Midterm #1

Question 1

What does incidence refer to?

Answer 1

Incidence is the rate of new cases of a disorder in a given time period ( e.g., Incidence rate of 2% if 2000 new cases occur in a population of 100000 in a 1 year period)

Question 2

What does prevalence refer to?

Answer 2

Prevalence is the percentage of a population that have a disorder at any given time. (I.e. point prevalence, one year prevalence, lifetime prevalence)

Question 3

Biopsychosocial model of psychopathology?

Answer 3

Biopsychosocial model: Psychopathology is determined by complex interactions between many biological and environmental variables.

Question 4

What is a gene?

Answer 4

A gene is a section of DNA that codes for a particular function or structure.

I.e Lip size, eye colour etc.

Question 5

What is a chromosome? How many from each parent?

Answer 5

A chromosome contains strands of deoxyribonucleic acid (DNA), which provides instructions on how to build the body and the brain.
Humans inherit 23 chromosomes from each parent

Question 6

Underdeveloped brain?

Answer 6

Caused by genetic errors in building the brain.
Likely Mental health consequence: Intellectual deficit: a large part of your brain is involved in thinking and processing. If your brain ends up underdeveloped then a typical consequence is intellectual deficiency.
I.e.: Microcephaly: Individuals are born with very small heads, resulting in a small brain, which results in severe intellectual disability.

FASD- overexposure to alcohol in utero will also produce a smaller brain and this will be associated with intellectual underdevelopment and impairment.

Having a smaller brain than normal results in intellectual deficits

Consequence of underdeveloped brain = intellectual deficiency.

Question 7

What happens when brain development is compromised in a *general way?

Answer 7

Increased impulsivity occurs. Impulsions are less inhibited so you see behavioural and emotional problems in people with underdeveloped brains.

Question 8

Oversensitive brain?

Answer 8

The brain has over 1 billion neurons which communicate via a highly complex electrochemical system. This is a finely-tuned system where there is just enough communication and electrochemical transmission. There are a billion transmissions whenever you speak. However, if your brain is sensitive and too many firings happen too often, you could end up with a trillion transmissions.

*An oversensitive brain is too likely to fire.

Stimulant drugs increase the likelihood of firing, thereby increasing the risk of seizures in individuals with epilepsy

Mental health issue from an oversensitive brain? Epilepsy

Question 9

Oversensitive peripheral nervous system?

Answer 9

Overactive nervous system. Causes tension.

Mental health condition: Anxiety

Personality: An overactive PNS causes shyness and introversion, more inhibition of behaviors.

Question 10

Undersensitive PNS?

Answer 10

Less reactive nervous system. Individuals with an undersensitive PNS don’t get nervous often. Low anxiety. They are very bold and break rules often

Personality: Extroverted, Low Inhibition, No Anxiety

Can cause psychopathy and sociopathy. Psychopaths are unlikely to get sweaty palms due to their lack of nervousness.

• *Undersensitive nervous system is often associated with drug addiction.
• Undersensitive PNS increases likelihood of risk taking. , such as with drug experimentation *. Drug users and abusers may be thrill seekers, as they are more likely to experiment with drugs-> More likely to use them regularly -> More likely to become drug dependent etc.

Question 11

Dysfunctional inhibitory systems (cortex)?

Answer 11

Dysfunction in inhibitory systems is associated with addictions. Addiction is an inability to inhibit something that you do., drug addiction, sex addiction etc.

Question 12

Overactive limbic system ( emotional regulation)?

Answer 12

Uninhibited emotions. lash out more frequently, anger, engage in disruptive behaviours.

Question 13

Underactive/Overactive reward systems pathway?

Answer 13

Can inherit an overactive or underactive reward systems pathway.
*An underactive reward system is the key component of ADHD. You must do much more in order to stimulate this reward centre and feel enjoyment, so this results in risky and thrill-seeking behaviours, experimentation, deviancy, breaking laws. * This is especially important in addictions. They must have much more intense stimulation to get the same level of enjoyment

Overactive reward system: You are able to find enjoyment in dry things. Gives a massive advantage because you can sustain your interest in dry things over other people. Cognitive perseverence.

Question 14

Dysfunctional Hypothalamus?

