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Psychiatry > Module 2 > Flashcards

Module 2 Flashcards

1
Q

patterns of behaviour or personality traits that are TYPICAL or that conform to some standard of proper and ACCEPTABLE ways of behaving and being…

A

Normality

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2
Q

Health vs Illness

A

HEALTH - State of complete physical, mental and social well-being and not merely the absence of disease or infirmity

ILLNESS - Reverse of health

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3
Q

IMPORTANCE of DIFFERENTIATING HEALTH from ILLNESS

A
  • Important step in the development of psychiatric nomenclature
  • Important in defining the domain of psychiatry
  • Important in understanding the epistemology of psychiatric diagnosis
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4
Q

According to DSM IV-TR:
- A behavioral/ psychological syndrome associated with: Distress
Disability (impairment in functioning)

  • Must NOT be an expected and culturally sanctioned response to a particular event (e.g. loss of a loved one)
A

Mental Disorder

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5
Q

Successful performance of mental functions (i.e. thought, mood, behaviour) that results in:

  • Productive activities
  • Fulfilling relationships with others
  • Ability to adopt to changes
  • Cope with adversities
A

Mental Health

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6
Q

PERSEPECTIVES of HEALTH and ILLNESS

A
  • Absence-of-pathology perspective
  • Utopia perspective
  • Statistical perspective
  • Systems perspective
  • Pragmatic perspective
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7
Q

Health

  • Absence of symptoms, physical signs and/or laboratory abnormalities
  • Free of undue pain, discomfort, disability, distress, disadvantage and other features of disorder

Biological perspective emphasizes this model

A

ABSENCE-of-PATHOLOGY PERSPECTIVE

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8
Q

ABSENCE-of-PATHOLOGY PERSPECTIVE: Goal of treatment

A
  • To free the person from the presence of the grossly observable symptoms
  • To help person attain reasonable functioning
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9
Q

LIMITATIONS of the ABSENCE-of-PATHOLOGY PERSPECTIVE

A
  • A biological etiology or pathology may not always be present or determinable in all cases of mental disorders.
  • The standard or optimal pattern of neurochemical structure and function is ambiguous and arbitrary.
  • Many people who are ill do not complain or even suffer, because they experience no symptoms, they accept their incapacity, or they find some benefit from it.
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10
Q

Health - State of ideal functioning

Emphasized in humanistic and psychoanalytic models of treatment

A

UTOPIA PERSPECTIVE

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11
Q

UTOPIA PERSPECTIVE: Goal of treatment

A
  • To help person actualize or reach his/her full potential

- To help person optimize functioning in some ideal manner

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12
Q

LIMITATION of the UTOPIA PERSPECTIVE

A
  • Obtained rarely and by a few persons

- Sigmund Freud: mental health is an “ideal fiction”

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13
Q

Health - Average level of functioning

Emphasized in

  • Psychometric models of psychopathology in psychology
  • Medical diagnosis and classifications such as hypertension
A

STATISTICAL PERSPECTIVE

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14
Q

LIMITATION of the STATISTICAL PERSPECTIVE

A
  • Average is not the same as healthy.

- E.g., in the general population, the mean weight or eyesight is actually unhealthy

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15
Q

Health - A condition that is not deemed sufficiently troublesome to seek treatment for is not pathological

The evaluation that a condition is a disorder is relative to the society and the citizens within that society

A

PRAGMATIC PERSPECTIVE

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16
Q

LIMITATION of the PRAGMATIC PERSPECTIVE

A

Defining mental disorders as those conditions treated by mental health professionals may be self-serving & relative to the complaints and economics of the local patients and interests of the local clinicians.

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17
Q

Health - Functional interplay of interacting systems that operate and fluctuate in a relative adaptivity over time

Emphasizes multiple processes and levels of adaptation that need to be studied longitudinally

A

SYSTEMS PERSPECTIVE

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18
Q

SYSTEMS PERSPECTIVE: Levels of adaptation

A
  • Biological
  • Cognitive
  • Affective
  • Interpersonal
  • Occupational
  • Familial
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19
Q

OTHER CAVEATS in DEFINING MENTAL HEALTH

A

What is healthy may depend on geography, culture and historical moment.

