Neuropsychology and Addiction – The Brain, Drugs, and Psychiatric Disorders

Many people with mood disorders and brain damage turn to drugs and alcohol. Sometimes, as in the case of Korsakoff’s Syndrome, alcohol can actually cause brain damage. Korsokoff’s Syndrome for example is thought to be a Temporal Lobe disorder that results in confabulation and irreversible brain damage. The treatment for Korsokoff’s Syndrome is a regiment of Thiamine, but some do not ever recover.

Brain damage and brain abnormalities in certain regions of the brain can cause psychiatric disorders that may lead to drug and/or alcohol abuse. For example, it has been discovered through research that schizophrenic brains weigh less than average, have enlarged ventricles, have a reduction in the number of neurons in the prefrontal cortex, and abnormal cellular structure in the prefrontal cortex and hippocampus. Neurochemically, it is thought that the brains of schizophrenics have abnormal dopaminergic functioning. One of the illegal drugs that is often associated with dopamine is methamphetamine. In fact, methamphetamine produces schizophrenic symptoms, which is one of the reasons why schizophrenia is thought to be related to the dopaminergic system. Antipsychotic are medications that act on the brain’s dopamine synapses and help reduce psychotic symptoms. Sometimes people who enter drug and alcohol treatment with amphetamine induced psychosis will be prescribed antipsychotics to help lessen their symptoms. Eventually people with amphetamine induced psychosis will be able to discontinue the medications, but some do not. Amphetamine induced psychosis often wears off after cessation of the drug.

In people with clinical depression, it has been found that there is decreased activity in the dorsolateral and medial prefrontal regions of the brain. This can cause a reduction in memory and attention. In people with clinical depression the sleep cycle can be disrupted as well, thought to be caused by lowered serotonin levels in the brain. Sometimes people may attempt to compensate for the decrease in serotonin levels in their brain by taking drugs or drinking alcohol to help offset their depressive symptoms or help them sleep.

In people with bipolar disorder, it has been found that there is a decrease in the gray matter in the temporal lobe and cerebellum. The decrease in gray matter is thought to directly correlate to the number of bipolar episodes. It is also hypothesized that people with bipolar disorder actually change their own brain each time they have an episode, causing symptoms to become worse as time goes by. Often bipolar patients will self-medicate by using illicit drugs. The type of drug, or direction of the drug (i.e., uppers or downers) varies, but most tend to prefer upper drugs as opposed to downer drugs. This helps mimic the more desirable manic stage of bipolar disorder. During manic phases it has been found through PET scans that bipolar patients exhibit an increase in blood flow to the subgenual area of the brain.

One of the best ways to determine whether or not a person’s psychiatric disorder or diminished mental functioning is due to drugs and/or alcohol is through a neuropsychological test battery. The most common of the neuropsychological test batteries is the Halstead Reitan Neuropsychological Test Battery. The Halstead-Reitan neuropsychological test battery is a fixed set of eight tests used to evaluate brain and nervous system functioning in individuals aged 15 years and older. Neuropsychological functioning refers to the ability of the nervous system and brain to process and interpret information received through the senses. Another commonly used way of determining neurological brain damage is called the Boston Process Approach developed by Edith Kaplan. Edith Kaplan, a renowned neuropsychologist, developed her own neurological testing battery which borrows from a number of testing instruments used in both neuropsychological testing.

Since neuropsychological testing is a specialized subset of psychological testing, it is vital that the testing be conducted by a trained/qualified neuropsychologist and not merely a psychologist familiar with neuropsychological testing. All psychologists are familiar with neuropsychological testing batteries, but only a specifically trained and licensed neuropsychologist should be used to conduct a full and proper neuropsychological test battery.

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