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7PAYFPSY Psychology and Neuroscience of Psychosis - October 2023 > Cognitive models in psychosis > Flashcards

Cognitive models in psychosis Flashcards

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1
Q

What brain structures are dopaminergic neurons found in?

A

Mid brain structures
Substantia Nigra [SNc]
Ventral Tegmental area [VTA]

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2
Q

Where do the dopaminergic neuron axons, located in the SNc and VTA, project to?

A

The axons project to the
- striatum,
including the caudate nucleus, putamen,
- ventral striatum, or nucleus accumbens, shown with a red line and the green line.

The dorsal and ventral prefrontal cortex are also projected too, and you can see that here displayed with the blue lines.

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3
Q

What found in post-mortem studies of patients with schizophrenia suggests higher levels of dopamine?

A

higher receptive density of D2 receptors

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4
Q

What is the relationship between the sensitisation of the mesostriatal dopamine system and psychotic symptoms in schizophrenia?

A

The sensitisation of the mesostriatal dopamine system, which includes dopaminergic pathways in the brain, has been linked to the severity of psychotic symptoms in schizophrenia. This suggests that the more the dopamine system is dysregulated, the more severe the psychotic symptoms are likely to be.

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5
Q

What role does dopamine D2 receptor antagonism play in the treatment of schizophrenia?

A

Dopamine D2 receptor antagonism is fundamental in the treatment of schizophrenia as it has been shown to significantly improve psychotic symptoms. Antagonists block the D2 receptors, countering the effects of dopamine dysregulation that contribute to psychosis.

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6
Q

What evidence supports the link between striatal dopamine dysregulation and schizophrenia?

A

Robust evidence from molecular imaging studies indicates that dis-regulated striatal dopamine is implicated in schizophrenia. These studies show that alterations in the function of the striatal dopamine system are associated with the presentation and severity of psychotic symptoms.

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7
Q

What has PET imaging revealed about L-DOPA uptake in patients with schizophrenia compared to controls?

A

PET imaging studies have demonstrated that L-DOPA, a precursor to dopamine, is taken up more rapidly in patients with schizophrenia than in control subjects. This finding supports the hypothesis that patients with schizophrenia may produce more dopamine.

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8
Q

What are the different neurotransmitter pathways that are thought to impact the negative and positive symptoms found in schizophrenia and what are the aims of the treatment in each case?

A
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9
Q

what are the 4 dopamine pathways?

A

Mesolimbic Pathway:

Mesocortical Pathway:

Nigrostriatal Pathway:

Tuberoinfundibular Pathway:

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10
Q

Give an overview of the Mesolimbic Pathway:

A

Originates from the ventral tegmental area (VTA).

Projects to various limbic structures, including the nucleus accumbens, part of the ventral striatum.

Often associated with the reward system of the brain, pleasure, and reinforcement; dysregulation in this pathway is implicated in the positive symptoms of schizophrenia and in addiction.

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11
Q

Give an overview of the Mesocortical Pathway:

A

Also originates from the VTA.

Projects to the prefrontal cortex, including the dorsolateral prefrontal cortex.

Involvement in cognitive control, motivation, emotional response; dysfunctions in this pathway are associated with the negative and cognitive symptoms of schizophrenia, such as blunted affect and impaired executive function.

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12
Q

Give an overview of the Nigrostriatal Pathway:

A

Originates from the substantia nigra, specifically the pars compacta region.

Projects to the striatum, which includes the caudate nucleus and putamen.

Plays a crucial role in the coordination of movement; degeneration of this pathway is a hallmark of Parkinson’s disease.

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13
Q

Give an overview of the Tuberoinfundibular Pathway:

A

Originates from the hypothalamus.

Projects to the pituitary gland.

Regulates the release of prolactin by inhibiting its secretion; antipsychotic drugs, which block dopamine, can disrupt this pathway and lead to elevated prolactin levels, resulting in side effects such as galactorrhea and amenorrhea.

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14
Q

What was the main observation in the response of dopamine neurons when monkeys received an unexpected weak liquid reward?

[study by Schultz and colleagues on dopamine release in response to stimuli and rewards in monkeys.]

A

The main observation was an increase in firing of dopamine neurons at the same time as the unexpected reward was given, indicating a surprise or salient event. This response to unpredicted primary rewards varies directly with the reward magnitude.

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15
Q

How does the dopamine response change during the course of learning when a reward is given as expected after a conditioned stimulus?

