Classification and Assessment

Question 1

What term is used in the ICD-11 to describe a period of psychotic symptoms lasting less than three months?

Answer 1

acute and transient psychotic disorder

NB: Brief psychotic disorder in DSM-5

Question 2

What is the DESS scale?

Answer 2

The DESS (Discontinuation-emergent signs and symptoms scale) is a 43-item rating scale which covers a broad spectrum of discontinuation symptoms.

Question 3

Which area of cognition is tested for by the following tests:
National Adult Reading Test (NART)

Answer 3

Pre-morbid inteligence

Question 4

Which area of cognition is tested for by the following tests:
Wechsler Adult Intelligence Scale (WAIS)
Raven’s progressive Matrices

Answer 4

General intelligence

Question 5

Which area of cognition is tested for by the following tests:
Rey-Osterrieth Complex Figure Test

Answer 5

Visual memory/ visuospatial skills

Question 6

Which area of cognition is tested for by the following tests:
Boston naming test
Animal Figure Test

Answer 6

Language

Question 7

What are the 4 core components of language?

Answer 7

Semantics - meaning of things, including in context
Syntax - structure of sentences
Pragmatics - rules and conventions in social context
Phonology - looks at how sounds function within a particular language or across languages.

Question 8

Which area of cognition is tested for by the following tests:
Continuous Performance Tasks (CPT), Stroop Test, Wisconsin Card Sorting Test (WCST), Tower of London, Animal Fluency Test, Trail Making Test (Part B)
(Also Hayling and Brixton tests)

Answer 8

Selective attention/ executive function

Note:
The Hayling test is a “sentence completion” test
The Brixton Test is a rule detection and rule following task.

Question 9

Which area of cognition is tested for by the following test:
Halstead-Reitan Neuropsychological Battery

Answer 9

Brain damage

Question 10

10 first-rank symptoms of schizophrenia:

Answer 10

1) Running commentary
2) Thought echo
3) Voices heard arguing
4) Thought insertion
5) Thought withdrawal
6) Thought broadcast (thoughts are perceived as leaving the subject’s head/mind)
7) Delusional perception
8) Somatic passivity
9) Made affect (belief that feelings are controlled by an outside force)
10) Made volition (belief that impulses and/or behaviour are controlled by an outside force)

Question 11

What is a Thurstone scale?

Answer 11

The Thurstone scale, also known as equal-appearing interval scaling, involves a panel of judges who evaluate each statement to determine its level of favourability towards a concept.

Question 12

What is a Guttman scale?

Answer 12

A Guttman scale has a list of statements. It can be inferred that respondents who agree to the statement placed at the end of this list, would have agreed to all the other statements above the last one.

Question 13

What is a Visual Analogue scale?

Answer 13

A VAS typically consists of a straight line with endpoints defining extreme limits such as ‘no pain’ and ‘worst imaginable pain’.

Continuous measure of variable = highly precise

Question 14

Re: Schizophrenia, what were the 4 A’s described by Bleuler in 1908?

Answer 14

Loosening of Associations
Autism
Ambivalence
Affectivity

Question 15

Define the following:
Neologism
Paraphrasia
Asyndesis
Paragramatism
Metonym

Answer 15

Neologism refers to the formation of new words.
Paraphasia occurs when one word is substituted for another e.g. orange instead of banana.
Asyndesis refers to a loss of conceptual boundaries.
Paragramatism is the inability to form grammatically correct sentences.
A metonym is an established word that denotes one thing but refers to a related thing, e.g. the word China can be used as the place or to refer to the crockery.

Question 16

What delusion is described here?
1) a syndrome where a delusion is transmitted from one person to another (aka a shared delusion)
2) belief that one has special powers, beliefs, or purpose

Answer 16

1) Foile a deux
2) Grandiose

Question 17

What delusion is described here?
3) belief that something is physically wrong with the patient
4) belief that one has been infested with insects

Answer 17

3) Hypochondriacal
4) Ekbom’s syndrome

Question 18

What delusion is described here?
5) belief that a sexual partner is cheating on them
6) belief that a person close to them has been replaced by a double

Answer 18

5) Othello Syndrome
6) Capgras delusion

Question 19

What delusion is described here?
7) patient identifies a familiar person (usually suspected to be a persecutor) in other people they meet
8) belief that doubles of him/her exist

Answer 19

7) Fregoli delusion
8) syndrome of selective doubles

Question 20

What delusion is being described here?
9) belief that one has been transformed into an animal
10) false belief that a person is in love with them

Answer 20

9) Lycanthropy
10) De Clerambault’s Syndrome

Question 21

What delusion is being described here?
11) Belief that they are dead/ do not exist
12) belief that others/TV/radio are speaking directly to or about the patient

Answer 21

11) Cotards/ Nihilistic delusions
12) Referential delusions

Question 22

What delusion is being described here?
13) belief that a normal percept (product of perception) has a special meaning
14) a condition whereby a woman believes herself to be pregnant when she is not. Objective signs accompany the belief such as abdominal enlargement, menstrual disturbance, apparent foetal movements, nausea, breast changes, and labour pains