Answer 14

sexuality, eating

Question 15

Dysfunctional motor cortex?

Answer 15

If you inherit a motor deficit in the motor system of your brain, this can result in *Cerebral palsy.

Deficit or compromise in the motor cortex results in difficulty with fine motor movements or gross motor movements. This is very common and can occur genetically because the instructions are wrong or during birth if damage is done etc.

Question 16

Dysfunctional Auditory Cortex?

Answer 16

Difficulties understanding speech.

Question 17

Dysfunctional Parietal Cortex?

Answer 17

Difficulties associating symbols with words. Ie Dyslexia

Question 18

Damage to the frontal lobe?

Answer 18

Dysfunction in planning ahead, inhibition, thinking

Question 19

What environmental experiences can cause neurodevelopmental damage during gestation?

Answer 19

Mother’s nutrition: if the other is not eating enough, then the baby will be smaller, resulting in a smaller brain. In turn, having a smaller brain increases the likelihood of having emotional and intellectual problems.

Mother’s Age
Giving birth at an older age, past 30, increases the risk of the child having down syndrome, trisonomy 21. which is thre copis of the 21st chromosome. Greater age of the mother, it is more difficult for her to seperate the chromosomes
Lots of other trisomies, but they are often fatal.
Miscarriages are often due to the embryo not being viable due to genetic defect.

Question 20

What is encephalitis? *Spell

Answer 20

Inflammation of the brain. Brain damage can result diectly from inflammation of the neurons, or from the swelling expansion, which results in cell death. Damage is diffuse throughout the brain.

Question 21

What is meningitis? * Spell

Answer 21

Inflammation of the membrane surrounding the brain and spinal cord. Brain damage can result from the inflammation. Causes swelling, but there is no room for expansion, resulting in cell death.

Question 22

What is the optimal age for mothers to have children for a decreased likelihood of problems in their offspring?

Answer 22

In their 20s
Any earlier: parents are still developing and their reproductive system is not fully matured.

If you give birth at an older age, ie 40s : Greater risk of mutation.*** Especially greater risk of down syndrome, trisomy 21. Three 21st chromosomes. Greater age of the mother results in less accurate separation of the chromosomes to be placed in the egg. Every cell in your body contains two pairs of chromosomes. 23 Chromosomes from each parent, which match up.

Question 23

Drugs that can kill neurons (Neurotoxic?)

Answer 23

MDMA/Ecstasy- neurotoxic
Alcohol - decreased brain size
Stress increases cortisol adrenalin which alter normal metabolic function. They can impair certain areas of the brain.

Question 24

What is one of the best protective factors for mental health problems?

Answer 24

Having friends and social support systems

Question 25

What makes a good coping strategy?

Answer 25

A good coping strategy is something that has a problem solving orientation.
This results in less stress, less liklihood of the problem recoccuring, as well as a better idea of how to handle it is it does.

Question 26

What are some protectie factors for mental illness?

Answer 26

• No genetic/family history of mental health problems
• Good intellect- Related to problem solving abilities

-Attractiveness- Tend to have a good social network, facilitates self esteem, people treat you better- Forgive you, promote you etc.
Your stressors may not be as strong or as prevalent

Question 27

What treatment differences are there between social workers and psychologists?

Answer 27

Psychiatrists and Psychologists are individual-oriented

Social work- More likely to treat people according to systems theory. They treat the system over the individual.

Question 28

What conditions respond better to medication than Psychotherapy?

Answer 28

1) Severe Depression
2) Schizophrenia
3) DNA Bipolar

Question 29

What is the main advantage of psychotherapy over medication?

Answer 29

Longterm efficacy:

In the second year: those on medication have double the relapse rate as those in psychotherapy.

Question 30

What are the two most common disorders that have a seasonal component?

Answer 30

Two Types of Seasonal Affective Disorder:

1) Seasonal Depression/Seasonal Affective Disorder: People who get depresed during season of the year. Normally during the fall/winter
2) Manic Depression/Bipolar: People who develop manic cycles in the summer. Bipolar disorder manic episodes are more likely to occur during the summer.

Question 31

What two things does a your body need to do in order to regenerate dead cells? How does this go wrong in cancer/tumours?