[study by Schultz and colleagues on dopamine release in response to stimuli and rewards in monkeys.]

A

During the course of learning, the dopamine response to the reward gradually decreases and a response to the conditioned stimulus that predicts the reward develops. The dopamine signal shifts from the reward to the predictor stimulus.

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16
Q

What happens to dopamine release when a conditioned stimulus is presented and the expected reward follows?

[study by Schultz and colleagues on dopamine release in response to stimuli and rewards in monkeys.]

A

There is a slight peak of dopamine release following the stimulus, reflecting the recognition that a reward is to come. However, when the expected reward is given, there’s no significant increase in dopamine release since there is no prediction error; the event occurred as expected.

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17
Q

Describe the dopamine response when a reward is predicted after a conditioned stimulus but is not given.

[study by Schultz and colleagues on dopamine release in response to stimuli and rewards in monkeys.]

A

Initially, there is a spike in dopamine release upon the recognition of the conditioned stimulus, but if the predicted reward does not follow, dopamine release decreases below normal levels, reflecting a negative prediction error.

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18
Q

What is the key message about the role of surprise in dopamine-mediated learning from Schultz’s study?

A

The key message is that the mismatch between what is expected and what actually occurs (surprise) drives learning. Dopamine release increases when events are better than expected, and there is a negative prediction error when events are worse than expected.

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19
Q

According to Miller’s hypothesis, how might an excessive supply of cerebral dopamine contribute to the positive symptoms of schizophrenia?

A

Miller proposed that in schizophrenic patients, an excessive supply of dopamine may facilitate the acquisition of associations between unrelated units of information, leading them to be treated as meaningful combinations. This can result in the formation of delusions and is associated with the positive symptoms of schizophrenia.

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20
Q

In the context of Miller’s hypothesis, how can aberrant salience lead to the formation of delusions in schizophrenia?

A

Aberrant salience occurs when a non-meaningful stimulus evokes dopamine firing, making it overly salient and attention-grabbing. This can lead individuals to form connections and seek explanations for these salient experiences, often resulting in the development of delusions.

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21
Q

What is a ‘delusion of reference’ as explained by Miller’s hypothesis, and how might it manifest in a patient’s experience?

A

A delusion of reference is an inference that a specific and unrelated stimulus is directly related to oneself. For instance, a patient might believe messages on TV are intended for them, assigning excessive salience to these messages and interpreting them as personally significant.

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22
Q

According to Miller’s hypothesis, how might antipsychotics affect the process of aberrant salience and its associated distress in schizophrenia?

A

Antipsychotics can block the aberrant salience of stimuli, supporting the extinction and unlearning of the associations that lead to delusions. However, they may also reduce the salience of normal events, potentially affecting motivation and normal emotional responses.

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23
Q

What is reinforcement-related speeding?

A

attributed to the anticipation of a potential reward on such trials leading to enhanced motivation and hence faster responding.

Faster reaction times in response to rewarding stimuli than neutral stimuli

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24
Q

In the reaction time study with psychosis and controls, with a reward and neutral type task, what difference was found? MURRAY

A

the difference was patients were significantly faster than controls on neutral trials.

