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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Cognitive impairment can affect sexual relationships. Memory, planning and judgement are all necessary components of intimacy. Libido may become reduced or increased. People with dementia may become less sensitive to their partner's needs. Disinhibition may develop. They could be demanding or aggressive in their requests for sexual interaction or be inappropriate around care staff. In addition, the capacity to consent to sex can become impaired, creating a risk of being the victim of abuse.
Synapses
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
Although the molecular mechanisms underlying LTD may differ somewhat in different parts of the brain, the general principle is that since LTP is caused mainly by phosphorylation and insertion of AMPARs in the plasma membrane, LTD involves the reversal of both of these processes. Thus, a modest rise in [Ca]i favors protein phosphatases rather than protein kinases, particularly PP1 and PP2B (Section 6.3.1). PP1 can dephosphorylate both CaMKII and AMPARs. However, since PP1 is not directly influenced by Ca2+, a phosphatase cascade is initiated with the activation of PP2B, which then dephosphorylates a phosphoprotein inhibitor 1 (I1) (Figure 6.15). In its phosphorylated state, I1 is a potent inhibitor of PP1, so that its dephosphorylation by PP2B removes this inhibition, thereby activating PP1. The removal of inhibition is termed disinhibition.
Neuropsychological Characteristics of Early Alzheimer Disease
Published in Robert E. Becker, Ezio Giacobini, Alzheimer Disease, 2020
Maura Mitrushina, Paula Altman Fuld
The disinhibition hypothesis is also consistent with intrusions of irrelevant material observed in AD patients (Fuld, 1980). In fact, a number of studies have suggested that the frequency of intrusions can be viewed as a marker of cholinergic deficiency associated with AD (Fuld, Katzman, Davies, & Terry, 1982; Brinkman & Gershon, 1983; Brinkman, Largen, Cushman, Braun, & Block, 1985; Fuld, 1985). According to Fuld et al. (1982) an increase in the frequency of intrusion errors is negatively correlated with levels of cholinergic enzyme choline acetyltransferase in the brain, and is positively correlated with the number of neuritic plaques in the cerebral cortex on the autopsy. The hypothesized relationship between frequency of intrusion errors and central cholinergic deficiency is supported by pharmacological (cholinergic) models, which reveal AD-like changes in cognitive functioning in non-demented people in response to scopolamine treatment, which blocks cholinergic neurotransmission (Drachman & Leavitt, 1974; Brinkman et al., 1985; Fuld, 1985; Beatty, Butters, & Janowsky, 1986). In addition, in a study on manipulation of an anticholinergic drug with concurrent evaluation of memory functioning by the Buschke-Fuld Selective Reminding Test, the number of intrusion errors was related to drug level (Thal, Fuld, Masur, Sharpless, & Davies, 1983).
Predicting addiction potential based on sensation-seeking, psychological hardiness and assertiveness in students in western Iran: an analytical study
Published in Journal of Substance Use, 2021
Faezeh Tatari, Vahid Farnia, Khodamorad Momeni, Omran Davarinejad, Safora Salemi, Bahareh Soltani, Negar Niazi, Mostafa Alikhani
Sensation-seeking was found to be positively and significantly associated with the total addiction potential and active and passive addiction potential, which is consistent with the findings obtained by Karami-Matin et al. (2016) and Banerjee and Greene (2009). Furthermore, individuals with lower levels of disinhibition control had higher addiction potential. According to Fillmore, sensation-seeking people have a poorer data processing and disinhibition control, and therefore suffer the effects of addiction more compared to individuals with low levels of sensation-seek (Fillmore et al., 2009). Sensation-seeking individuals always seek new experiences. Addiction can serve as means of developing rapid arousal, and can increase one’s tendency toward new experiences. These individuals are therefore more inclined to use drugs, as a way of escaping monotony (Banerjee & Greene, 2009; Karami-Matin et al., 2016; Lydon‐Staley & Geier, 2018).
The treatment of acute agitation associated with schizophrenia or bipolar disorder: investigational drugs in early stages of their clinical development, and their clinical context and potential place in therapy
Published in Expert Opinion on Investigational Drugs, 2020
Potential side effects of benzodiazepines in the short term, acute management setting include respiratory depression, dizziness, extreme sedation, dry mouth, and increased risk of falls and cognitive impacts in the elderly [3,26]. Respiratory side effects like drop in oxygen saturation appear to be more common with midazolam, potentially due to the faster onset and shorter half-life, leading to more frequent re-dosing [26]. Benzodiazepines may be most advantageous for patients with agitation and psychosis or mania who are also undergoing, or assumed to be undergoing, alcohol or benzodiazepine withdrawal, or excited catatonia [29]. On a practical note, dosing will need to be adjusted in persons chronically exposed to benzodiazepine treatment as they likely have developed some degree of physiological tolerance. The phenomenon of behavioral disinhibition, although reported in the medical literature, is uncommon [30]. Benzodiazepines are not FDA-approved for agitation associated with psychosis or mania.
Methamphetamine use among gay men: An interpretive review of a non-sanctioned occupation
Published in Journal of Occupational Science, 2020
Alexander Gish, Niki Kiepek, Brenda Beagan
In this sense, disinhibition coexists with a sense of agency; using meth facilitates doing things one otherwise might not, while remaining in control of one’s own behavior. However, when limits are broken (e.g., selecting a sex partner while high, who would not be selected while sober; contracting HIV), then blame is typically attributed to the drug (O’Byrne & Holmes, 2011). In these instances, the drug is positioned as doing the “acting,” not the person using meth. In this way, loss of control is not synonymous with disinhibition, because loss of control represents an absence of boundaries. Loss of control is typically framed as undesirable and is not considered a valid rationale for behavior among men who engage in boundary play. As O’Byrne and colleagues (2011) described, “They wanted to explore, not escape, and to move within their boundaries, not overcome them” (p. 1519). The researchers argued for clearer distinctions between ‘disinhibition’ and ‘loss of control.’ When limits or boundaries exceed agentive disinhibition, this may constitute loss of control. In some instances, however, it may be more accurate to discuss risky sex while high on meth as ‘failed disinhibition.’