Take Test: Module 6 Knowledge Check Question 1 1. A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 1 of 4: Describe the positive symptoms of schizophrenia and relate those symptoms to the case study patient. Question 2 1. A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 2 of 4: Explain the genetics of schizophrenia. Question 3 1. A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 3 of 4: The APRN reviews recent literature and reads that neurotransmitters are involved in the development of schizophrenia. What roles do neurotransmitters play in the development of schizophrenia? 1 points Question 4 1. A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 4 of 4: The APRN reviews recent literature and reads that structural problems in the brain may be involved in the development of schizophrenia. Explain what structural abnormalities are seen in people with schizophrenia. Question 5 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 1 of 6:Module 6 Knowledge Check Essay Discuss the role genetics plays in the development of bipolar 2 disorders. Question 6 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 2 of 6: Explain how the hypothalamic-pituitary-adrenal (HPA) system may be associated with bipolar type 2 disease. Question 7 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 3 of 6: Discuss the role inflammatory cytokines play in the development and exacerbation of bipolar type 2 symptoms Question 8 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 4 of 6: Discuss the role of the amygdala in bipolar disorder. Question 9 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 6 of 6: How does neurochemical dysregulation contribute to bipolar disorders? Question 10 1. A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 6 of 6: What is the current status of the use of nutraceuticals in management of depression? Question 11 1. A 27-year-old female presents to the Emergency Room, with a chief complaint of palpitations, rapid heart rate, sweating, tremors, and inability to catch her breath. The symptoms started about 10 hour ago and have gotten worse. She states she has some chest pain that remains constant no matter what. She also has numbness and tingling around her mouth and lips. She says she knows something “terrible is going to happen”. She denies having any similar episode in the past. Past medical history noncontributory. Social history significant for recent stressor of applying for medical school and taking the Medical College Admission Test (MCAT). She had not received the results prior to the episode but is sure that the failed the test. Says she doesn’t know if anyone else in her family has had similar episodes. Physical exam reveals a thin, anxious appearing female who is profusely sweating despite cool ambient air temperature. BP 176/88, Pulse 136, and respirations 26. Electrocardiogram negative for evidence of myocardial infarction and all lab data within normal limits except for mild respiratory alkalosis. The patient’s symptoms are subsiding and the patient states she is feeling better. The APRN suspects the patient has just experienced a panic attack. Question 1 of 2: What are panicogens and how do they contribute to the development of panic attack symptoms? Question 12 1. A 27-year-old female presents to the Emergency Room, with a chief complaint of palpitations, rapid heart rate, sweating, tremors, and inability to catch her breath. The symptoms started about 10 hour ago and have gotten worse. She states she has some chest pain that remains constant no matter what. She also has numbness and tingling around her mouth and lips. She says she knows something “terrible is going to happen”. She denies having any similar episode in the past. Past medical history noncontributory. Social history significant for recent stressor of applying for medical school and taking the Medical College Admission Test (MCAT). She had not received the results prior to the episode but is sure that the failed the test. Says she doesn’t know if anyone else in her family has had similar episodes. Physical exam reveals a thin, anxious appearing female who is profusely sweating despite cool ambient air temperature. BP 176/88, Pulse 136, and respirations 26. Electrocardiogram negative for evidence of myocardial infarction and all lab data within normal limits except for mild respiratory alkalosis. The patient’s symptoms are subsiding and the patient states she is feeling better. The APRN suspects the patient has just experienced a panic attack. Question 2 of 2: How does the GABA-benzodiazepine (BZ) receptor systems contribute to panic attacks/disorders? Question 13 1. A 21-year-old female college junior makes an appointment to see the APRN in the Student Health Clinic. The student tells the APRN that it has gotten harder and harder for her to attend classes, especially her history class where the class is preparing for the semester’s end presentations. She says she is terrified to speak to the class and is considering dropping the class so she will not have to present. She has a significant impairment in social activities and has resigned from her sorority. She is unable to go to the library to study as she feels everyone is looking at her