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Clinical Psychology > Applied Neuropsychology > Flashcards

Applied Neuropsychology Flashcards

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1
Q

What can distress span from?

A

Biological/ physical changes
Social changes
Psychological changes

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2
Q

What are some psychosocial & behavioural difficulties following Brian injury

A

Self-isolation
Apathy
Aggression
Reduced empathy
Rule breaking
Suicide attempts/ self-harm
Reduced social awareness

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3
Q

What are some psychological difficulties in neurodegenerative diseases?

A

Depression
Irritability
Hallucinations
Anxiety
Aggression
Obsessive-compulsive behaviours
Paranoia

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4
Q

What are possible biological changes of neurological conditions?

A

Physical brain changes
Hormone imbalance (hypothalamus damage)
Pain
Change in mobility
Reduced energy and/ or increased fatigue
Changes to awareness (seizures)

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5
Q

What are possible social changes to neurological conditions?

A

Losing/ changing roles & responsibilites
Financial implications
Lessened ability to understand & cope with social interaction
Others might not understand how it feels

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6
Q

How do neurological conditions differ?

A

Prolonged disorder of consciousness to return to work & activities with little/ no visible ongoing functional/ psychological change
Wide range

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7
Q

What are possible psychological changes to neurological conditions?

A

Shock
Frustration, anger & denial
Low mood
Anxiety
Low motivation
Move back & forward between feelings

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8
Q

What is MS?

A

Incurable neurological condition with progressive/ relapse-remitting effects on mobility, cognition & emotion over time
No cure so support individuals as much as possible with adjustment

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9
Q

How can we see a change curve with MS patients?

A

First 6 months - high anxiety, decrease towards end of 1st years
End of first year on - depressive symptoms increase, peaking at 20th month
Maniscalo et al (2019)

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10
Q

How are difficulties faced transdiagnostic?

A

Commonly experienced by people living with health & neurological conditions
Therapy can help work through loss & changes in function
Some transdiagnostic are specific experiences & difficulties

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11
Q

What are difficulties associated with ageing?

A

Memory - worsens
Attention - difficulty filtering distractions & multitasking
Speed of processing - slows
Executive functions - struggle with complex cog abilities

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12
Q

What are some feelings associated with ageing difficulties?

A

Scary
Bring up thoughts of dementia
Embarrassing
Shaming

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13
Q

What is the stigma associated with cognitive ageing?

A

Feel more shame & perceived stigma
Embarrassment at symptoms like forgetfulness, noticing others treat them less capable
Feelings of people with cog impairments - shame, avoid potentially embarrassing situations, view self negatively, lose faith in abilities due to symptoms - similar to those with dementia

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14
Q

How does typical ageing affect people?

A

Often people worry about cognition
All benefit form feelings validates & respected
Challenge own expectations & biases about ageing

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15
Q

What are different names for functional neurological disorders?

A

Functional neurological symptom disorder
Functional movement disorder
Conversion disorder
Psychogenic seizures/ movement disorder
Dissociative seizures/ motor disorder
Non-epileptic seizures

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16
Q

What are some functional neurological issues?

A

Physical difficulties e.g. weakness, paralysis
May experience numbness, pain, sensory disruptions
May have seizures/ faint
No organic origin - often get diagnosis after other options exhausted
Huge impact on self image

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17
Q

What are possible contributing factors of FND?

A

Previous trauma
Emotion regulation
Expression of psychological distress through physical symptoms
Low mood/ anxiety
Stressful life events
Experiencing epilepsy

18
Q

How does FND feel from the clients perspective?

A

Frightening symptoms indicating serious neurological issue but no one can say why
Worrying its all in their head
Therapy about building & understanding role of stressors, low mood/ anxiety & difficulties in wellbeing contributing to functional difficulties

19
Q

What is the stigma against these people with FND?

A

Stigma affects diagnosis, treatment & research
Can be misunderstood, invalidated or dismissed
Frustration by providers & distressing interactions for patients

20
Q

What is Huntingdon’s disease (HD)?

A

Rare life-limiting neurological disease - 10 in 100,000 people
Caused by CAG expansion on HTT gene
Dominant gene - inherited by affected parent
Mutant huntingtin causes symptoms

21
Q

What is the onset of HD?

