Child and adolescent psychiatry 1 Flashcards

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1
Q

How to determine the link between genetic factors and mental illness

A

twin studies - MZ and DZ

% variance due to genetics and environment

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2
Q

Variance in PKU

A

100% genetics

environmental factor is causative factor (PKU)

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3
Q

What have genetic factor studies shown?

A

ADHD and autism highly genetic

depression and anxiety substantially genetic

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4
Q

GWAS - main findings

A

genetic risk factors for psychiatric disorder
many genes implicated
micro RNA and epigenetic
synapses

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5
Q

Intra-uterine and perinatal factors

A
drugs and toxins 
maternal ab, obesity, diabetes
premature birth 
twinning 
epigenetics - folate controlled methylation 
endocrine - androgens
alcohol
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6
Q

Signs of fetal alcohol syndrome

A

small head, eyes, body and brain - cerebellum
smooth philtrum
growth retardation

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7
Q

fetal alcohol syndrome: neuro developmental effects

A
sensorimotor 
cognitive 
developmental 
executive function 
language
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8
Q

Working memory white matter connectivity

A

hippocampus and anterior cingulate

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9
Q

What is low connectivity in the white matter associated with?

A

neural “noise”
intra-individual variability
cognitive instability

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10
Q

Developing brain low white matter connectivity

A

ADHD - poor concentration

distractibility

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11
Q

Common outcomes of low white matter connectivity and grey matter gyrification

A

learning difficulties
conduct disorders eg ODD
combines ADHD or ADD
anxiety disorders

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12
Q

ODD symptoms

A

frequent loss of temper
arguing
becoming easily angered or annoyed
showing vindictive behaviour

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13
Q

ADD symptoms

A

distractibility
sustaining attention to tasks that don’t provide stimulation or reward
problems with organisation

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14
Q

Hyp/imp symptoms

A

difficulties with remaining still
impulsivity
without considering consequences

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15
Q

Examples of anxiety disorders

A

panic disorder
phobia
separation anxiety
GAD

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16
Q

Environmental factors during childhood

A
attachment 
parental mental disorder
family/marital function 
nutrition/poverty/neglect
abuse and discipline 
schooling and peers 
life events 
physical disability
17
Q

Attachment

A

proximity-seeking behaviour

contact with parent when injured, frightened or ill

18
Q

How do we classify attachment as secure or insecure?

A

direct observation of behaviour during “strange situation”

19
Q

Difference between brains reaction to physical and mental stress

A

brain responds to stress similarly to both

20
Q

Early life stress on the brain

A
function of limbic system 
mood and patterns of response to threat including withdrawal/aggression
21
Q

Early experience of adversity outcomes

A

perceived behaviour/aggression
limbic response, increase amygdala activity
cortical response

22
Q

triad of head injury and behaviour

A

head injury
behaviour
life events

23
Q

When do dopamine neurons fire?

A

associate an action with reward

24
Q

Reward deficiency model of adverse experience

A
reduces DA response
decreased reward sensitivity
increase behaviour for reward and so increased reward for satiety
increase tolerance
increase behaviour
25
Q

Consequence of reward deficiency model

A

“addiction” - obesity, drugs and alcohol, gambling, porn

increased delay-aversion

26
Q

Executive and cortical control

A

CBT
inhibit prepotent response
intentional decision making
requires self awareness

27
Q

Delay aversion (specific condition implicated in)

A

theory to explain ADHD - inability to wait and maintain attention in absence of immediate reward

28
Q

“social brain” - emotion contagion

A

infant-mother interaction

29
Q

“social brain” - 6 weeks

A

sensorimotor control

smiling intentionally

30
Q

“social brain” - 24 months

A

secondary representation

able to recognise and label emotions

31
Q

“social brain” - 3/4 years

A

metarepresentation
self-aware of emotion
able to deceive

32
Q

“theory of mind”

A

A true test of ability to represent other’s thoughts as different to one’s own - autism

33
Q

Expressed emotion

A

stress and worry impact patients illness and increase relapse rate of chronic conditions

34
Q

Modelling development of aggressive

A
cognitive - self control, empathy
environment - social and familial reinforcers 
drugs 
testosterone 
social conditioning 
early adversity 
genetics 
brain development & injury