Mental health and Psychiatry

Question 1

What does trans-diagnostic mean?

Answer 1

A symptom that is present in numerous disorders e.g compulsion

Question 2

What is the definition of compulsion?

Answer 2

The experience of overwhelming urges to repeat a behaviour even in the knowledge that it is harmful. I

Question 3

What is state anxiety?

Answer 3

psychological and physiological transient reactions directly related to adverse situations in a specific moment. This is what motivates us to keep out of harm as it causes us to feel nervousness and apprehensiveness

Question 4

PersWhat is trait anxiety?

Answer 4

Your ability to become anxious under a given set of stressors, it is a personality aspect of anxiety. It is an adaptive response to your environment (e.g more threatening environment=higher trait anxiety) and can have genetic components

Question 5

How does trait anxiety affect state anxiety?

Answer 5

If a certain thing triggers your trait anxiety e.g. a snake then this can lead to you constantly avoiding it leading to you having a conditioned fear towards it therefore it becoming part of your state anxiety

Question 6

What are the features of state anxiety that have a positive feedback effect on state anxiety?

Answer 6

Avoidance-perpetuating of conditioned fear

Attentional and cognitive Bias-make you hypervigilant for threats, you may be thinking constantly about bad things that could happen, you may be more likely to notice potential hazards and threats in the environment. All this effects how you perceive and process whats going on around you

Rumination-The process of continuously thinking about the same thoughts, which tend to be sad or dark Poor sleep-if rumination is bad enough this can lead to poor sleep

Question 7

define anxiety disorder?

Answer 7

Anxiety disorder can be conceptualised as a SELF PERPETUATING NETWORK OF POSITIVE FEEDBACK LOOPS arising from normally adaptive responses

Question 8

What is anhedonia?

Answer 8

Inability to feel pleasure in normally pleasurable activities

Question 9

What factors can contribute to depression?

Answer 9

-Abuse -Loss -Chronic illness -PROLONGED STRESS -Genetic and environmental factors -Low self worth -Social withdrawal is cause by depression and has a positive feedback effect by leading to further low moods and less self worth -Sleep loss is a result of depression and has a positive feedback effect by causing depression to worsen -anxiety (comes from a low mood response that is normal )

Question 10

Why do people self harm?

Answer 10

-Low self worth = you believe bad things will happen to you but by doing it yourself at least you have control over the punishment=less anxiety provoking -Endorphin release -Pain is better than feeling empty an numb - you feel you deserve to be punished -temporary relief from anxiety as you can control the punishment -can become compulsive

Question 11

How is compulsive behaviour developed?

Answer 11

State of distress-> distress reducing behaviour(self harm, substance abuse, disordered eating, compulsive rituals)->temporary relief-> negaitve reinforcement(usually a normal thing for survival) is when the bad thing which in this case is the state of stress, is removed due to the behaviour exhibited-> if you repeat the behavior enough times it leads to an URGE to exhibit this behaviour each time, not because its a good idea but because you feel like you need to do it (unconscious learning process, it almost becomes hardwired into your brain until you no longer really have a conscious control over it ) eventually this stress reducing behaviour causes more stress and therefore a never ending cycle = this leads to things like self harm and eating disorders, addiction

Question 12

What happens when one rat is given cocaine and is isolated and another rat is given cocaine and lives in rat heaven with others?

Answer 12

The isolated rat becomes addicted to cocaine, eventually overdoses and dies. The other rat tries the cocaine however it doesn’t continue and instead lives a happy life

Question 13

How can depression by defined?

Answer 13

same as anxiety- a self perpetuating network of positive feedback loops arising from normally adaptive responses

Question 14

When does self harm typically occur?

Answer 14

In the context of low self worth and persistent distress -it serves various functions mainly related to reducing stress

Question 15

How can support and kindness effect someone who self harms?

Answer 15

-Doesn’t help because they think they deserve bad things to happen to them so they felt even more anxious (cognitive dissonance between what they think should be happening and what is actually happening) New intrusive thought triggered

Question 16

What characterises OCD?

Answer 16

INTRUSIVE THOUGHTS/IMAGES which are: -distressing -involuntary COMPULSIVE BEHAVIOURS-serve to relieve state of anxiety/tension

Question 17

What causes OCD?

Answer 17

Its the compulsion cycle: 1-Intrusive thoughts 2- this leads to stress 3-distress reducing behaviour 4- this provides temporary relief 5-negative reinforcement from this 6-causes the urge to repeat the behaviour 7- as you continues to ruminate over the intrusive thought 8- the cycle repeats leading to compulsion that is central to OCD

Question 18

What is the difference between someone who wants to lose weight and someone who develops an eating disorder?

Answer 18

The person who develops an eating disorder ties there self worth to their body image and has anxiety about body image

Question 19

How do bulimia develop?

Answer 19

1-Low self worth and anxiety projected onto the body 2- leads to diet restriction 3- Causes you to be hungry and eat 4-leads to intense feelings of failure and negative thoughts 5-binge because you think whats the point (loss control) 6- This intensifies feeling of failure 7-intense stress 8- Leads people to purging to get rid of the source of stress(food) 9-temporary relief 10-Negative reinforcement 11-You eat again because you feel back in control 12- this compulsive cycle keeps repeating itself

Question 20

How does Anorexia develop?

