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MD1 > Psychology > Flashcards

Psychology Flashcards

1
Q

Frontal Lobe Activities

A

Planning, execution, and regulation of behaviour, working memory, emotion
“Executive Functioning”

Last area of brain to develop
Positive Processes: Neuronal Proliferation
Negative Processes: Pruning

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2
Q

Temporal Lobe Activities

A

Audition, language, music, memory, emotion

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3
Q

Parietal Lobe Activities

A

Somatic & visuospatial representations

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4
Q

Occipital Lobe Activities

A

Vision

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5
Q

Luria’s Cortical Zones

Posterior

A

PRIMARY

  • high modal specificity
  • afferent layer IV

SECONDARY

  • perception/’gnosis’
  • layers II and III

TERTIARY

  • integrate across modalities
  • mature at 7 years of age
  • upper cortical layers
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6
Q

Luria’s Cortical Zones

Anterior

A

PRIMARY

  • Execution of Movement
  • Motor Cortex

SECONDARY

  • Organisation of Movement
  • Premotor Cortex

TERTIARY

  • Prefrontal Cortex
  • Planning goal-directed activities
  • intent and behaviour
  • self monitoring and regulation
  • alertness
  • mature @ adolescence
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7
Q

Emotion

A

Inferred behaivoural state
Core: anger, fear, sadness, disgust, happiness, (surprise)

We experience emotion in response to physiological changes (smiling makes us happy)

Limbic System:
Hippocampus, Cingulate, Hypothalamus, Amygdala, Septum, Nucleus Accumbens, Orbitofrontal Cortex

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8
Q

Orbitofrontal cortex

A

Highly connected to limbic areas
Identification & Expression of Emotion
Inhibition
- Emotional (crying at random)
- Cognitive (failure to stop doing a task)
- Social (blurting out things they shouldnt)
Impulsivity (complete tasks fast but make many mistakes)

Supplied by Anterior Cerebral Artery and Middle Cerebral Artery

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9
Q

Dorsolateral Prefrontal Cortex

A

“Traditional” executive functions

  • Working memory
  • Response selection
  • Planning and organising
  • Hypothesis generation
  • Flexibility maintaining or shifting set
  • Insight (recognising own difficulties)
  • Moral Judgement

Primarily supplied by Middle Cerebral Artery

Neurophsycological tests target this area, medial and orbitofrontal harder to assess (use clinical history)

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10
Q

Medial Prefrontal Cortex

A 
Emotional
- Apathy 
- Initiative (not mood - initiation of task)
- Indifference
Attribution of emotion to others
Understanding ones own emotions

Supplied by Anterior Cerebral Artery

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11
Q

Executive Dysfunction vs Frontal Lobe Dysfunction

A

Frontal lobe is highly connected, if there is a lesion anywhere in the system you will get executive dysfunction (e.g. from thalamic lesions, cerebellar lesions, etc).

Prefrontal cortex ‘coordinates’ executive function

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12
Q

Executive Dysfunction

Positive vs Negative Symptoms

A 
POSITIVE:
Distractability
Social dis-inhibition
Emotional instability
Perseveration (unable to stop tasks)
Impulsivity
Hypergraphia
NEGATIVE:
Lack of concern
Restricted emotion
Deficient Empathy
Failure to complete tasks
Lack of initiation
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13
Q

Neuropsychological Tests

  • Tower of London
  • Stroop
  • Rey Complex
A

Tower of London: test planning, impulsivity, learning from mistakes

Stroop: test inhibition

Rey Complex: Test planning, visiospatial

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14
Q

Hyperalgesia

A

An increased response to a normally painful stimulus

e.g. sunburn & hot water

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15
Q

Allodynia

A

A painful response to a normally innocuous stimulus

e.g. sunburn & touching with cotton wool

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16
Q

Aphasia

A

Disturbance in language

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17
Q

Dysarthria

A

Motor speech disorder

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18
Q

Non-fluent Aphasia

A 
Broca's aphasia
Intact selection of content
Loss of sentence structure
Anterior lesion
Preserved Comprehension
Right face / arm weakness
19
Q

Fluent Aphasia

A 
Wernicke's aphasia
Impaired selection of content
Intact sentence structure
Posterior lesion
May use made up words (consistently)
Impaired comprehension
20
Q

Generalized Anxiety

A

Dread over something unlikely to happen (different from fear)
Excessive worry occuring more days than not for at least 6 months
Fatigue/Sleep difficulty
Work/School impairment
Not attributable to substance abuse or other disorder

21
Q

SPIKES protocol

A 
SETTING UP the interview
assessing patients PERCEPTION
obtaining patients INVITATION
giving KNOWLEDGE and information
address patients EMOTION
STRATEGY for treatment
22
Q

WHO guidelines relating to capacity

A
  1. must be an organ level abnormality
  2. abnormality must cause cognitive impairment
  3. impairment must lead to disability in decision making
23
Q

Retrograde & Anterograde Amnesia

A

Retrograde: prior to the time of the event
Anterograde: can’t make new memories from the event onwards

24
Q

Short & Long term memory

A

Short: Working memory, i.e. ability to repeat numbers backwards
Insertion of AMPA receptors, phosphorylation, enhanced presynaptic release via retrograde signalling

Long: List learning retrieval
Protein synthesis, structural changes (new synapses)

25
Q

Left Hippocampus vs Right Hippocampus memory

A

LEFT HIPPOCAMPUS:

  • verbal memory
  • list learning
  • paired associate learning (‘chair, grass’)
  • story recall

RIGHT HIPPOCAMPUS:

  • visuospatial associations (disorientated in environment)
  • face recall (ask to recall drawings later on)
26
Q

