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130 Cards in this Set
- Front
- Back
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What is the theoretical approach of animism? What time period does it belong to? |
The natural world consists of demons/spirits. Mental health problems explained as possession, possibly a punishment. From 'pre-history' (20,000BC). |
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What treatments are associated with animism? |
Exorcism and trepining. |
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Define somatogenesis. In what time period did it originate? |
Something to do with the body changes the mind. Emotional distress caused by biological factors. From the Greek Period. |
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Define the Roman theory of psychogenesis. |
The mind can play tricks on you. People are not concerned by things, but by the view they take of them. |
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What theories emerged in the Dark Ages? |
Demonology and possession (treated with prayers and relics). |
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How was mental health treated in the Medieval Period? |
Mental health problems - witchcraft and scapegoating. Treated with executions. |
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How did the Renaissance advance on the Medieval Period? |
People considered how events caused emotional distress. |
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What is animalism, and what was created as a result during the Industrial Revolution? |
The dehumanisation of those with mental health problems - treated as 'mad' and couldn't control themselves. Asylums created. |
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What did Pinel's 'social theory of vulnerability' suggest? |
Mental health problems caused by severe personal and social problems. |
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Name some features of the eugenic movement. |
White, European males ranked at the top. Mentally unwell scapegoated. Rise of fascism. |
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Between 1856-1926, Kraeplin proposed what approach? |
The Biological Approach. Mental health problems caused by chemical imbalance. Used medical knowledge rather than social prejudice. Genetics and metabolism (the way the body reacts) |
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What new theories formed between 19c and 20c? |
Psychological approaches - biological symptoms described by neurologists - foundations of psychoanalysis - [Freud - underlying background] Socio-behavioural approaches - fears can be learnt and unlearnt - conditioning - PTSD |
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What theory is emphasised today (by WHO)? |
Bio-psycho-social |
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Name and describe the three concepts of consciousness. |
State (Wakefulness, alertness) Content (Experience, awareness) Self-consciousness (Complex, self-perception, metacognition, theory of mind) |
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What is the 'material basis' for consciousness? |
Brainwaves |
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How does an EEG work? |
Detects small voltage changes in electrodes applied to the skull. |
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What is the 'wakeful' brain wave? |
Beta waves |
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What is the 'relaxed wakeful' brain wave? |
Alpha waves (from the back of the brain) |
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What is the 'deep sleep' (and states of impaired awareness) brain wave? |
Theta and delta brain waves |
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What is gamma activity? |
Very fast waves |
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Where in the brain does wakefulness occur? |
In the upper brain stem |
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What are some of the activating systems? |
Thalamus, dopamine system, noradrenaline system, serotonin system |
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Describe the global neuronal workspace theory of consciousness. |
Stimulus strength + attention and how it affects preconscious and conscious |
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What is the integrated information theory of consciousness? |
Modular activity and their interconnectivity |
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Describe some features of a coma. |
Absence of arousal, awareness of self or surroundings; eyes closed, absent sleep-wake cycle; not obeying commands; reflex activity only; variable respiratory function; EEG typically slow |
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What is a coma caused by? |
Focal pathology in activating system, diffuse in hemispheres - recovery, VS or death within weeks |
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Give some features of a vegetative state. |
Wakefulness without awareness, no evidence of a functioning mind (no communication, no purposeful action, no evidence of discriminative perception, 'irrelevant' spontaneous behaviour (i.e. smiling out of context) |
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What can cause a vegetative state? |
May follow extensive damage to cerebral cortex, cerebral white-matter, or thalamus. (Activity particularly reduced in global workspace regions) |
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What is a locked in state? |
Awake and aware, but cannot communicate awareness - typically caused by stroke in brainstem that does not affect arousal system |
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What is the fundamental problem with diagnosing disorders of consciousness? |
You can be awake and aware with no sign of consciousness, leading to high risk of misdiagnoses. |
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What is a minimally conscious state? |
Beginning to emerge from a vegetative state. |
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What is brain death? |
Brainstem has died (no reflexes, no breathing) - followed by complete death. At this point is diagnosed dead. |
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What are medically unexplained symptoms (MUS)? |
Physical symptoms for which there is no known organic pathology identified. |
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How prevalent are MUS? |
Estimated in 1 in 5 new consultations in primary care (Very prevalent) |
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Name some features of assessment linked to a better outcome in diagnosis. |
Time to diagnosis, communication of diagnosis, systematic protocol (reducing rejection) |
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What are some contributory factors? |