Answer 31

1) Create the appropriate cell. I.e a skin cell, not a Neuron etc.
2) Mechanism that recognizes that “work is done. We dont need any more new cells. Shut off”.

Question 32

What is exposure therapy? What is it most effective for?

Answer 32

Type of classical conditioning. Most often done with Phobias. I.E. if you are afraid of snakes, then you are exposed to snakes.

Most effective for: PTSD and Phobias

Question 33

What are the two types of exposure therapy?

Answer 33

1) Flooding: Massive exposure to your feared object for hours.
2) Systematic desentization: Exposure takes place in steps of increasing stimulus.

Question 34

Stress

Answer 34

There are a lot of different forms of stress and they havea very straightforward relationship to many mental health problems.

Different forms of stress: Physical- back back, diabetes, etc. ANyone with a physical problem has stress in their lives.
Psychological stress that arises from physical problems can cause mental health problems

Different people manifest their stress in different ways. Ie if a group is stressed to an equal degree: Some would develop ulcers, eating disorders, dissociative symptoms. People manifest stress in different ways. The way that you manifest stress in the past is a good indication of how you will manfiest stress in the future. Ie if you developed an ulcer last time, you are more likely to the next time that you are under a lot of stress

Question 35

differences in male vs female coping patterns

Answer 35

Woman are more likely to talk with their friends about it
Men are more likely to ignore the problem and distract themselves from it

Both strategies can be adaptive or maladaptive, depending on the situation.

Ie Maladaptive in women- cant let the problem go, keep reactivating the negative emotions
Ie adaptive in men: Sometimes you need that distance or distraction in order to calm down, resulting in calm thinking later on

Question 36

Example of conditions that are caused almost entirely by biology

Answer 36

Severe intellectual disability- Almost always caused by neurological injury

Autism- almost exclusively 100% biological, due to genetic inheritance rather than biological injury

Homosexualiy: Almost no environmental influence seems to be related to developing homosexuality, meaning that it must be biological.

Question 37

Examples of conditions caused almost entirely by the environment

Answer 37

Eating disorders: Primarily due to envrironment. They dont run in families.
Conduct disorder: Out of control kids are caused by poor parenting. Except in the case of antisocial personality disorder.

Question 38

Family studies

Answer 38

Compare the concordance rate in first degree, second degree, or third degree relatives

1st degree) 50%- same genes that you have. Mothers, siblings, your own children
2nd degree) 25% aunts, uncles, nieces, nephews, grandparents.
3rd degree) 12.5% cousins, great-grandparents, great aunts, great uncles

Ie If schizophrenia is genetic: More prevelance in 1st degree relatives, with less in second, and even less in third degree

If schizophrenia is environmental: No difference in frequency between first, second, or third degree relatives.

Question 39

Family studies

Answer 39

Compare the concordance rate in first degree, second degree, or third degree relatives

1st degree) 50%- same genes that you have. Mothers, siblings, your own children
2nd degree) 25% aunts, uncles, nieces, nephews, grandparents.
3rd degree) 12.5% cousins, great-grandparents, great aunts, great uncles

Ie If schizophrenia is genetic: More prevalence in 1st degree relatives, with less in second, and even less in third degree

If schizophrenia is environmental: No difference in frequency between first, second, or third degree relatives.

If biological: Greater prevalence descending
If environmental: No set pattern

Question 40

Twin studies

Answer 40

Traits similar to biological parents: Biological

Traits simiar to adopted parents: Environmental

Question 41

Why is medication the most common biological treatment?

Answer 41

1) Family Physicians are the main resource for mental health problems, and this is the solution that they are familiar with
2) We have a wide range of drugs that effectively treat a wide range of mental health problems, which we didnt have before

We have a society that is deeply engrained in the medical model, with a large portion of society taking medication.

Question 42

What are some general points about medication effectiveness?

Answer 42

1) Most mental health problems can be treated with medication. Not cured, but it can be treated
Medication is equally effective in the short term when compared to therapy. Except for DNA bipolar, schizphrenia, and severe depression. For these, medication is more effective than psychotherapy.

Question 43

Why is psychotherapy more effective than medication in the longterm?

Answer 43

1) Psychotherapy provides tools to deal with stressors etc.

