clincial psych Flashcards
1
Q
history of bromides
A
Sir Charles Locock gave potassium bromide to people to calm them down patients’ epilepsy improved, sir Samuel wilks also found this. Bromide sleep, the pills last for 9 days in body, sleeps day and night and cannot wake up.
2
Q
Bromo-seltzer history
A
contained potassium bromide (plus sodium bicarbonate and citric acid for fizz), invented by Isaac Emerson in 1888. Continued in over-the-counter form under mid-1970’s. inlincation to kill you if you take too much.
3
Q
Barbituates
A
veronal, 30 minute sleep, 8 hour sleep, 9 hour sleep, struggled to get out of bed after higher dose. pentonarbital, given to chidlren as well.
4
Q
risk of barbituates
A
major risk over overdoes
they were the cause of two thirds of poisning deaths in the 50s
5
Q
who started developing benzodiazepines?
A
Leo Sternbach - making six drugs
6
Q
what drug was the most perscribed in the US in 1978?
A
valium
7
Q
positives of valium
A
less sideffects than other BD and makes you calm
8
Q
how do benzodiazepines work?
A
- GABAA receptors are found in high concentrations in limbic structures such as the amygdala and associated limbic structures.
- Benzodiazepines bind to a specific site on the GABAA receptor.
- This activates GABA chloride ions flood through its center into the neuron, causing it to fire and release GABA downstream.
drain opens when the benzo attaches
alpha sub-units
5 subunits, different distributions around the brain
9
Q
how many subunits form the GABA receptor?
A
theres 5 different alpha
10
Q
where is α1 most spread
A
cortical and cerebellar regions
11
Q
where is α2 the most intense
A
striatum
12
Q
where is α3
A
frontal
13
Q
wehre is α5?
A
hippocampus
14
Q
what is the specific function/ side effects of α1?
A
- sedation
- anti-convulsive
- amnesia
- addictive
15
Q
what is the specific function/ side effects of α2?
A
- anxiolysis - relaxing
- muscle relaxation
- addictive
16
Q
what is the specific function/ side effects of α3?
A
- muscle relaxation
17
Q
what is the specific function/ side effects of α5?
A
- muscle relaxation
- amnesia
18
Q
Rudolph study using mice to asses the sedative properties of alpha one …
A
Rudolph - got rid of alpha one subunit in mice, genetic knock out, to assess sedative effects
found dizapem didnt work and its sedative properties rely on alpha one sub unit
19
Q
Rudolph research into alpha one role in anxiety …
A
anti anxiety effects measured in an elevated X-maze, where mice got to choose how much time they preferred to spend on its dark (preferred) vs. lighted (anxiety-provoking) areas .
Diazepam increased time on lighted arms (reduced anxiety) even in mice lacking the α1 subunit, therefore its anti-anxiety effects were not dependent on the α1 subunit.
20
Q
memory test on alpha one sub unit
A
Passive avoidance memory test, in which mice normally remembered not to enter a dark box that they’d previously encountered an aversive stimulus on entering it. However, mice lacking the α1 subunit did not step through, so they remembered the aversive experience as well as controls. This form of anterograde amnesia therefore depends on the α1 subunit.
since they remebred to not go in clearly drug effects memory
21
Q
what happens to anxiety levels on a mouse with a a2 knock out?
A
when given diazepam to the a2 knock outs it doesnt work anymore, still anxious
22
Q
midazolam procedure on memory a2
A
Presented patients about to have surgery with pictures to remember before and after midazolam (given 8mins prior full anaesthesia). Following recovery from surgery, patients’ memory for pictures shown just before midazolam was unaffected, but they were really bad at remembering pictures once given midazolam. Midazolam therefore induced anterograde amnesia.
23
Q
what is the most localised sub unit?
A
a5 - to the hippocamus
24
Q
a5 study into hippocampus and a5 knock out
A
Crestani et al. (2002): being able to remember a conditioned stimulus e.g. a tone across a trace interval before the presentation of an unconditioned stimulus e.g. food depends on the hippocampus. Participants lacking the GABAA α5 subunit actually remembered better than controls!
