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Section 10
The Convergence of Counseling & Psychiatric Genetics: Alzheimer’s Disease

Question 10 | Test Table of Contents

Competing Systems of Gene Expression
Outside the realm of genetic regulation, there is yet another explanation of the failure of certain individuals with genetic predisposition to manifest the symptoms of disorder. In this additional case, the expression of one set of genes actually competes with the expression of another set of genes. If one applies this principle of competition to mental disorder, a mechanism emerges in which the expression of one set of genes protects the individual from the damaging effects of a second set of unrelated mental disorder genes. Dementia of the Alzheimer’s type offers a compelling example of a case in which one form of gene expression may compensate for another form.

It has been well established that Alzheimer’s disease is linked to the presence of particular genes (Blacker, 1997). The later stages of this devastating disease are characterized by a dementia that carries the potential to destroy memory, cognitive capacity, and elements of basic temperament. The individual identity once known to family, friends, and self is
eclipsed by the disease process, and distinguishing changes in brain tissue are evident when an autopsy is performed.

Although genetic links to dementia of the Alzheimer’s type have clearly been established, equally compelling information has emerged showing that it may be possible to counteract the damaging effects of Alzheimer’s genes by building complex verbal skills early in life (Snowdon, 1997; Snowdon, Greiner, Kemper, Nanayakkara, & Mortimer, 1999; Snowdon et al., 2000). Neuroscientists speculate that in the process of building these complex verbal skills, powerful brain pathways are created that are able to compensate for faculties lost through the pathological processes of the Alzheimer’s disease.

Autopsy results reveal that, in many cases, the brains of highly verbal individuals harbor the pathological changes characteristic of Alzheimer’s disease but that outwardly these individuals do not show any significant deficits in memory, cognition, or affect. Although there is clear evidence that the Alzheimer’s genes are being expressed, the genes responsible for laying down alternate pathways are effectively mitigating the outward manifestation of the disease.

In practical terms, knowing that it may be possible to prevent outward manifestations of Alzheimer’s pathology role of advocacy in early childhood. Counselors could contribute significantly to Alzheimer’s prevention efforts by advocating for preschool reading programs and other initiatives that foster verbal development. In fact, counselors have opportunities
throughout the life course to help prevent the symptoms of Alzheimer’s dementia. By targeting other variables correlated with the manifestation of Alzheimer’s pathology, such as stress (Kiecolt-Glaser & Glaser, 2001; Sapolsky, 1996; Snowdon, 1997), depression (Green et al., 2003), and cardiovascular disease (Snowdon et al., 1997), the role of the counselor in Alzheimer’s prevention efforts could include, for example, individual counseling for stress and depression, social action targeting systems variables that result in high stress or depression levels, or advocacy for healthy diet and exercise programs for adults.
- Douthit, Kathryn ; The Convergence of Counseling and Psychiatric Genetics: An Essential Role for Counselors; Journal of Counseling & Development, Winter 2006, Vol. 84, Issue1.

Personal Reflection Exercise Explanation

The Goal of this Home Study Course is to create a learning experience that enhances your clinical skills. We encourage you to discuss the Personal Reflection Journaling Activities, found at the end of each Section, with your colleagues. Thus, you are provided with an opportunity for a Group Discussion experience. Case Study examples might include: family background, socio-economic status, education, occupation, social/emotional issues, legal/financial issues, death/dying/health, home management, parenting, etc. as you deem appropriate. A Case Study is to be approximately 250 words in length. However, since the content of these “Personal Reflection” Journaling Exercises is intended for your future reference, they may contain confidential information and are to be applied as a “work in progress.” You will not be required to provide us with these Journaling Activities.

2018 Alzheimer's Disease Facts and Figures

- Alzheimer’s Association. 2018 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2018;14(3):367-429.

Personal Reflection Exercise #1
The preceding section contained information about the convergence of counseling and psychiatric genetics with Alzheimer’s Disease. Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
Relationship between Nutrition, Lifestyle,
and Neurodegenerative Disease:
Lessons from ADH1B, CYP1A2 and MTHFR

- Barati, S., Fabrizio, C., Strafella, C., Cascella, R., Caputo, V., Megalizzi, D., Peconi, C., Mela, J., Colantoni, L., Caltagirone, C., Termine, A., & Giardina, E. (2022). Relationship between Nutrition, Lifestyle, and Neurodegenerative Disease: Lessons from ADH1B, CYP1A2 and MTHFR. Genes, 13(8), 1498.

Peer-Reviewed Journal Article References:
Gold, D., Rosowsky, E., Piryatinsky, I., & Sinclair, S. J. (2020). Comparing patient and informant ratings of depressive symptoms in various stages of Alzheimer’s disease. Neuropsychology, 34(5), 535–550.

Gyurkovics, M., Balota, D. A., & Jackson, J. D. (2018). Mind-wandering in healthy aging and early stage Alzheimer’s disease. Neuropsychology, 32(1), 89–101.

Maxfield, M., Cui, R., Roberts, J. R., & Fiske, A. (2020). Interest in dementia testing: Family history, dementia-related anxiety, and coping. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry. Advance online publication.

QUESTION
According to Douthit, how might it be possible to counteract the damaging effects of Alzheimer’s genes? To select and enter your answer go to Test.


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