Answer 22

13) Delusional perception
14) Pseydocyesis

Question 23

Name 4 types of PROJECTIVE personality tests:

Answer 23

Rorschach Inkblot
Thematic Apperception Test
Draw a Person Test
Sentence Completion

Question 24

Name 4 types of OBJECTIVE personality tests:

Answer 24

• Minnesota Multiphasic Personality Inventory
• Sixteen Personality Factor Questionnaire (16PF)
• NEO Personality Inventory (OCEAN)
• Esyenck personality test (EPQ)

Question 25

5 German terms to be aware of:
1) Gedankenlautwerden
2) Gegenhalten
3) Schnauzkrampf
4) Vorbeigehen/ Vorbeireden
5) Wahnstimmung

Answer 25

1) thought echo
2) a phenomenon in which a patient opposes all passive movements with the same degree of force as applied by the examiner
3) a grimace resembling pouting sometimes observed in catatonic patients
4) Seen in Ganser syndrome. Patient’s who exhibit this give approximate answers to questions (e.g. How many fingers does a man have, answer 14).
5) delusional mood

Question 26

Who came up with the following terms?
1) Dementia praecox, manic depression, katatonie
2) schizophrenia
3) Hebephrenia
4) Catatonia

Answer 26

1) Kraepelin
2) Bleuler - differentiated between primary and secondary symptoms
3) Heckler
4) Kahlbaum

Question 27

Who came up with the following terms?
5) Demence precoce (not to be confused with dementia precox = Kraeplin)
6) Schizoaffective
7) Neurasthenia
8) Unipolar and bipolar

Answer 27

5) Morel
6) Kasanin
7) Beard
8) Kleist

Question 28

Who came up with the following terms?
9) Schizophreneform schizophrenia
10) demence - to mean loss of mind
11) apophenia - the human tendency to perceive meaningful patterns within random data. It’s especially pertinent in schizophrenia where individuals may connect unrelated experiences or stimuli, perceiving them as being significantly related.
12) schizotypy
13) Type 1 and Type 2 schizophrenia

Answer 28

9) Langfelt
10) Pinel
11) Klaus Conrad
12) Rado / Meehl
13) Crow (Type 1 = excess D2 receptors, Type 2 = more neg symptoms, would respond less well to pharmacological treatment)

Question 29

Who came up with the following terms?
14) psychiatry
15) Group dynamics
16) Group psychotherapy
17) Psychopathic inferiority

Answer 29

14) The term ‘psychiatry’ was coined by Johann Reil in 1808
15) Lewin
16) Moreno
17) Koch

Question 30

Which British psychiatrist, associated with the antipsychiatry movement said:
Madness need not be all breakdown. It may also be break-through. It is potential liberation and renewal as well as enslavement and existential death. (The Politics of Experience/The Bird of Paradise).

Answer 30

rLaing - he believed there could be something liberating in what society labelled a ‘schizophrenic breakdown’. Laing believed that mental illness could arise as a response to dysfunctional family or societal dynamics. He advocated for a more humane and compassionate approach to psychiatric treatment, stressing the need for therapeutic relationships, empathy, and the creation of supportive environments to aid individuals in their recovery.

Question 31

Which psychiatrist associated with the antipsychiatry movement is this?

He believed that mental illness was a social construct rather than a biological disease. He argued that labelling certain behaviours as mental disorders was a way for society to exert control over individuals and suppress unconventional thinking. Advocated against involuntary psychiatric treatment

Answer 31

Thomas Szasz

Question 32

Which psychiatrist associated with the antipsychiatry movement is this?
He examined the historical and social dimensions of power and knowledge, including how psychiatric institutions exerted control and discipline over individuals. He explored the relationship between psychiatry, society, and the normalization of behaviour, questioning the validity of psychiatric diagnoses and challenging the authority and oppressive aspects of institutional psychiatry.

Answer 32

Michel Foucault (French)

Question 33

Which psychiatrist associated with the antipsychiatry movement is this?

He advocated for the closure of psychiatric hospitals and the development of community-based mental health services He implemented a model known as ‘democratic psychiatry,’ which involved treating mental health issues within the community, destigmatizing mental illness, and promoting social inclusion for those with psychiatric disorders

Answer 33

Franco Basaglia (1924-1980) - Italian

Question 34

Who wrote:
The Presentation of Self in Everyday Life
Asylums
Stigma?

Answer 34

Erving Goffman

Question 35

Who came up with the following terms?
9) Hypnosis
10) Group dynamics
11) Group psychotherapy

Answer 35

9) Braid
10) Lewin
11) Moreno

Question 36

Who came up with the following terms?
12) Psychopathic inferiority
13) Psychiatry
14) Institutional Neurosis

Answer 36

12) Koch
13) Reil
14) Barton

Question 37

Who contested the notion that a single factor could account for intelligence, instead proposing a model of intelligence comprising seven distinct primary mental abilities?

Answer 37

Thurstone - he proposed the ‘Theory of Primary Mental Abilities’ which comprises seven distinct dimensions: verbal comprehension, word fluency, number facility, spatial visualisation, associative memory, perceptual speed, and reasoning.

