Final Flashcards
(113 cards)
1
Q
Why, according to the Greeks, do we act against reason?
A
Emotion interferes with reason.
2
Q
The Greeks viewed mental disorder as a disorder of ______. This changed with _______ (person).
A
Thought; Maudsley.
3
Q
What were the two broad views on suicide? Elaborate a bit.
A
That is was either irrational or rational. Aquinas and the laws of nature, man, and god versus the enlightenment thinkers: god gave us the desire to die.
4
Q
Who was the first person to normalize irrational thought/
A
Freud
5
Q
What is the important takeaway from Jian Ghomeshi.
A
We agreed that the way he acted was culturally expected, thus Jian Ghomeshi should NOT receive a DSM diagnosis for depression.
6
Q
With who did the idea of depression as irrational return? Why?
A
Aaron Beck described depression as a systematic bias against oneself.
7
Q
How does systematic bias vary between depressed and non-depressed populations
A
Depressed individuals are less biased; non-depressed individuals often employ positive illusions to maintain self-esteem.
8
Q
What evidence does psychiatry provide that depression and suicide should be a disorder?
A
Absolutely none.
9
Q
William Paley made what argument to Darwin?
A
That evolution occurs per saltum as most mechanisms would not be functional unless entirely intact (e.g. the spine or eye).
10
Q
What were the two problems that Darwin had to solve?
A
Speciation and adaptation.
11
Q
How did Darwin initially explain the 15 species of finch on the Galapagos islands?
A
He concluded that they must have evolved from one ancestral finch. Although, he was confused why god would create such redundancy.
12
Q
What was first stage through which Darwin discovered adaptation?
A
There is a small difference between species–not large.
13
Q
What was second stage through which Darwin discovered adaptation?
A
There is an undescribable change between generations.
14
Q
What was third stage through which Darwin discovered adaptation?
A
Species seem to match their climate; climates change in a slow/gradual fashion. Thus, evolution must occur gradually.
15
Q
What did the organism evolve to maximize?
A
Inclusive fitness.
16
Q
What is the only logical explanation for non-random organization?
A
Natural selection.
17
Q
How did Darwin explain that an organism can be poorly fit for their environment?
A
In the event of rapid environmental change.
18
Q
How percentage of births do juvenile sheep contribute to?
A
15%
19
Q
What are some characteristics of a juvenile sheep?
A
Eat less, more aggressive, and more physically active.
20
Q
What are some disadvantages of being a juvenile sheep?
A
1.85x higher mortality rate in winter.
21
Q
What is a green beard an important example of? Why might the associated mechanism be useful?
A
Kin recognition. Allows one to track degree of relatedness and prioritize kin.
22
Q
How related are drones to the queen?
A
r = 0.5
23
Q
How related are workers to the queen?
A
r = 0.75
24
Q
Why does it make sense for most workers to prefer their role instead of queen?
A
Workers are related to each other at r = 0.75. The queen is only related to their workers at r = 0.5.
25
What is the metaphor between eusociality and our body?
Most of our cells do not reproduce—they are like worker bees that increase the reproductive success of the whole.
26
What was one unique feature of the DSM-I and II?
Disorder could happen anywhere on the symptom continuum if the symptoms were incongruent with the situation.
27
What were the two reasons that the DSM-III was made?
1) to increase reliability.
| 2) to distance itself from psychoanalysis.
28
What was the lifetime prevalence of every disorder in the DSM-III-R? How did this change with the clinically significant distress in DSM-IV?
It was always 50% lifetime and 30% annual. These rates did not change with the clinical significance criterion.
29
What is Dr. Andrews' view on the bereavement exclusion?
He believes that the exclusion should exist.
30
What is the lifetime prevalence for MDD?
~50%.
31
What are two factors about the DSM that seem to increase alongside each other, according to Dr. Andrews'
The number of disorders in the DSM and the revenue generated for the APA.
32
What was the major force in leading psychiatrists to medication?
Health companies began requiring that patients go to the cheapest available treatment option: medication is cheap.