  • Punctuality is a virtue in some countries but not in others.
  • Gen. George Patton’s competitive temperament was a psychological liability in time of peace but a virtue in two world wars.
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20
Q

OTHER CAVEATS in DEFINING MENTAL HEALTH 2

A

One must make clear whether one is discussing trait or state.

Who is physically healthier?

  • An Olympic miler disabled by a simple but temporary ankle fracture?
  • A type 1 diabetic with a temporary normal blood sugar level?
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21
Q

OTHER CAVEATS in DEFINING MENTAL HEALTH 3

A

One must appreciate the danger of “contamination by values”.

  • What is mental health good for?
    For self or the society? For fitting in or for creativity? For happiness or survival?
  • Who should be the judge?
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22
Q
  • Polarized, elongated cells capable of instantaneously, intracellular communication
  • Transmission of information
A

Neurons

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23
Q

Anatomy of Neuron

A

Dendrites: take input information into neuron

Cell body: cellular metabolism, incoming signal communicated

Axon: carries information away from cell bodies towards output terminals

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24
Q

3 Types of Glial Cells

A
  1. Astrocytes
  2. Oligondendrocytes-CNS/ Schwann Cells-PNS
  3. Microglia
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25
Q
  • Most numerous
  • Nutrition of cells
  • Deactivation of neurotransmitters
  • Integration of blood cell barrier
A

Astrocytes

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26
Q

Wrap their processes around axons resulting in-myelin sheaths that facilitate conduction

A

Oligondendrocytes-CNS/ Schwann Cells-PNS

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27
Q
  • Derived from macrophages

- Removing cell debris

A

Microglia

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28
Q

processes external stimuli into neuronal impulses and create an internal representation of the external world

A

Sensory systems

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29
Q

enable people to manipulate the environment and to influence others’ behavior through communication

A

Motor systems

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30
Q

where the sensory inputs, representing the external world, is integrated with internal drives and emotional stimuli and in turn drive the actions of the motor units

A

Associated units

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31
Q

The Basic Unit Of Behavior is THE REFLEX ARC

A
  • RECEPTOR
  • SENSORY/AFFERENT NEURON
  • SYNAPSE IN THE CNS
  • MOTOR/EFFERENT NEURON
  • EFFECTOR
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32
Q
  • transforms external stimuli into neural impulses and then filter out irrelevant formation to create an internal image of the environment which serve as the basis for reasoned thought.
  • Alteration of conscious perception through hypnosis
A

Sensory Systems

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33
Q

Sensory Systems: Sensory inputs

A
  • Auditory
  • Gustatory
  • Visual
  • Olfactory
  • Tactile
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34
Q
  • state of heightened suggestibility - gross distortions of perception of any sensory modality
A

Hypnosis

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35
Q

Visual Association Areas

A

Parietal=Place!
“Where object is!”
Temporal=Type
“What object is!”

L ITC=response to facial features
R ITC=response to complex shapes

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36
Q
  • inability to recognize faces
A

Prosopagnosia

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37
Q

inability to identify and draw items w/ preservation of other sensory modalities

A

Apperceptive Visual Agnosia

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38
Q

Inability to name or use objects despite ability to draw them

A

Associative Visual Agnosia

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39
Q

Inability to recognize color despite being able to match it

A

Color Agnosia

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40
Q

Inability to name color despite being able to match it

A

Color anomia

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41
Q

Complete inability to perceive color

A

Central achromastopsia (color blindness)

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42
Q
  • Failure to acknowledge blindness

- Interruption of fibers involved in self assessment Bilateral occipital lesions

A

Anton’s syndrome

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43
Q
  • Dyscalcula
  • Dysgraphia
  • Finger agnosia
  • Right and left disorientation
  • Problem w/ dominant parietal lobe
A

Gertsman Syndrome

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44
Q

severe difficulty in making arithmetical calculations

A

Dyscalculia

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45
Q

inability to write coherently

A

Dsygraphia

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46
Q
  • Optic ataxia
  • Occulumotor apraxia
  • Simultanognosia
A

Balint’s Syndrome Triad

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47
Q
  • inability to direct optically guided movement

- An inability to guide the hand toward an object using visual information

A

Optic Ataxia

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48
Q

Inability to direct gaze rapidly

A

Occulomotor apraxia

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49
Q

inabilty to integrate visual scene to perceive it as whole

A

Simultanagnosia

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50
Q

(auditory system)

intact hearing for voices, inability to recognized

A

Word deafness: (word, verbal, auditory agnosia)

