Environmental Influences on Mental Health

Question 1

Topic 1

Neighbourhood characteristics

Question 2

More recent research shows that urban living is associated with substance use, mood disorders, eating disorders and autistic spectrum disorder (ASD)

true or false?

Answer 2

TRUE

Question 3

there are two social characteristics that have received particular attention regarding urban living

What are they?

Answer 3

Social cohesion:
Quality/quantity of interactions between neighbours
Examples:
Trust, shared values and support.

Neighbourhood disorder:
Physical/social signs of threat and danger
Examples:
Graffiti, vandalism, gang activity, muggings and burglaries.

Question 4

What are 2 positive symptoms in psychosis?

Answer 4

Hallucinations:
Hearing and seeing things that are not there

Delusions:
Being very paranoid, believing in supernatural abilities

Question 5

High prevalence during childhood and adolescence:
5-30% of children and teens experience them at some point

true or false?

Answer 5

TRUE

Question 6

Psychosis is a signal risk for developing mental health problems such as?

Answer 6

Psychotic disorder, suicide, depression, anxiety, substance problems

Question 7

Psychotic symptoms are more common among children growing up in non- urban settings versus urban versus

true or false?

Answer 7

FALSE

Psychotic symptoms are more common among children growing up in URBAN versus non- urban settings.

Question 8

Studies have tended to use objective data to measure neighbourhood, which is relatively easy to obtain and helps to avoids shared method variance

TRUE OR FALSE

Answer 8

TRUE

Question 9

Adolescents who perceive more
neighbourhood disorder are also more likely to have psychotic experiences

true or false?

Answer 9

TRUE

Question 10

PART 2: AIR POLLUTION

Question 11

What are some examples of primary pollutants?

Answer 11

Carbon monoxide (CO) 
Sulphur dioxide (SO2) 
Nitric oxide (NO)
Nitrogen dioxide (NO2) 
Particulates (PM)
Volatile organic compounds (VOCs)
Ammonia (NH3)

Question 12

What are some examples of secondary pollutants?

Answer 12

Sulphur trioxide (SO3) 
Sulphuric acid (H2SO4) 
Ammonium (NH4+)
Nitric acid (HNO3) 
Hydrogen peroxide (H2O2) 
Ozone (O3)
Particulates (PM)

Question 13

What are some examples of sources of primary and secondary pollutants?

Answer 13

industry, motor vehicles, heating appliances, and tobacco smoke

Question 14

Name 3 common types of outdoor air pollution and briefly explain the sources?

Answer 14

Nitrogen dioxide (NO2)
Sources:
Emissions from motor vehicles and industry

Nitrogen oxide (NOx)
Sources:
Car engines and naturally, via lightning and acid rain

 Particulate matter (PM2.5 & PM10)
Sources:
Emissions from motor vehicles, wood burning heaters and industry

Question 15

By 2050, urban air pollution is set to become the biggest environmental cause of mortality, ahead of poor sanitation and dirty drinking water.

true or false?

Answer 15

TRUE

Question 16

Exposure to air pollution may be associated with WHAT 5 THINGS?

Answer 16

• behavioural problems
• anxiety

depression

ADHD

suicide attempts

Question 17

PM2.5 :
• exposure for more than 6 months has been
associated with?

• exposure for less than 6 months was
associated with?

Answer 17

More than 6 months: depression and anxiety

less than 6 months: Suicide attempts

Question 18

Research has shown that small particles (such as PM2.5) are capable of reaching the brain.

TRUE OR FALSE?

Answer 18

TRUE

Question 19

Other pollutants may inflame the lungs or damage the nasal epithelium through increased inflammation
This might lead to what?

Answer 19

• stunted brain development

* neuroinflammation

Question 20

Child and adolescent brains may be more susceptible due to their rapid development

true or false?

Answer 20

TRUE

Question 21

TOPIC 3: Urban Mind Project

Question 22

the Urban Mind project aims to explore what 3 questions?

Answer 22

• What specific factors within the urban environment have a negative / positive impact on mental health?
• What are the underlying pathways?
• How do these factors interact with the lifestyle of the individual?

Question 23

What are 5 advantages of collecting data via smartphones?

Answer 23

• higher ecological validity
• lower recall bias
• higher temporal and spatial resolution
• both active and passive data
• large number of people can be enrolled at minimal cost

Question 24

What were 3 findings from the Urban Mind Project?

Answer 24

• the more time participants spent outdoors in natural settings, the lower were their levels of stress and the higher were their levels of relaxation and happiness
• this effect was noticeable at the time of the assessment and up to 7.5 hours later
• these associations were stronger in people with higher trait impulsivity, which is indicative of a higher risk of developing mental health issues

Question 25

The Urban Mind app could also be used to improve the care of people who are already experiencing mental health problems: what are 4 ways in which this could occur?