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25
In the Murray 2008 study, more positive symptoms were associated with a __________ distinction between ________ and non-__________ events in the brain
26
What is Anhedonia?
27
What is avolition?
28
What symptoms can in fact worsen with antipsychotics?
Anhedonia and Avolition
29
What did researchers start to hypothesise when studies showed that patients showed liking and enjoying positive things, just as much as non clinical patients, when the thinking had previously been that they do not experience pleasure?
That measures used to assess anhedonia may not reflect cons ummatory (in the moment) pleasure, but rather focus on the ability to anticipate pleasure. even thought you might like chocolate, you might not have the drive to go to the shop and buy it.
30
What tasks are used to investigate reward anticipation?
31
Neuroimaging studies in patients with schizophrenia support abnormalities in processes related to the anticipation of.....
reward
32
Unmedicated patients showed reduced_________ activation during the presentation of reward-indicating cues which is inversely correlated with the severity of ___________.
higher symptoms - lower activation in this area.
33
What does this suggest? [studies related to anticipation of reward]
That atypical medication might normalise the reward response or that the medication is given to patient groups that are fundamentally different. [but not gender, age etc]
34
What brain areas are implicated in these processes?
dorsal later PFC orbital FC anterior cingulate cortex
35
Evidence from the the wisconsin card sorting task has shown that people with schiz. may have problems......
tasks where feedback changes quickly. they learn 1st category well, but then have problems switching. explicit feedback not integrated. difficult to update value representations.
36
What was the outcome of this study
people with more negative symptoms were less likely to make more effort when the reward was certain. they may have computed the effort wasn't worth it, when it was most salient.
37
According to ICD 10 how does psychosis present and what are some of the abnormalities of behaviour?
38
What percentage of patients with schizophrenia will experience auditory hallucinations?
39
25% of people who experience auditory hallucinations have done what?
Attempted suicide in response to these voices
40
What percentage of patients remain refractory to treatment for auditory hallucinations?
25-30%
41
What two areas of the brain seem to be active when people are hearing voices/hallucinations according to the Shergill, Brammer 2000 study?
Both speech and hearing areas. Broca's area and inferior frontal gyrus
42
According to Shergill 2001 with health control people, what did they see in the brain fMRI, when people were asked to generate words in their mind, with no sound or movement?
similar pattern of activation to people with auditory hallucinations.
43
What is the superior temporal gyrus responsible for?
monitoring of your own speech + auditory processing
44
What is the cerebellum responsible for?
monitoring motor movements
45
What is the parahippocampal gyrus responsible for?
46
In this study showing the difference in active brain regions between health controls and patients prone to auditory hallucinations, what areas were less active in people with schizophrenia?
47
48
What did this 2010 study show about the difference between healthy controls and patients prone to auditory hallucinations related to listening to external speech?
In both groups, when the speech was external, the left superior temporal gyrus was activated, and when they were prompted to listen to inner speech, in the health ppl, they flicked an internal switch that turned down the hearing part of the brain, but in patients with schizophrenia this signal was really weak and they only partially turned down the hearing part of the brain and so it mostly stayed in the external hearing part.
49
What area does the superior longitudinal fasciculus tend to link to?
The frontal to the temporal cortex
50
What brain regions are these three?
51
What was shown about the integrity of white matter bundles between brocas' Superior longitudinal fasiculus and the speech perception area between people who are currently hallucinating and people that have never hallucinated??
52
What's the difference between moving the lever with your own finger and moving the lever with a joy stick, in the experiment where you need to match the pressure from the otherside with your other hand?
You will have to apply more force when you do it with your hand, and less effort when you do it with the jobstick. with the jot stick you're not using so much corollary discharge. When moving the lever directly with their finger, there's a greater involvement of corollary discharge. This is because the brain is actively processing and anticipating the sensory feedback from the direct physical interaction. The brain predicts the consequences of the self-initiated movement, which affects the perception of effort and force required. On the other hand, when using a joystick, the direct physical connection is removed. The sensory feedback and motor action are less directly linked, leading to a reduced role of corollary discharge. Since the brain is not anticipating and adjusting for the sensory feedback of the movement to the same extent, the perceived effort and actual force applied may be lower.
53
What is corollary discharge?
a mechanism in the nervous system where an efferent (motor) signal is copied and sent as an afferent (sensory) signal to sensory areas of the brain. This process helps the brain to distinguish between self-generated movements and external stimuli.
54
When the joystick, pressure experiment is run with people who have auditory hallucinations, what was found by Sherghil?
when healthy people are asked to match the force, they apply more force, to try and match it. patients with schizophrenia using corollary discharge. they are significantly different. they are actually more accurate then healthy people, because the Corollary discharge system doesn't work as efficiently, so they show an intermediate levels of force.