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51
Q

(auditory system)

inability to recognize non verbal sounds (e.g. cat’ meow) intact hearing and speech recognition

A

Auditory sound agnosia

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52
Q

Motor systems

A
  • Brainstem
  • Corticospinal tract
  • Basal ganglia
  • Cerebellum
  • Motor cortex
  • Autonomic cortex-sympathetic and paraympathetic
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53
Q

primitive systems produce gross coordinated movements of the entire body

A

Brainstem

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54
Q
  • controls fine movements and dominates the brainstem
  • Motor strip - posterior frontal lobe
  • planned movements
A

Corticospinal tract

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55
Q
  • subcorticate matter that medicate postural tone

- Four distinct ganglia: striatum, pallidum, substantia nigra, subthalamic nuclei

A

Basal ganglia

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56
Q
  • harbor components of both motor and associated systems
  • plays an important role in the modulation of motor acts
  • decreased activate is related with OCD behavior
  • when functioning properly, acts as the gate keeper to allow the motor system to perform only those acts which are goal directed.
A

Corpus striatum - caudate and putamen

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57
Q

Overactivity of the striatum - due to lack of dopaminergic inhibition - results in __- an inability to initiate movements

A

bradykinesia

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58
Q

receives inputs from the corpus striatum and project fibers into the thalamus

A

Globus pallidus

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59
Q
  • melanin pigment

- degenerates into Parkinson’s disease

A

Substantia nigra

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60
Q

yields ballistic movements, sudden limb jerks - projectile movements

A

Subthalamic nucleus

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61
Q

(complex fine movement!)

- Inability to use contralateral hand in presence of preserved strength

A

Limb Kinetic Apraxia

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62
Q

(motor!)

- Inability to perform isolated motor act or command

A

Ideomotor apraxia

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63
Q

(sequence!)
- Individual components of a sequence of skilled acts can be performed in isolation but the entire series cannot be executed

A

Ideational apraxia

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64
Q

capable of initiating and maintaining the full range of useful movements

A

Nuclei of the basal ganglia

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65
Q
  • Basic organization of the brain

Three main processing blocks

  1. Brainstem and the thalamic reticular activating system
  2. Posterior cortex - integrates perception and generates language
  3. Frontal cortex - highest level - generates programs and executes plans
A

Association Cortex

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66
Q
  • key feature of higher cortical processing
  • primary sensory cortices for touch, vision, hearing, smell and taste are represented bilaterally
  • e.g. Recognition of familiar faces; localization of language
A

Hemispheric lateralization of function

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67
Q

responsible for generating and modifying memories and for assigning emotional weight to sensory and recalled experience

A

Limbic system

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68
Q
  • one of the nucleus of the limbic system that receives fibers from all sensory areas
  • serve as a gate for the assignment of emotional significance to memories
A

Amygdala

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69
Q
  • Voluntary movement
  • Language production
  • Motor prosody
  • Motivation
  • Executive functions
A

Frontal lobe

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70
Q
  • Audition
  • Language comprehension
  • Sensory prosody
  • Memory
  • Emotion
A

Temporal lobes

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71
Q
  • Tactile sensation
  • Visuospatial function
  • Reading
  • Calculation
A

Parietal lobes

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72
Q
  • Vision

- Visual perception

A

Occipital lobes

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73
Q
  • Slowed thinking, poor judgment, decreased curiosity, social withdrawal, irritability
  • Apathy to sudden impulsive disinhibition
  • May be largely unnoticed, becoming apparent only under unstructured, stressful, real-life situations
  • Trauma, infarcts, tumors, lobotomy, multiple sclerosis, Pick’s disease
A

Frontal Lobe Syndrome

74
Q

Localization of specific brain functions

A 
Arousal 
Attention
Memory
Language
Emotion
75
Q
  • establishment and maintenance of awake sate
  • Brain regions: brainstem, ARAS, cortex
  • within the brainstem - ARAS - sets the level of consciousness
  • absence of which leads to stupor and coma
A

Arousal

76
Q
  • maintained by an intact right frontal lobe
  • the skill of maintaining a coherent line of thought is distributed throughout the cortex
  • medical conditions that affect the cortex: loss of skill, confusion and delirium
A

