Gavin- Clinical 2

Question 1

Thich nhat hanh

Answer 1

Created mindfulness. Born in Vietnam when time of colonialism, people treated badly. Used buddah peaceful protest/ nonviolent disobedience. Nominated for Nobel peace by mlk

Question 2

Effectiveness

Answer 2

Canby 2014: 6wk mindfulness, training increased mindfulness and reduced global symptom severity (anx,dep) ahmad 2020: 12vid practice and group as well as partial treatment (just vid) partial decreased anx, dep and stress, full decreased further. Wells and orussis 2014: 3 ways to deal w intrusive imaginable, acceptance or mindfulness and decreased in that order

Question 3

Biology

Answer 3

Echouffo tcheugo 2018: ps W highest cortisol showed white matter degen, esp in cc. Also showed cog issues and grey loss in frontal. Bremner 2004: sit adverse events resulted in ptsd and reduced hippo. Frodle: depressed ps has less grey in orbitofrontal and dorsolateral pfc. Smaller white in hippo

Question 4

Effects of mindfulness

Answer 4

Rosenkrantz: training over 8wks, trier social stress test (5m speech in front of judges and mental maths) cortisol reduced by mindfulness and stoping increased it. Took cytokine (inflam) baseline then stress test W capsaicin. Induced blister and analysed inflam. More practice, reduced response to cap following stress test

Question 5

Hippo

Answer 5

Luders 2013: experienced mindfulnesss ps had 15% larger , mostly radial and in the left. Sevinc 2019: half did 8wks mindfulness stress reduction course, controls stress management. Hippo of mindfulness grew, increased connections in pfc

Question 6

Default mode network

Answer 6

Made up by medial pfc, posterior cingulate and angular gyrus. Christoff 2009: mri go no go and asked what their thoughts were, when daydreaming dmn most active. Allen 2012: 6wks mindfulness or being read Jane Austen. Mindfulness improved stroop conflict/anxiety test (less rt), increased activity in dmn and insular- correlated W training

Question 7

Limbic system and rumination

Answer 7

Goldin and gross 2010: ps w social anxiety were subjected to inducing phrases before and after 8wks mindfulness, breath focused training. Training reduced their subjective response to threats and their amygdala bold response. Functional connectivity between dmn and pfc predicts level of depressive rumination

Question 8

Genetic basis of depression

Answer 8

Kessler 2003: prevalence 10-16%
Kendler 2006: mz twins, depression moderately inheritable at 38%
Flint and kendler 2014: review of candidate genes for depression - most only weakly associated with depression

Question 9

Bacterial basis of depression

Answer 9

Maes 2008: higher levels of blood antibodies to a marker for infectious gut bacteria in depressed people. Increased translocation of gram negative bacteria (leaky gut) plays a role in inflammatory pathophysiology of depression (p. Aeruginsoa, p.putida, c.koseri, morganella morganii)
Qin 2022: 20% increased risk of depression per s.d. Rise in gut conc of morganella

Question 10

Serotonin and depression

Answer 10

Delgado 99:previously depressed ps given tryptophan free diet for 2 days, over half showed increase in depressive symptoms (deprived S). Booji 2002: found intervening factors like no. Of priori episodes of depression. Gedded 2003: meta anal showed antidepressants helped prevent relapse after 2m. Yatham 99: antid increase serotonin in medial frontal gyrus

Question 11

DMN and depression

Answer 11

Posner 2013: severity of depressed ps depression correlated W levels of activity in DMN posterior and amygdala. 10wks treatment W antid reduced activity in DMN in depressed ps to normal. Rubin falcons 2018: 14 cbt sessions reduced - feelings to bad memories and DMN activation in cingulate and pfc

Question 12

History of cbt

Answer 12

Zeno: founder of stoic school of philosophy in Athens known as stoa poikile (stoics)- happiness through use of reason and bad from errors in judgment. Marcus Aurelius a follower of stoicism

Question 13

Aaron Temkin beck

Answer 13

Born Rhodesia island, siblings died and mother depressed. Mendlowicz 2022: events influenced later career. Did medical degree and psychoanalysis, rosner said he liked being experimental, disagreed w psycho. Hoffman - cbt says due to cog factors

Question 14

Principles of cbt

Answer 14

Beck 67: ppl have dep as a result of negative thinking. Maladaptive attitudes/- schemas begin on childhood (self worth dependent on school and parents only praise that), may lie dormant. Cog triad: - schemas cause - thoughts about self, current situation and the future

Question 15

Cbt studies

Answer 15

Metalsky 82: students W internal attribution also style had more depressed mood to a low grade. Those W external were not-so style to learned helplessness. Errors in logic maintain triad like arbitrary inference /- conc event when diff evidence). Selective abstraction (focus on - even when +). Overgeneralisation ( single events taken to apply to everything). Automatic through to

Question 16

Evidence of errors in logic

Answer 16

Bradley and Mathews 83- abstraction- depressed ps recalled fewer + words when related to themselves, not for stranger of familiar. Inference-leppaan 20l4- depressed interpreted neutral faces as sad, in amongst happy and sad

Question 17

Treatment

Answer 17

Catonguay 2018: 4 phases: behavioural component (increase mod, acitivities). I’d and challenge negative thoughts (record), I’d and challenge - schemas, coping strategies for the furniture. Rush, beck 77: cbt reduced depression more than drugs, maintained for 6m. Blackburn 81:, combo of drug and cbt most effective. Memdlowicz 2022: cbt used for many disorders and most studied

Question 18

ECT tut history

Answer 18

For severe depressed, last resort. Largus Greek slave then physician to Claudius- describes ECT, baptise le Roy says blindness cured. Cerletti and Bibi- created electric shocks instead of chemicals, safer but still had joint dislocation/fracture, alleviated W muscle relaxer, memory loss

Question 19

ECT tut depression

Answer 19

Paganin 2004: meta anal of ECT, shows works better than control and more effective than antidep in sever cases. Sacksim: double blind study showed ECT effective even in medication resistant and effectiveness dose dependent. Nowak & dulinski: ECT increased sens and no. Serotonin receptors. Strome 2007: increased binding to dop receptors in striatum. Perrin 2012: depressed have more frontal cort connections-eliminated by ect