Legitimised by repeated medical investigations- makes disorder more resistant to psychological reframing; physician's ability to tolerate risk of missing a rare condition; invasive procedures produce risk of iatrogenic disorder; risk of litigation affecting medical practice |
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Outline factors influencing diagnosis. |
Patient attitude to role of doctor; time available in consultation; behaviour of health professionals; GPs discussing psychosocial discussion |
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Why is an MUS diagnosis unpopular with patients and professionals? |
Patients - don't see themselves as mentally ill Professionals - seen as tiresome and causes despondency; excessive use of NHS resources |
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How can the delivery of this diagnosis be improved? |
Functional language - talk about disruption in 'functioning' (avoids physical vs. psychological) Believe symptoms, be interested Be honest Only order appropriate investigations Prepare for normal results Explain bio-psycho links |
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What do professionals NOT do in situations of MUS? |
Say nothing is wrong Say test results normal without explanation Order investigations without explanation Continue treatments without benefit |
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Why might MUS not really be unexplained? |
Brains are behaving differently - changes in cortex activation and limbic structures |
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What did Voon et al. (2010) find about functional movement difficulties? |
Increased functional connectivity with the right amygdala (emotional reactions) and right supplementary motor area - especially when exposed to fearful stimuli Higher emotional arousal during motor preparation may prevent movement |
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What did Geraldes (2008) find about transcranial magnetic stimulation in people with functional movement disorder? |
Inhibitory activation over the pre-motor and motor cortex - due to increased activation of orbito frontal and frontal regions (limbic affective system) |
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What did Aybek et al. (2015) find in an fMRI study of functional movement disorder? |
Increased activation in the amygdala for negative emotions - increased activation in areas of 'freeze response' and areas concerned with motor control and self awareness. |
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What is anxiety? |
An unpleasant emotional state characterised by fearfulness and unwanted and distressing symptoms and thoughts |
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List some types of anxiety. |
Phobias; Panic Disorder; GAD; OCD; PTSD |
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When is a phobia diagnosed? |
When fear is out of proportion with the actual threat of the object/situation; recognised as largely groundless; disrupting to life (impairment of functioning) |
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What is a phobia's evolutionary purpose? |
More alert to danger = less risk of predation - genetic inheritance |
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How does the biological approach explain phobias? |
Evolutionary preparedness - fight or flight system (evolutionary mechanism involving primitive brain areas and decision making (limbic and frontal)) - transmits 'adrenaline' surge - heart races - muscles tense up - in anxiety this may be misfiring |
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Describe the genetic risk associated with phobias. |
More or less 'autonomic liability' (readiness to arousal) - those with 1st degree relative with agoraphobia have greater risk of agoraphobia and other phobias, but role-modelling of fear important factor |
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What is the amygdala? |
The fear system. The amydala mediates rapid unconscious processing of fearful stimuli - a person can experience a fear reaction before they are consciously aware of a stimulus. |
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What is the behavioural approach's avoidance-conditioning theory? |
Some things are, with no experience, frightening, but we can be made to fear pretty much anything. Avoiding situations stops people from 'unlearning' the 'faulty learning' - stuck in an avoidance loop |
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How does vicarious conditioning explain phobias? |
Trans-generational or peer generated; role-modelled; reinforced by others; media influence |
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How does systematic desensitisation work? |
Unlearning the fear response (avoidance loop); learning coping response - managing Negative Intrusive Thoughts (NITs) |
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How is PTSD different to a phobia? |
There is a known 'presumed' aetiology' - the person has directly experienced or witnessed an event in which there was actual threatened death or serious injury |
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What are the co-existing 'bimodal reactions' associated with PTSD? |
Fight/fight - nightmares, flashbacks, hyper-arousal to reminders of trauma, hypervigilance for danger Freeze - avoidance behaviour, numb and blunted effect, amnesia states, derealisation, disassociation |
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Describe the course and duration of PTSD. |
Symptoms typically begin within 3 months of a traumatic event - PTSD is diagnosed when symptoms last more than one month |
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What are the risk factors of PTSD? |
Pre-morbid history (e.g. family history); Female gender (more reporting due to coping styles? Lack of social power, more abuse? Under reporting by men?); Nature of event (severity, exposure level, control) |
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Outline biological mechanisms of PTSD. |
Biological readiness for 'fear conditioning response'; stress hormone levels being elevated within a few hours of 'common civilian trauma' |
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Outline psychological mechanisms of PTSD. |
Cognitive-Behavioural- fear conditioning and avoidance learning. |
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What are some problems co-morbid with PTSD? |
Sleep disturbances; depression; anxiety; irritability or outbursts of anger; substance abuse; impairment in socio-occupation functioning |
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Describe behavioural treatments of PTSD. |
CBT: Manage NATS, relaxation training, exposure, desensitisation EMDR Group theory Medication for associated symptoms |
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What is personality disorder? |
Persistent, pervasive abnormality of social relationships and social functioning. Perceptions about the outside world are inflexible and deviate markedly from cultural expectations |