Question 38

In rating scales for depression and anxiety, name 6 self-rated scales:

Answer 38

BDI (Beck depression inventory) - 21 Qs
GDS (geriatric depression scale) - 30 Q’s
ZSRDS (Zung self rated depression scale) - 20 Q’s (1-4)
HADS (Hospital Anxiety depression scale)
EPDS (Edinburgh postnatal major depression scale)
PHQ-9 (9-question Patient Health Questionnaire)

Question 39

In rating scales for depression and anxiety, name 5 clinician-rated scales:

Answer 39

MADRS (Montgomery-Asberg depression rating scale)
HAMD (Hamilton depression rating scale) - 17-21 Q’s
BASDEC (Brief Assessment Schedule Depression Cards)
HAMA (Hamilton anxiety rating scale)
CSDD (Cornell Scale for Depression in Dementia)

Question 40

What type of scales are the BPRS (Brief psychiatric rating scale) and PANSS (Positive and negative syndrome scale)?

Answer 40

Clinician-rated scales for schizophrenia

Question 41

What is the CAMDEX scale?

Answer 41

CAMDEX (Cambridge Mental Disorders of the Elderly Examination) - clinician-rated scale for dementia

Question 42

What are the YMRS and the Y-BOCS rating scales?

Answer 42

Both clinician-rated

YMRS = Young Manis Rating Scle for bipolar

Y-BOCS = Yale-Brown Obsessive-Compulsive scale

Question 43

For rating scales related to medication, what are the LUNSERS and the DESS?

Answer 43

LUNSERS (The Liverpool University Neuroleptic Side Effect Rating Scale)
DESS (Discontinuation-Emergent Signs and Symptoms scale)

Both SELF-RATED

Question 44

For rating scales related to medication, what are the AIMS and the SAS?

Answer 44

AIMS (Abnormal involuntary movement scale)
SAS (Simpson-Angus scale)

both CLINICIAN-RATED

Question 45

In screening for personality disorder, what are 3 interview-method tests you can use?

Answer 45

SAPAS - Standardised assessment of personality abbreviated scale

IPDE (International Personality Disorder Examination Screen)

IPDS (Iowa Personality Disorder Screen)

Question 46

In screening for personality disorder, what are 3 self-reported tests you can use?

Answer 46

FFMRF - Five factor model rating form

PDQ-R (Personality Diagnostic Questionnaire-Revised)

IIP-PD (IIP Personality Disorder Scales)

Question 47

What are the 7 areas tested in the 30-point MMSE?

Answer 47

Orientation to time
Orientation to Place
Registration
Attention and Concentration
Recall
Language
Visual Construction

Question 48

What is “Incentive Salience”?

Answer 48

Incentive salience is a process through which the brain comes to desire certain things such as drugs. This process is mediated by mesolimbic dopamine systems. This is a separate process to that of liking something. As such desire and pleasure are separate processes with dopamine regulating the former and not the latter.

Grief has been hypothesized to be underpinned by a very similar process as drug addiction (Kakarala, 2020). This is referred to as the ‘incentive salience theory of grief’

Question 49

What are the 6 mixed-effective states described by Kraeplin?

Answer 49

1) Depressive/anxious mania
2) Excited depression
3) Depression with flight of ideas
4) manic stupor
5) mania with poverty of thought
6) inhibited mania

Question 50

Emil Kraeplin coined the term paramnesia to describe disorders of memory where fantasy and reality are confused.
Define the following:
1) Deja-vu
2) Jamais-vu
3) Confabulation
4) Reduplicative paramnesia (3 forms)
5) Retrispective falsification
6) Cryptomnesia

Answer 50

1) The experience of feeling that one has witnessed or experienced a new situation before
2) The experience of being unfamiliar with a person or situation that is actually very familiar
3) The unconscious filling in of gaps in the memory by events which never took place
4) The delusion that a place has been duplicated. It comes in three forms (Politis, 2012):

1 - Place reduplication - the belief that two places with identical features exist simultaneously, but are geographically distant
2 - Chimeric assimilation - the belief that two places become combined, for example, a patient in hospital believes that they are in their own home which has somehow transformed into the hospital
3 - Extravagant spatial localisation - belief that their current location is actually somewhere else, usually a location familiar to them

5) the process of distorting a memory
6) This is characterised by having a thought without realising you have had the thought before (for example, some plagiarists claim they are unaware that they were recounting other peoples work)

Question 51

What are the “7 sins of memory”?

Answer 51

The 7 ways memory can fail
1) transience - the decreasing accessability of memory over time
2) blocking e.g tip of the tongue syndrome
3) absent-mindedness - some failure in memory retrieval
4) suggestibility - incorporation of misinformation into memory
5) bias - retrospective distortions based on current knowledge/ beliefs
6) persistence - unwanted, intrusive memories e.g in PTSD
7) misattribution - e.g deja vu and cryptamnesia (e.g plagerism - not realising you’ve had the thought before and thinking it’s new)

Question 52

What is the format of the PANNS (Positive And Negative Syndrome Scale) for assessing the symptom severity in schizophrenia?