Attention

77
Q

Major causes of acute confusion

A
  • Infectious
  • Metabolic: Hypoxia, Hypoglycemia, Uremia, Hepatic disease
  • Toxic: drugs
  • Vascular: stroke; SAH
  • Neoplastic
  • Traumatic: brain injury
78
Q
  • functions over a period of seconds

- implicit in the concept of attention and ability o follow train of thought

A

Immediate memory

79
Q
  • applies on the scale of minutes to days

- working memory - ability to store information and relate to cognitive information

A

Recent memory

80
Q
  • memory encompasses months to years
A

Remote memory

81
Q

Basic structures critical to the formation of the memory:

A
  1. Medial temporal lobe
    - house the Hippocampus
    - Amygdala - rates the emotional importance of an experience and to activate the level of hippocampal activity
  2. Diencephalic nuclei
  3. Basal forebrain
  4. Hippocampus
82
Q
  • significant site for the formation and storage of immediate and recent memories

left - efficient for forming verbal memories
right - non-verbal memories

A

Hippocampus

83
Q

memorized motor acts

A

activation of the median temporal lobe

84
Q

with practice; for highly skilled acts

A

left parietal cortex

85
Q

Causes of amnesia:

A

alcoholism, seizures, migraine, drugs, vitamin deficiencies, trauma, strokes, tumors, infections and degenerative diseases

86
Q
  • for formation of memory
    dorsal medial nucleus of the thalamus
    mamillary bodies
A

Diencephalon

87
Q
  • most common clinical disorder of memory
  • char. by degeneration of neurons and their replacement by senile plaques and neurofibrillary tangles
  • impaired language comprehension and visuospatial organization - parietal lobe
A

Alzheimer’s disease

88
Q
  • due to thiamine deficiency in chronic alcoholics

- char. by severe inability to form new memories and inability to recall

A

Korsakoff’s syndrome

89
Q
  • Clearly demonstrates hemispheric localization of function

- The dominant hemisphere for language directs the dominant hand

A

Language

90
Q

Language comprehension is processed at three levels.

A
  1. Phonological processing - individual sounds
  2. Lexical processing matches the phonological input with recognized words
  3. Semantic processing - connects the words to their meaning
91
Q
  • Derives from basic drives: feeding, sex, pleasure, pain, fear and aggression
  • Neuroanatomical basis: limbic system
  • other distinct human emotions: affection, pride, guilt, pity, envy, resentment - are learned and represented in the cortex
A

Emotion

92
Q

Hemispheric dichotomy of emotional representation

A

Left hemisphere - houses the analytical mind
Right hemisphere appears dominant for affect, socialization and body image

Left prefrontal cortex - appears to lift mood
Right prefrontal cortex - causes depression

93
Q
  • Reading (parietal)
  • Calculation (parietal)
  • Language comprehension (temporal)
  • Adds internal details, embellishment, shape, complexities
  • Right and left disorientation
  • Verbal task (parietal)
  • Lifts mood (PFC)
  • Response to facial features (Inferior temporal Lobe)
  • Analytical Mind
  • Limb Apraxia, Aphasia
A

Left Hemisphere

94
Q
  • Maintaining attention (frontal)
  • Visuospatial (parietal)
  • Overall contour
  • Perspective
  • Right and left orientation
  • Performance Task
  • Depression
  • Uncontrollable crying
  • Affect
  • Somatization
  • Body image
  • pRosody
A

Right hemisphere

95
Q

houses the emotional association areas which directs the hippocampus to express the motor and endocrine components of the emotional state

A

Limbic system

96
Q
  • hippocampus, the fornix, the mamillary bodies, the anterior nucleus of the thalamus and the cingulate gyrus
A

Limbic system: Papez circuit (1937)

97
Q

To __ is to behave in a way that one’s attitudes and actions are well matched to the demands and constraints of the external environment and where one’s sense of internal discomfort or distress is minimized.

A

FUNCTION ADAPTIVELY

98
Q

The ability to adapt depends on:

A
  • The individual’s behavior repertoire

- The external environment

99
Q

True or False

An individual’s personality style has a great influence on his/her behavior and adaptive functioning.