Answer 25

* allow clinicians to remotely assess and monitor patients in real-time * help predict when a patient might be starting to relapse so that they could be offered an emergency appointment or intervention * by tracking symptoms and side effects as they occur, the app could also ensure patients get the best treatment for them sooner * used in clinical trials of new medications or therapies as a way of testing in real-time how patients are responding

Question 26

The built environment is just one factor that can influence our mental health so it’s important to combine data from the Urban Mind app with other data about what 3 things?

Answer 26

* our environment, such as air pollution, crime rates and social cohesion within a neighbourhood * our social relationships * our genetic make-up

Question 27

Individuals exposed to the highest levels of which air pollutant are more likely to meet criteria for major depressive disorder?

Answer 27

NOx and NO2

Question 28

A few MCQ practice questions.... Which of the following is the term for a human cell that contains 22 single autosomes, and an X or a Y chromosome? a. A female somatic cell b. A sperm cell c. An unfertilised egg cell d. A male somatic cell

Answer 28

B: a sperm cell

Question 29

In the candidate gene approach what is one of the first steps? & what is one of the most targeted genes?

Answer 29

In a candidate gene study of GxE, one of the first steps is to identify a plausible genetic candidate. One of the most targeted genes is the serotonin (5-HT) transporter.

Question 30

Why does serotonin represent a good functional candidate?

Answer 30

Serotonin is involved in determining mood. It is the site of action of selective serotonin re- uptake inhibitors (SSRIs), a pharmacological intervention in the treatment of internalising problems. There is genetic variation in a regulatory molecule in the serotonin system, the 5-HT transporter (5-HTT).

Question 31

The most widely explored polymorphism is the?

Answer 31

serotonin transporter polymorphism (5HTTLPR).

Question 32

What is associated with greater 5-HTT expression and what is associated with reduced 5-HTT expression?

Answer 32

* LL (L is associated with greater 5-HTT expression) | * SS (S is associated with reduced 5-HTT expression)

Question 33

Which means what?

Answer 33

The S 5-HTTLPR variant produces significantly less 5-HTT mRNA and protein than the long (L) variant. This leads to higher concentrations of serotonin in the synaptic cleft.

Question 34

What is the finding regarding 5HTTLPR and anxiety-related traits?

Answer 34

Individuals with one or two copies of S, the allele associated with reduced 5HTT expression, have a greater likelihood of experiencing internalising problems including depression and anxiety.

Question 35

The first study was conducted by Lesch et al in two independent samples of 505 individuals. The effect has been replicated by Katsuragi et al. However there have been numerous non replications. What is thought to be a possible reason for this?

Answer 35

One reason why there could be inconsistencies is genetic heterogeneity in the action of the marker – in other words, GxE.

Question 36

After the candidate gene has been selected in depression, the next step is what?

Answer 36

to select a relevant environment that shows heterogeneity in response to exposure. Death of a family member, losing a job, or having a serious illness or injury, have all been associated with depression

Question 37

Life events represent a good candidate as there is variation in response - not everyone who experiences a life event goes on to develop depression. This heterogeneity could be in part explained by genetic variation True or false?

Answer 37

TRUE

Question 38

Evidence for GxE: Dunedin Multidisciplinary Health and Development Study Explain it in more detail?

Answer 38

A study by Caspi et al. that was the first to show a measured GxE. Caspi suggested the variability of research findings with regard to 5HTTLPR and depression could be due to environmental heterogeneity

Question 39

How did they test the GxE hypothesis?

Answer 39

using the Dunedin Multidisciplinary Health and Development Study. The Dunedin study is a birth cohort of 1000+ followed for many years. Participants were asked about 14 different life events that had happened to them in the previous year.

Question 40

There were no significant differences between the three genotype groups in the number of life events they experienced. The 5-HTTLPR genotype did not influence exposure to stressful life events – no GxE. True or False?

Answer 40

TRUE

Question 41

Individuals with SS and four or more stressful life events were at greatest risk of depression true or false?

Answer 41

TRUE

Question 42

The interaction has been replicated in childhood and adolescence using other stressors, including what 3 things?

Answer 42

* maltreatment * sexual abuse * negative life events.

Question 43

Do meta-analyses provide further evidence for GxE?

Answer 43

Meta-analyses by Karg et al and Uher et al have provided strong evidence that 5HTTLPR moderates the relationship between stress and depression. However, there have been numerous non-replications. Also another meta-analysis failed to find evidence that the serotonin transporter genotype alone, or in interaction with stressful life events, is associated with an elevated risk of depression.