and mocking her. She admits to having some of these symptoms in high school, but the guidance counselor was able to work with her to decrease some of her symptoms. Past medical history noncontributory except for the milder symptoms exhibited in high school. Family history noncontributory. Social history positive for anxiety related to social situations that has had a negative impact on both her scholarly and social endeavors. The APRN diagnoses the student with social anxiety disorder (SAD). Question 1 of 2: Describe the areas of the brain that are associated with social anxiety disorder. Question 14 1. A 21-year-old female college junior makes an appointment to see the APRN in the Student Health Clinic. The student tells the APRN that it has gotten harder and harder for her to attend classes, especially her history class where the class is preparing for the semester’s end presentations. She says she is terrified to speak to the class and is considering dropping the class so she will not have to present. She has a significant impairment in social activities and has resigned from her sorority. She is unable to go to the library to study as she feels everyone is looking at her and mocking her. She admits to having some of these symptoms in high school, but the guidance counselor was able to work with her to decrease some of her symptoms. Past medical history noncontributory except for the milder symptoms exhibited in high school. Family history noncontributory. Social history positive for anxiety related to social situations that has had a negative impact on both her scholarly and social endeavors. The APRN diagnoses the student with social anxiety disorder (SAD). Question 2 of 2: How is oxytocin associated with SAD? Module 6 Knowledge Check Essay Question 15 1. A 36-year-old female comes to see the APRN in clinic with a chief complaint of “I’m so and I feel all keyed up all the time”. She states she feels restless, keyed up, and on edge most of the time. She fatigues easily and has difficulty concentrating and says her mind goes blank. She admits to being irritable and snapping at her coworkers which she worries will affect her job. She says the symptoms have been present for about 8 or 9 months. and Increased muscle tension. She has had difficulty falling asleep or stay sleeping. Further questioning revealed that prior to her symptoms, her parents got divorced which has been a great stressor for her. Past medical history noncontributory. Social history positive for a case of “nerves” when she was in high school that seemed to resolve after she graduated from college. No drug or alcohol history. The APRN believes the patient has generalized anxiety disorder (GAD). Question 1 of 2: Discuss the role of neurotransmitters in the expression of GAD. Question 16 1. A 36-year-old female comes to see the APRN in clinic with a chief complaint of “I’m so and I feel all keyed up all the time”. She states she feels restless, keyed up, and on edge most of the time. She fatigues easily and has difficulty concentrating and says her mind goes blank. She admits to being irritable and snapping at her coworkers which she worries will affect her job. She says the symptoms have been present for about 8 or 9 months. and Increased muscle tension. She has had difficulty falling asleep or stay sleeping. Further questioning revealed that prior to her symptoms, her parents got divorced which has been a great stressor for her. Past medical history noncontributory. Social history positive for a case of “nerves” when she was in high school that seemed to resolve after she graduated from college. No drug or alcohol history. The APRN believes the patient has generalized anxiety disorder (GAD). Question 2 of 2: Explain the structural brain changes that occur in people with GAD. 1 points Question 17 1. A 27-year-old man comes to the Veteran’s Administration Hospital at the insistence of his fiancée who accompanies him to the appointment. She tells the APRN that her fiancée has not “been the same” since he returned from his second tour in Iraq. He was an infantryman with a local Marine Reserve unit and served 2 tours and was honorably discharged. Since his return, he has had difficulty sleeping, and says he “sleeps with one eye open” and fears sleep. Deep sleep brings vivid nightmares. He grudgingly admits to having experienced several traumatic events during his second tour of duty. He is unwilling to discuss them and will not reveal specific details. He is short tempered and irritable and is afraid to be around people as he doesn’t want to snap at people and alienate them. He startles easily at loud noises, especially the sounds of cars backfiring. He admits to thinking there are threats everywhere and spends an excessive amount of time searching for them but never finding any. He has intrusive memories almost every day and says he really isn’t interested in doing much of anything. He is very worried that these symptoms are irreparably hurting his relationship with his fiancée who he loves very much. The APRN diagnoses him with post-traumatic stress disorder (PTSD). Question 1 of 2: Describe the changes seen in the brain structure in patients with PTSD. Question 18 1. A 27-year-old