33
Why are ghost written papers problematic?
Psychiatrists are paid for pharmaceutical companies to use their name on a paper. This adds their credibility without having their expertise in designing the experiment.
34
Describe the publication bias around ADD.
Published: 94% positive
Unpublished: 51% positive
35
How does the FDA approval process work?
The pharma company only needs to provide two successful drug trials as evidence.
36
What did Robet Spitzer use as an alternative to dysfunction in DSM-III?
The disability and distress criteria.
37
Andrew's uses the word purpose in a definition for function, what do you do?
I run.
Purpose implies a creator, which is false.
38
What three words does Wakefield associate with function?
Explains the existence, structure, and operation of an object/trait.
39
What must we do to diagnose a Wakefieldian disorder?
Find a function that is breaking down.
40
What is the course principle that Dr. Andrews discusses time and again?
Understanding etiology is crucial to developing appropriate treatments.
41
What happens when you take medication for a cold? And what lesson can we take from this?
The pathogen load decreases slower thus elongating the illness.
That when you interfere with an adaptive system things go awry.
42
The heritability coefficient shows ______.
the proportion of variation among individuals that we can attribute to genes.
43
What is the correct 'Common disease, _____' hypothesis? And why should we care?
Common Disease, Rare Variant (CDRV): mental disorders are caused by many mutations that are each individually rare.
Disorders are highly polygenic.
44
What do GWAS studies tell us about schizophrenia and depression respectively?
Schizophrenia: all implicated alleles account for 23% of the variance in schizophrenia.
Depression: There are no significant alleles related to depression except for in the Han Chinese. The Han have alleles on Chromosome 10 that are implicated in depression.
45
A chromosome is short. What prediction would you make from this?
The relevant chromosome would explain less variance of a given trait than a comparably larger chromosome; the large chromosome contains more SNPs.
46
The watershed model makes what prediction?
That the more central an adaptation to fitness the more polygenic it will be.
47
What type of mutated alleles are quickly removed from the pool? Which remain?
Harmful alleles.
Recessive or subtle alleles will remain.
48
A run of homozygosity measures what? And why do we care about this?
Inbreeding. We find that for every 1% increase in a ROH the risk of developing schizophrenia increases by 17%.
We know that schizophrenia is largely recessive, as the watershed model predicted.
49
Provide an explanation for the Lek paradox.
Tails are strongly tied to fitness thus they are highly polygenic. Since the trait is highly polygenic, mutation adds sufficient variance between generations to sustain assortative mating practices.
50
When does MDD peak in the life course?
During peak reproductive years.
51
Depression is under which type of selection?
Directional selection.
52
What are the three types of depression discussed? Describe the goal of each.
Starvation (preserve brain and find food), infection (up-regulate immune), and melancholia (up-regulate cognition).
53
Which depressive phenotypes share insulin patterns?
Starvation and melancholia.
54
In which depressive phenotypes does body temperature increase?
Infection and melancholia.
55
The Pathos-D hypothesis says ______.
that depression is an adaptive response to social stressors that increase risk of infection.
56
When rats are shocked we see what? This is increasing why?
An increased immune response.
This shows a clear carry over between the infection and melancholic depressive phenotypes; perhaps also explains why we see a febrile response in melancholia.
57
Animals can test hypotheses? True or false.
True.
58
How do people generally feel about their own ruminations?
They typically like their own ruminations.
59
What genes become unmethylated in individuals with PTSD?
Immune related genes. Hence why these individuals are then less capable of fighting off an infection.
60
Physicians react how after a patient commits suicide or they make a mistake?
they make a mistake are positively associated with changes to practice: greater attention to detail, personally confirm patient data, seek more advice, read more relevant literature, etc.
61
How would you describe the goal of root cause analysis?
To identify the causal chain of events where preventable actions could have been taken.
62
Why is being depressed useful for root cause analysis?
Depressed individuals have less positive illusions and are better able to reflect on events.
63
What do depressed individuals typically seek out in the world? Why?
Negative feedback on their actions, not because they are depressed but rather so that they can make change.
