Ch. 14 (1)Psychopathology LM

Question 1

Which of the following brain structures is MOST consistently implicated in schizophrenia, with enlargement often observed in neuroimaging studies?

a) Hippocampus
b) Amygdala
c) Ventricles
d) Thalamus

Answer 1

c) Ventricles

Explanation: The consistent finding of enlarged ventricles in individuals with schizophrenia. This enlargement reflects brain atrophy, particularly in areas like the frontal and temporal lobes, which are crucial for many cognitive functions affected by the disorder.

Question 2

Hypofrontality, a key characteristic of schizophrenia, refers to:

a) Increased activity in the frontal lobe during resting states.

b) Reduced activity in the frontal lobe, even during tasks that typically engage this region.

c) Excessive pruning of synapses in the frontal lobe during adolescence.

d) Abnormally heightened dopamine activity in the frontal lobe.

Answer 2

b) Reduced activity in the frontal lobe, even during tasks that typically engage this region.

Explanation: The hypofrontality as reduced frontal lobe activity observed in individuals with schizophrenia, both at rest and during tasks that normally activate this region. This underactivity is thought to underlie many of the cognitive deficits associated with the disorder, such as working memory impairments and difficulties with executive functions.

Question 3

Sensory gating deficits, commonly observed in schizophrenia, are thought to contribute to:

a) Negative symptoms, such as flat affect and social withdrawal.

b) Positive symptoms, such as hallucinations and disorganized thought.

c) Motor abnormalities, such as catatonia.

d) Difficulties with emotional regulation.

Answer 3

b) Positive symptoms, such as hallucinations and disorganized thought.

Explanation: Sensory gating refers to the brain’s ability to filter out irrelevant sensory information. Individuals with schizophrenia often exhibit deficits in sensory gating, meaning they are overwhelmed by sensory stimuli. This sensory overload is thought to contribute to positive symptoms, such as hallucinations (experiencing sensory perceptions without external stimuli) and disorganized thought (difficulty filtering and processing thoughts).

Question 4

The neurodevelopmental hypothesis of schizophrenia proposes that:

a) Schizophrenia is caused by a single gene mutation that disrupts brain development.

b) Subtle alterations in brain development early in life increase vulnerability to schizophrenia, which may manifest later in life due to environmental factors.

c) Schizophrenia is primarily caused by adverse childhood experiences that lead to brain abnormalities.

d) Schizophrenia is a purely psychological disorder with no biological basis.

Answer 4

b) Subtle alterations in brain development early in life increase vulnerability to schizophrenia, which may manifest later in life due to environmental factors.

Explanation: The neurodevelopmental hypothesis suggests that schizophrenia arises from a combination of genetic vulnerability and environmental factors. It posits that subtle abnormalities in brain development occur early in life, creating a predisposition to the disorder. These vulnerabilities may remain dormant until later in life, when environmental stressors, hormonal changes during puberty, or other factors trigger the onset of symptoms.

Question 5

Antipsychotic medications primarily target which neurotransmitter system?

a) Serotonin
b) Norepinephrine
c) Glutamate
d) Dopamine

Answer 5

d) Dopamine

Explanation: The sources indicate that the most common treatment for schizophrenia is antipsychotic drugs, which primarily act on the dopamine system, particularly by blocking dopamine D2 receptors. This mechanism of action is believed to be effective in reducing positive symptoms, but less effective in addressing negative symptoms.

Question 6

Which of the following is a negative symptom of schizophrenia?

a) Hallucinations
b) Delusions
c) Disorganized speech
d) Flattened affect

Answer 6

d) Flattened affect

Explanation: The sources differentiate between positive symptoms (excesses or distortions of normal behavior) and negative symptoms (absence of normal behavior) in schizophrenia. Hallucinations, delusions, and disorganized speech fall under positive symptoms, while flattened affect (lack of emotional responsiveness) exemplifies a negative symptom.