Causes of memory impairment

A

Degenerative disorders

  • Alzheimer’s Disease
  • Chronic Alcoholism

Cerebrovascular disorders

  • Bilateral thalamic infarction
  • Cardiogenic cerebral anoxia

Paroxysmal/transient disorders

  • Transient global ischaemia (idiopathic, sudden)
  • Temporal lobe epilepsy (hippocampal CA1 sclerosis)
  • Post-traumatic amnesia (severity related to trauma)

Surgical resection

27
Q

Structures associated with memory

A 
Anterior Thalamus
Basal Forebrain
Mesial Temporal Region
Mammillary Bodies
Retrosplenial Cortex
Hippocampus
Amygdala - emotional response (pavlov's dog)
(entorhinal & parahippocampal cortex)
Striatum - skills & habits
28
Q

Major Depression (DSM5)

A

5 of more symptoms present for same 2 week period

  • depressed mood
  • diminished interest in activities
  • weight loss / appetite
  • insomnia / hypersomnia
  • psychomotor agitation
  • fatigue
  • feelings of worthlessness
  • diminished concentration
  • recurrent thoughts of death
29
Q

Development
Stages
Tasks
Trajectories

A

Stages:
- each life stage has a challenge and results in positive/negative growth (trust vs mistrust)
- linear and simplistic
Tasks:
- each life stage is associated with ‘tasks’ which must be completed (marriage)
- not normative for current sociocultural changes
Trajectories:
- sum of forces propelling us in a direction
- turning points disrupt trajectory (abuse, education, environment)
- risk factors vs protective factors in transactional model

30
Q

Resilience

A

Positive adaptation in the context of adversity (thriving vs succumbing)
Assimilation (adjust the environment)
Accommodation (adjust self and attitudes)

31
Q

Multifinality vs Equifinality

A

Multifinality:
one risk factor associated with a number of different outcomes (e.g. disrupted early attachment may lead to anxiety, antisocial behaviour, personality disorders)

Equifinality:
multiple possible risk factors leading to the same outcome (e.g. depression)

32
Q

Environmental vs Compensatory strategies for rehabilitation

A

Environmental

  • useful for those who have reduced insight, self monitoring, significant executive defects
  • declutter, reduce stimulation, set routines

Compensatory

  • use of mnemonics (internal strategy)
  • use of cues, aids, diaries, smartphones/apps (external strategy)
33
Q

DAT vs bvFTD

  • Dementia of Alzheimer’s Type
  • behavioural variant FrontoTemporal Dementai
A

DAT shows early cognitive changes (memory) however behaviour and personality are preserved. bvFTD is opposite.

34
Q

DAT vs VCI

*Vascular Cognitive Impairment

A

VCI show preserved memory and more prominant deficits in psychomotor speed, attention, executive function.

35
Q

Dementia of Alzheimer’s Type

A

Gradual, insidious onset
increase with age
progressive decline

memory impairment
visuospatial impairment
language impairment
impaired attention and executive function
apraxia
aggitation
wandering/disorientation
failure to recognise others
sleep disturbance
36
Q

Behavioural Variant Frontotemporal Dementia

A 
Gradual onset
 mutism)
reduced speech
depression
anxiety
personality changes
dietary changes
obsessive behaviour
37
Q

Vascular Cognitive Impairment

A

Gradual onset
stepwise decline

Diffuse cognitive impairment
cognitive slowing
reduced attention
psychomotor retardation
irritability
apathy
withdrawal
variant with location of lesion
38
Q

Cognitive Development and Piaget’s Stages

A

SENSORIMOTOR (0 - 2 yo)

  • learning about the world through SENSORY EXPLORATION
  • Failure to grasp: object permanence

PREOPERATIONAL (2 - 7 yo)

  • Representing the world through LANGUAGE, symbols, internal representations
  • Failure to grasp: glasses filled with liquids

CONCRETE OPERATIONAL (7 to 12 yo)

  • LOGICAL reasoning about concrete events/ideas/stimuli
  • Failure to grasp: A->B, B->C, therefore A->C
FORMAL OPERATIONAL (12yo +)
* ABSTRAT and HYPOTHETICAL thinkiing
39
Q

Communication Strategies for Children

A
  • use unambiguous language
  • check understanding
  • reduce threat-related language (‘get the medicine in’)
  • use honesty while promoting coping (‘bravery’)
  • provide choices (‘left vs right arm’)
  • use visual aids & props
40
Q

Age definitions of:
Adolescents
Youth
Young People

Early
Middle
Late

“Emerging Adulthood”

Aging

A

Adolescents: 10-19
Youth: 15-24
Young People: 10-24

Early: 10-14
Middle: 14-16
Late: 17+

“Emerging Adulthood” 18-25

Aging >65

41
Q

Five Factor Model of Personality

A

NEUROTICISM decreases across adulthood
OPENNESS to new experiences declines (risk averse)
AGREEABLENESS increases
CONSCIENTIOUSNESS increases (sticking to tasks)
EXTRAVERSION stable

42
Q

Menopause

A

12 months of amenorrhea
Hot flushes, night sweats, vaginal dryness, vasomotor symptoms
“empty nest” feelings
Increased risk of illness
majority of women do not develop depression (symptoms are of perimenopause)

43
Q

Ageing

including 3 models

A

40+ year long life stage
Tends to be viewed as a time of loss and decline
Leading cause of YLD (dementia, hearing loss, stroke)
64% rate their health as good
Working memory decline
slowing of cognition and decline of intellectual skills
personality remains relatively stable

MODELS:
Lifespan maturation
- career consolidation, keeper of meaning, concern for legacy -> lead to integrity

Selective Optimisation and Compensation
- making the best of capacities, compensate for limitations

Successful Ageing
- low disease, high cognition, active engagement with life

MD1 (11 decks)

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