2) Drug tolerance occurs to antidepressants

Question 44

Cingulotomy

Answer 44

A brain surgery designed to break associations between emotional parts of the brain

Question 45

Transplantation of embryonic stem cells

Answer 45

Embryonic stem cells transplant. Stem cells become like the cells surrounding it
Very effectie for many conditions. * Especially effective for Parkinsons.

Question 46

ECT- works by inducing an epileptic seizure

Answer 46

works by inducing an epileptic seizure
most effective treatment for severe depression

May work by stimulating the frontal cortex
may work by breaking train of thought, causing them to forget harmful memories
Problem: it also causes subtle brain damage

Question 47

TCMS

Answer 47

Basically putting magnets in front of the patients brain

Question 48

Deep brain stimulation

Answer 48

Very effective for treatment resistant depression and parkinsons, chronic pain and ptsd

Question 49

Behaviour modification

Answer 49

Restructuring the rewards and punishments within an individuals environment to better shape desired behaviours. * This is a form of operant conditioning

*Rewarding the behaviour that you want to see, while punishing/ignoring behaviour that you don’t

Question 50

Aversion therapy

Answer 50

Punishing a behaviour that you don’t want to see.

Commonly done for sexual deviancy, ie pedophilia. Punished whenever they are aroused by images scantily clothed children via electrical shock
Ie making a child smoke a whole pack of cigarettes
Trying to form a negative association

*Aversion therapy is not particularly effective.

Question 51

Cognitive restructuring

Answer 51

Notion is that mental health problems are due to bad self-talk.
You keep a diary of your thoughts, when you find yourself saying maladaptiveand unwarranete,d you then rite it down into the diary and correct it.

CBT- Objective rational response to replace overgeneralizations.

Question 52

Psychoanalysis

Answer 52

Classical insight therapy. The goal was to identify what stage of psychosexual development the individual was stuck in and then to fix that.

Question 53

Talking therapy

Answer 53

Three types of talking therapy:
Insight therapy:
Psychoanalysis:
Play therapy is done in kids. Kids dont understand what is bothering them. They can have somatic effects. Play therapy is good at getting reports of somatic symptoms

Supportive counselling: Just being a supportive friend and counsellor. The role here is to be a good friend to them and provide the support that a good friend would.

1) Give a sounding board for your ideas
2) gives support. be on your side no matter what. a good therapist is never judgemental and always supportive
3) occassionally offer obective advice from a neutral perspective

Family therapy: Often when dealing with adolescents the parents dont take responsibility. Inevitable parents have a lot to do with the behaviour occuring.

Group therapy: You are doing supportive counselling on a group basis. This is done for people with similar problems, Ie AA, Eating disorder groups
An advantage is that it creates a sense of belonging, and is cost effective.
a disadvantage is that group dynamics may not be cooperative

Question 54

What has a weak relationship to therapy outcome?

Answer 54

Duration of treatment: People who get 20 sessions dont do any better than those who get half a dozen. This may have to do with the efficiency of the setting. The solution is likely very apparent early on. If you are there for 20 sessions then you probably have a chronic problem that isnt going to respond very strongly. If client is not improving within 6 sessions then they may not respond at all.

Experience training and profession of the therapist: Average success is the same across professions, regardless of experience.

Type of treatment: Antidepressants vs cognitive behavioural therapy: There is no difference in the first year.

Question 55

What has a strong relationship to therapy outcome?

Answer 55

Client qualities: * This is the most important thing. CLients must be motivated to change their behaviour.

Premorbid functioning: Someone who is homeless, never held a job etc wont suddenly become a model citizen just because of therapy. Outcomes are best if someone is a high functioning individual and then has a slip up, there i sa good chance that they will return to being high functioning.

Therapist qualities: Who you are as a therapist. While there is no variability by professions, there is variabilities within individuals in a profession.
Interpersonal skill of the therapist: Interacts in an aooprotiate way and is able to see what is going on with the client
Empathetic, warm
Worst therapists are thosr that are rigid, ie only offer CBT
A big factor for therapy is to keep them attending therapy. You have to be able to engage with and understand their conceptualizations of prolems, ie religious conceptualizations. You need to be able to address them in a way that is consistent with their own understanding.