Question 7

Which statement about genetic influences in schizophrenia is MOST accurate according to the sources?

a) While genetics plays a significant role, schizophrenia is not caused by a single gene, and multiple genetic factors are likely involved.

b) The serotonin transporter gene is the primary gene responsible for schizophrenia risk.

c) If one identical twin has schizophrenia, the other twin has a 100% chance of developing the disorder.

d) Genetic factors account for all cases of schizophrenia, with environmental factors playing no role.

Answer 7

a) While genetics plays a significant role, schizophrenia is not caused by a single gene, and multiple genetic factors are likely involved.

Explanation: The sources emphasize that schizophrenia’s genetic basis is complex and involves multiple genes rather than a single gene. While a family history of schizophrenia increases the risk, it’s not a deterministic factor, highlighting the influence of environmental factors and gene-environment interactions. The Finnish adoption study mentioned in the sources provides evidence for this complex interplay.

Question 8

Smooth pursuit eye movement abnormalities observed in schizophrenia provide further support for:

a) Temporal lobe dysfunction.
b) Frontal lobe dysfunction.
c) Dopamine hyperactivity.
d) Enlarged ventricles.

Answer 8

b) Frontal lobe dysfunction

Explanation: Difficulties with smooth pursuit eye movements, where individuals with schizophrenia exhibit jerky eye movements when tracking a moving object, suggest impairment in the frontal lobe. The frontal lobe is crucial for controlling eye movements and other executive functions, and this finding aligns with the broader observation of hypofrontality in schizophrenia.

Question 9

Which of the following statements about the course and treatment of schizophrenia is TRUE?

a) Schizophrenia is a curable condition with proper medication and therapy.

b) Negative symptoms are typically more responsive to antipsychotic medications than positive symptoms.

c) Schizophrenia is a chronic condition, but symptoms can be managed with treatment, which often includes antipsychotic medications.

d) All individuals with schizophrenia experience the same symptoms and disease progression.

Answer 9

c) Schizophrenia is a chronic condition, but symptoms can be managed with treatment, which often includes antipsychotic medications.

Explanation: schizophrenia is currently considered a chronic condition that requires ongoing management. While not curable, treatment with antipsychotic medications, often combined with therapy, can effectively control symptoms, particularly positive symptoms. The course of the illness and response to treatment vary among individuals.

Question 10

Which of the following is NOT a cognitive function frequently disrupted in schizophrenia?

a) Working memory
b) Attention
c) Cognitive control
d) Long-term memory

Answer 10

d) Long-term memory

Explanation: The sources highlight various cognitive impairments associated with schizophrenia, including deficits in working memory (holding and manipulating information in mind), attention (focusing on relevant stimuli), and cognitive control (regulating thoughts and actions). While long-term memory can be affected in some individuals, it is not as consistently or prominently impaired as the other cognitive functions listed.

Question 11

Which brain region is frequently implicated in the somatic and vegetative symptoms of depression, showing increased activity in depressed individuals compared to non-depressed individuals?

a) Dorsolateral Prefrontal Cortex (DLPFC)
b) Amygdala
c) Subgenual Cingulate Cortex
d) Hippocampus

Answer 11

c) Subgenual Cingulate Cortex

Explanation: The sources identify the subgenual cingulate cortex as a critical region involved in depression, particularly in relation to somatic and vegetative symptoms like changes in appetite, sleep disturbances, and low energy levels. This area shows heightened activity in individuals with depression, and interestingly, its activity decreases when therapeutic interventions, such as antidepressant medications or electroconvulsive therapy, prove effective

Question 12

The impaired ability to shift mental sets, often observed in depression, is linked to reduced activity in which brain regions?

a) Amygdala and hippocampus

b) DLPFC and dorsal anterior cingulate cortex

c) Subgenual cingulate cortex and basal ganglia

d) Ventral tegmental area and nucleus accumbens

Answer 12

b) DLPFC and dorsal anterior cingulate cortex

Explanation: the difficulty in shifting mental sets, a common cognitive challenge in depression, with diminished activity in the DLPFC and the dorsal anterior cingulate cortex. These regions are crucial for executive functions, including cognitive flexibility and the ability to adapt to changing demands, which are compromised in depression.