A

True

100
Q

Personality is shaped from a blend of:

A
  • Inborn temperament
  • Genetic strengths and vulnerabilities
  • Impact of positive and negative life experiences
101
Q
  • Individual behavioral styles - activity levels, biological rhythmicity, emotional style and sociability, and response to stimulus or change
  • affects the degree to which different infants are susceptible to distress as well as their variations in attachment style
A

Temperament

102
Q

Temperament characteristics

A
  • “Difficult” children
  • “Easy” children
  • “Slow-to-warm-up” children
103
Q

– had irregular sleeping patterns, tended to withdraw from new situations, were not adaptable, and had intense and negative reaction

A

“Difficult” children

104
Q

– were biologically regular, adaptive, and in good moods; they had positive reactions to situations and reactions were mild in intensity

A

“Easy” children

105
Q

– had initial withdrawal responses, slow adaptation, and mild reactions.

A

“Slow-to-warm-up” children

106
Q
  • play a role in development, especially when they interact with the environment.

Link between early loss of a parent and vulnerability to depression in the face of later stressful life events

In general, genetic factors account for 30% - 60% of the variance in adult personality traits

A

Genetic factors

107
Q
  • have an impact on the individual and affect one’s behavior for better or worse
  • need to consider their impact and meaning: if particular experiences are the result of fate in contrast to whether they are partially brought about by the person’s own actions
A

Life experiences

108
Q

Broad Classes of Coping Mechanism

A
  1. Consciously Seeking social support
  2. Conscious Cognitive strategies
  3. Adaptive involuntary mechanisms-defense mechanisms
109
Q
  • Reduces conflict
  • Reduces cognitive dissonance
  • If not distorted and denied can result in anxiety or depression
  • Can restore psychological homeostasis by ignoring or deflecting sudden increases in the lodestar impulse-affect and emotion
A

Involuntary Mechanisms

110
Q

Can provide a mental time out to adjust to sudden changes in reality and self image w/c cannot immediately integrated

Can mitigate sudden unresolvable conflict with important people living or dead
E.g. Death, unexpected proposal of marriage

A

Involuntary Mechanisms

111
Q
  • Maximize gratification and allow awareness of feelings and ideas and their consequences
  • Promote an optimum balance between conflicting motives
  • Altruism
  • Anticipation
  • Humor
  • Sublimation
  • Suppression
A

MATURE DEFENSES

112
Q
  • Involves an individual giving pleasure to others what the individual would have liked to receive
  • E.g. Alcohol abuser becomes leader of AA
A

Altruism

113
Q
  • Transforming unacceptable needs into acceptable ambitions and actions; Allows instincts to be channeled, not blocked or diverted
A

Sublimation

114
Q

(mature defenses)

Sexual drives can be poured into sports or music

A

Sublimation

115
Q

(mature defenses)

Anger and resentment of the advantages of others can be funeled into an obsession to excel in a lucrative career

A

Sublimation

116
Q
  • Defense that modulates emotional conflict or internal or external stressors through stoiticism
  • Minimizes postpones but does not ignores gratification
A

Suppression

117
Q

(mature defenses)

  • You forget to do things or try to think of other things so you can “settle down” and function better
  • Counting to 10 before acting in anger
A

Suppression

118
Q

Realistically anticipating or planning for future inner discomfort

A

Anticipation

119
Q

(mature defenses)

  • An employee who is on the verge of termination plans out his next course of action.
  • A student who anticipates failure in school begins to inform his parents about this.
A

Anticipation

120
Q
  • more common approach in clinical psychiatry
  • a person is described as meeting or not meeting the criteria for various diagnostic categories
  • unique characteristics of one’s personality style
  • the categories are not overlapping
A

DSM IV: Categorical system

121
Q
  • a person is evaluated in terms of a blend of traits or factors one possesses, measured on a continuum
  • Everyone’s personality can be maladaptive or adaptive (quantity of a given trait rather than quality makes it a problem)
  • Important determinants of a person’s adaptive capacity: flexibility and variability
A

Dimensional system:

122
Q

Oldham and Morris’ Personality Style-Personality Disorder Continuum 1

A

Vigilant: Paranoid
Solitary: Schizoid
Idiosyncratic: Schizotypal
Adventurous: Antisocial

123
Q

Oldham and Morris’ Personality Style-Personality Disorder Continuum 2

A 
Mercurial: Borderline
Dramatic: Histrionic
Self-confident: Narcissistic
Sensitive: Avoidant
Devoted: Dependent
Conscientious: Obsessive-compulsive
124
Q

– encompass anxiety, hostility, depression, impulsiveness

A

Neuroticism

125
Q

– include warmth, assertiveness, excitement seeking, positive emotions

A

Extraversion

126
Q
  • fantasy, feelings, actions, ideas
A

Openness

127
Q
  • trust, altruism, compliance, modesty
A

Agreeableness

128
Q
  • competence, order, dutifulness, self-discipline
A

Conscientiousness

129
Q

Each person’s unique personality style is reflected in the various domains in which a person functions.