Question 56

Dissociation

Answer 56

A dissociation is a splitting off of some part of your memory, personality from your conscious awareness etc.

Question 57

dissociative disorders are highest amongst?

Answer 57

Sex workers, exotic dancers, and male sex offenders

Question 58

Dissociative amnesia

Answer 58

Can’t recall important personal information that is too extensive to be explained by ordinary forgetfulness
Ie you may forget your name, or waht happened for an entire week. *It all has to do with you personally
*Normally caused by a traumatic event, which has caused memories to be repressed.

ot everyone has DA, not everyone can repress memories. THis is predicted by if you can be hypnotized or not. If you can be hypnotized then you can have DA. High hypnotizability is always present in people with repressive or dissociative amnesia.

Features:
Uncommon, sudden onset

*DA is most common is in adolescent females and young men during wartime
Most people, most of the time, their memories come back naturally.. 50% will have it return in a day. 75% will have the memory come back within a week

Your mind cant originally deal with the experience, so it blocks it out. Then at a later date, you are better able to process it

For a small percentage of people the memories dont come back. Not everyone can repress psychologically distressing knowledge.

for a good part of our conscious state we are reality testing. In a dissociative state reality testing goes out the window and we believe wha we are told

Treatment: if memory has not returned and patient wants the memories desperately, hypnosis may be useful. Sometimes it is better to leave it untreated, since the memory has been repressed due to trauma

Ouija board can also be used. THis is because of dissociated awareness of your own movements. In a situation like this. it is the same thing as hypnosis , so it works just as well. The client can ask questions of the ouija board and their unconcious will answer.

Question 59

Dissociative fugue

Answer 59

Bigger version of dissociative amnesia

Very rare
can happen any age
cross cultural variations- may be considered demonic posession in some cultures, this is a specific manifestation of dissocative fugue

Normally caused by being stuck in a situation you cant stand. Ie bad famiy and job. So you end up forgetting who you are and going elsewhere. Then youre in a new environment. It is a way of escaping a bad environment

commonly occurs during wartime

Treatment: Sam as DA. Hypnosis, but only if the person really wants it done.

Question 60

Dissociative identity disorder

Answer 60

Most traumatic
Formerly known as multiple personality disorder
More common in females
Most common in late adolescence and young adult females
Lots of comorbid health coditions, which is why it is normally misdiagnosed. Depression and anxiety are also present since these people are not functioning well.

*Different types of personalities are used to handle different types of situations. Each of these will be simplifications. Ie Angry person, child etc.

***** Unlikely fugue and DA which are temporary, dissociative identity disorder is chronic and likely to exist for a substantial part of their life

*This is exclusive to north america. not found in europe etc.
UFO abduction is a specific manifestation of this in Americans and Canadians

North american manifestations of DID: Being abducted by aliens, and having multiple personalities

Cause: all Did report pysical and sexual abuse. When you have a child that is very hypnotizable they ioften have imaginary friends,When a child is abused they start dissociating that experience from who they are. Once you do that, you start developing personalities for other situations too.

Treatment: Gradual intensitve treatment therapy.

Question 61

The liklihood of developing a mental health problem depends on:

Answer 61

A mix of genetic and environmental factors

Question 62

psychopathology is determined by:

Answer 62

1) Genetic inheritance
2) Environment
3) Behavioural and psychological patterns

ALl of which can either increase or decrease risk

Question 63

What affects the mother affects the fetus

Answer 63

Some viruses or bacteria can affect the babies brain. THe placenta will generally not act as a barrier to viruses or bacteria, so any infection a mother gets has a strong liklihood to infect the baby

Any drug that affects the mothers brain will affect the baby, because it is easier to get through the placenta than it is the blood brain barrier.

FASD: Eye folds, absence of depression of philtrum, also intellectual and learning disabilities are generally associated with a smaller brai

Nicotine: Low birth weight, prematurity, Unclear if there are any intellectual or behavioural deficits

toxins: lead stays in the brain

x rays: too many too long can damage a pregnant mom

Question 64

Problems during birth that can cause problems:

Answer 64

Anoxia: lack of oxygen to the brain

Forceps: Can cause intellectual impairment or cerebral palsy