Neuro+Clin Key Words🧠 Flashcards
(97 cards)
1
Q
History of psychopathology
A
Four humours-Hippocrates
Poverty and fear make you melancholy-Burton
Kreapellin-exogenous and exogenous mental disorders
Explained by the supernatural, individuals shunned from society
Mental health issues existed before, trepanning
2
Q
Biological approach to psychopathology
A
Genetics- vulnerability
Neurochemical dysfunction-serotonin, dopamine
Environmental stress-HPA stress axis
Lesions-damage and predisposition
3
Q
Statistical approach
A
Deviation from statistical norm (mean)
4
Q
Functional approach
A
Unable to function to support self and meet needs, maladaptive
5
Q
Distress based approach
A
Unable to cope with problems, focused on individual and their norms
6
Q
Neuronal classification
A
Number of processes (bipolar, multipolar)
Length of axon (Golgi type 1 and type 2)
Shape of cell body (ovoid, fusiform, triangular)
7
Q
Glial cells
A
Oligodendrocytes- form myelin, insulates axon
Astrocytes- star shaped, cuff nodes of ranvier, cover capillaries form blood brain barrier
Microglia- small rod shaped somas, immune system of brain
Schwann cell- PNS, guide axonal regeneration after damage
8
Q
Normative approach
A
Not socially normal, not adaptive
9
Q
Cell stains
A
Nissl: targets rough endoplasmic reticulum, shows density
Golgi stain: structure/ shape of golgi
10
Q
Self stigma
A
Based on discrimination
Concerned about other’s perspectives, affects quality of life and seeking help
11
Q
Tract tracers
A
Retrograde- inject into region receiving inputs
Anterograde- inject into region giving inputs
12
Q
Hindbrain
A
Nuclei control respiration, tongue musculature, blood pressure and heart rate- mylencephalon
Pons( sleep and arousal) cerebellum (sensory info and motor output) - metencephalon
13
Q
Midbrain
A
Tectum- auditory and visual system
Tegmentum- species typical behaviour
Red nucleus- motor system
Substantial Nigra- motor system
- mesencephalon
14
Q
Forebrain
A
Diencephalon- thalamus and hypothalamus, survival and homeostasis
Telencephalon- limbic system, basal ganglia,somatosensory cortex
15
Q
Limbic system
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Fighting, fleeing, feeding, sex
16
Q
Basal ganglia
A
Voluntary motor responses and decision making
17
Q
Resting potential neuron
A
At rest, inside of neuron is more negatively charged (-70) than exterior
Ions unevenly distributed across the membrane
More Na+ outside (positive)
More K+ inside (positive)
18
Q
Resting potential
Passive process
A
Selection of diffusion of potassium produces electrical current
Separation of charge
19
Q
Resting potential
Active process
A
Sodium potassium pump: sodium out and potassium in
3 Na+ for every 2K+ so negatively charged inside
Requires energy from ATP
20
Q
How is Action potential generated
A
Depolarisation- Na+ channels close and K+ channels open
More sodium flows in making inside more positive
Hyperpolarisation- too positive, overshoots. Sodium channels close and potassium channels open. Potassium flows out down concentration gradient becoming less positive
Reversal from -70 to +50, all or nothing
21
Q
Types of pressure on Na+ to enter the neuron
A
Electrostatic pressure-opposite charges attract (-70 attracts Na+)
Random motion-Na+ ions to move down concentration gradient, but sodium ion channels are closed
22
Q
How action potential travels down axons
Role of myelin
A
Positive charge depolarises the adjacent axon, action potential travels (PROPAGATION)
Inside becomes briefly positive, outside negative
Myelin insulates the axon, travels faster
23
Q
What can a post synaptic element be
A
A dendrite
A cell body
A terminal bouton
24
Q
Two types of receptors
A
Directly associated with an ion channel, made of subunits- ionotropic
Indirectly associated with ion channel, do not consist of subunits- metabotropic
25
Polarised cell
Resting state -70 with charge built up across the membrane
26
What opens when neurotransmitter binds to receptors on post synaptic element
Ion channels open, causes ions to flow through
| Entry of positively charged ions makes cell more likely to fire an action potential (excitatory)
27
Neurotransmitter release
Action potential reaches presynaptic element
Calcium channels open, force docked vesicles to open and release neurotransmitters to the synaptic cleft
Diffuse across
28
Postsynaptic potentials
Inhibitory-hyperpolarisation, cell less likely to fire action potential
Many synapses activated at the same time
Excitatory-depolarisation, cell more likely to fire an action potential
One synapse activated repeatedly
29
How neurotransmitters are inactivated
Removed from synaptic cleft by active transport back into presynaptic element or diffusion
Glial cells or enzymes break down
30
CAT scan
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Separate x rays at 180’
Can inject contrasting agent into blood