A

DOMAINS OF FUNCTIONING

130
Q
  • provides a scale to rate a person’s overall level of adaptation(100-point scale)
    1. Social and Interpersonal functioning
    2. Occupational functioning
    3. Degree of symptoms
A

GAF - Global Assessment of Functioning

131
Q

Social and Interpersonal Functioning

A
  • A person’s perception of relationships with others
  • Quality and depth of bonds
  • Degree to which a person feels reticent about being open within each relationship
  • Degree to which others are depended on for help; i.e. advice and financial support
  • Freedom from friction and arguments, reciprocity and supportiveness– inherent assumption in its assessment
132
Q
  • Provides a quantitative way to investigate interpersonal functioning (e.g. person’s relationship with family of origin, spouse or partner, children, work colleagues, friends and acquaintances
  • Provides a way to assess whether someone initiates contact with others (i.e. whether the individual feels an urge to be defiant or rebellious; overly concerned, guilty, or resentful within each relationship)
A

Social Adjustment Scale

133
Q

Requires: Capacity for interpersonal functioning ADAPTIVE occupational functioning: consist of being engaged and feeling satisfied about and competent at work

Requires examining ways of….
Completing tasks
Taking and giving orders
Delegating responsibility
Cooperating with others
Ability to balance demands
Obeying regulations
Decision-making
A

Occupational Functioning

134
Q

Focuses on externally observable behaviors

  • Number of days lost in a month
  • Degree of impairment of performance at work
  • Internal states: feelings inadequate, angry, and distressed at work (and by work) and/ or its positive correlates (are these reflected in work performance, relationships with superiors and subordinates?)
A

Social Adjustment Scale

135
Q
  • The capacity to enjoy leisure depends on:
    External demands and responsibilities
    Financial and other resources
  • Gusto with which leisure activities are pursued
  • Types of activities chosen
A

Leisure

136
Q

Assesses how well developed and specific a patient’s interests are:

  • Frequency of pursuit (quantify aspects of leisure)
  • Leisure-time adaptation – the experience of loneliness and boredom during free-time as well as the person’s ability to compensate for these painful states
A

Social Adjustment Scale

137
Q

Tools In Assessment Of Domains Of Functioning

A
  1. Weissman’s Social Adjustment Scale
  2. Benjamin’s Structural Analysis of Social Behavior
  3. “Psychiatric Clinical Interview”
    - Gives information on: personality style; level of adaptive functioning; usual patterns of behavior
    - MSE assesses appearance, attitude, motor behaviors provides clues to: Personality; Capacity for interpersonal interactions; Potentially problematic behavior patterns
138
Q

Assessing Behavior and Adaptive Functioning in the Clinical Interview

A
  1. Appearance – overall clinical impression reflected by grooming, clothing, poise and posture
    Problems in appearance can suggest the possibility of other functional impairments as well.
  2. Attitude and Cooperation- To detect the patient’s attitude and willingness to cooperate in the examination
    - Friendly, hostile, seductive, apathetic, defensive
    - Suggests general level of interpersonal functioning
    - Is affected by psychiatric illness
139
Q
  • Overall level of activity
  • Impulsivity
  • Restlessness, pacing, hand wringing or other forms of agitation
  • Tics
  • Provides clues to person’s internal state
    Mania – increased motor behavior
    Depress/ intoxicated – psychomotor slowing
  • Clues to Personality
A

Motor Behavior

140
Q

sudden, rapid involuntary stereotyped movements (e.g. facial grimaces, blinking, neck jerking, shrugging, coughing, barking, etc

A

Tics

141
Q

Problem Patterns of Behavior

A

Cuts across diagnostic groups

Fruitful way of characterizing maladaptive functioning

  • Impulsive behavior
  • Compulsive behavior
  • Avoidant behavior
142
Q

Are actions that arise without much delay between the formation of an idea or desire and its gratification in action

self-mutilation
suicide
substance abuse
pathological gambling
banging and purging
hair pulling
paraphilias
kleptomania
A

