Clinical Neuroscience

Question 1

mental disorders

Answer 1

abnormal thoughts, emotions behaviour and relationships

Question 2

prevalence of mental disorders

Answer 2

depression - 17.5% lifetime
17% AD - women >65
3% ADHD, 1% autism
20% at one time

Question 3

2 types of diagnoses/approaches

Answer 3

nomothetic

idiographic

Question 4

Nomothetic

Answer 4

General laws eg long term course, risk factors, genetics, epidemiological data
feighner criteria
Kahlbaum and Hecker

Question 5

Idiographic

Answer 5

individuals, single case

Freud and Jung

Question 6

Manuals of criteria

Answer 6

ICD-10 and DSM-5

Question 7

Some ICD-11 categories

Answer 7

neurodevelopmental 
schizophrenia 
anxiety
mood
personality 
food related

Question 8

Depression diagnostic criteria

Answer 8

5 + symptoms for 2 weeks
low energy, anhedonia, low mood
apettite, guilt, suicidal, concentration

Question 9

Phenomenology

Answer 9

study structures of consciousness as experienced from first-person point of view

Question 10

history of psychoses

Answer 10

Kahlbaum and Hecker
tertiary syphilis
delirium vs psychoses

Question 11

Kraeplinian dichotomy

Answer 11

1890s - bipolar and schizophrenia

also dementia praecox

Question 12

delirium vs psychoses

Answer 12

delirium - disorientation in time, place, person
poor short term memory, visual hallucinations
psychoses = oriented, auditory hallucination, delusions

Question 13

schizophrenia

Answer 13

negative symptoms 
schneiders 1st rank sx
1. auditory hallucinations
2. delusional beliefs 
3. control - thoughts and body

Question 14

bipolar disorder

Answer 14

altered affect
2nd order hallucinations
disturb sleep/appetite

Question 15

schizophrenia vs bipolar

Answer 15

course of illness important
bipolar - earlier onset, cyclical, recovery between episodes
schizophrenia - recovery from +ve
schizoaffective disorder
dichotomy not so neat

Question 16

Treatments for schizoaffective

Answer 16

antipsychotics 
antidepressants 
mood stabilisers 
hallucinogens
ECT, TMS, DBS
cognitive therapy

Question 17

Reserpine

Answer 17

invented to treat hypertension
caused depression in some
block monoamine transporter

Question 18

monoamine hypothesis

Answer 18

monoamines eg serotonin, norepinephrine and dopamine

decrease in these cause depression

Question 19

problems with monoamine hypothesis

Answer 19

long time to have effect

no baseline deficit in serotonin or noradenaline function in depression

Question 20

Neuroplasticity theory of depression

Answer 20

too much stress - cortisol
hippocampal degradation
dendritic spines and densities - glutamate
neuroplasticity

Question 21

Non-pharmacological treatments depression

Answer 21

ECT
hallucinogens
psychosurgery
insulin coma therapy

Question 22

How do ECT, psychosurgery and hallucinogens work?

Answer 22

decreasing frontal over-connectivity

Question 23

drugs which increase dopamine - examples and what do they induce?

Answer 23

psychosis
L-dopa
cocaine
dexamphetamines

Question 24

what drugs reduce psychotic symptoms?

Answer 24

those which block dopamine receptors

Question 25

schizophrenia and dopamine

Answer 25

increased binding at D2 receptor

Question 26

Problems with dopamine theory of schizophrenia

Answer 26

most predictive is negative symptoms - motivation, cognition, blunted affect
abnormal hippocampus
smaller brains
ketamine and PCP - antagonise NMDAR

Question 27

variable manifestation of depression and anxiety

Answer 27

negative eg depression, anger, anxiety
depression - psychoses
no symptoms eg just somatic
psychosis in adolescence –> bipolar

Question 28

Huntingtons disease

Answer 28

1 triple repeat

accumulation of huntingtons protein in caudate and putamen kills cells

Question 29

huntingtons symptoms

Answer 29

motor control 
apathy
OCD
balance 
impulsive

Question 30

GWAS - mental illness

Answer 30

SNPs
large overlaps for mental illnesses
neurotic personality and smoking
genes involved in regulation of DNA transcription

Question 31

Simple inaccurate bullet model

Answer 31

disease - abnormal brain - psychopathology

abnormal brain - treat - normal

Question 32

More complicated model

Answer 32

correlation not causation
genes, gestation, life events, inflammation, nutrition
treatments and prevention
abnormal brain development

Question 33

RDOC

Answer 33

diagnoses map poorly into psychiatry

dimensional measures of agreed constructs more useful for research eg effectiveness of treatments

Question 34

temporal aspects of brain function and malfunction

Answer 34

synpase transmission = 0.5ms
conversation = minutes
mood = hours 
personality = years 
mental illness, days, weeks or years

Question 35

intra-individual variation

Answer 35

High levels
differences week to week
eg circadian rhythm, fatigue

Question 36

psychometry

Answer 36

underpin clinical psychology
tools to measure presence and degree of abnormality of one or more behaviours
quantitative

Question 37

medical model

Answer 37

clinical observatoins - signs and symptoms
pattern recognition
qualitative

Question 38

What is developmental psychopathology

Answer 38

processes go wrong during development

genes, biological processes and life experiences interact

Question 39

Genetic factors

Answer 39

twin studies
autism and ADHD
polymorphisms
innate temperament

Question 40

intra-uterine and perinatal factors

Answer 40

maternal health, substance misuse, premature, twin, epigenetics, androgens

Question 41

Epigenetic regulation of HPA axis

Answer 41

transcription (cpg) methylation

Question 42

Inflammation

Answer 42

stress impairs immune response - cortisol
inflammation activates HPA axis
altered reward circuitry

Question 43

early environment

Answer 43

attachment, PND, marital harmony, nutrition, discipline

Question 44

Later experiences

Answer 44

peers, school, abuse

childhood maltreatment and ASBO