25
negative of a5
not predictive sometimes improves memory sometimes make it worse
26
how are BD linked to the reward system?
addictive potential effects the reward system,
indirectly active the mesoaccumbens projection, they disinhibite it
gana is an inhibitory NT that keeps them in check then BZD comes and attaches to receptor and reduces gaba effect and means more dopamine is produced from the nucleus accumbens
27
who cerated psychoanalysis first?
Breuer
28
who was Breuers first client?
rst case of Bertha —> couldn’t find a physical basis of her symptoms so acknowledged it must be psychological and sociocultural factors. Said it denial of education and being treated as unequal to her male counterparts caused her to have psychological issues.
29
what was Breuers theory?
Breuer created cathartic psychology, the talking cure, recovering unconscious memories and emotions to relieve emotional distress.
30
why and who got rid of the people in the vienna psychoanalytical society?
ernest jones
31
halo effect study by Nizbett and wilson
- PP were taught by a mean and nice teacher but they did the same mennerisms
- people who had nice said it was her mannerisms that made her nice
- people who had mean said it was her vibe
- we constanly guess our feelings
-
32
what was wens study into halo effect?
Wen et al. (2020): participants either carried out a basic visual pattern matching task (Control Group) or a highly analytical problem-solving task, then watched warm/cold teacher video and rated their physical characteristics. Control Group showed typical Halo Effect, Analytical Group did not.
important to articulate thoughts because reduced ability to be fooled by our thoughts
people who thought knew
33
what are freuds defence mechanisms?
- denial
- displacement
- repression
- projection
- reaction formation
- regression
- rationalisation
- sublimation - unccaeptal sexual.agressive behaviour into socially valued
34
Anderson and green - think no think procedure
- think/no-think procedure - participants trained with word pairs, then presented with one word from each pair and asked either to say out loud the associated word, or to suppress all conscious memory of it. Participants successful rather quickly.
35
what does rge supression hypothesis state?
supression is trained by inhibiting the target not via thought strategies or a weakeneing of the cue-target association
36
repressing the word ROACH study
told to repress a roach - given independent cue of roach bug letter R but they couldnt remember it suggetsing theyve repressed the roach target has been turned away
question did they not remeber or were they scared to say
but then if you offered money for saying the R word they still took it hard to find the word roach
we do this process all the time without thinking about it
wed predict this would happen more with negative thoughts.
37
what has increased activity for repsression etc?
dorsolateral prefrontal cortex - increased activity
38
hippocampus in no think task
it has decreased activity in the think no think task
39
what did Apšvalka propose about the neurological basis of psychotherapy?
- stated that the lateral prefrontal cortex inhibts motor control via M1 in the primary motor cortex and also inhibts recall of emotional memories via hippocampus
40
Apšvalka study
- equired participants to learn **both** a stop-signal task, *and* a think/no-think task! 5/30 participants did not reach the 40% learning criterion on the Think/No-Think task, and **one fell asleep** during fMRI acquisition!
better they were at think no think better at the other suggetsing similar source
common neural mechanism - dorsolateral and ventrolateral orefrontal cortex
41
who developed mindfulness into a psychological theory?
Thích Nhất Hạnh
42
main point of Thích Nhất Hạnh theory
become aware of your breath and you come into the present moment where everyday activities become joyous. Reducing anxiety and positive thinking emerges.
43
Thích Nhất Hạnh life
- Born in Vietnam
- Hue imperial city
- 2nd youngest of 6 children
- pivotal momement when he saw Buddha and wanted to become a monk as he thought it brought peace
- in response to vietnamese conflict he formed engaged Buddhism
- Meditation is about awareness of what is going on—not only in your body and in your feelings, but all around you…."
- banned from vietnam
44
What did canby find about the effectivness of mindfulness when PP completed a 6 week reduction class?
- Pp did 2 hour a week
- plus exercises, groups lectures
- mindfulness score increaseed and symptom severity decreased
45
what did ahmed find about the succsesfullness of partial and full time mindfullness treatment?
found that part time and fulltime were effective after watchinh twleve video sessions
46
high levels of what lead tp tress
cortisol
47
what is the effect of high cortisol levels?
- showed extensive white matter degeneration compared
- specifically, the corpus callosum
- and other communication regions
- decreased recall and poor immediate recall
- left orbitofrontal cortex abd dorsolateral prefrontal cortex
48
Bremner found that if a PP had an adverse event that resulted in PTSD that also reduced in decreased brain tissue in what brain region?