Impulsive Behavior

143
Q

Hallmarks:

  • Tension-action-relief
  • Frankly pleasurable at the moment of action even if the person is extremely remorseful afterward
  • Experience relative imperviousness to the consequences of the actions and tend to underestimate their chances of being caught
A

Impulsive Behavior

144
Q

Hallmarks:

  • Act may increase the odds of apprehension and punishment (e.g. poor planning and execution)
  • Behavior that it seemed out of control (e.g. binging, suicide, self mutilation, substance abuse, gambling, purging, kleptomania, pyromania, paraphilias)
A

Impulsive Behavior

145
Q

– time-consuming; senseless; experience of distress; done to relieve distress/ anxiety

  • Versus carefulness or attention to detail
  • hand washing and checking
  • sexual compulsions
  • food restriction
A

Compulsive behavior

146
Q
  • Agoraphobia
  • Simple phobias
  • Social phobia
  • arise from history of being fearful from a given situation; has a tendency to be self-reinforcing
A

Avoidant behavior

147
Q

True or False

In evaluating the adaptiveness of a person’s behavior, an understanding of the strengths & weaknesses of various character styles and the constraints and demands of the external environment is essential.

A

True

148
Q

True or False

Behavior is the final common pathway for the expression of genetics, temperament, personality traits and psychiatric symptoms

A

True

149
Q
  • The study of the chemical interneuronal communication
  • Basic electrophysiology
  • Translation of the AP into chemical neurotransmission
A

Neurophysiology and Neurochemistry

150
Q
  • Ion channels open in response to binding of ligands to receptors
  • Use of neurotransmitters
A

ligand-gated ion channels

151
Q
  • in response to changes in membrane potential

- Use of electricity

A

Voltage-gated ion channels

152
Q
  • instantaneous pulses of membrane depolarization

- myelin sheath - increase the rate of AP along the axon

A

Action potential

153
Q
  • AP triggers the release of chemical neurotransmitters, which enter the synaptic cleft and bind to receptors

Neuronal cell bodies - gray matter
Myelinated axon tracts - white matter

A

Synaptic cleft

154
Q

making a membrane more positive

A

Polarization

155
Q

the inside of the membrane is even more negatively charged than it was at baseline

  • 70-80mV: resting state
  • 55mV= spike threshold
A

Afterhyperpolarization

156
Q

(Voltage-Gated ion channels)

  • open cation channels that depolarize the membrane and increase the likelihood of the generation of an action potential.
  • These ligands are said to elicit excitatory postsynaptic potentials (EPSPs).
A

Excitatory neurotransmitters

157
Q

(Voltage-Gated ion channels)

open chloride channels that hyperpolarize the membrane and decrease the likelihood of the generation of an action potential.
These ligands are said to elicit inhibitory postsynaptic potentials (IPSPs).

A

Inhibitory neurotransmitters

158
Q

Post Synaptic Components

A
  • Receptors
  • Secondary messengers
  • Neurotransmitters
159
Q

2 Major Types of Neurotransmitter Receptors

A
  1. seven-transmembrane-domain receptors - which require G proteins,
  2. ligand-gated ion channels - w/c the channel is an integral part of the complex that binds the ligand
160
Q

1st messengers:

  • The neurotransmitters
  • bring a signal to a neuron.
  • For the neuron to act on the signal, the 1st-messenger signal must be translated into an intraneuronal signal via formation of __
A

second-messenger molecules

161
Q

Chemical signals that flow between neurons

A

Neurotransmitters

162
Q
  • is the process involving the release of a neurotransmitters by one neuron and the binding of the neurotransmitter molecule to a receptor on another neuron

anti- psychotics - block D2
anti-depressants - increase the amount of serotonin or norepinephrine

A

Chemical neurotransmission

163
Q

Criteria for a Neurotransmitter

A
  1. The molecule is synthesized in the neuron.
  2. The molecule is present in the presynaptic neuron and is released on depolarization in physiologically significant amounts.
  3. When administered exogenously as a drug, the exogenous molecule mimics the effects of the endogenous neurotransmitter.
  4. A mechanism in the neurons or the synaptic cleft acts to remove or deactivate the neurotransmitter
164
Q