Answer 52

7 x positive symptoms
7 x negative symptoms
16 x general psychopathology symptoms

Each item is scored out of 7
Requires a trained interviewer

Question 53

What are the 7 positive symptoms on the PANSS?

What are the 7 negative symptoms?

Answer 53

Pos:
Conceptual disorganisation
Delusions
Grandiosity
Hostility
Hallucinations
Hyperactivity
Suspiciousness/ persecution

CDGHHHS

Neg:
Blunted affect
Difficulty with abstract thinking
Emotional withdrawal
Poor rapport
Passive/ apathetic social withdrawal
Lack of spontanaity and flow in conversation
Stereotyped thinking

Question 54

What are the 4 types of non-declarative/ implicit memory?

Answer 54

1) Procedural - involves basal gangliaq and cerebellum
2) Associative - involves amygdala, hippocampus, prefrontal cortex
3) Non-associative
4) Priming

Question 55

What are the parts of the Baddeley’s multi-storehouse model of (working) memory?

Answer 55

1) CENTRAL EXECUTIVE
- the other 3 can feed in and out of this
- capacity to focus, divide and switch attention
- Frontal lobes involved

2) Visuospatial sketchpad
- allows us to manipulate images in our mind
- stores and processes information in visual or spatial form including location and speed of objects moving

3) Phonological buffer/ loop
- holds auditory/ verbal info
- phonological store is related to speech perception
- articulatory rehearsal system is linked to speech production
- holds info for 1-2 seconds in speech based form

4) episodic buffer
temporary storage system which integrates info from different sources of working memory above, plus long-term knowledge into a coherent whole

Question 56

Who came up with the “sick role”?

Answer 56

Talcott Parsons

Based on Mechanic and Volkart’s phrase “illness behaviour”

Question 57

What are the 4 conceptual rules of the sick role?

Answer 57

1) Sick person is exempt from normal societal roles for the duration of illness
2) not responsible for their illness
3) has a duty to try to get well
4) they must seek help and cooperate with their caregiver

Question 58

Name two people involved in the discussion of Social Capital

Answer 58

Putnam 1996
McKenzie 2002

Question 59

Which frontal lobe function are assessed by the following tests?
Verbal and categorical fluency

Answer 59

Initiation

Question 60

Which frontal lobe function are assessed by the following tests?
Proverbs
Similes
cognitive estimates

Answer 60

Abstraction

Question 61

Which frontal lobe function are assessed by the following tests?
Tower of London
Cambridge stockings
gambling tasks

Answer 61

Problem solving and decision making

Question 62

Which frontal lobe function are assessed by the following tests?
Alternating sequences
Go-no-go test
Luria motor test
trail making test
Wisconsin card sorting test
Stroop test

Answer 62

Response inhibition and set shifting

Question 63

What are the 2 types of somatoform disorders described in the ICD-11?

Answer 63

Bodily distress disorder
Body integrity Dysphoria

Question 64

What is “la belle indifference”?

Answer 64

= beautiful ignorance

Associated with CONVERSION DISORDER

Question 65

Describe the Brief Psychiatric Rating Scale, developed by Overall and Gorham in 1960s

Answer 65

Originally 16 items, expanded to 18, now new 24 item version
Each item scored out of 7 and some ratings are based on interview, others on observation
Clinician-administered
Versions now for children and older adults

Question 66

What is the AUDIT tool?

Answer 66

Alcohol Use Disorders Identification Test
Designed by WHO for screening excessive drinking
10 item questionnaire
Score: 0-40
20+ = likely alcohol dependence
AUDIT-c is a shorted version consisting of 3 questions

Question 67

Name 6 alcohol screening tools:

Answer 67

AUDIT (WHO) - 10 Q’s
FAST - 4 Q’s
CAGE - 4 Q’s
SASQ - Single question (when 8+ men or 6+ drinks women) in one day. If within 3 months = possible hazardous drinking
PAT - Paddington Alcohol Test
MAST
RAPS4

Question 68

In catatonia, what is the meaning of the following:
1) Waxy flexibility (cerea flexibilitas)
2) Automatic obedience
3) Mitmachen
4) Mitgehen
5) Gegenhalten (Negativism)

Answer 68

1) patient can be positioned in an unnatural position and maintain this for some time (look like a waxwork)
2) exaggerated co-operation, automatically obeying the examiner’s instructions
3) a form of automatic obedience - body can be placed into any position even if asked to resist but UNLIKE waxy flexibility, it returns to its usual position
4) an extreme form of mitmachen - requires much less force (e.g anglepoise lamp sign)
5) patient resists attempts by examiner to move their body. Resistance offered is the same as the force applied

Question 69

In catatonia, what is the meaning of the following:
6) posturing
7) stupor
8) ambitendency
9) mannerisms
10) stereotypies
11) obstruction

Answer 69

6) maintaining specific posture e.g crucifix for long time
7) combo of mutism and immobility
8) patient alternates between complying and resisting examiner’s instructions
9) GOAL-DIRECTED repetitive movements e.g combing hair without brush, saluting door
10) NON-GOAL DIRECTED repetitive movements e.g rocking
11) motor counterpart to thought blocking

Question 70

What is the meaning of the following:
1) Echolalia
2) Echopraxia
3) Logorrhoea
4) Logoclonia
5) Verbigeration

Answer 70

1) involuntary repetition of language and sounds
2) involuntary imitation or repetition of someone’s ACTIONS
3) incoherent talkativeness
4) meaningless repetition of a syllable like at the end of a word
5) meaningless repetition of words and phases

Question 71

Who came up with the social readjustment rating scale, which lists events called Life Change Units?