64
How does rumination relate to learning according to Dr. Andrews?
Well, if learning occurs through repetitive recall then perhaps rumination is a form of learning.
65
What is one thing that the current model of depression cannot account for?
Spontaneous remission.
66
What do we call the old scale for rumination?
The Ruminative Response Scale (RRS)
67
What did the RRS measure? How did these vary?
Two types of rumination: brooding and reflective pondering.
Brooding: comparing oneself to an unachieved standard; worsens symptoms.
Reflective Pondering: turning inward to solve problems; improves symptoms.
68
How would you respond to a claim that depressed individuals are pessimistic. Provide evidence to support your point.
Depressed individuals are not pessimistic, they are simply better at integrating new information.
We know this from a study on depressed versus non-depressed women who were asked to rate their risk of developing breast cancer before and after receiving information about prevalence rates.
69
What humour did Galen believe to cause depression?
Black bile.
70
How have the words melancholy, rumination, and brood changed in meaning over time?
Psychiatry has co-opted them as disordered words when they are not.
71
What is Dr. Andrews' hypothesis on rumination called?
The Analytical Rumination Hypothesis (ARH).
72
What did Dr. Andrews propose as the two types of rumination?
Causal analysis (identify the cause) and problem solving analysis (solve the problem).
73
What words are typically associated with causal analysis and problem solving analysis, respectively?
Causal analysis: why and what.
Problem solving analysis: how.
74
Describe the relationships within the ARH.
Depression is positively correlated to causal analysis.
Causal analysis is positively associated with problem solving analysis.
And problem solving analysis is negatively associated with future depressive symptoms.
75
What are the two most commonly endorsed types of statements that depressed people make?
Causal analysis and problem solving analysis related.
76
How did iproniazid and reserpine spur the low serotonin hypothesis?
The low serotonin hypothesis began when iproniazid decreased depressive symptoms by raising serotonin and norepinephrine levels and reserpine increased depressive symptoms by lowering monoamine levels.
77
What happens to serotonin levels when a rat is shocked?
They rise.
78
Extracellular serotonin does not measure transmission. Instead, what do we use?
The 5-HIAA/5HT ratio.
79
What would you expect with a lesion to the dorsal raphe nucleus (DRN)? Why?
The DRN is responsible for serotonin production. Cessation of serotonin production would lower depressive symptoms.
80
How does Hyman and Nestler's view of oppositional tolerance differ from Fava's view?
Hyman & Nestler: oppositional tolerance facilitates therapeutic effects.
Fava: oppositional tolerance cancels acute therapeutic effects.
81
What are typical two-year relapse rates within people who are taking SSRIs?
Around 60%
82
A drug is hormetic if ________.
it induces two different responses at different doses (biphasic responses)
Ex. Aggression decreases with low doses and increase with high doses; as well, anxiety increases at low doses and decreases at high doses.
83
Describes serotonin effects during these three stages of SSRI usage.
Acute:
Chronic:
Discontinuation:
Acute: Total pool reamins the same; extracellular serotonin increases.
Chronic: Total serotonin pool decreases.
Discontinuation: There is a dose-dependent recovery period where transmission momentarily decreases and then rapidly increases until normalization. We call this an oscillation pattern.
84
What are two common beliefs of people with suicidal ideations?
that the world would be better off without them and that they have no purpose in life.
85
What did Tolstoy view as the solution to life?
The non-cowards way of living was to end life.
86
The burdensome to kin hypothesis has two requirements, state them.
1. Low direct fitness
| 2. Existence suppresses the reproductive success of close relatives
87
How has our direct fitness changed over time.
Our direct fitness has decreased over time as the age of first marriage has moved later and later; as well, there is a negative association between wealth and direct fitness.
88
What are the two stages of suicidal ideation?
1. Self-critical thoughts (low self-esteem or inward self-defeat).
2. Self-destructive thoughts (hopelessness and withdrawal).
89
How would you describe the egg laying habits of great egret birds?
They lay more eggs than they need as an insurance plan?
