Week 2 - Models Flashcards
Describe the scientist-practitioner approach to psychopathology (x6)
Research/empiricism guides assessment, diagnosis, treatment - otherwise unethical
Models (representations of real world) used to explain:
o Origins of abnormal behaviour
o How to treat it
o How to prevent it
Research tests/drives hypotheses derived from models
List 6 models of psychopathology
• Biological (physiological, neurochemical factors)
• Psychodynamic (internal unconscious factors)
• Humanistic/existential (internal conscious factors)
• Behavioural (interaction of social & psychological factors)
• Cognitive (cognitions)
Biopsychosocial - multidisciplinary
What does biomedical model see as the primary cause of psych disorders? (x1)
With aetiology as… (x4)
Inherited/acquired brain disorders involving neurotransmitter imbalances/damage to brain structures
Genetics, biochemistry, neuroanatomy, endocrine system
What is the ‘pedigree method’ of studying gene/environment interactions? (x6)
Family incidence method - Proband (first family member affected by genetic disorder) identified
How prevalent is the disorder in their family?
Nature versus nurture?
• Families share environments as well as genes – imperfect method due to inability to disentangle nature, nurture
Describe the use of classical twin studies in investigating gene/environment interactions (x4)
Good method for nature, nurture distinction
Compares concordance (when both twins have it) rates for MZ and DZ twins
• In MZ twins should be 100% if purely genetic, 50% concordance in DZ – but not many disorders like that
• Differ in genetic similarity, but not likelihood of sharing same environment/experiences
How do we use MZ and DZ concordance rates to decide genetic/environment contributions to disorders? (x3)
o If MZ > DZ: genetic contributions
o If MZ = DZ and both show high concordance; shared environmental contributions (family environment etc)
o If MZ = DZ, and both show low concordance; non-shared environment contributions (eg one twin having an ABI)
Describe the use of adoption studies in investigating gene/environment interactions (x2)
Compares concordance of adopted children to biological versus adoptive relatives
o Eg higher rates of alcoholism in adopteds with biological parents who were alcoholic
Describe the use of molecular genetics in investigating gene/environment interactions (x1)
And two types of studies?
Instead of concordance, investigates influence of specific genres
Genetic association studies
Genome-wide association studies
What is involved in genetic association studies?
Plus e.g. of genetic variation/cause found this way
Needs prior identification of candidate gene
• Is one allele of it more frequently seen in people with the disorder than in people without?
ApoE-e4: 37% of people with AD vs. 14% in general population (but many with alzheimers don’t have the variant)
What is involve in genome-wide association studies? (x2)
- Assess common variation across the entire genome
* Try to identify knew genes that are involved
How does the biomedical model look at biochemistry as aetiology of disorders? (x4)
Most drug therapies increase or decrease the activity of specific neurotransmitters
BUT: effects of neurotransmitter activity are very broad
o Many interact with different neurotransmitters too
o So far too simplistic to say that an imbalance is the cause of disorder
Name four neurotransmitter systems
Serotonin
Gamma Amino Butyric Acid
Noradrenalin
Dopamine
What does the serotonin system do? (x1)
With correlational evidence associating it with… (x4)
Which mean that… (x1)
Regulates behaviour, mood & thought processes
• Aggression
• Suicide
• Impulsive overeating
• Hyper-sexual behaviour
(When these are symptoms, drugs get prescribed at target serotonin)
What two classes of drugs primarily affect the serotonin system?
With what tertiary benefit/use? (x1)
Tricyclic antidepressants
Serotonin specific reuptake inhibitors (e.g., Prozac)
Anxiolytics properties – these drugs can also reduce anxiety in some cases, but don’t know why
What does the GABA system do? (x3) With the most common class of medication being? (x1, plus explain x1)
Inhibits a variety of behaviours & emotions
• Seems to reduce overall arousal
Anxiolytic effects
Benzodiazepines - make it easier for GABA molecules to attach themselves to the receptors of specialized neurons
Noradrenalin/norepinephrine is secreted by the… (x1)
With CNS noradrenalin circuits in… (x2, plus function of each)
Adrenal glands
Hindbrain, in area that controls basic bodily functions such as respiration
Another circuit influences emergency reactions/alarm responses (fight, flight, adrenalin rush) to sudden danger
What does the dopamine system do? (x1)
With circuits that… (x1)
Meaning that dopamine… (x1)
Relays messages to control movements, mood and thought processes
Merge/cross with serotonin circuits
Influence many of same behaviours
How does the dopamine system relate to Parkinson’s disease? (x4)
Dopamine-producing cells damaged.