Answer 71

Holmes and Rahe

Question 72

What are the 4 models for doctor-patient relationships?

Answer 72

1) Paternalistic AKA autocratic
2) Informative - pt makes choice based on info given by doctor
3) interpretive - doctor takes patient’s individual circumstances into account, and uses shared decision making to help them make a decision
4) deliberative - doctor acts as a “friend” to the patient and tries to steer them in a specific direction but ultimately lets the patient make the choice

Question 73

What are the 3 main theoretical perspectives on aggression?

Answer 73

1) psychodynamic (Freud)
- death instinct (thanatos) and life instinct (eros)
- catharsis - becoming calm = basis of hydraulic model of the mind
2) sociological/ drive (Lorenz)
- studied birds
- aggressive instinct is becessary for survival
3) cognitive/ learning (Berkowitz, Rotter, Bandura, Anderson)

Question 74

What culture-bound illnesses are being described here?
1) Philipines/ Malaysia - men have a trauma, and then get very angry and go on a killing frenzy. Amnesia. Only stopped when caught and restrained.
2) Latinos - during stress, intense emotional upset leading to aggression, shouting, seizure-like activity or dissociation
3) African diaspora - concentration difficulties, poor retention, strange sensory disturbances like heat sensations; happens during studying/ working hard

Answer 74

1) Amok
2) Ataque de nervios (‘attack of nerves’)
3) brain fag

Question 75

What culture-bound illnesses are being described here?
4) South Asia - young males who attribute symptoms to semen loss
5) Cambodians - panic attacks with autonomic arousal, centred on concern that khyal (wind-like substance) may be within them
6) SE Asia, China - males believe the penis is withdrawing into the abdomen

Answer 75

4) Dhat
5) Khyal cap (wind attacks)
6) Koro

Question 76

What culture-bound illnesses are being described here?
7) Zimbabwe - “thinking too much causes anxiety”
8) Malaysia - women, hypersensitivity to sudden fright/ startle. Display strange responses like exchopraxia, echolalia, dissociative behaviours
9) Haiti - A cultural explanation for diverse medical and psychiatric disorders. Illnesses are believed to have been sent from others who are envious or seek to cause malice
10) Greek - eeling of loss of control, of having one’s nerves ‘burst out’ or ‘break out’, or ‘boil over’. An attack is often accompanied by shouting and screaming and throwing things. Headaches, dizziness etc associated

Answer 76

7) Kufungisisa
8) Latah
9) Maladi Moun (“sent sickness”/ human-caused sickness)
10) Nevra

Question 77

Where would you find the following culture-bound illnesses and give a short description:
11) Piblokto
12) Shenjing shuairuo (‘weakness of the nervous system’
13) Susto (“fright”)
14) Taijin kyofusho (‘interpersonal fear disorder’)
15) Wendigo

Answer 77

11) Arctic, Inuit - women, abrupt episodes of extreme excitement, often followed by apparent seizures and transient coma
12) Mandarin Chinese - Integrates conceptual categories of traditional Chinese medicine with the Western diagnosis of neurasthenia. Assoc with work/ family stress, sense of failure
13) Latinos - An illness attributed to a frightening event that causes the soul to leave the body and results in unhappiness and sickness.
Symptoms may appear any time from days to years after the fright is experienced.
14) Japanese - characterized by anxiety about and avoidance of interpersonal situations due to the thought, feeling, or conviction that one’s appearance and actions in social interactions are inadequate or offensive to others
15) North America, Native Americans - Long, harsh winters - scarsity of food leads to distaste of it and ++ anxiety. The sufferer then construes the repugnance for food as evidence that he or she is turning into a wendigo, which is a cannibalistic ice spirit of giant size

Question 78

What are the levels of traits, described by Gordon Allport?

Answer 78

1) Cardinal - so pervasive that most of the persons behaviour and activities can be traced to this particular trait.
2) Central - easily detected characteristics within a person, traits that all people have a certain number of, five to ten on average
3) Secondary - Less evident and only manifest in select circumstances

Question 79

When describing delusional beliefs, what are three ways of describing a deusional belief’s relationship with reality?

Answer 79

1) Polarised - the delusion and fact are mingled together
2) Juxtaposed - the delusion and fact exist together but sit side by side and do not interact
3) Autistic - actual reality is not taken into account and the patient lives in a delusional world

Question 80

What are the
Id
Ego
Super-ego
described by Freud in his STRUCTURAL model?