man comes to the Veteran’s Administration Hospital at the insistence of his fiancée who accompanies him to the appointment. She tells the APRN that her fiancée has not “been the same” since he returned from his second tour in Iraq. He was an infantryman with a local Marine Reserve unit and served 2 tours and was honorably discharged. Since his return, he has had difficulty sleeping, and says he “sleeps with one eye open” and fears sleep. Deep sleep brings vivid nightmares. He grudgingly admits to having experienced several traumatic events during his second tour of duty. He is unwilling to discuss them and will not reveal specific details. He is short tempered and irritable and is afraid to be around people as he doesn’t want to snap at people and alienate them. He startles easily at loud noises, especially the sounds of cars backfiring. He admits to thinking there are threats everywhere and spends an excessive amount of time searching for them but never finding any. He has intrusive memories almost every day and says he really isn’t interested in doing much of anything. He is very worried that these symptoms are irreparably hurting his relationship with his fiancée who he loves very much. The APRN diagnoses him with post-traumatic stress disorder (PTSD). Question 2 of 2: Briefly discuss the role glucocorticoids may have on the development of PTSD. Question 19 1. A 17-year-old male high school junior comes to the clinic to establish care. He recently moved from a relatively urban area to a very rural area and has just started his junior year in a new school. The mother states that she has noticed that her son has been frequently washing his hands and avoids contact with any dirty or soiled object. He uses paper towels or napkins over the knob on a door when opening it. According to the mother, this behavior has just appeared since moving. The patient, upon close questioning, admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is worried about all the germs the boys are carrying around. Past medical history is noncontributory. Social history -lives with parents and 2 siblings in a house in a new town. Is an honors student. Based on these behaviors, The APRN thinks the patient has obsessive-compulsive disorder (OCD). Question 1 of 2: What is primary pathophysiology of OCD? Question 20 1. A 17-year-old male high school junior comes to the clinic to establish care. He recently moved from a relatively urban area to a very rural area and has just started his junior year in a new school. The mother states that she has noticed that her son has been frequently washing his hands and avoids contact with any dirty or soiled object. He uses paper towels or napkins over the knob on a door when opening it. According to the mother, this behavior has just appeared since moving. The patient, upon close questioning, admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is worried about all the germs the boys are carrying around. Past medical history is noncontributory. Social history -lives with parents and 2 siblings in a house in a new town. Is an honors student. Based on these behaviors, The APRN thinks the patient has obsessive-compulsive disorder (OCD). Question 2 of 2: Describe the role the dorsal anterior cingulate cortex (dACC) has in reinforcement of obsessive behaviors.
Question 1
One of the positive schizophrenia symptoms include hallucinations. Hallucination symptoms can be olfactory, visual, voices conversing, auditory, somatic-tactile, as well as voices commenting. Other symptoms originate from thought disorder and include incoherence, distractible speech, derailments, distractible speech, circumstantiality, and illogicality. This patient shows signs of disheveled appearance, auditory hallucinations, and persecutions.Module 6 Knowledge Check Essay
Question 2
Generally, the causes of schizophrenia are unknown. However, the predisposing factors can be perinatal or genetic. Evidently, a greater risk of schizophrenia is seen in biological relatives as opposed to the adopted ones. There is a 10% risk in first-degree relatives of people that suffer from schizophrenia. In cases where both parents suffer from schizophrenia, there is a 40% risk of their children suffering from it too in their childhoods.
Question 3
In the case of schizophrenia, the dopaminergic system is thought to have some abnormalities. Some of these drugs taken by mentally ill patients are structurally different. The antipsychotic ones lower the firing rates of mesolimbic dopamine D2 neurons. On the other hand, the psychotic ones stimulate these neurons. These two interactions may result into schizophrenia.
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Question 4
Based on the advanced neuroimaging studies, there is a difference in the brains of people suffering from schizophrenia and those who do not. From brain imaging, those with schizophrenia have a decreased brain volume, larger ventricles, and changes in the hippocampus.
Question 5
According to studies show that genetics plays a significant role in bipolar disorder. For instance, the first degree-relatives of a person with bipolar are about 7 times more likely to develop the disorder as compared to the rest of the population.