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Is personality disorder persistent or episodic? |
Persistent (not episodic like other MHP) |
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Why is it important to study personality disorder? |
It is common; presents with significant levels of morbidity and mortality; makes co-morbid conditions more difficult to treat |
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What disorders are co-morbid with personality disorder? |
Depression, bipolar, anxiety; substance misuse; ADHD; eating disorders |
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How do neurotransmitters influence personality disorder? |
Serotonergic dysfunction: associated with impulsiveness, auto-aggression and outwardly directed aggression Enhanced dopaminergic activity in psychotic-like thinking Noradrenergic abnormalities associated with risk-taking and sensation seeking |
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Describe developmental theories of personality disorder. |
Kernberg: excessive aggression leads to splitting Adler and Buie: object constancy Mahler: Abandonment the organising conflict Bowlby: Attachment theory - increased anxious-ambivalent or avoidant attachment |
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What are psychosocial factors for personality disorder? |
Parental separation or loss; family history of mood disorder or substance misuse; abnormal parenting attitudes; childhood trauma |
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Which treatments are most effective? |
Psychological therapies: Dialectical behaviour therapy, mentalisation-based therapy |
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Describe biosocial theory for personality disorder. |
Emotional vulnerability - emotional dysregulation - pervasive invalidation. All reciprocal. |
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High emotional sensitivity has what effect on reactions? |
Makes them immediate |
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High reactivity has what effect on reactions? |
Makes them extreme |
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Slow return to baseline has what effect on reactions? |
Makes them long-lasting |
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What is mentalisation based therapy? |
Reflective function and attachment - mentalising and secure attachment go together in the care given associated with a coherent working model of the child richly imbued with representations of internal states |
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What is mentalisation based therapy's neurological basis? |
Right hemisphere specialised for emotion and social cognition. Optimal development associated with development of affect regulation - associated with theory of mind |
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Name a failure of mentalisation. |
Psychic equivalence; the teleological stance; hyperactive mentalisation and pretend mode |
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What is autism? |
A neurological disorder - what happens when social communication doesn't develop |
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What does 'differentiation' refer to in terms of infant brain development? |
Neurones are created and migrate - as they migrate they specialise in response to chemical signals |
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Define neurogenesis and synaptogenesis. |
Neurones migrate and start to make connections |
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What is the term for the discarding of synapses? |
Synaptic pruning |
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Darwin theorised there were how many main facial expressions? |
Six |
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The rapid development of emotional reading skills is associated with the growth of which part of the brain? |
Prefrontal cortex |
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Define the theory of mind. |
To attribute mental states to others, to know they have beliefs, desires, and intentions that are different from our own (prefrontal cortex, amygdala) |
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What is empathy? What is the difference between cognitive empathy and affective empathy? |
Empathy: to understand another's state of mind AND co-experience their outlook and emotions Cognitive empathy: Understanding someone else's different perspective Affective empathy: (feeling someone else's emotion) |
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What are the survival reasons for the Theory of Mind? |
Detecting threats from cues like angry faces helps avoid danger |
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What are the social reasons for the Theory of Mind? |
Detecting emotions helps understand their thoughts and behaviour and forms social bonds |
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What is refrigerator mother theory? |
A notion of cold, rejecting parents causing autism - no evidence, very damaging, completely debunked |
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Name the three parts of the Triad of Impairment. |
Socialisation, Language development, Behaviour. |
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What is the concordance rate for autism between MZ twins? |
91% |
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Other than genetics, what biological factor can cause autism? |
Illness - rubella meningitis, tuber sclerosis, encephalitis |
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What is the fusiform? |
Part of the brain that recognises faces |
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What are signs of social impairment, and why does autism cause this? |
Absent/impaired imitation; absent/abnormal social play; impaired ability to make friendships; no/lack of wanting to seek comfort Due to: Lacking a theory of mind |
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What are signs of language impairment? |
No developmentally appropriate mode of communication; absent nonverbal communication; abnormalities in speech; pronominal reversals (referring to self in third person); abnormalities in speech production; lack of understanding of abstract language |
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What are signs of a restricted behavioural repertoire? |
Stereotyped body movements; preoccupation with parts of objects or attachment to unusual objects; marked distress over change; insistence on routine; absence of imaginiation |
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What should be considered goals for intervention? |
Provide with adaptive skills for engaging and making sense of greater part of the world and promote independence; relieve symptoms of anxiety, frustration and difficult behaviour |