Answer 80

The Id is the area that contains the instinctive drives. It operates under ‘primary process thinking’, acts according to the ‘pleasure principle’, and is without a sense of time.

The ego attempts to modify the drives from the Id with external reality. It operates on the ‘reality principle’. It has aspects that are conscious, pre-conscious, and unconscious. It is home to the defenses mechanisms.

The super ego constantly observes a person and acts as critical agency. Freud claimed it developed from internalised values of a child’s main carers. The ‘ego ideal’ is part of the super ego and represents ideal attitudes and behaviour. It is useful to think of the super ego as the conscience.

Question 81

What are the
1) Conscious system
2) Pre-conscious system
3) Unconscious system
described by Freud in his TOPOGRAPHICAL MODEL in the book The Interpretation of dreams?

Answer 81

The conscious system: This refers to the part of the mind that is aware.

The preconscious system: This is the information that is known and can potentially be brought into consciousness.

The unconscious system: Freud believed that this area of the mind was outside conscious awareness. It operates on the primary process thinking, which means it is aimed at wish fulfilment. It is governed by the pleasure principle. It has no concept of time, and denies the existence of negatives, and is irrational as it allow the existence of contradictions.

Question 82

What type of amnesia is this?
a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years.
Can be global (fugue states) or situation specific

Answer 82

Psychogenic aka dissociative amnesia

Question 83

What type of amnesia is this?
primarily expresses itself in the form of problems with language use and acquisition.

Answer 83

Semantic amnesia

Question 84

What type of amnesia is this?
transient loss of memory. It typically affects those over 50 and spontaneously resolves within 24 hours. No clear cause has been identified but it has been proposed to be a variant of migraine, a form of epilepsy, and a presentation of a TIA (transient ischemic attack)

Answer 84

Transient global amnesia

Question 85

What code was the first international document which advocated voluntary participation and informed consent in medical experimentation?

Answer 85

Nuremberg code

Question 86

The DSM divides 10 personality disorders into 3 categories:
Cluster A (3) “mad”
Cluster B (4) “bad”
Cluster C (3) “sad”

Name the disorders in each category:

Answer 86

A:
Paranooid
Schizoid
Schizotypal

B)
Narcissistic
Borderline
Histrionic
Antisocial

C)
Obsessive Compulsive
Dependent
Avoidant

Question 87

What are the 5 traits laid out in the ICD-11 which can describe personality disorders?

Answer 87

Negative affectivity
Detachment
Dissociality
Disinhibition
Anankastia

(Also, mild, moderate or severe)

Question 88

What are:
Felt Stigma
Enacted Stigma
Courtesy Stigma?

Answer 88

Felt stigma (internal stigma or self-stigmatisation) refers to the shame and expectation of discrimination that prevents people from talking about their experiences and stops them seeking help
Enacted stigma (external stigma, discrimination) refers to the experience of unfair treatment by others
The stigma that attaches to those who are merely associated with a stigmatized person

Question 89

What was the Tarasoff case?

Answer 89

two therapists failed to warn a lady that their patient expressed an intention to kill her. They chose not to do so as they wished to respect the patient’s confidentiality and failed to see that they had a duty of care to the lady as well as the patient. The lady was eventually murdered by this patient.

Centred on “Duty to Warn”

Question 90

Who publicised the term autism, suggested this could be a form of childhood schizophrenia, and referred to the “refrigerator mother”?

Answer 90

Leo Kanner

Question 91

When was Autism first included in the ICD/ DSM?

Answer 91

ICD-9 1965
DSM-III 1980

Note: ICD-11 now uses Autism Spectrum Disorder

Question 92

What is Therapeutic privilege?

Answer 92

Therapeutic privilege (TP) is a defence that may be available to doctors who fail to disclose to the patient relevant information when seeking informed consent for treatment if they have a reasonable belief that providing that information would likely cause the patient concerned serious physical or mental harm

Question 93

What is the diathesis-stress model?

Answer 93

The diathesis-stress model recognises that both experience (nurture) and genetics (nature) contribute to a persons behaviour.

It suggests that certain people have a predisposition (diathesis) towards a certain illness and that types of environmental stress can trigger illness in such vulnerable people.

Question 94

What is the Pygmalion effect?

Answer 94

When higher expectations from an authority figure, such as a teacher, can lead to an improvement in the performance of those they guide, primarily due to the authority’s belief in the individual’s potential.

Question 95

What is the Barnum effect?

Answer 95

involves the tendency of people to accept vague and generic personality descriptions as uniquely applicable to themselves, often seen in settings involving personality assessments and horoscopes. This effect leverages the generality of the information, which could apply to a wide range of individuals, making it seem personally relevant.

Question 96

The Office of Population Censuses and Surveys uses a classification system of 5 levels. Who is represented by each level?