A

Motor symptoms start around 30-50
Include rigidity, bradykineasia
Effects on independence
Cognitive behavioural & emotional changes predate physical by at least 15yrs

22
Q

What are cognitive changes in HD?

A

Memory
Orientation
Speed of processing
Executive function - inhibition, cog flexibility, WM, anosognosia (loss of insight)

23
Q

What is an insight on HD?

A

May have wide range of MH difficulties
Communication can get in the way
Report fewer symptoms than carers - overestimate abilities
Only reports from informant been shown to have predictive validity about abilities in future

24
Q

What was Gunn et al (2020) study on?

A

Evaluate difference in psychological symptom reporting with & without informant
4 groups - manifest HD, premanifest HD, genotype negative, family controls

25
Q

What were the results of Gunn et al (2020)?

A

Apathy - people with HD underestimate apathy but someone who knows can adjust score
Affect - no difference is HD person came alone or with informant
Scores higher for manifest HD, but also premanifest & genotype negative with informant present

26
Q

What is the importance of family & context of HD?

A

Entirely genetically determined
MH issues not linked to disease progression same as cognitive issues
Systemic impacts seen by looking at affected families & see if everyone experiencing poor wellbeing or just people carrying HD gene expansion

27
Q

What else may cause distress in HD?

A

Changes in narratives & expectations
Loss & grief
Worries for relatives
Financial stressors
Affects relatives without just as much as patient

28
Q

What is the heritability component of HD?

A

Children of affected parents 50% risk of inheriting disease
Predictive gene testing available from 18+
Multiple family members can be affected

29
Q

What was Maltby et al (2021) study?

A

Examine MH difficulties across same 4 groups
Manifest, premanifest, genotype negative & family controls

30
Q

What did Maltby et al (2021) find?

A

4 factors consistent across groups - anxiety, depression, outward irritability & self-harm
No difference between anxiety for groups
Depression & outward irritability - manifest group different from genotype negative consistently
Manifest group consistently differed for self-harm

31
Q

Why do study results matter?

A

Understand mental wellbeing for HD sufferers helps to improve care & open up therapy options
Provides new level of confidence to MH professionals not specialising in HD
Highlight psychological needs for HD affected families - improve support

32
Q

What kind of support can be offered to neurological conditions?

A

Therapeutic support to individual around adjustment, emotional management & managing changes
Support relatives emotionally and/ or practically
Co-working with carers changing how they interact with patient

33
Q

What is acceptance & commitment (ACT) therapy?

A

3rd wave CBT
Focuses less on what as wrong & more on adjusting to difficult situations, promoting valued living & enjoyment
Important for neurological conditions where fixing isn’t possible
Similar understanding about interrelations between thoughts, feelings, physical sensations & behaviour

34
Q

What are key points in ACT?

A

Defusion
Acceptance
Contact with present moment
Values
Committed action
Self as context

35
Q

What is defusion?

A

Ability to step back from thoughts, emotions & sensations - see as stories told by mind
Can be compelling
Don’t have to accept them
Full of metaphors

36
Q

What is acceptance?

A

Ability to make space from distressing thoughts, images, emotions & sensations
Accepting they can’t be got rid of
Concept of clean & dirty pain
Make space for unavoidable difficult experiences in order to live valued lives

37
Q

What is being present in the moment?

A

Skill developed through mindfulness practice - focus attention on specific stimuli
Breath, physical self, activity, inner experience of thoughts, sensations, emotions
Notice what’s going on rather then spending all time worrying about future or thinking about past

38
Q

What is self as context?

A

Learn to see oneself as container of experiences, not experiences themselves
Witness emotional reactions, distress, stories told by mind but remain distinct form them

39
Q

What is finding values?

A

Underlying guide to life, heckling to make choices that are right for you
Not goals - remain instead of being completed
Point the way to pleasure & fulfilment

40
Q

What is committed action?

A

Once identified values, start finding ways to change behaviour & explore new options
Find new ways to live in line with values, lead richer, fuller more meaningful lives, despite effects if neurological conditions

Clinical Psychology (9 decks)

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