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High-Yield Brain and Behavior Part II > Week 8 > Flashcards

Week 8 Flashcards

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1
Q

Assumption/theory of psychodynamic therapy

A

unconscious reasons underly action. Past experiences determine perception. Patterns develop from mind’s desire to “replay”/”master” old pain (repetition compulsion)

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2
Q

Outcome data of PDT and CBT

A

long term PDT most effective. Short term, PDT and CBT equally effective

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3
Q

Conceptual framework of ego psychology

A

Impulse (drive) –> Prohibition (fear) –> Defense (coping) –> compromise (behavior)

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4
Q

Projection

A

Defense mechanism: false attribution of feelings onto another

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5
Q

Idealization

A

Defense for feelings of powerlessness, unimportance: attribute exaggerated positive qualities to people that they associate with

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6
Q

Devaluation

A

Defense for feelings of powerlessness: exaggerate negative qualities of others

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7
Q

Intellectualization

A

Defense for disturbing feelings: excessive use of abstract generalization or 3rd person.

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8
Q

Repression

A

defense for unwanted instincts/emotions/ideas: expel from consciousness, often break through (ie panic attacks). Is not Denial (disavow reality) or Suppression (conscious decision to disavow emotions–more “mature”)

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9
Q

Core problems

A

Things exposed by therapist/patient underlying

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10
Q

Transference

A

Replay of patterns from old relationships on

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11
Q

Theory of CBT

A

Emotional disorders involve systematic biases/distortions of thinking

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12
Q

Standard techniques of CBT

A 
Rational Responding (how else can I view this situation)
Self-monitoring (Take stock)
Behavioral "experiments"
Role-playing
Metaphors
Guided imagery
Homework
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13
Q

Yerkes-Dodson Law

A

inverse U shaped curve (performance vs arousal)

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14
Q

Areas implicated in anxiety

A

ACC, insula, amygdala (repsonds to fearful stimuli even when below level of consciousness)

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15
Q

Phases of anxiety/General Adaptation Syndrome

A

Alarm: “fight or flight.” glucose mobilized
Resistance: glucose preserved
Exhaustion: collapse (exhaustion of reserves, failure of electrolyte balance, structural/funcional damage)

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16
Q

Learning theory of anxiety

A

Formed by Classical conditioning, maintained by operant conditioning.
Safety learning competes with fear learning.
Extinction (inhibiting CR) is context dependent, so conduct extinction in multiple contexts!

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17
Q

Generalized Anxiety Disorder Criteria

A

Excessive and uncontrollable worry >6mos + Additional problems (sleep, muscle, concentration)

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18
Q

GAD neurobio/genetics

A

distinct mechanism from panic (functional deficiency in GABA). Genetic factors; strongly related to neuroticism and depression

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19
Q

PTSD criteria

A

A. Experience: actual or threatened injury, response of intense fear, helplessness, horror
B:Re-experience. Intrusive recollections, nightmares, flashbacks, emotional/physical reactions to reminders
C: Avoidance of trauma-related stimuli and numbing
D: Increase arousal (hypervigilance, difficulty sleeping, outbursts, etc). Foreshortened horizon
E: Duration >1month
F: distress/impairment

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20
Q

Neural basis of PTSD

A

impaired extinction of fear response. Lesioned vmPFC

Hippocampus reduced –> overgeneralized fear response

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21
Q

Tx for PTSD

A

SSRIs, exposure therapy improve hippocampus size and amygdala disfunction

22
Q

Hallucination vs Illusion vs Flashback vs Delusion

A

Hallucination: perception w/o stimulus
Illusion: mis-interpretation of stimulus
Flashback: re-experiencing/re-living, including sensory perception (~waking dream)
Delusion: Fixed false belief. Specific.

23
Q

Panic Disorder criteria

A

Attacks + preoccupation (w or w/o agoraphobia)

24
Q

Social phobia criteria

A

fear of embarrassment + fear of scrutiny (can also have panic attacks)

25
Q

ECT (indications, contra-indications)

A

Indications: MDD, BPD, Catatonia, severe autism, PD.
Contra: CVD, craniotomy/skull fracture, cognitive impairment, seizure disorder, substance abuse

26
Q

ECT electrode placement

A

Start right unilateral (fewest side effects), progress to bi-temporal, left uni

27
Q

Factors determining ECT quality

A

1) Quality of seizure 2) Length of seizure 3) degree of suppression

28
Q

TMS benefits, indications, downsides

A

geographically specific, excitation and inhibition. Approved for depression (as effective as anti-depressants). Expensive!

29
Q

Vagal nerve stimulation

A

initially for epilepsy, works for treatment-resistant depression

30
Q

Conceptual underpinnings of treatment for suicide

A

suicide as primary problem: inappropriate coping behavior

31
Q

Effective treatment for suicidality

A

Reaching out, Cognitive Therapy: “safety plan” (replacing coping mechanism)

32
Q

OCD Criteria

A

Obsessions (unwanted thoughts/impulses that are egodystonic, with attempts to suppress/ignore)
Compulsions: Repetitive behavior/mental act aimed at reducing distress or preventing feared event. Neutralizing!

33
Q

brain areas for OCD

A

orbital cortex: caudate

34
Q

Learning theory of OCD and treatment implications

A

Obsessions –> Distress –> compulsions –> relief –> reinforcement of compulsions
Tx: Break Distress –> compulsions link! (with exposure therapy)

35
Q

Therapies for OCD

A

Combined treatment does not impede monotherapy, better than med alone but week evidence for superiority to CBT alone.
big site/implementation effect for CBT

36
Q

frequency of non-medical use of Rx

A

opioid > sedative > stimulants

37
Q

benzo MOA

A

binds GABA-A

38
Q

pseudo-addiction (opioids)

A

looks like addiction but disappears with adequate meds

39
Q

Most common illicit drug in ER reports

A

Cocaine

40
Q

MOA cocaine

A

blocks DA reuptake

41
Q

How drugs act on mesocorticolimbic dopamine system

A

Alcohol: indirect, partly through opioid receptors
Heroin: VTA neurons, results in stimulating NAc
cocaine/nicotine: directly on NAc neurons

42
Q

CNS toxicity of cocaine

A

Seizures, stroke

43
Q

Cardiac complications of cocaine

A

Chest pain, MI, cardiomyopathy, myocarditis

Especially when combined with alcohol –> cocethelene

44
Q

Sensitization with cocaine

A

paradoxical (not tolerance). LTP in VTA cells (via NMDARs)

45
Q

Neuro effects of long-term use

A

Frontal lobe activity dec –> impulse control —> more use (cycle)

46
Q

Tx cocaine dependence

A

very difficult to treat. Voucher programs short-term. CBT long term. No effective medications. Topiramate (GABA inc on VTA) and disulfiram work OK. Vaccine could be promising

47
Q

Marijuana and addiction

A

Long-term using now getting addicted (difficult to treat. Block CBs–>depression)

48
Q

Marijuana impairment

A

high: ~2hrs. impairment ~10hrs (implications for driving)

49
Q

Cannabinoids and psychosis

A

endogenous are anti-psychotic. But marijuana use as a teenager increases risk for schizophrenia

50
Q

Cannabinoid subtypes

A

CB1: all over brain, especially emotion/reward areas
CB2: lymphocytes, macrophages, etc.

51
Q

OCD vs OCPD

A

OCPD is egosyntonic

52
Q

OCD epi

A

women > men (except in Munich)

High-Yield Brain and Behavior Part II (6 decks)

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