Answer 96

Social class I - Professional
Social class II - Intermediate
Social class III - Skilled, manual, or clerical
Social class IV - Semi-skilled
Social class V - Unskilled

Question 97

Who is associated with the following terms?
1) Womb envy
2) Total institution
3) Foundation matrix
4) Institutional neuroses

Answer 97

Karen Horney - Womb envy
Erving Goffman - Total institution
Siegfried Foulkes - Foundation matrix
Barton - Institutional Neurosis

Question 98

What types of delusions are being described here?
1) Highly organised, logical delusions
2) the delusion and fact are mingled together
3) the delusion and fact exist together but sit side by side and do not interact
4) actual reality is not taken into account and the patient lives in a delusional world

Answer 98

1) systematised.

One can also describe the delusional beliefs’ relationship with reality in the following ways:

2) Polarised
3) Juxtaposed
4) Autistic actual reality is not taken into account and the patient lives in a delusional world

Question 99

Who proposed the theory of attribution?

Answer 99

A theory of attribution was first proposed by Fritz Heider (1958).

Question 100

What type of attribution bias is being described here?
1) when we make attributions about another person’s actions, we are likely to over emphasize the role of dispositional factors, rather than situational causes.
2) in addition to over-valuing dispositional explanations of others’ behaviours, we tend to under-value dispositional explanations and over-value situational explanations of our own behaviour.
3) the tendency to draw inferences about a person’s unique and enduring dispositions from behaviours that can be entirely explained by the situations in which they occur

Answer 100

1) Fundamental Attribution Error (FAE) (focus is on other people’s behaviour)
2) Actor-observer Bias (how behaviour is viewed differently between actor and observer)

Note: The fundamental attribution error is strictly about attributions for others’ behaviours. The actor-observer bias is about the relative difference in attributions about one’s own versus others’ behaviours.

3) Correspondence bias (focus is on other people’s behaviour)

Note: Sometimes the terms fundamental attribution error (FAE) and correspondence bias are used interchangeably. However, there is a difference between the two. The FAE is the tendency for people to attribute other’s behavior to internal causes rather than external causes. When we see someone behaving in a certain way we think it is because of something inside of them rather than the situation they are in.

The correspondence bias goes one step further. We don’t just attribute the behaviour to something internal, we attribute it to the person’s personality or other enduring characteristics. The difference is that we think this is always how the other person is..

Question 101

What type of attribution bias is being described here?
4) people’s tendency to attribute their successes to internal factors but attribute their failures to external
5) an interpretive bias wherein individuals exhibit a tendency to interpret other’s ambiguous behaviour as hostile, rather than benign.
6) refers to the tendency for people to project their way of thinking onto other people. In other words, they assume that everyone else thinks the same way they do.

Answer 101

4) self-serving bias
5) Hostile Attribution Bias (focus is on other people’s behaviour)
6) False consensus effect

Question 102

What is the structure of the Hopsital Anxiety and Depression (HAD) scale?

Answer 102

consists of 14 questions, 7 for anxiety and 7 for depression
each item is scored from 0-3
produces a score out of 21 for both anxiety and depression
severity: 0-7 normal, 8-10 borderline, 11+ case

Question 103

What is the SF-36?

Answer 103

The SF-36 (Short-form 36) is a 36-item, patient-reported survey that measures patient-rated functioning and well-being.

The SF-36 is comprised of the following eight scales (four pertain to physical health, and four to mental health):

physical functioning
role limitations due to physical health problems
bodily pain
general health
vitality (energy/fatigue)
social functioning
role limitations due to emotional problems
mental health (psychological distress and psychological well being).

The measure can be completed by the patient on their own and takes approximately eight minutes to do.

Question 104

The following indeces are scored on which test?

Processing Speed
Perceptual Reasoning
Verbal comprehension
Working memory
(PPVW)

Answer 104

WAIS-IV

Processing Speed - symbol search, coding, cancellation
Perceptual Reasoning - block design, matrix reasoning, visual puzzles, picture completion, figure weights
Verbal comprehension - similarities, vocabulary, conformation, comprehension
Working memory - digit span, arithmetic, letter-number sequencing

Question 105

What is the term used for Munchausen’s syndrome in the ICD-11?

Answer 105

Facticious disorder

Question 106

What is another term for dissociative disorders?

Answer 106

Conversion disorder

Question 107

What is the name given to a person’s identification with a particular group based on common heritage but also language, culture, religion or ideology?

Answer 107

Ethnicity

Question 108

Who wrote the first book on medical wthics?

Answer 108

Ishaq bin Ali Rahawl (Adab al-Tabib - Conduct of a Physician)

Question 109

A question involvig extraoccular muscle weakness, diplopia, proximal muscle weakness, ptosis and dysphagia refers to what ilness?

Answer 109

Myesthenia Gravis

Question 110

What are 5 tests for MG?

Answer 110

1) Single fibre electromyography (92-100% sensitivity)
2) CT thorax (thymoma)
3) Normal CK
4) Autoantibodies (present in 85-90%) to acetylcholine receptors, anti-muscle specific tyrosine kinase (40%)
5) Tensilon test

Question 111

Which vitamin deficiency is described here:
1) night blindness (nyctalopia)
2) rickets, osteomalacia
3) haemolytic anaema, ataxia
4) coagulation disorder

Answer 111

All FAT-SOLUBLE vitamins

1) Vitamin A
2) Vitamin D
3) Vitamin E
4) Vitamin K

Question 112

Which vitamin deficiency is described here:
seborrheic dermatitis, atrophic glossitis, angular chelitis, confusion, sleepiness, polyneuropathy, associated wit Isoniazid

Answer 112

Vitamin B6 deficiency - usially happens in people with alcohol dependence

Question 113

Which vitamin deficiency is described here:
signs of heart failure
What other conditions could be described?