Question 13

Which subcortical structure is often overactive in depression, particularly in response to negative information?

a) Hippocampus
b) Amygdala
c) Basal ganglia
d) Thalamus

Answer 13

b) Amygdala

Explanation: The amygdala, a brain region central to processing emotions, as being hyperactive in depression, especially when individuals encounter negative information. This heightened amygdala activity contributes to the negative biases in attention and memory commonly experienced in depression, leading to a focus on and stronger recall of negative experiences.

Question 14

The underactivity of subcortical reward pathways in depression is thought to contribute to which symptom?

a) Increased anxiety and agitation

b) Difficulties with concentration and decision-making

c) Apathy, lack of motivation, and anhedonia

d) Disturbed sleep patterns and fatigue

Answer 14

c) Apathy, lack of motivation, and anhedonia

Explanation: The decreased activity in subcortical reward pathways, specifically involving dopaminergic circuits, to the experience of apathy, lack of motivation, and anhedonia—the inability to experience pleasure—in depression. These pathways are responsible for processing reward and motivation, and their underactivity can lead to the diminished interest and drive that characterize depression.

Question 15

Antidepressant medications primarily target which neurotransmitter systems?

a) Acetylcholine and glutamate

b) GABA and dopamine

c) Serotonin, norepinephrine, and dopamine

d) Endorphins and oxytocin

Answer 15

c) Serotonin, norepinephrine, and dopamine

Explanation: antidepressant medications work by influencing the monoamine neurotransmitter systems, specifically serotonin, norepinephrine, and dopamine. While the precise mechanisms by which these medications alleviate depressive symptoms remain unclear, their action on these neurotransmitter systems is well-established

Question 16

6. Which of the following statements about the efficacy of antidepressant medications is supported by the sources?

a) Antidepressant medications are universally effective in treating all forms of depression.

b) While relatively effective for many, the specific mechanisms by which antidepressants relieve depressive symptoms are not fully understood.

c) Antidepressant medications have no effect on brain activity related to emotional processing.

d) Antidepressant medications only target the amygdala, reducing its response to negative information.

Answer 16

b) While relatively effective for many, the specific mechanisms by which antidepressants relieve depressive symptoms are not fully understood.

Explanation: The effectiveness of antidepressant medications for a substantial portion of individuals with depression. However, they also emphasize that the precise ways in which these medications achieve symptom relief are not fully elucidated, highlighting the complexity of depression’s neurobiology. Notably, antidepressants influence brain activity beyond just the amygdala, impacting areas like the prefrontal cortex as well.

Question 17

Cognitive therapy for depression primarily focuses on:

a) Identifying and modifying maladaptive thought patterns and beliefs.

b) Using relaxation techniques to reduce anxiety and stress.

c) Resolving unconscious conflicts from childhood experiences.

d) Changing behavioral patterns to increase positive reinforcement.

Answer 17

a) Identifying and modifying maladaptive thought patterns and beliefs.

Explanation: cognitive therapy as a treatment approach that centers on helping individuals with depression recognize and change their negative and self-defeating thoughts and beliefs. This therapeutic approach aims to address the cognitive distortions and negative biases that contribute to and maintain depressive symptoms.

Question 18

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment for depression that involves:

a) Implanting electrodes in the brain to stimulate specific regions.

b) Applying magnetic pulses to the scalp to modulate brain activity in the underlying region.

c) Stimulating the vagus nerve to indirectly influence brain function.

d) Using light therapy to regulate circadian rhythms and mood.

Answer 18

b) Applying magnetic pulses to the scalp to modulate brain activity in the underlying region.

Explanation: rTMS as a non-invasive technique that utilizes a magnetic coil placed over the scalp, typically over the left DLPFC, to deliver repetitive magnetic pulses. These pulses induce electrical currents in the brain, aiming to alter the activity of the targeted region, which in the case of depression often involves stimulating the DLPFC.

Question 19

Deep brain stimulation (DBS) for depression involves:

a) Surgically implanting electrodes in specific brain regions to deliver continuous electrical stimulation.

b) Administering electrical shocks to induce a brief seizure.

c) Using magnetic fields to stimulate the vagus nerve.

d) Non-invasively stimulating the brain using focused ultrasound waves.