Horizontal scans (tomography) gets 3D image
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31
MRI scan
Blasted with electromagnetic energy at right angle causes hydrogen atoms to align and move with magnet
Flip and fan out (process) move in phase
Pulse detected from energy released, time to move back influenced by tissue
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fMRI
Blood supply increased to active areas
Deoxyhaemoglobin can be magnetised
BOLD dependent
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EEG and ERP
Net of electrodes measure neocortex
Frequency depends on arousal
Responds to stimuli
34
Electrophysiological techniques
Intracellular recording=record action potential, electrode picks up release of neurotransmitter
Extracellular= ions flow across cell, potential field picked up by electrode
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Stimulation techniques
Electrical-force neurons to produce bursts by electrode
Optogenetics- Opsins are light sensitive receptors in algi
Allow ions to enter the cell when open, inserted into neuron so sensitive to light. Optical fibre inserted into animal to activate channels
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Disruptive techniques
Chemical lesions, remove area to disrupt function
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Neuropharmacological
Mirco-dialysis- semi permeable probe, fluid passed through. Chemicals that diffuse across are collected and measured using chromatography
Immunohistochemistry- protein injected into animal so antibodies bind to it. Locate neurotransmitters that bind to the enzymes
38
Animal learning paradigms
Morris water maze-spatial memory. Opaque tank, rat uses platform to escape. Uses objects in the room as reference
Escape latency=how quickly escapes
Spatial transfer=platform removed, see where rat thinks it is
Radial maze- central platform, rat won’t return to food if good memory
39
Behavioural methods
Open field-Animal in unfamiliar environment, shows species common behaviour, social defeat if addicted
Conditioning paradigms- place preference: classically condition rat to location, addicted if preference changes
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Field observations
Aggression-polygamous mammals compete for females to reproduce
Social dominance- submission has lower results
Courtship-female rear offspring so must be attracted for her effort
Sex-makes invest more in mating
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Goals of assessment
Understand causes, improve knowledge
Diagnose specific disorders
Identify appropriate treatments and determine effectiveness
Determine if can stand trail/compensation
42
Reliability
How consistency produces same results
Test-retest= same participant, another time
Inter-rater=same results, different clinician
43
Validity
Measures what it claims to
Concurrent- scores correlate with another measuring the same
Predictive- predict symptoms/behaviour
44
DSM diagnosis evaluation
More diagnoses added over false negative concerns
Everyday conditions medicalised
Pharmaceuticals benefit
Arbitrary and subjective cut off
45
Clinical interview
Predetermined questions
High inter rater reliability
Low reliability if unstructured, biases cause errors
46
Intelligence tests
Standardised, high internal consistency
Test-retest and predictive validity
Low inter rater reliability and validity
47
Psychological tests
Assess specific characteristics
Objective, good concurrent validity
Standardised to statistics
Cannot diagnose, time consuming
Has lie scales but can be faked
48
Projective tests
Rorsharch ink blots, sentence completion, thematic apperception
Client interprets fixed stimuli, may determine thought disorders
Low inter rater reliability and validity
49
Clinical observation
Direct observation in natural context, shows triggers
A-antecedent
B-behaviour
C-consequences
Better ecological validity, find treatments
Time consuming, inter observer reliability may be poor
50
Biologically based assessment
Skin concordance, muscle activity , EEG, CAT,PET
Cannot diagnose
51
Cultural biases
Most tests validated on white populations
Different diagnoses on ethic groups, uncertain if biased or vulnerable
Some view those from low social economic backgrounds as more disturbed
52
Disruptive technology
Changes in an entire field or way of life
Potential to change the mind’s function
CRISPRR-CAS9- alter DNA, cure genetic diseases. May pass down effects to generations
Optogenetics-treat epilepsy and Alzheimer’s, insert viruses which can be dangerous, don’t know long term effects
53
Why ethics are at the forefront of new technologies
Super humans may make us extinct, human biology cannot compete
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Why ethics can fail
Scientists feel the need to publish many papers to get grants