Answer 20

1- Low self worth and anxiety projected onto body image 2- diet restriction 3- This causes you to feel safe, control and a sense of achievement 4-Weight loss reinforces these good feelings of safety and control 5- This shields you from the anxiety and low self worth temporarily 6- anxiety and lows elf worth can worsen due to other factors of your life so you need to strengthen this shield 7- So you continue to restrict food as this is the only thing that is making you feel better about yourself 8- Then the thought of going back to normal eating begins to terrify you -losing control 9-Brain starvation leads to cognitive inflexibility and eventually compulsion as they develop rules to maintain control

Question 21

How does binge eating disorder develop?

Answer 21

1-Low self worth and anxiety projected onto body image 2- seek out high calorie food 3-Neural reward ( natural opiods) 4- temporary relief 5-negative reinforcement 6- cycle repeats

Question 22

What is delirium?

Answer 22

A type of madness caused by acute brain failure which leads to clouding of consciousness and attention deficit The brain failure can be caused by drugs, infections, endocrine (thyroid etc), metabolic(ca2+,mg2+ etc)

Question 23

What is encephalopathy?

Answer 23

Aquired brain injury such as stroke leading to madness

Question 24

What things are associated with madness?

Answer 24

-Psychosis (e.g. Schizophrenia, manic depression etc) -Delirium -Encephalompathy -Dementia -Personality disorder

Question 25

What are the symptoms of psychosis?

Answer 25

-Hallucinations -Delusions -Thought disorder

Question 26

What is reality failure?

Answer 26

Group of pathologies that disrupt the process of PERCEIVING and INTERPRETING reality This can lead to the symptoms of Psychosis(hallucinations, delusions)

Question 27

What causes someone to experience auditory verbal hallucinations?

Answer 27

exsisting clinical disorders combined with : -negative emotional state -specific cognitive difficulties -poor coping -family history of psychosis -environmental exposures such as childhood adversities experienced by 5% of the population

Question 28

What can trigger delusions?

Answer 28

-result of efforts to make sense of PERPLEXITY and things the brain no longer understands -false beliefs formed due to intense feelings of being controlled etc -often as a result of fears - often in higher proportions in immigrants and ethnic minority ( can cause paranoia and fear of persecution)

Question 29

What are the symptoms of schizophrenia

Answer 29

Positive: -Hallucinations -Delusions (these experiences are very real for the patient) Negative: -Anhedonia -Apathy -social withdrawal -Blunted Mood Disorganised symptoms: -Thought disorder -disorganised speech/behaviour -Inappropriate affect Lack of self awareness: -Everything seems to be about them -disruption in language/meaning -overwhelmed by the sense that something isn’t quite right -Others intrude into their internal world(mind and body)

Question 30

How significant is the genetic component of schizophrenia?

Answer 30

-80% heritability -10% heritability form one parent -50% heritabiltiy from both parents -40% in monozygotic twins -200 genes contribute to schizophrenia

Question 31

What do PET scans of schizophrenia patients show?

Answer 31

Excess of striatal dopamine especially in response to stress -lots of stimulus independent thought and self reflection

Question 32

What is the role of dopamine?

Answer 32

-Part of the reward pathway, it stimulates a positive response so we do more of it -SALIENCE(causes us to believe something is really important if lots of dopamine released due to something in particular) -Allows us to predict things e.g rewards

Question 33

how does the working memory relate to schizophrenia?

Answer 33

-usually stores lots of data and allows you to contextualise the present moment - defficits in the working memory lead to thought and perception loses context, flow and order

Question 34

What cause psychosis?

Answer 34

-Genetic component (genens predisposing to SCZ must also have some sort of advantage) -Developmental adversity/abuse (bad family dynamic) -Neurodevelopmental disturbance (prematurity, hypoxia, infection) -Life stress -Recreational drug use(25% of psychosis, strong correlation with earlier age of cannabis use and strength of cannabis with onset of psychotic illness)

Question 35

What are treatments for Psychosis?

Answer 35

-Antipsychotics: ANTIDOPAMINERGIC as they try to block overexpression of dopamine -Psychological therapies: CBT for psychosis, Avatar therapy (designed avatar image of the patients voice that the patient could talk to, so patient could try regain control over the character that is disturbing them) Social support: supportive nevironments, structure and routines, housiong benefits, support with budgeting/employment

Question 36

What are some medications for psychosis?

Answer 36

-Medicine to block dopamine pathways in cerebrum(cortical and limbic), striatum, pituitary

Question 37

What are the side effects of blocking dopamine pathways?

Answer 37

Over block striatal pathway=Parkinson like symptoms Over block pituitary-Prolactin issues that can lead to gallacteria(expressing milk when not breast feeding), developing man boobs, erectile disfunction, gynaecomastia Metabolic effect-diabetes, weight gain etc GI Effect- increased appetite, constipation Muscarinic effect- hypersalivation Haematological effect- neutrapenia, agranulocytosis Cardiac effect- arrhythmias (irregular heart beat), tachycardia (too fast heartbeat) Sedation

Question 38

How is schizophrenia related to violence?

Answer 38

-They are more likely to be victims of violence -However people with SCZ who are untreated and abuse substances e.g cannabis are 2-4 x more violent

Question 39

How does alcohol relate to violence?

Answer 39

makes someone 10-20 x more aggressive

Question 40

Summarise Psychosis?

Answer 40

-Everything a patient experiences is real for them -It is a complext syndrome which represents a lot of different disease processes -Lots of social factors/persons environment contributes to SCZ - To help treat you have to try and understand the patient and there history not just think they are crazy