Hippocampus, bilaterally
49
what did Frodl find caused smaller hippocampal volume?
childhood emotional neglect
50
Trier social stress test
5 min impromptu speech in front of judges followed by 5min mental arithmetic. Cortisol response to stress was greatly reduced by the mindfulness training. Cessation of the training increased the cortisol response to stress once more.
51
immue system inflametry response study with mindfullness
ook topical capsaicin found in hot petters put it on skin and 1hour later applied suction device to induce a blister. analysed inflammatty response of blister. the more self reported practice greater reduction in response to hot chilli
52
what effect does mindfulness have on white matter n the brain
- hippocampul volume increase
- prefrontak cortical activity increase
53
default mode network
- areas of the brain that are activated when people are not engaged in any specific cognitive task
- medial prefrontal cortex
- angular gyrus
- posterior cingulate gyrus
54
can mindfullness improve reaction time?
allen - 6 weeks training improved reaction time in anxiety test
55
what else did allens reaction time study find?
- found mindfulness training improved activty in regions of defulat mode network
- medial prefrontal cortex, insula
- activity levels correlated with amount of training
56
What did Goldin and gross find the effect of mindfulness was on people with social anxiety?
- 8 week training
- found reduced responses to threats
- and their amygdala BOLD signal response
57
zeno stated that
- Happiness can only be achieved through the use of reason coinciding with the universal reason (Logos) which governs everything, and in accordance with nature.
- distructive emotions emerg from errors in judgement
- pur emotions arent due to the thing itself but how we react to it
58
what does beck think causes deppression?
- negative thinking
59
what is the negative triad
- negative thoughts about the self
- the world
- the future
60
what is a negative schema?
- negative frameworks
- self worth is low
- slef worth = on school
61
what are the three errors in logic?
Arbitrary inference
Selective abstraction
overgeneralisation
62
Arbitrary inference
Arbitrary inference: negative conclusions from little or even contradictory evidence, e.g. if glanced at in the street, assumes “They must think I’m really stupid”
63
Selective abstraction
Selective abstraction: inappropriate focus on negative aspects of a generally positive situation, e.g. at a dinner that otherwise went very well, a single clatter of a fork taken to indicate a disastrous night.
64
CBT aims to
changes negative thoughts in themselves
65
Overgeneralisation
Overgeneralisation: a single negative event is taken to apply at all times/places, e.g. following the dinner above, a person might concluded “I’m always absolutely hopeless at socialising”.
66
mathews study - people who are depressed will recall what words
Bradley and Matthews (1983): Controls vs. depressed participants presented with words and told they either related to an unfamiliar or familiar person, or themselves. Depressed participants recalled fewer positive words and more negative words specifically when words related to themselves
67
when shown sad, happpy and neutral faces depressed PP ..
Leppäanen et al 2004: Happy, sad or neutral faces briefly shown to controls or depressed participants. Depressed participants specifically interpreted neutral (ambiguous) faces as sad (negative) ones. they had the same results for happy,sad and neautral faces
68
steps for CBT
1. behaviour component - improve mood
2. identify and challenge negtiave thoughts - record thoughts and experiences
3. ientify the challenge attitudes and schemas
4. coping stratergies developed
69
blackburn finding on CBT and Drugs
blackburn - drug and cbt combo finding 70% IMPROVEMENT WITH BOTH
70
Mendlowicz fiund cbt is effective for multiple disorders, such as ....
Mendlowicz et al. 2022: “Cognitive therapy was found to be effective for treating panic disorder and agoraphobia, social phobia, OCD, PTSD, insomnia, and eating disorders. CBT has now become the most commonly practiced and extensively researched form of psychotherapy in the world.
71
what was Becks first emprical study?
Rush, Beck et al (1977): First empirical study of CBT, with a second, antidepressant group (imipramine, a ‘tricyclic’ antidepressant). 12 weeks treatment in each case, 20 sessions of CBT. Fairly small initial study: CBT, n=19; Drug, n=22. However, 8 drug dropouts, just one CBT dropout.
72
how long was becks findings found
6 months +
73
wolf, Xanax experiment
fMRI of affect of Xanax on brain - found increased blood flow in the nucleus acummbens suggetsing increase in reward system
74
what was freuds life like?
