Gavin- Clinical

Question 1

Background to medication

Answer 1

Moss 1026: need broader training, coverage of other science. Most work with at least one person using drug but no training. Tombs 2017: withdrawal thought of as a relapse of MI. Long term use may create other problems, dsm doesn’t take into account so could mask diagnosis , Mamie caused by antidepressants in bipolar/behavioural toxicity. Iatrogenic comorbidity is bad effects of meds

Question 2

Bromides

Answer 2

Charles locock doc to queen Vicky, claimed 13/14 epilepsy improved from K+bromide. Wilks 1861: same findings. Behrend 1864: 2 case studies of anxiety and insomnia treated with KB. Macloed 19000: 8 cases of bromide sleep/deep sleep therapy. Couldn’t get out of bed for 5-9 days, success but no follow up one died from “supervenening penuemonia”

Question 3

Dr miles’ nervine

Answer 3

Intro in 1884, had Na, K, NH4 bromides W Na bicarbonate and citric acid to fizz, available to 70s. Bromo seltzer had KB by emerson 1888. In music lyrics by Ella Fitzgerald . Used to calm nerves

Question 4

Barbiturates

Answer 4

Lopez-munoz 2011: bromides toxic due to 12 day half life so barbiturates replacement. Con mering: reported sedative effects of veronal - gives deep sleep increasing to knock out. Pentobarbital were other variations called Nembutal. Even marketed toward children. Overdose risk: Marilyn monorail may have overdosed, johns 7m said accounted for 2/3 deaths from poisoning 50s-70s

Question 5

Leo sternbach

Answer 5

Influential, born in Croatia and moved to us- created 6 benzodiazepine drugs used today. Between 69-82, Valium was most prescribed in us. Hesbacher first double blind test of Valium and found similar effects as phenobarbitone but less side effects

Question 6

GABA receptors

Answer 6

High conc in limbo structures like amygdala. Benzos bind to gaba receptors so cl- move in and inhibit? release of gaba. 5 subtypes and variations. Heterogenous distribution: Frits hyp and mohler 95: A1 widespread but most in cortical and cerebellar, a2 in striatum / frontal and a5 in hippo

Question 7

Spec functions of subunits

Answer 7

A1 used for sedation and anti convulsive but amnesia and addiction. A2 used for anxiolysis and muscle relaxation but addiction. 5 used for muscle relaxation but amnesia

Question 8

Evidence of spec

Answer 8

Rudolph 99: diazepam sedative effects stopped when mice lacked a1. ‘’ dia antianxiety measured in x maze half light half dark (less anxiety). Dia increased time on light arm for mice so reduced anxiety even if lacked A1 so not dependent for antianxiety

Question 9

Evidence of spec a2

Answer 9

Low 200p: dia sedative effects still there when lacked a2, measured antianxiety using x maze and found dia increased time on light arms in controls (reduced anxiety) but no effect for mice lacking a2- a2 needed for anti anxiety

Question 10

Memory effects

Answer 10

Rudolph: mice normally remembered not to enter dark box where they had shock. Mice lacking A1 didn’t enter but normally do on diazepam so anterograde amnesia dependent on A1. Bulach: showed ps about to have surgery pics before and after midazolam. Memory before was unaffected so midazolam induces anterograde amnesia but retro fine

Question 11

A5

Answer 11

Crestsni: removal of a5 had no effect on sedation from dia and dia increased time in light if no a5 so doesn’t affect sedation or anxiety. Ps lacking a5 remembered conditioned stim better so no amnesia

Question 12

Addiction

Answer 12

Mainly A1 and 2. Valium described as mothers little helper by Rolling Stones. Known addiction and withdrawal known as delerium tremens. Later said used as opium of the masses as given to housewives instead of offering support

Question 13

The Mesolithic system

Answer 13

Starts in VTA, then MA and nucleus A. In VA, Benz’s indirectly activates MA. Normally gaba inhibits dopamine but when benzo attaches to a1 it inhibits gaba so excites domoamine so more released in NA. Tan: gaba rate decrease in VTA dependent on A1. Wolf: eased CBF in NA. Gosselin: cbt more effective than placebo in stopping meds

Question 14

Types of psycho therapies and other therapies

Answer 14

Adlerian-Adler:idiv psych, early experiences. Jungian/analytical bring unc and conc into balance. Psychoanalysis, psychodynamic therapy (focuses on immediate problems). Animal assisted, art, creative, emotionally focused, family. Gestlalt (acting out, dreams), transactional anal (split person into parent, adult and child). All assume repression

Question 15

Freud

Answer 15

Father financial failure and weak, rejected as role model. Mother favoured him, my golden sigi. Good student bu didn’t care for others, controlled sisters. Favoured his daughter Anna. Freud was German but field bc of nazis after Anna arrested, 4/5 sisters didn’t leave and died. Came to London

Question 16

Joseph Breuer

Answer 16

Physician, Modest and inventor of psychoanalysis . Bertha pap pen hemi his first case. She became ill after caring for father W no physical basis. He said it was her intelligence wasted as denied education- cathartic method/talking cure to get unconscious. She then became social worker. Freud made joint publication on Anna O but Freud cut him off

Question 17

Vienna psychoanalytic societu

Answer 17

Built in Germany- Freud seen as leader, cut off anyone that didn’t agree W him. Ernest Jones went to London, expelled jungian and supported Freud. Anna fought W melanie klein as she focused on children and child centred therapy. Split into 3: Freudian, klenian and independent

Question 18

Components of personality

Answer 18

Conscious ego, precon superego and unconscious I’d. (Mediator, moral and impulse). Wilson and nesbett: ps given electric shocks then asked what level they’d do and of damage info affected willingness. Control reassured after, test before. Didn’t differ in shock they’d take but test group thought the knowledge had increased their willingness (unconscious rationalisation)

Question 19

Halo effect

Answer 19

Nisbett and Wilson: ps watched same vid of teacher either warm of cold style. More ps said same mannerisms were appealing in warm even tho the same. Ps said mannerisms reason for likability. Ps either did visual pattern task or highly analytical task then repeated. When think rationally halo decreases so didn’t rate warmer as nicer

Question 20

Repression - Anderson and green

Answer 20

Anderson and green : ps trained W word pairs then presented one asked asked to say associated word of suppress memory of it- in suppression, recall decreased. Suresssion hyp is that suppression inhibited target not diversionary thought of weakening of cue as added independent cue normally associated to target but didn’t help. If ps confused and didn’t want to say, told to guess and get money if right- still found repression W independent

Question 21

Repression-lambert

Answer 21

Used trained and independent cue procedure. Suppression to negative words seen in trained and independent only- evidence that it’s used as a defence mechanism

Question 22

Biology lf repression

Answer 22

Anderson: during suppression, increased activity in dorsolateral pfc and decreased hippo (inhibiting it). Apsvalka: lateral pfc inhibits primary motor cortex and recall of emotionally aversive memories via hippo. Ps did think monthink, 5/30 didn’t meet learning criteria, inhibitory performance correlated to stop signal so common source- lateral pfc activated in both- decrease hippo in emotional

Question 23

Counselling

Answer 23

Uk council for psychotherapy and British association for counselling BACP does counsellors UKCP psycho, counselling shorter - takes years and hours, paid