55
Does attenuation of the signal in the sensory cortex have a temporal element?
yes it only attenuates within a particular time window. so if there is a delay, there is less attenuation in the sensory cortex .
56
What was negatively correlated with PANSS hallucinations score in a corollary discharge experiment?
Movement-related sensory attenuation
57
What is the difference between health people and schizophrenic people and their somatosensory cortex attenuation?
58
Give a top level explanation of what TMS is.
Transcranial Magnetic Stimulation is a safe, non-invasive technique for stimulating or inhibiting cortex. an alternating magnetic field in a coil induces a weak electric current in the underlying cortex.
59
What happens at 1Hz (slow TMS) versus fast?
It decreases excitation in the underlying cortex whereas 'fast TMS' will increase excitation.
60
What can TMS do to connected regions in the brain?
It can inhibit connected regions via propagated trans-synaptic effects.
61
How long do the results of TMS last?
The brain changes can last for hours, beyond stimulation and results that last several weeks.
62
What happens to brain activity in the homologous region of the temporoparietal area when TMS reduces activity on one side while listening to sentences?
When TMS reduces activity in the right-sided temporoparietal area while listening to sentences, the homologous region (left side) shows increased activity. This compensatory mechanism reflects the brain's ability to adapt and redistribute processing tasks across regions.
63
What is the observed compensatory effect in the brain when TMS reduces activity in one temporoparietal region?
When TMS reduces activity in one temporoparietal region, the opposite side of the brain shows increased activity as a compensatory effect. This indicates the brain's ability to adapt by enhancing activity in other linked regions to maintain functionality.
64
What is the role of the corpus callosum in the brain, especially in relation to the temporoparietal junctions?
The corpus callosum is the largest bundle of white matter fibers in the brain, playing a crucial role in connecting the left and right temporoparietal junctions. These junctions work together regularly, and the corpus callosum facilitates their communication and coordination.
65
How does TMS affect functional connectivity in the brain's right-sided frontal and temporal areas?
TMS (Transcranial Magnetic Stimulation) can increase functional connectivity between the right-sided frontal and temporal areas of the brain. This means that after TMS, these areas show heightened collaboration or synchronized activity.
66
What is the effect of tDCS (transcortical direct cortical stimulation) on brain activity, particularly in auditory cortex and hallucinations?
tDCS, involving a small electrical current applied to the brain, can reduce activation in the auditory cortex. Studies show that after tDCS, patients experiencing hallucinations have significantly reduced activation in this area, correlating with a decrease in hallucination scores.
67
How does neurofeedback with fMRI assist patients with hallucinations?
Neurofeedback with fMRI assists patients by providing them with real-time feedback on their brain activity, particularly in the superior temporal gyrus. By learning to control this activity, patients can reduce the intensity or frequency of hallucinations over time.
68
What's the difference between hot and cold cognitive mental processes?
69
What are some examples of double dissociations found in real life?
70
What are the key social cognitive domains?
71
What is Theory of Mind?
72
What is emotion perception?
73
Explain social perception and tests for it...
74
Explain social knowledge and what other cognitive domain it interfaces with
75
What is attribution style?
76
How do we measure attribution
Which allows for distinction between - external personal attributions / caused by others - external situational attributions / caused by the situation -internal attributions / caused by oneself
77
What is an example of two brain regions associated with social processes that are not entirely separate and what are they involved in?
78
What brain regions, implicated in emotional recognition processes are involved in face perception?
79
What brain regions, implicated in emotional recognition processes are involved in voice perception?
80
What brain regions, implicated in emotional recognition processes are involved in emotion experience?
81
What brain regions, implicated in emotional recognition processes are involved in emotional regulation?
82
What brain regions, implicated in emotional recognition processes are involved in mentalising, theory of mind?
83
The brain areas typically activated during social-cognitive processing overlap with brain regions of the........
84
85
The onset of psychotic illness is preceded by a drop on what functioning in a number of cases?
social functioning
86
What 2 impairments with alrge effect sizes did a meta analysis looking at schizophrenia and theory of mind find
87
What is the link between schizophrenia symptoms and attribution style?
88
Research supports a pattern of lower brain activation in schizophrenia patients in areas including...
89
What are the areas of higher brain activation in schizophrenia patients and what could it point to?
90
What hormone increases trust in social situations?
Oxytocin.
91
Trust is strongly influenced by learning during interactions and the other person's.......
reputation
92
The research into trust has shown that better perspective-taking or theory of mind abilities are associated with higher....... and lower.
higher trust towards cooperative others and lower trust towards unfair others
93
The outcome phase of the trust game, when the partner is revealed, is associated with what system, and in what particular area?
The dopamine-governed reward learning areas, particularly the caudate nucleaus.
94
What type of game did Paula Gromann and colleagues use in their study on trust in patients and healthy controls?