Answer 113

B1 (thiamine) deficiency - Wet Beriberi presents like heart failure

Can also get Dry beriberi (when the CNS is invovedi = mpaired reflexes and symmetrical motor and sensory deficits in the extremities. Loss of myelin is seen without any acute inflammation) and Wernicke’s

Question 114

Which vitamin deficiency is described here:
triad of dementia, diarrhoea and dermatitis

Answer 114

Vitamin B3 (Niacin) deficiency = pellagra

Question 115

Which vitamin deficiency is described here:
Glossits, stomatitis

Answer 115

Vitamin B2 (riboflavin) deficiency

Question 116

Which vitamin deficiency is described here:
Dermatitis, alopecia, parasthesia

Answer 116

Vitamin B7 (biotin) deficiency

Question 117

Which vitamin deficiency is described here:
Gingivitis, increased infection, fatigue, aching joints

Answer 117

Vitamin C deficiency = Scurvy

Question 118

Which test is described here:
To assess abstract thinking - patient requird to sort objects by colour or material, copy block patterns with coloured cubes. To diagnose neurological problems.

Answer 118

Goldstein Scheerer Object Sort Test

Question 119

Which test is described here:
Examiner demonstrates a 3-stage hand sequence and asks the paient to copy it

Answer 119

Luria motor test

Question 120

What is the definition of the following:
Pelopsia
Teleopsia
Dysmegalopsia
Metamorphosia

Answer 120

Pelopsia - objects appear nearer than they are
Teleopsia - objects appear farther away than they are
Dysmegalopsia - objects appear larger on one side than the other
Metamorphosia - objects appear irregular in shape

Question 121

Which type of illusion is described here:
1) tendency to fill in missing information to make sense of a stimulus
2) arrise due to specific mood states
3) when dtailed images ar seen from shapes e.g seeing Jesus on a piece of toast

Answer 121

1) completion - tend to happen during inattention
2) affect
3) paraideolic - tend to happen hen concentrating

Question 122

What is the name given to the pupil of an older person that is associated with reduced reaction to both light and accommodation?

Answer 122

Senile pupil (senile miosis)

Question 123

What is the difference between covert sensitisation and avoidance conditioning?

Answer 123

Covert - relies on imagery rather than an actual occurrence

Question 124

What is the structure of Beck’s Depression inventory?

Answer 124

21 q’s
Max score 63 (0-3/ question)
Assesses severity of depression
Self rated
Covers last 2 weeks

Question 125

What is the term eudaimonia associated with?

Answer 125

Virtue ethics

The Greek term eudaimonia has no one-word translation in English. Hursthouse describes it as a combination of well-being, happiness and flourishing

Question 126

What is Sydeham’s chorea?

Answer 126

<18 yrs
rapid, uncoordinated jerky movements of face, feet, hands
Group A beta-haemolytic strep (6 months after infection)
resoves after a few months

Question 127

What is paraschemazia?

Answer 127

Feeling of body parts being twisted or distorted

Can happen in migraine, epileptic aura, hallucinogens

Question 128

When would you see Sick Euthyroid Syndrome?

Answer 128

Anorexia patients after starvation - abnormal TFTs (low T3) in setting of non-thyroidal illness

Question 129

What is the difference between a functional and a refex hallucination?

Answer 129

Functional - same sensory modality
Reflex = different sensory modality

Question 130

The 6 subsets below are seen in which test?
1) conceptualisation
2) mental flexibility
3) motor programming
4) conflicting instructions
5) go-no-go
6) prehension behaviour

Answer 130

FAB - Frontal Assessment Battery

Question 131

Chorea vs athetosis:

Answer 131

Note: chorea and athetosis are often confused. In chorea the movements are jerky whereas in athetosis there is a continuous flow of movement.
Athetosis is ‘worm like’ = continuous stream

Chorea is ‘dance like’ = more discrete movements than athetosis

Question 132

What term is described here:
1) Involuntary expression of socially unacceptable gestures
2) Involuntary expression of socially unacceptable words
3) Eating faeces
4) Copying others words
5) Repeating one’s own sounds
6) Copying others actions

Answer 132

Involuntary expression of socially unacceptable gestures = copropraxia
Involuntary expression of socially unacceptable words = coprolalia
Eating faeces = coprophagia
Copying others words = echolalia
Repeating one’s own sounds = palilalia
Copying others actions = echopraxia

Question 133

What is the HCR-20 test?

Answer 133

The HCR-20 is a risk assessment tool used for adults, which considers past, present, and future factors, and is used to assess the risk of future violence.

Historical
Clinical
Risk-Management

Question 134

What is the Simoson-Angus scale used for?

Answer 134

Drug induced parkinsonism