May result in misconduct with lower ethics to produce papers and get funding
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Ethical frameworks around animal research in the UK
Regulated by home office-only performed when no alternatives
Need a home office personal license, last for 5 years
Establishment licence, Home office inspections can remove it
Reduce Replace Refine offers grants with adherence to guidelines
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Ethical research
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Full consent
Freedom of choice
Minimise harm and maximise benefits
Randomised trails
Privacy and confidentiality
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57
Ethical implications of psychological treatments
Do not prioritise treating neurological disorders for the wealthy, greater access to enchantments making the social divide greater
Legally authorised representatives must consent for those who cannot
Do not rely too much on neuroscience in laws e.g. free will
Potential harms may be for the good of humanity
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Environments that challenge ethical practice
Aftermath of a disaster-trauma, may see research as therapy
Research in prisons-imbalance of power, concerns of censorship and how findings are used. Prisoners may hope to gain benefits, may be obliged to disclose everything
59
Biopsychosocial explanation for drug use
Positive incentive theory-craving for a positive incentive
| Physical dependence-cycle of drug taking and withdrawal
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Tolerance
Decreased sensitivity to drug effects from exposure, less effective per dose
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Withdrawal
From a sudden elimination of drug after having it in the body
Opposite effects of the drug
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Sensitisation
Increase of drug effect from repeated exposure
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Contingent tolerance
Tolerance develops only to drug effects that are actually experienced
Rats would have seizures as they become tolerant to alcohol’s anticonvulsant effects
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Conditioned drug tolerance
Tolerance maximised when drug is administered in the same situation or environment
Tolerance when rats are injected in the same location, addicts may overdose in different location
65
Tobacco
Nicotine absorbed through lungs
| Acts on acelylchloride receptors in the brain, nicotine acts as an agonist
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Alcohol
Molecules soluble in fat and water, invade all parts in the body. Dampens neural firing (depressant)
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Marijuana
THC causes psychoactive effect
| Addiction is low, tolerance from sustained use
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Cocaine and stimulants
Increase neural and behavioural activity
| Blocks dopamine transporters leaving more in the synapse
69
Opiates
Bind to opioid receptors whose normal function is to bind to endogenous, neurotransmitters (endorphins or enhephalis)
70
Role of dopamine in drug use
Dopaminergic neurons project from the mesencephalon (mid brain)to the prefrontal cortex
Intracranial self stimulation increase dopamine release in these pathways (works like a natural reward)
Dopamine agonists increase intracranial self stimulation, dopamine antagonists decreases
Dopamine input pathways are hyperactive
71
Diagnostic criteria for alcohol use disorder
Addiction replaced with dependence (biological adaptations)
DSM V- abuse and dependence
Persistent desire, craving
Failure to fulfil obligations
Use in hazardous situations despite knowledge of damage
Tolerance/withdrawal
72
Substance use disorder epidemiology
SUDs more common in men
Male alcohol use disorder- South America, Eastern Europe
Female alcohol use disorder-North America, Eastern Europe
Male drug use disorder-USA, South America
Female drug use disorder-South America, USA
Male tobacco-Europe, East Asia
Female tobacco-Europe
73
Psychological theories of substance use disorder
Operant-positively reinforced from positive outcome (pleasure) negatively reinforced when remove negative outcome (withdrawal symptoms)
Classical- take substance in presence of cues e.g. sight, smell which elicts a response (craving)
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Comorbidity
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SUDs common in people diagnosed with:
Bipolar
Major depression
Generalised anxiety disorder
PTSD
Schizophrenia
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75
Habit forming (operant, voluntary)
Stimulus (see drug)
Anticipated outcome (getting high)
Response (using)
With repetition stimulus goes straight to response-HABIT FORMED