They used a computerized version of the trust game.
95
Describe the behavior of the unfair partner in the trust game.
The unfair partner decreased the chance of a repayment that was at least equal compared to the investment with each increase in trust.
96
What was the observed baseline trust level in patients compared to controls in the first investment of the computerised trust game?
Patients showed a lower baseline trust in the first investment when nothing was known about the interaction partner.
97
How did patients' trust levels compare to controls during repeated cooperative interactions in the computerised trust game?
Patients had lower trust on average during all repeated cooperative interactions.
98
Was there a difference in behavior between the groups in the unfair condition of the computerised trust game?
No, there was no difference between the groups in behavior in the unfair condition.
99
Complete the sentence: The computerised trust game social study suggests that there may be no general learning deficit when it comes to _______ information.
social
100
In the computerised trust game study, which brain area showed lower activation in patients with schizophrenia, and in which condition?
The caudate nucleus showed lower activation in patients with schizophrenia, but only in the cooperative condition.
101
In the computerised trust game, How did the level of positive symptoms in patients relate to caudate activation?
Patients with higher positive symptoms showed less caudate activation.
102
Fill in the blanks: The more _______ a patient was, the less reward activation in the brain was observed during _______.
paranoid, cooperation
103
What brain area showed reduced activation in the computerised trust game study and is implicated in theory of mind?
The temporal parietal junction.
104
In the computerised trust game study, What might the reduced activation in the temporal parietal junction during the repayment phase suggest about patients?
It may suggest that patients utilize less mentalizing.
105
According to the trust game study, what might cause the loss of trust in schizophrenia?
A loss of trust in schizophrenia may be caused by aberrant sensitivity to the rewarding propensity of social interactions and possibly aberrant theory of mind processing.
106
Fill in the blanks: Reduced experience of social reward may limit _______ to others and may explain _______.
social connection, social dysfunction
107
What was observed about basic trust in patients and their first-degree relatives in interactive trust game studies?
Lower basic trust in both patients and first-degree relatives, suggesting a possible biological or genetic background for being less social and trusting.
108
In the trust game studies, How does learning in unfair interactions differ in patients with different stages of illness?
Learning seems to be intact in unfair interactions, regardless of whether someone is in the chronic or early illness stages.
109
Fill in the blanks: In the early illness stages, patients are still _______ to the positive social signals of other people, whereas chronic patients are _______.
very much sensitive, not
110
What opportunity might the early illness phases present according to the trust game study's findings?
A window of opportunity to design interventions aiming to keep social functioning intact.
111
What is the relationship between the lack of attenuation in patients with schizophrenia and their hallucinatory experiences?
The severity of hallucinatory experiences in patients with schizophrenia predicts the lack of attenuation.
112
Complete the sentence: In schizophrenia, impaired motor prediction leads to symptoms explicable by a ________.
.. fundamental misjudgment of agency.
113
True or False: In individuals with schizophrenia, somatosensory cortical activation is similar to that in healthy individuals during self-generated movement.
In individuals with schizophrenia, there is no attenuation in somatosensory cortical activation as seen in healthy individuals.
114
Fill in the blanks: In schizophrenia, a lack of attenuation in somatosensory cortical activation is linked to the severity of ________ experiences.
... hallucinatory
115
What are the two cognitive-affective processes involved in perspective-taking?
1) The ability to understand another person's intentions, desires, and beliefs (cognitive empathy or theory of mind). 2) The ability to share others' feelings without personal emotional stimulation (empathy or affective ToM).
116
What is 'theory of mind' (ToM) and why is it important?
Theory of mind (ToM) is the ability to attribute mental states to others and understand that others have beliefs, desires, and intentions different from one's own. It's crucial for normal social interactions and functioning within a community
117
What does the 'social brain network' consist of?
The social brain network includes prefrontal cortex areas (dlPFC, mPFC, vm/vlPFC, OFC), temporal lobe regions (temporal poles, pSTS), parts of the parietal cortex (TPJ, IPL, precuneus), and deeper brain structures (insula, amygdala, striatum).
118
Which brain areas are predominantly involved in theory of mind (ToM)?
Medial frontal brain areas, temporal poles, and orbitofrontal cortex (OFC) are predominantly involved in ToM.
119
What roles do the temporal poles and OFC play in the social brain network?
The temporal poles and OFC are involved in processing social reward-related information and integrating social conceptual knowledge.
120
Fill in the blanks: The 'social brain network' also includes the ________, which are implicated in change of perspective and ToM.
... temporo-parietal junction (TPJ), inferior parietal lobule (IPL), and precuneus.
121
What is the function of the inferior frontal gyrus (IFG) and the premotor and parietal cortices in social cognition?
They are implicated in decoding actions and emotional states of others by subserving 'mirror mechanisms', which mimic neural activation underlying observed behavior in the brain of the observer.

7PAYFPSY Psychology and Neuroscience of Psychosis - October 2023 (5 decks)

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