90
A chick falls out of a great egret nest. How does food allocation change?
The parent actually begins bringing less food to the nest to maintain competition.
91
What sort of suicidal behaviour do we see in the youngest great egret chick when they realize that they are burden on their kin?
None. Suicide is a uniquely human behaviour.
92
Dr. Andrews discussed anaclitic depression as an infant analogue for what?
Infantile depression as the infant resists and food and care.
93
Why does apoptosis make sense in most cases over necrosis?
Cells are entirely related to each other. Apoptosis is a cell analogue for the burdensome on kin hypothesis.
94
What two types of selection can be used to conceive of psychopathy?
Balancing selection (frequency-dependence) and contingent shift perspectives.
95
What experimental data was presented on psychopaths?
We would use this as evidence for what?
Psychopaths are rated as more trustworthy and attractive by females.
In particular, open and extroverted females found psychopaths most attractive.
We would use this as evidence to claim that psychopathy is a special design.
96
When do we frequently see depression in Alzheimer's? Why does Dr. Andrews posit this to be?
Early in appearance. The disappearance of depression is associated with negative outcomes.
Hypothesizes that serotonin is being used as a protective factor in the case of Alzheimer's--depression is merely a by-product of this. Hence why we see depression decrease as the protective factor disappears.
97
Amyloid A and B differ how?
Alpha: Neuroprotective.
Beta: associated with Alzheimer's.
98
Protein Tau begins to hyperphosphorylize when? And when does it functionally peak, causing what?
Begins around age 10
Functionally peaks around age 40 where it begins to result in Amyloid B build up.
99
What are the two dysfunctions that Dr. Andrews discusses in relation to Alzheimer's?
1. The hyperphosphorlyization of Tau results in Amyloid B.
| 2. The atrophy of cortical folds. We lose our folds which are adaptive mechanisms to increase cortical area.
100
Dr. Andrews had another course principle that relates to treatment. What was it?
Treating cause will be more effective than treating symptoms.
101
At which point do patients begin to require medication?
Most patients with moderate to severe depression will require medication.
102
What are the treatment trends for mental disorder over time?
Medication is becoming more popular.
Psychotherapies are becoming less popular.
103
Are anti-depressants considered clinically significant from placebo controls?
No. There is a 1.8-point difference between them.
104
Explain why most ADD studies are done on severely depressed individuals.
Severely depressed individuals show a weaker placebo effect so pharma companies can establish significance with HDSR scores around 25.
105
What did the STAR*D study conclude, and why should we not trust it?
The STAR*D study concluded that 67% of patients who went through drug treatment met the criteria for remission.
This study had a 93% drop-out rate and they changed their scale post-hoc to increase their reported remission rate.
106
Which class of drugs produces the strongest serotonin and norepinephrine responses?
MAO-Inhibitors
107
What is the core risk in using strong ADDs?
They produce much higher relapse rates following discontinuation.
108
Describe the interaction between medication and CT in terms of producing long-term effects.
Medication alone produces poor long-term effects: suicide and hospitalization.
CT alone produces the best long-term effects.
A combined treatment of medication and CT is enough to ruin the strong long-term treatments of CT.
109
What is the best depression treatment for short-term results?
A combined medication and CT treatment.
110
What about CBT is effective?
There are studies to suggest that the behavioural component of CBT produces most of the postive outcomes.
111
When is behavioural therapy most useful?
Behavioural therapy is best at producing positive results in severely depressed samples.
112
How does an individual's history with ADDs influence future treatment? Think about across many options.
Worsened outcomes if other ADDs are used.
NO EFFECT when CT is used. Meaning, CT is not weakened by a history of medication.
113
What did we learn from the final treatment paper? How does this trend typically occur?
That negative affect and experience is necessary for mood improvement.
Depressive symptoms typically get worse before dramatic improvements are made. It has been shown that in these 'depressive spikes' individuals show increased processing and insight.
This kind of summarizes what he has been trying to teach us the whole term.
You can do this, Brent. Go, go, go.
