3. Mental Health

Question 1

Dimensionalist vs Wakefield

Answer 1

Wakefield = mental illness is harmful, failure of brain mechanism
Dimensionalist = mental illness is extreme form of normal function

Question 2

DSM5 and biopsychosocial, challenges to diagnose

Answer 2

define mental illness - became more valid and reliable over time, challenges to diagnose because of comorbidity, multiple ways to diagnose, and categorical/dimensional
biopsychosocial, invovle person, not just brain

Question 3

RDoc and HiTOP and P Factor

Answer 3

Research Domain Criteria -NIH framework to docus on brain function instead of diagnosing categories, bio mechanisms not symptoms
Example: Depression and substance abuse, study reward dysfunction as the link. Neurobio changes in reward pathways

Hierarchical Taxonomy of Psychopathology - categorize illnesses in components, spectra and symptoms

P Factor - all illnesses explained by one ‘general psychopathology’ p factor. Neural basis example in fMRI for cognitive control network, similar pattern across many disorders

Question 4

Benefits of early diagnosis

Answer 4

reduce symptoms, shorter duration of untreated = better symptom outcomes

Question 5

Structural MRI how measure

Answer 5

measure gray matter volume
= cortical thickness x area
youth with psychosis have reduced gray matter volume

Question 6

How to use neuroimaging for diagnosis

Answer 6

must be sensitive (correctly identify patients with illness)
specific (rule out other illnesses)
feasible (money and time)

example: salience network expanded gray matter in depression

also use as computational model based on activity as training data

Question 7

TMS in mental health

Answer 7

standard TMS can reach < 2cm
deep TMS can do < 6cm
excitatory or inhibitory
FDA approved for MDD, OCD, smoking
expesive though
example: excite connections that create ‘happy’ for depressive disorder, fire together wire together, happy circuit has LTP now, easier to be happy

Question 8

Neurofeedback in mental health and sham feedback

Answer 8

self regulation of brain acitivty by providng feedback
example: patients with anxiety taught to increase connectivity between dmPFC and amygdala
example: TMS in rIFG (inhibitory control) reduced ADHD symptoms

still works even with ‘sham’ feedback from previous participant, placebo effect