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Name two types of eating disorders. |
Anorexia Nervosa and Bulimia Nervosa |
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What characterises AN? |
Restriction of energy intake; significantly low body weight; intense fear of gaining weight; disturbance in body weight or shape evaluation; denial of seriousness of current low body weight |
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What characterises BN? |
Recurrent episodes of binge eating - eating large amounts of food in a discrete amount of time, sense of lack of control over eating during an episode; inappropriate compensatory behaviour (purging); both occur at least once a week for three months; self-evaluation faulty |
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What are effective treatments of AN? |
Food; family-based interventions - but no first line approved treatment |
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What are effective treatments for BN? |
CBT-E |
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List some risk factors for eating disorders that emerge during birth/infancy. |
Gender; genetic factors; obstetric complications; early feeding difficulties; high concern parenting |
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List some risk factors for eating disorders that emerge during childhood. |
Childhood obesity; anxiety disorders; sexual abuse; OCD; adverse life events |
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List some risk factors for eating disorders that emerge during adolescence. |
Body dysmorphic disorder; high level exercise; dieting; OCD/perfectionism; negative self-evaluation |
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What are the 'five Ps' that formulate eating disorders? |
Predisposing; precipitating; presenting; perpetuating; protective |
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How is impaired Visual Spatial Processing linked to AN? |
Linked to body image disturbance |
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How is impaired Cognitive Flexibility linked to AN and BN? |
Linked to getting stuck with thoughts and rituals about eating |
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How is impaired Central Coherence linked to AN and BN? |
Linked to a detailed focus on weight and calories rather than the bigger picture of life |
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How is impaired Risk/Reward Processing linked to BN and AN? |
Linked to bing-eating in BN and altered reward value of food in AN and BN |
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How is impaired Emotion Processing linked to AN? |
Linked to distorted body image, intuition difficulties and alexithymia (lacking words for feelings) |
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What is Cognitive Remediation Therapy? |
For treatment of cognitive impairments in psychosis; based on cognitive remediation of acquired brain injury; neurocognitive deficits linked with AN; 10 45 minute sessions; relating skills practiced to everyday activities |
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What is a mood disorder? |
Disorder in which primary disturbance appears to be one of mood - can be unipolar (MDD, minor depression, dysthymia) or bipolar (Bipolar I, Bipolar II, cyclothymia, hyperthymia |
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List some symptoms of depression. |
Sadness, guilt, worthlessness, foreboding, poor sleep, appetite changes |
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List some signs of depression. |
Social withdrawal, fatigue, poor concentration, inactivity, restlessness |
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What is dysthmia? |
Depressed mood, at least 50% of the time for at least two years. A kind of chronic depression |
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What is the point prevalence and lifetime prevalence for depression? |
PP: 1-5%. LP: 10-20% |
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What kind of illnesses can lead to depression? |
Nervous system diseases; vascular diseases; endocrine diseases |
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What are SSRIs? |
Selective Serotonin Reuptake Inhibitors. |
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What is ECT? |
Electroconvulsive Therapy. |
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What is the negative triad of beliefs, and to which approach does it belong? |
Negative views of the self, the world, and the future. The cognitive-behavioural approach |
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What are NATs? |
Negative Automatic Thoughts. Based on negative core beliefs about the self - maximising negative aspects, minimising positive aspects |
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What is the vicious spiral of depression? |
Do less, less to feel good about, more to feel bad about, withdrawal |
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What factors make you more vulnerable to depression? |
Female gender; family history; past history; stressful events; low income, debts, poor housing; negative styles of thinking |
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How can you reduce vulnerability? |
Ride emotional waves; have healthy friendships; keep active etc. |
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What's the difference between Bipolar I and Bipolar II disorder? |
Bipolar I: One or more manic episodes Bipolar II: One or more manic depressive episode, plus at least one hypomanic episode |
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What are some symptoms of mania? |
Delusions; hallucinations; four days or more of persistently elevated, expansive or irritable mood and persistently increased activity or energy |
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What is cyclothymia? |
Brief spells of mild hypomania and mild depression (not sufficient to meet clinical criteria) |
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Is Bipolar Disorder associated with creativity? Why? |
BD over-represented amongst creative individuals - people with BD tend to choose more creative hobbies but there is considerable variation. Association between energised positive mood, drive and ambition, and mania symptoms |
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How does the diathesis stress model explain how an episode develops? |
Diathesis: Biological factors - high heritability rate, treatment with medication, early structural differences in prefrontal cortical structures, amygdala and striatum Stress: Life events and bipolar episodes - mania particularly associated with goal-attainment |
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How does CBT for Bipolar Disorder work? |
Prodromes (warning signs of an episode of illness); psychoeducation; social rhythm stabilisation; medication adherence; stressful life events; dysfunctional cognitions |