Substantia negra damaged, motor slowing when about 80% damage
Also emotional regusltion and cognitive function issues
(Dopamine also in other mental health problems, but Parkinson’s is primary)
Name 4 areas of the brain (plus function) that may lead to specific disorders if damaged (neuroanatomy as aetiology)
Hindbrain
o Bodily functions involved in sustaining life, regulation of stages of sleep
Midbrain - reticular activating system
o Involved in regulation of some motor activities (fighting & sex), and sleep
Forebrain
o Site of most sensory, emotional, & cognitive functioning
o Limbic system
Orbitofrontal cortex - damage causes disinhibition
What brain regions are thought to control theory of mind? (x2)
Temporoparietal junction
Dorsomedial prefrontal cortex
What brain regions are thought to control empathy? (x2)
Dorsal anterior cingulate cortex
Anterior insula
What brain regions are thought to control social perception? (x3)
Posterior superior temporal sulcus
Fusiform face area
Amygdala
What brain regions are thought to control social behaviour? (x2)
Ventromedial prefrontal cortex
Orbitofrontal cortex
How is the endocrine system involved in the aetiology of disorders?
Endocrine system produces hormones, that travel in bloodstream
And function to:
o Help regulate the body’s physiological processes – eg maturation, internal functions
o Co-ordinate internal bodily processes with external events
Prolonged stress can cause dysfunction - and maybe permanent damage
Top down, what glands/organs are involved in the endocrine system? (x10)
Pineal body Pituitary gland Parathyroid gland Thyroid gland Thymus gland Stomach Adrenal glands Pancreas Kidney Ovaries/testes
How do we understand the stress relationship through the hypothalamic-pituitary-adrenal-cortical (HYPAC) axis? (x5)
Is where hypothalamus and endocrine system interact and controls reactions to stress
o Hypothalamus connects to the adjacent pituitary gland – which is co-ordinator of endocrine system
o Pituitary gland, in turn, may stimulate the cortical (outer part) of the adrenal glands to produce:
• Surges of adrenalin at inappropriate times
• Cortisol (stress hormone)
What are two biological treatments?
Electro-convulsive shock treatment
Pharmacotherapy
What is involved in electro-convulsive shock treatment? (x3)
Which is used to treat? (x3)
Unilateral or bilateral shocks - both produce whole brain seizures
May change metabolism, blood flow in areas of brain associated with disorder
Side effects – short term amnesia, hit largely managed through dosage
Major/unresponsive depression, bipolar psychosis and some suicidal behaviours
How did John Cade discover uses for Lithium? (x1)
Which is now most effect treatment/management for?
Trying to treat TB in animals, found it made them calm/lethargic, so he gave to psych patients - happened across benefits
Bipolar depression - esp manic phase
What are some issues around pharmacotherapy? (x3)
Side effects - feel terrible, non-compliance
Anti-depressant induced suicide
Dangers of over-prescribing for normal ebb/flow of life - up to 25% prescription rate for kids in US summer camps
What claims does Peter Gotzsche make regarding problems in pharmacotherapy/industry? (x3)
Inherent problems in RCTs that mislead us as to efficacy of drugs - few people benefit from medications
Prescription drugs are the 3rd leading cause of death after heart disease and cancer,
Mainly due to dishonest research/marketing, permissive regulation, over-medicalisation, polypharmacy, not understanding harms
How do WHO studies of prescription drug use raise questions over the value of medicalisation? (x3)
In third world/developing countries, 15% of mentally ill on antipsychotics
Developed countries, 60%
Yet those in developing countries doing better on average