PSCH 262 Final Exam

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3 Stages of Clinical Trials

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3 Stages of Clinical Trials

Pre-Clinical, Clinical & Review/Approval Process

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3 Phases for Clinical Trial

Phase I - III

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Which phases for clinical trials test for efficacy?

II & III

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How are clinical trials performed?

Randomized Trials

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5

What are the positive symptoms of Schizophrenia?

Hallucinations & Delusions

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6

What are some negative symptoms of Schizophrenia?

  • Flat Affect

  • Alogia

  • Poor Attention

  • Avolition

  • Anhedonia

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7

How can one’s environment affect their risk of schizophrenia?

Dysfunctional Family

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8

What are the chances of identical twins both having schizophrenia?

48%

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What are the chances of fraternal twins both having schizophrenia?

10%

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10

Sensory Gating Deficits

Difficulties filtering sensory input in the brain

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11

How are Sensory Gating Deficits tested?

Pre-Pulse Inhibition Tests

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12

Aberrant synaptic pruning during development can cause what?

Aberrant Grey Matter

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13

What are some structural abnormalities with Schizophrenia?

  • Disorganization of Hippocampal cells

  • Atrophying of cortical layers

  • Enlarged Cerebral Ventricles

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14

What are the 4 Pathways of Dopamine in the brain?

  • Mesolimbic

  • Mesocortical

  • Nigrostriatal

  • Tuberhypophyseal

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Which dopamine pathway deals with increase in positive symptoms?

Mesolimbic

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Which dopamine pathway deals with increase in negative & cognitive symptoms?

Mesocortical

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What effect can amphetamines have on schizophrenia?

Development of schizophrenic symptoms

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18

What medication is used to block dopamine receptors?

Chlorpromazine

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19

What are some symptoms of depression?

  • Depressed Mood

  • Fatigue

  • Decreased interest/pleasure

  • Change in Weight/Appetite

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20

Major Depressive Disorder

Feeling 5 or more symptoms of Depression for a period longer than 2 weeks

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21

What is the heritability of MDD?

40%

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Epigenetics

A potential mechanism for by which adverse stimuli (e.g., abuse) can result in persistent changes in the expression of inherited genes

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23

What is used to research psychiatric disorders?

Research Domain Criteria (RDOC)

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What are the components of RDOC?

  • 6 domains of function

  • 7 levels of analyses

  • Context of development & environment

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Negative Valence Systems

Responses to adverse situations such as anxiety, fear and loss

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Loss Valence System

Response to a state of deprivation of a motivationally significant con-specific, object, or situation (e.g., shelter, behavioral control, status, loved ones, or relationships)

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Connectomics

Brain areas that fire together are functionally connected

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28

Resting State Functional Connectivity

Measure of baseline brain activity

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29

Default Mode can affect what types of networks?

Task-positive networks

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How can the resting state affect MDD?

  • Increased connectivity in Default Mode

  • Decreased connectivity in Task-Positive Networks

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Why are Coritsol levels high with MDD?

Corticotrophin is high, leading to an increase in cortisol. Negative Feedback is decreased with MDD

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32

What are the 2 components of CBT?

  • Cognitive Restructuring/Reappraisal

  • Behavioral Activation

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Cognitive Restructuring/Reappraisal

Identifying and correcting inaccurate thoughts associated with negative emotion

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Behavioral Activation

Helping patients engage with pleasurable activities

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35

How does Cognitive Reappraisal work with Depression?

  • Increases activation of lateral and medial pre-frontal cortex

  • Decreases activation of the amygdala and medial-orbito frontal cortex

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36

What 2 medications are used to treat Depression?

  • Selective Serotonin-Reuptake Inhibitors

  • Selective Norepinephrine- reuptake inhibitors

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37

Which sex is more prevalent to anxiety disorders?

Females

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38

Generalized Anxiety Disorder

Excessive anxiety or worry, most days for at least 6 months

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39

What are some symptoms of Generalized Anxiety Disorder?

  • Feeling restless

  • Easily Fatigued

  • Difficulty Concentrating

  • Irritability

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40

What percentage of adults experience GAD in their lifetime?

21%

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Does GAD have high comorbidity?

Yes

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42

Can we use RDOC for Diagnosis?

No

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43

Potential Threat Valence System

Response to Potential Threats

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Which disorder is most prevalent with Potential Threat Valence System?

Generalized Anxiety Disorder

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45

Bed Nucleus of the Stria Terminals

Center of integration for limbic information and valence monitoring

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46

Enhanced BNST activity is correlated with which Disorder?

Generalized Anxiety Disorder

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47

Acute Threat Valence System

Activation of the brain to engage in behaviors that protect you from perceived danger

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48

Which test is used to assess stress levels?

Trier Social Stress Test

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49

Amygdala response is highest with what?

Social Phobia

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50

What is the amygdala’s role in ‘bottom up’?

Detects relevant negative signals in environment

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51

What is the anterior insula’s role in ‘bottom up’?