Question 6
The HPA system is known to play a vital role in the ability of an individual to cope with stress. When someone is chronically stressed, it induces the activation of the HPA system. At the same time, there is an increased level of glucocorticoid secretions. This is a common occurrence in people with bipolar disorder.Module 6 Knowledge Check Essay
Question 7
From various studies, it has been shown that there is a correlation between depressive and maniac episodes as well as a pro-inflammatory state that involves both the adaptive and innate immune system. Blood brain barrier (BBB) cells, through active transport, can transport cytokines. In turn, inflammatory cytokines end up activating microglia in the brain thereby making them to increase their inflammatory response. This is does by releasing cytokines, chemokines, and reactive oxygen. I turn, bipolar type 2 symptoms are created.
Question 8
The brain amygdala plays a role in modulating anxiety and fear. Anxiety disorder patients tend to show an increased response of the amygdala to cues of anxiety and stress. When the amygdala is hyperresponsive, this is related to a reduction in the activation of thresholds towards response to threats.
Question 9
According to the monoamine theory of depression, depression is associated with reduced levels of norepinephrine, dopamine and serotonin in the central nervous system. On the other hand, those with mania tend to display an elevation in the monoamine concentrations.
Question 10
There has been a growing interest in the use of nutraceutical therapy for treating depressive and bipolar disorders. This has been informed by the numerous studies that show the importance of adding zinc to an established antidepressant therapy.
Question 11
The exact cause of panic attacks/disorders is not known. However, for individuals prone to panic attacks, chemicals known as panicogens may bring about panic attack symptoms. Panicogens include carbon dioxide, caffeine, sodium lactate, cholecystokinin, and androgenic receptor agonists. These tend to alter the Ph of the brain that panic-prone individuals detect easily. When pH is heightened in the amygdala, this generates fearful perceptions that bring about panic symptoms.Module 6 Knowledge Check Essay
Question 12
BZ heightens the response of GABAA ion channel to GABA. In turn this elevates chloride ion influx as well as the production of a neuroinhibitory effect. Drugs known for blocking the benzodiazepine receptor tend to increase anxiety feelings and panic attack. Thus, when the inhibitory neuromodulation is altered, this contributes to the development of panic disorders.
Question 13
From imaging studies, there is an increase in activity in the frontal cortical and limbic areas.When individuals suffering from SAD depict threatening facial expressions, they perceive criticism, dislike, and rejection. This shows the connection between the amygdala and the other regions of the brain. An elevated anxiety in SAD may come about due to the discrepancies in inhibition from the areas of prefrontal cortical to the amygdala.the studies have revealed a decrease in white matter connectivity between the orbitofrontal cortex and the amygdala.
Question 14
Based on a number of studies, oxytocin has antianxiety effects as it reduces the activation of HPA. This promotes social attachment, trust, empathy, and maternal behavior. The levels of oxytocin are considerably reduced in those suffering from SAD.
Question 15
For people with GAD, the serotonin levels are decreased, α2-adrenergic receptor binding reduces as well. At the same time, the platelet binding of paroxetine also reduces. Also, a reduction is also seen in the binding of BZ in the left temporal hemisphere.
Question 16
The exposure of people with GAD to angry faces induces the increased activation of right amygdala. This correlates positively with how severe the anxiety becomes.
Question 17
For patients with PTSD, the hippocampus is reduced in size. The amygdala becomes too reactive, while the media prefrontal cortex becomes less responsive and smaller.
Question 18
Individuals with PTSD usually have low to normal cortisol levels considering their ongoing elevated stress levels. This is also despite the regular increase in the Corticotropin Releasing Factor (CRF). The presence of cortisol results in a decreased production of CRF. Low cortisol levels mean high CRF. Additionally, it stimulates the release of norepinephrine by the anterior cingulate. In turn, the norepinephrine comes with elevated blood pressure and rapid heartbeat in people with PTSD.Module 6 Knowledge Check Essay
Question 19
Based on neuroimaging studies, an increase inf metabolic activity and blood flow in the orbitofrontal cortex, caudate, thalamus, and limbic structures accompanied with a trend toward the predominance of the right side associated with OCD.
Question 20
According to various neuroimaging studies, people with OCD have displayed hyperactive dorsal anterior cingulate cortex as compared to the controls. The dACC is the main area for receiving negative emotion and the reinforcement of information. It also does the integration of that information for the direction of
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