Answer 19

a) Surgically implanting electrodes in specific brain regions to deliver continuous electrical stimulation.

Explanation: DBS as a highly invasive procedure reserved for severe, treatment-resistant depression. It involves the surgical implantation of electrodes into specific brain regions, such as the subgenual anterior cingulate cortex, to provide continuous electrical stimulation, modulating the activity of the targeted area.

Question 20

Which novel treatment for depression involves stimulating a nerve that connects the brain to various organs in the body?

a) Electroconvulsive therapy (ECT)

b) Transcranial direct current stimulation (tDCS)

c) Vagus nerve stimulation (VNS)

d) Phototherapy

Answer 20

c) Vagus nerve stimulation (VNS)

Explanation: VNS as an experimental treatment for depression that involves implanting a device in the chest to stimulate the vagus nerve. This stimulation, delivered through the vagus nerve, indirectly influences brain function, potentially impacting regions involved in mood regulation.

Question 21

1. The integrated model of depression suggests that the disorder may be the end-stage of which biological response?

a) Rest and digest response
b) Fight or flight response
c) Immune response
d) Sleep-wake cycle

Answer 21

b) Fight or flight response

Explanation: depression might represent the extreme end of the fight or flight response, a physiological reaction to perceived threat. This model suggests that prolonged or chronic activation of this stress response system can lead to the emotional and behavioral changes seen in depression.

Question 22

Which of the following is a primary target of antidepressant medications, aiming to increase their availability in the brain?

a) Monoamine neurotransmitters
b) Endorphins
c) Glutamate
d) GABA

Answer 22

a) Monoamine neurotransmitters

Explanation: Antidepressant medications primarily focus on increasing the levels of monoamine neurotransmitters, specifically serotonin, norepinephrine, and dopamine. These neurotransmitters are involved in mood regulation, motivation, sleep, and reward, and their imbalances are thought to contribute to depression.

Question 23

Which cognitive function, associated with the dorsolateral prefrontal cortex (DLPFC), is often impaired in depression, leading to difficulties in concentration and decision-making?

a) Long-term memory
b) Working memory
c) Sensory processing
d) Motor coordination

Answer 23

b) Working memory

Explanation: The DLPFC plays a crucial role in working memory, which is the ability to hold and manipulate information in mind. Depression often disrupts DLPFC activity, leading to impairments in working memory, making it challenging to concentrate, make decisions, and solve problems effectively.

Question 24

Which novel treatment approach involves applying magnetic pulses to specific brain regions to modulate activity and has shown promise in treating depression?

a) Deep brain stimulation

b) Vagus nerve stimulation

c) Repetitive transcranial magnetic stimulation (rTMS)

d) Electroconvulsive therapy

Answer 24

c) Repetitive transcranial magnetic stimulation (rTMS)

Explanation: rTMS is a non-invasive technique that uses magnetic pulses to stimulate or inhibit activity in targeted brain regions. It has emerged as a potential treatment option for depression, particularly for those who have not responded well to other therapies.

Question 25

According to the integrated model of depression, how might cognitive therapy and antidepressant medications work together to address different aspects of the disorder?

a) Cognitive therapy focuses on reducing inflammation in the brain, while antidepressants improve blood flow to the frontal lobes.

b) Cognitive therapy aims to modify negative thought patterns and beliefs, while antidepressants target neurotransmitter imbalances to improve mood regulation.

c) Cognitive therapy enhances the production of endorphins, while antidepressants reduce the activity of the amygdala.

d) Cognitive therapy strengthens the connections between the hippocampus and the amygdala, while antidepressants increase dopamine levels in the reward pathways.

Answer 25

b) Cognitive therapy aims to modify negative thought patterns and beliefs, while antidepressants target neurotransmitter imbalances to improve mood regulation.

Explanation: The integrated model emphasizes the interplay between cognitive and biological factors in depression. Cognitive therapy directly addresses the maladaptive thoughts and beliefs that maintain the cycle of depression, while antidepressants work on the neurochemical level to improve mood regulation and emotional processing.