Interoception (subjective feeling state)

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52

What are the top-down regions for emotion?

  • Anterior cingulate cortex

  • Dorsolateral prefrontal cortex

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53

What is a predictor for a positive psychotherapy outcome?

Pre-frontal cortex and Amygdala connectivity

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54

What are the effects of anxiolytics?

  • Binds to GABA receptors

  • Opens Chloride channels

  • Chloride can enter cell

  • Hyperpolarization of membrane

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55

Principle of Antithesis

Opposite messages signaled by opposite behaviors

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56

Darwins Six Core Emotions

  • Anger

  • Fear

  • Surprise

  • Disgust

  • Happiness

  • Sadness

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Micro-Expressions

Unconsciously displaying a concealed emotion

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Emotional Valence

The extent to which an emotion is negative or positive

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Arousal

Intensity or strength of the emotional state

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Modern Biopsychological View

  • Perception of emotion-inducing stimuli

  • Autonomic and somatic responses to the stimuli

  • Emotional Response

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Sham Rage

Removal of the cortex excited aggression

Lesioning in the hypothalamus led to a diminish in rage

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Control-Question Technique

Physiological response to a target question compared with a response to a control question

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What is the success rate of Control-Question Technique?

80%

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Guilty-Knowledge Technique

Ask a question only the culprit would know the answer to

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What is the success rate of Guilty-Knowledge Technique?

88%

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Fear Conditioning

Pair a neutral stimulus with an aversive stimulus

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How can fear conditioning be blocked?

Lesions in the amygdala

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What is the amygdala’s role in Fear Conditioning?

  • Adding emotional significance to stimulus

  • Projects to brain stem regions that control emotional behavior output.

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What parts of the amygdala are critical in Fear Conditioning?

Lateral and Central Amygdala

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Corticolimbic System

  • PFC suppresses conditioned fears

  • Hippocampus mediates conditioned fear learning by giving context about event to lateral amygdala

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Fear Acquisition

Tone is paired with shock in one environment, but fear/freezing generalizes to a new context

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Fear Extinction

Tone given without shock in both environments and fear response is extinguished

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What is clinical application of Extinction in humans?

Exposure Therapy

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What is the role of the PFC in emotional regulation?

  • Regulates emotional responses

  • Inhibits inappropriate motor responses

  • Regulates attention, thought, and action

  • Error monitoring and reality testing

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75

Which area of the brain is responsible for hormonal responses?

Hypothalamic Pituitary Adrenal Axis

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Which area of the brain is responsible for neural responses?

Sympathetic Nervous System

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What is the hormone released during a hormonal response to stress?

Cortisol

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What hormones are released during a neural response to stress?

Norepinephrine & Epinephrine

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What section of the brain is responsible for the neural and hormonal responses to stress?

Diencephalon

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The Anterior Pituitary Gland

Releases hormones into general circulation and targets other glands and organs

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What are the 2 types of Adrenal Glands?

Cortex & Medulla

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Cortex Adrenal Gland

Secretes cortisol, androgens, and estrogens

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Medulla Adrenal Gland

Secretes norepinephrine and epinephrine

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What are the effects of Cortisol?

  • Increases blood pressure

  • Increases blood sugar level

  • Suppresses immune function & inflammation

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What are the effects of Epinephrine & Norepinephrine?

  • Increase heart rate

  • Increase blood pressure

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86

What is the Hypothalamus responsible for the stress response?

Releasing Corticotropin-relasing hormone

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87

What is the Anterior Pituitary responsible for the stress response?

Stimulates the release of the adrenocorticotropic hormone from the Anterior Pituitary Gland

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What is the Adrenal Gland responsible for the stress response?

Releasing cortisol as a result of the ACTH

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89

When is cortisol at its peak?

Near Awakening

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90

Cortisol Awakening Response

A period of increased cortisol secretory activity initiated by awakening and peaking between 30 and 45 min after awakening

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What is high Cortisol Awakening Response related to?

Job stress and General Life stress

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92

What is low Cortisol Awakening Response related to?

  • Fatigue

  • Burnout

  • Exhaustion

  • PTSD

  • Positive traits

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93

According to Trier Social Stress Test, which gender shows higher levels of cortisol to the test?

Men

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94

What are some examples of Animal Models of Stressors?

  • Cold water restrain stress

  • Predatory Stress

  • Sleep Deprivation

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95

What are the key dimensions of Stressors?

  • Predictability

  • Controllability

  • Duration

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96

What are the 3 stages of Addiction?

  • Binge/Intoxication

  • Withdrawal/Negative Affect

  • Preoccupation/Intoxication

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97

What are the neurological underpinnings of Binge/Intoxication?

Addictive drugs cause sharp increases in dopamine release

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What is the main dopamine system in the brain?

The mesotelencephalic dopamine system

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What are the 2 pathways of the mesotelencephalic dopamine system?

Nigrostriatal & Mesocorticolimbic Pathways

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Drug Self-Administration Paradigm

Rat presses the lever to self-inject drug into brain

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