation

●​ The process of using or transforming the environment so that it can be

placed in preexisting cognitive structures

Accomodation

●​ The process of changing cognitive structures in order to accept

something from the environment

Preoperational Period B.F. Skinner

●​ Ages two to seven ●​ Proposed that children “operate” on their environment, operational

●​ Improvement in their use of mental images conditioning

●​ Conservation- the awareness that physical quantities remain constant ●​ Believed that learning could be broken down into smaller tasks, and

despite changes to shape or appearance that offering immediate rewards for accomplishments would stimulate

further learning.
Classical Conditioning
THE HUMAN BRAIN ●​ Can instinctly read others' emotions, and respond friendly by natures.

Although not very into taking initiatives in moving forward, but this

person will always take a step back in supporting others. Stable

personality and considerate, give others a being protected feeling. But

the weakness is they cannot say no; regardless how unwilling they

are, they will take care of others.

Right - Right

●​ Loves challenges type

Are you Left or right brain? ●​ Straightforward. Once they decided on one thing, will take action right

See if you are using your left or right brain? away.

●​ First, identify yourself as right or left-brain person: ●​ Very curious, and love challenges. Dare to face dangers without

1.​ Hold your hands together, as if you were praying thinking through (Sometimes foolishly). Their weakness is they don’t

Look at your hands. If you see listen to others, will filter in only what they want to hear in a

Left thumb is below the right thumb → Left brain conversation, and very subjective.

●​ However, because of their straightforward attitude, they tend to be

Right thumb is below the left thumb → Right brain
fairly popular.
2.​ Fold your arms in front of you (as if you are angry)
Left - Left
Right arm above left arm → left brain
●​ Dedicated, cold, perfectionist
Left arm above right arm → right brain
●​ Very logical in all aspects. The only way to defeat (or win over) him/her
Based on 1 + 2 (order important), below is the interpretation of your is through reason. Has a lot of pride, and feeling strongly about doing
personality. the right thing. If they are your friends, they are very trustworthy.
Right - Left However, if they are your opponents, they will be very tough to deal
●​ Considerate, traditional, indirect type
 with. Because they can be very “anal” as a perfectionist, they usually

leave a bad impression of being hard to deal with when first met.

Left - Right

●​ Likes to tackle care of others, leader type

●​ Has a cool and keen observation ability to see through situations, yet

still can be considerate in other needs. Because of their cool and calm

nature, and strong sense of responsibility, they tend to become hthe

ead of a group Electroencephalogram (EEG)

●​ Popular among people. However, they may not be able to help ●​ An amplified recording of the waves of electrical activity that sweep

themselves in meddling because they want to take care of others too across the brain’s surface

much. ●​ These waves are measured by electrodes placed on the scalp

CT (computed tomography) Scan

●​ A series of X-ray photographs taken from different angles and

combined by computer into a composite representation of a slice

through the body; also called a CAT scan

PET (positron emission tomography) Scan

●​ A visual display of brain activity that detects where a radioactive form

of glucose goes while the brain performs a given task

MRI (magnetic resonance imaging)

●​ A technique that uses magnetic fields and radio waves to produce

computer- generated images that distinguish among different types of

soft tissue; allows us to see structures within the brain.

 Neurotransmitter Function Examples of Malfunctions

Acetylcholine (ACh) Enables muscle action, Undersupply, as ACh-

learning, and memory producing neurons deteriorate,
marks Alzheimer’s disease

Dopamine Influences movement, Excess dopamine receptor

learning, attention, and activity linked to schizophrenia;
emotion starved of dopamine, the brain
produces the tremors and
decreased mobility of
parkinson’s disease

Serotonin Affects mood, hunger, Undersupply linked to

sleep, and arousal depression; Prozac and some
other antidepressant drugs
raise serotonin levels

Norepinephrine Helps control alertness Undersupply can depress

and arousal mood

GABA A major inhibitory Undersupply linked to

(gamma-aminobutyri neurotransmitter seizures, tremors, and
c acid) insomnia.

Glutamate A major excitatory Oversupply can overstimulate

neurotransmitter the brain, producing migraines
involved in memory or seizures (Which is why
some people avoid MSG,
monosodium glutamate, in
food)