11. Declarative memoryPoor cognitive function has also been linked with acute psychotic symptoms in patients with BPD (Glahn et al.) It is hypothesized that these changes may be driven by motivational changes (increased pleasure seeking) this has also been described as increased focus on potential gains rather than losses(Yechiam et al.)
12. Impaired Cognition A study conducted by Glahn, et. al, found patients with BPD had impaired Speed of processing Attention Executive functioning Working and declarative memory These findings suggest that BPD involves and impairs multiple brain systems (Glahn et al.)
13. Impaired Cognition cont. Glahn, et. al, found 75% of BPD patients performed more than 1 standard deviation below healthy volunteers on various levels of cognition Greatest effects were seen in the speed of processing BPD patients were also found to make increasingly random and erratic choices compared to control patients (Yechiam et al.) Patients with acute BPD had a low choice consistency—they made more erratic choices
14.
15. Although these behaviors are hard to define, it has been noted that manic patients have the following risky behaviors:
26. Little STI protection was used – more than half reported no use of condoms during their last 5 sexual acts (King)BPD patients, in some cases, have been found to express hypersexuality, which may augment their risk taking behavior (King) The addition of drug use to hypersexuality further exploits a BPD patient’s risk-taking behavior
27.
28. Sleep deprivation has been found to decrease the global brain activity and slow cognitive processes,
40. It was noted in one article, “patients in a manic state often believe they have unlimited financial resources” (Leahy)
41. Thus, patients with BPD are oversensitive to rewards of gambling/spending without financial means to recover from losses
42.
43.
44.
45.
46.
47. Serotonin plays a large role in mood regulation. It was suggested that hyperactivity of serotonin may play a role in mania and hypoactivity may play a role in depression. (Applebaum et al.)
48. In animals, ingestion of tryptophan free amino acid mixtures rapidly reduced plasma tryptophan levels without directly affecting other neurotransmitters (Applebaum et al.)
59. Clozapine**These may all have value in animal models as their use in humans is becoming increasingly more common**
60.
61. Lithium has well established efficacy for the prevention of mania and, to some extent, depression.(Alda et al.)
62. In rats and mice, lithium administration has been shown to attenuate amphetamine induced hyperactivity. (Willson)
63.
64. Valproate is less validated for preventing manic symptoms than lithium.(Alda et al.)
65. In rats and mice, Valproate has been shown to as an effective pre-treatment for attenuation of hyperactivity (Willson).
66. In humans, valproate has been shown to significantly attenuate amphetamine induced energy, happiness, and alertness (Willson)
67.
68. Antipsychotics have had mixed results in terms of attenuation of amphetamine-induced mania, but should not be discounted from future studies
69. Because of the link between serotonin and mania, administering a tryptophan free diet may provide an alternate way to attenuate manic-like symptoms
70.
Notas del editor
Bpd-oscillating depression and maniaFor the purposes of risk-taking, I will focus on mania
Euthmic patients are defined as those not manic or depressed…..the happy medium
this is important because it escillates the difficulty we have in treating bpd/risk taking without impacting other systems
From this we can determine that they have greater difficulty with clear thinking, and thus may engage in risky behavior
Physical-not needing to wear a coat in winter, belief that they can fly, believing they can drive their car into ongoing traffic Mental-receiving messages from television, ability to control the minds of others
It should be noted that these patients have various disorders, schz, bpd, mania, ~40% had an affective disorder
Impaired cognition may be a way of mimicing what manic patients experience
![Negative Symptoms Surrounding Bipolar Disorder (BPD) ,[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)