Types of Neurotransmitters

A
  1. Biogenic amines (least!) - Dopamine; Norepinephrine; Epinephrine; Serotonin; Acetylcholine; Histamine
  2. Amino acids (most!) - GABA; Glutamate
  3. Peptides (middle) - Oxytocin; Cortisol releasing factor(CRF); ACTH; Prolactin; Substance P; Thyrotropin-releasing hormone (TRH)
165
Q

Clarification of Terms

A

Catecholamines:Dopamine; Epinephrine; Norepinephrine

Monoamines: Dopamine; Norepinephrine; Serotonin

Biogenic amines: Dopamine; Norepinephrine; Epinephrine; Serotonin; Acetylcholine; Histamine

166
Q
  • Increased in Schizophrenia
  • Increased by antidepressants
  • Decreased in Parkinson’s disease
A

Dopamine

167
Q
  • mood D/O
  • Anxiety
  • panic states
A

Norepinephrine and Epinephrine

168
Q
  • Increased in Schizophrenia and Mania
  • Decreased in Depression
  • Increased by Antidepressant
A

Serotonin

169
Q

All biogenic amines NT are synthesized in the

A

axon terminal

170
Q
  • amino acid precursor of serotonin
A

Tryptophan

171
Q
  • amino acid precursor of the catecholamines: D, NE, E
A

Tyrosine

172
Q

Dopamine Pathway

A

Nigrostriatal tract
Mesolimbic-mesocortical tract
Tuberoinfundibular tract

173
Q
  • cell bodies in the substantia nigra—>corpus striatum
  • D2 receptors in the caudate nucleus suppress the activity of the caudate nucleus
  • caudate nucleus regulates motor acts by gating which intended acts are carried out
A

nigrostriatal tract

174
Q
  • cell bodies in the ventral tegmental area which is adjacent to the SN, CC, and LS
  • mediate effects of anti-psychotic drugs
A

Mesolimbic-Mesocortical tract

175
Q
  • arcuate nucleus and the periventircular area of the hypothalamus and project to the infundibulum and the anterior pituitary
  • D acts as a release -inhibiting factor of prolactin in the anterior pituitary
A

Tuberoinfundibular tract

176
Q
  • Noradrenergic and the adrenergic systemLife cycle
  • CNS noradrenergic tracts
    project into the locus ceruleus in the pons
    axons project through the medial forebrain bundle in the CC, LS, thalamus and hypothalamus
A

Norepinephrine and Epinephrine

177
Q
  • Life cycle: axon terminal
    tryptophan - is the rate-limiting function
    dietary variations:
  • low: irritability, hunger
    high: sleep, relieve anxiety, increase a sense of well-being
  • Major site: upper pons and midbrain, median and dorsal raphe nuclei, the LC and postrema
A

Serotonin

178
Q
  • Contain the building blocks of protein
  • Brain: glutamate and aspartate
    Two major AA:
    GABA- Gamma-aminobutyric acid - inhibitory amino acid (IAA); monocarboxylic amino acid
    Glutamate -excitatory amino acid (EAA); dicarboxylic amino acid
  • several anti-convulsants act through the GABAergic mechanisms
A

Amino Acid

179
Q
  • synthesized from glucose and glutamine in the presynaptic neuron terminals and stored in the synaptic vesicles
  • primary NT in cerebellar granule cells, the striatum, the cells of the hippocampus
  • its release is stimulated by nicotine
A

Glutamate

180
Q
  • a glutamate receptor plays an essential role in learning and memory as well in psychopathology
A

N-methyl-D-aspartate (NMDA) receptor

181
Q
  • found most exclusively in the CNS and does not cross the BBB
  • midbrain and diencephalon, less in the cerebral hemispheres, the pons, and the medulla
  • synthesized from glutamate by the rate limiting enzyme glutamic acid carboxylase (GAD) which requires pyridoxine (Vit. B6) as cofactor
  • is the primary NT in intrinsic neurons that function as local mediators for the inhibitory feedback loops
A

GABA

182
Q
  • Refers to the chemical bond between the carboxylic acid group and the amino group of adjacent amino acids in a protein
  • Differ from other NT because they are manufactured in the cell body
  • May serve as neuromodulary role at some synapses
A

Peptides

Psychiatry (6 decks)

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