Question 26

A patient with severe, treatment-resistant depression has not found relief through various medications and therapy. They are seeking a non-invasive treatment option that directly stimulates a specific brain region implicated in mood regulation. Which of the following treatments would be the most appropriate recommendation for this patient?

a) Vagus Nerve Stimulation (VNS)

b) Deep Brain Stimulation (DBS)

c) Repetitive Transcranial Magnetic Stimulation (rTMS)

d) Electroconvulsive Therapy (ECT)

Answer 26

c) Repetitive Transcranial Magnetic Stimulation (rTMS)

Explanation: rTMS is a non-invasive procedure that uses magnetic pulses to stimulate the dorsolateral prefrontal cortex (DLPFC), a brain area involved in mood regulation. It’s considered a potential alternative for treatment-resistant depression when other approaches have been unsuccessful.

Question 27

A physician is considering Deep Brain Stimulation (DBS) for a patient with extremely severe and chronic depression who has not responded to any other treatment. What is a crucial ethical consideration the physician must discuss with the patient before proceeding?

a) The potential side effects of long-term antidepressant use.

b) The invasive nature of the procedure and the risks associated with brain surgery.

c) The possibility that DBS may only provide temporary relief from symptoms.

d) The cost-effectiveness of DBS compared to other treatment options.

Answer 27

b) The invasive nature of the procedure and the risks associated with brain surgery.

Explanation: DBS involves implanting electrodes in the brain, which is a significant surgical procedure with inherent risks. It’s ethically imperative for the physician to thoroughly discuss these risks with the patient, ensuring they understand the potential complications and long-term implications of such an invasive treatment.

Question 28

A researcher is studying the effects of Vagus Nerve Stimulation (VNS) on a patient with depression. Which of the following physiological responses would the researcher expect to observe as a direct result of VNS?

a) Increased blood flow to the occipital lobe.

b) Reduced activity in the hippocampus.

c) Stimulation of the vagus nerve as it travels towards the brainstem.

d) Enhanced dopamine release in the reward pathway.

Answer 28

c) Stimulation of the vagus nerve as it travels towards the brainstem.

Explanation: VNS involves a device implanted in the chest that sends electrical signals to the vagus nerve, a long nerve that connects the brain to various organs in the body. The stimulation travels along the vagus nerve, ultimately influencing brain activity in regions associated with mood and emotional regulation.

Question 29

A patient with depression is curious about the differences between rTMS and DBS. Which of the following statements accurately distinguishes these two treatments?

a) rTMS primarily targets the amygdala, while DBS focuses on the hippocampus.

b) rTMS is a non-invasive procedure, while DBS requires surgical implantation of electrodes.

c) rTMS uses electrical currents to stimulate the brain, while DBS employs magnetic pulses.

d) rTMS is typically a long-term treatment strategy, while DBS provides more immediate and short-term effects.

Answer 29

b) rTMS is a non-invasive procedure, while DBS requires surgical implantation of electrodes.

Explanation: The key difference between rTMS and DBS lies in their invasiveness. rTMS is non-invasive, using magnetic fields to stimulate brain activity externally. DBS, on the other hand, involves surgically placing electrodes within specific brain regions to modulate neural activity.

Question 30

A neurologist is explaining the potential benefits of rTMS to a patient considering this treatment for depression. Which of the following points would the neurologist likely emphasize?

a) rTMS can permanently alter the structure of the brain, leading to long-lasting remission from depression.

b) rTMS can modulate activity in the dorsolateral prefrontal cortex, a brain region involved in mood regulation, potentially alleviating depressive symptoms.

c) rTMS can enhance the production of serotonin, eliminating the need for antidepressant medications.

d) rTMS can directly target the amygdala, reducing the experience of fear and anxiety associated with depression.

Answer 30

b) rTMS can modulate activity in the dorsolateral prefrontal cortex, a brain region involved in mood regulation, potentially alleviating depressive symptoms.

Explanation: While the exact mechanisms of rTMS are still being studied, it’s believed to work by stimulating the DLPFC. This region is crucial for executive functions, planning, and emotional regulation, all of which are often disrupted in depression. By modulating activity in the DLPFC, rTMS aims to restore more balanced brain function and alleviate depressive symptoms.