- born in vienna
- big family
- favourite - golden sigi
- family revolved around him
- freud had a family - his favourite = anna
- moved to london
75
what are the three componenst of personality?
ego - conscious - rational
superego - preconscious - morals
id - unconcscious - impulses
76
wilson and nisbett shock study
Objective: Examine if reassurance about no permanent damage affects willingness to endure electric shocks.
Setup:
Experimental Group: Told beforehand no permanent damage.
Control Group: Told afterwards.
Findings:
No significant difference in shock level willingness (Exp: 3.3V; Con: 3.48V).
Many in the Experimental Group thought reassurance increased their willingness, some believed it decreased it.
Conclusion: Perception of reassurance impacts reported willingness, highlighting cognitive dissonance and rationalization effects.
77
Anderson & Green (2001): Think/No-Think Procedure
Objective: Explore active memory suppression.
Method: Train with word pairs, then either recall or suppress the memory.
Findings: Participants quickly learned to suppress memories.
Implications: Supports the concept of Freudian repression, showing conscious control over memory suppression.
78
what is the conclusion of the roach study?>
Anderson & Green's study supports the idea that memory suppression is a direct process, not just a result of distracting thoughts or weakening associations.
79
lambert found that repression is specific to
- negativity
80
what is minfullness defined as?
indfulness is defined as the awareness that arises from paying attention to the present
moment, non-judgmentally
81
does partial treatment still have apositive effect on mental health?
yess
82
Wells & Roussis (2014): Coping with Intrusive Thoughts study
Methods: Imaginal Exposure, Acceptance, Mindfulness.
Findings: Mindfulness group had fewest intrusive thoughts, significantly different from Control Group.
Intrusions (Average): Control (1.1), Imaginal Exposure (1.6), Acceptance (1.4), Mindfulness (1.2).
83
which matter in the brain degenrates with high cortisol elevls
both grey and white matter
84
hippocampus in regular medittators
Hippocampal regions up to 15% larger in
experienced meditators, predominantly in
the ‘radial’, width-wise dimension and
particularly in the left hippocampus.
85
whene is DMN most active
when you are engaged with another task rather than urself
86
Goldin & Gross (2010): Mindfulness Training and Social Anxiety
Obje
bjective: Examine effects of mindfulness on social anxiety.
Findings: Mindfulness training reduced subjective and amygdala responses to threats.
Method: Participants with social anxiety underwent 8 weeks of mindfulness training.
Graph: Before training, higher amygdala response; after training, reduced reactivity to anxiety induing phrases.
87
genetics as a cause for deppression
essler et al. (2003): depression common
generally, lifetime prevalence around 10-16%.
* Kendler et al. (2006): identical twin study of over
42,000 twins: depression moderately inheritable
at around 38%.
* Flint and Kendler 2014: major review of
candidate genes for depression.
7392608
88
Maes et al. (2008) & Qin et al. (2022): Gut Bacteria and Depression
Maes et al. (2008): Found higher gut bacteria antibodies in depressed individuals, suggesting a role in depression's inflammatory aspect.
Qin et al. (2022): Reported increased depression risk with higher gut concentrations of Morganella bacteria.
89
Delgado et al. (1999): Serotonin Depletion and Depression
Method: Tryptophan-free diet given to previously depressed patients.
Findings: Over half experienced significant increase in depressive symptoms.
Graph: Shows depression ratings higher in tryptophan depletion group.
Conclusion: Serotonin depletion worsened depressive symptoms in previously depressed individuals.
90
what influences the impact of seratonin depletion?
number of prior deppressive episodes
91
Posner et al. (2013): DMN-Amygdala Connectivity in Depression
jective: Explore connectivity between DMN and amygdala in relation to depression severity.
Findings: Depression severity correlated with DMN-amygdala connectivity.
Graph: Shows connectivity between these brain regions associated with depression rating.
Conclusion: Increased connectivity linked to more severe depressive symptoms.
92
Rubin-Falcone CBT on DMN
- CBT reduced negative feeling
- reduced neural resposn in DMN related regions
- e.g., subgenual cingulate gyrus and medial prefrontal cortex
93
what did metalsky find might be an important indictor of vulnerablity to depression?
negative thoughts and learned helpessness
94