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Dual process theories (cognitive) drug use
Novice user- controlled process, outcome expectancies, intentions to use
Addicted user-automatic process, spontaneous attentional bias
77
Habit forming evaluation
In lab animals habits persist despite negative consequences but may differ in humans
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Evaluate dual process theory
Addiction is characterised by automatic cognitive processing biases to cues
Retraining cognitive processing biases may be an effective treatment
79
Addiction- choice or compulsion
Motivation to change predicts recovery
Motivational interviewing resolves ambivalence
Drug use dependent on price change
Contingency management is effective
80
Evidence of addiction being a brain disease
Changes in structure and function after long term chronic drug use
But our brain always changes and evidence for recovery without treatment
81
Drug treatments: Motivational interview and CBT
MI- collaborative approach brings out patient’s aims and motives for change
CBT-identify distorted thoughts, generate positive thoughts about getting clean, coping
Effective, increase in abstinent patients
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Drug treatments: Self help groups
Paired with sponsor to maintain abstinence, changes social. Increase self efficacy
Free, used in AA
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Drug treatments: Contingency management
Rewards for clean urine sample
Inexpensive, greater abstinent than other treatments
84
Drug treatments: Pharmacotherapy
Smoking-nicotine replacement
Heroin- methadone substitute
Alcohol-naltrexone blocks pleasurable effects, disulfiram causes sickness
Will not cure addiction or address dysfunction in brain reward system
85
Evaluate SUD treatments
Unclear what counts as success
Interval validity-should work from treatments itself not therapist being kind etc
Treatments increase motivation to abstain and change behaviour
Any treatment better than none, many equal to placebo however
All treatments found to be very similar
86
Aims of treatment
Relief from distress
Increase self awareness and insight
Teach coping skills to manage symptoms
Identify and resolve root causes of the disorder
87
Treatment-psychodynamic/analytic
Unconscious conflicts brought to conscious
Defence mechanisms from childhood experience
Free association, dream analysis
Many sessions per week
88
Behaviour therapy
Faulty learning (classical/operant) unlearn or re learn associations
Systematic desensitisation- increase fear hierarchy until directly exposed
Aversion therapy-link undesirable behaviour with undesirable outcome (classical)
Flooding-direct contact either top of fear hierarchy
Contingency management- reward not doing the behaviour, reward positive behaviour (operant)
89
Cognitive behavioural therapy
Distorted thoughts and cognitive biases cause symptoms
Selective abstraction, personalisation, magnification/minimisation, arbitrary inference, overgeneralisation
Improves coping skills
Between 6-10 sessions to challenge dysfunctional beliefs, homework
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Humanistic therapies
Holistic-consider whole person not just disorder, use motivation
Rogers: client centred therapy. Unconditional positive regard, non directive
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Family and systemic therapies
Assumes disorders arise from dysfunctional relationship with family
Discuss with patient and family
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Drug treatment
Brain dysfunction can be alleviated with medication (GABA, SSRIs)
Side effects and withdrawal, may be ineffective or no better than placebo if has mild symptoms
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Delivery of treatment
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On to one therapy
Group therapy
Computerised CBT
E-therapy
Mobile apps
Telephone
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Control conditions
Waitlist control- half get treatment and half get placebo
Befriending- social support,
Active control- looks like real therapy but lacks key elements
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Combining evidence
Narrative summaries- randomised pattern, what is suggested overall
Meta analysis-combine RTC findings, estimate the effect of bias
Meta meta analysis- don’t go to original source, meta of meta analysis
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Case study and series
Case study- detailed report of treatment on patients, improvements and outcomes
Case series- descriptive report of treatment and patient outcomes in groups of patients
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Issue with case studies and case series
Vulnerable to selection bias
30% spontaneous recovery anyway
Placebo and social support may explain
