Child And Adult Psychiatry Part 2

Question 1

What psychiatric conditions are genes implicated in?

Answer 1

Autism
Anxiety
Depression
ODD

Question 2

What else contributes to psychiatric diseases

Answer 2

Inflammatory and autoimmune diseases are also implicated

Question 3

What do you look for when looking for risk factors for child psychiatry

Answer 3

Maternal health- maternal antibodies, obesity, diabetes
Substance misuse- alcohol, marijuana
Toxins- lead, Mercury and PCB’s
Drugs- lipid soluble
Epigenetics- folate controlled methylation
Endocrine environment- esp androgen and cortisol
Immune environment
Premature birth
Twinning

Question 4

How does alcohol stunt growth?

Answer 4

Fetal alcohol syndrome

Small eyes
Small head
Small brain
Smooth upper lip
Smooth filtrum

Question 5

How is white matter implicated in ADHD

Answer 5

White matter provides the connection between areas of the brain
In ADHD there are poor connections, leading to more noise
Poor connectivity can be caused by alcohol

Question 6

What are some common outcomes of fetal alcohol syndrome

Answer 6

Highly variable clinical picture
Learning difficulties
Conduct disorders including ODD (oppositional defiant disorder)
ADHD or ADD or hyp-imp subtypes
Anxiety disorders

Question 7

What is OOD (oppositional defiant disorder)

Answer 7

Frequent loss of temper, arguing, becoming easily angered or annoyed, showing vindictive or other negative behaviours.

Question 8

What environmental factors during childhood can lead to mental disorders?

Answer 8

Carer- child relationship
Parenting skills and parental mental disorders
Marital harmony
Nutrition, poverty, deprivation
Abuse, neglect
Discipline
Day care/schooling
Peer relationships
Life events
Physical disability

Question 9

What is attachment?

Answer 9

The constant of an attachment figure is paramount for life. Problems in mental health have been attributed to early attachment patterns although there is little evidence for this.

Question 10

How does stress impact development?

Answer 10

Macrophages with pro-inflammatory phenotype caused by the sympathetic nerve chain and cortisol lead to low grade peripheral inflammation
Risky behaviours such as a high fat diet, smoking and drugs also lead to low grade peripheral inflammation.
This can lead to low grade peripheral inflammation on the microglia.

Question 11

How does the brain respond to physical and mental stress

Answer 11

Brain response similarly to physical and mental stress
Response to stress involves interplay or brain body
Early life stress influences function of the limbic system including the amygdala
Determines the subsequent patterns of stress response.
Early life stress influences mood and patterns of response to threat including withdrawal and/or aggressive symptoms

Question 12

How does early adversity help train the brain?

Answer 12

Perceived behaviour/aggression
Limbic response
Heightened amygdala activity
Cortical response/ preparation of aggressive response
Behavioural response
Aggression

Question 13

How can head injury affect behaviour

Answer 13

Head injury more likely to affect behaviour which can effect life events which can cause a head injury and so on.

Question 14

What is reward based training

Answer 14

Dopamine fires in the brain in response to rewards and positive stimulus

Question 15

How does adveristy relate to dopamine reposnses?

Answer 15

Decreases the ability of dopamine to fire in response to rewarding stimuli

Early adversity leads to reduced function and therefore more is needed to satisfy dopamine response

Question 16

What is meant by executive and cortical control?

Answer 16

People at the top of an institution taking control of an organisation

This same thing happens within the brain, bits of your brain provide control over your actions.

There is connections between the frontal lobe and the reward and punishment centres of the mind

Question 17

What us delay aversion

Answer 17

The capacity to wait and maintain attention in the absence of immediate reward.

Question 18

What is the social brain?

Answer 18

Increasing understanding, reflection and control with age

Picks up emotions from others, from a young age. They develop sensorimotor control, secondary representation (others emotions).

Question 19

What is expressed emotion

Answer 19

Carers negative emotion in the clinic predicts the relapse from chronic illness

Methods to measure it for research but you can also do it informally

Illness causes worry and stress, more severe illness leads to more worry and stress

Worry and stress leads to negativity in relationships at home

Question 20

What is ADD

Answer 20

Distractibility, sustaining attention to tasks that don’t provide high levels of stimulation of frequent reward.

Question 21

What is Hyp/IMP

Answer 21

difficulties in remaining still, most evident in situations that require behavioural self control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks or concentration.