psych 127b

autonomic nervous system (ANS)

- branch of PNS
- two divisions: sympathetic & parasympathetic
- sympathetic: involved in AROUSAL & preparing body for expenditure of energy
- parasympathetic: involved in RELAXING body, often competing w those of sympathetic division

\#HPA axis

- Interaction between the nervous and endocrine systems to produce the body's response to stress - Elevated levels of one of these hormones may lead to depression
- hypothalamus, pituitary & adrenal

\#Benzodiazepines

- drugs that lower anxiety and reduce stress
- GABA is major inhibitory neurotransmitter in brain, including in hypothalamus
- GABA (or a GABA agonist) binds to a sit on GABA-A receptor & makes neuron LESS likely to fire, so HPA axis will be less stimulated

\#sympathetic nervous system

- fight for flight
- involved in arousal & preparing body for expenditure of energy
- NE

\#sympathetic nervous system: fight or flight

- inhibits salivation
- dilates pupil
- inhibits digestion
- stimulates epinephrine
- stimulates sweating
- stimulates glucose release
- speeds up heartbeat

\#parasympathetic nervous system

- rest & digest
- involved in relaxing body, often competing w those of sympathetic nervous system

\#parasympathetic nervous system: rest & digest

- stimulates salivation
- constricts pupil
- slows heartbeat
- stimulates digestion
- constricts airways

\#how might HPA axis go wrong?

- may have hyper reactive HPA axis (for instance, due to early life stress)
- when functioning properly, has an "off" mechanism; those loops might not work
- hypothalamus controlled by balance of excitatory or inhibitory input (glutamate & GABA neurotransmitters) if there isn't enough inhibition, will be overactive

\#Neurotransmitters

chemical messengers that cross the synaptic gaps between neurons

\#panic attack

- intense fear response w/o any reason to be afraid

\#Phenotype

- resulting traits that you can observe
- physical characteristics
- influenced by: genes; environment; gene-environment interactions

\#Gene-evironment interaction

- genes render individual vulnerable to the effects of environment
- genes are only a problem when combined w certain environments

\#things that can change the genes that are passed on

- mutation-selection balance: \# of mutations in humans higher than prev thought (2-3 NEW deleterious coding mutations per person; 500-2000 OLD slight deleterious coding mutations per person)
- epigenetic: environment can change structure & function of genes & whether they're expressed or not

\#genotype

- genetic makeup of an organism
- what we are born with

\#function of genes

- a gene contains info to make a specific protein (each gene codes for just ONE protein)
- code for structural proteins ex muscle, hair
- active proteins ex enzymes

\#phrenology

- idea that you can tell by the lumps on someone's head what that part of the brain under the lump did
- skull is bumpy but not in the same way brain is

\#John Hughlings Jackson

- established "Jacksonian March" - pattern of seizure activity
- distinct pattern of progression follows the way the body is mapped in motor cortex
- seizure activity excites certain part of brain, would impact certain part of body & would happen the same way every single time

\#Broca's Aphasia

- non-fluent, expressive aphasia (can't get words out) - problem in frontal lobe

\#Wernicke's Aphasia

- fluent, receptive aphasia (can produce words, but they don't make sense) - temporal-parietal junction

\#Broadmann's regions

can look @ the microstructure of cortex & use that to divide the brain into specific areas

\#what different implications does the idea of different brain regions having different functions have for our conceptualization of mental illness & how to treat them?

- likely that disorders that have different symptoms, probably have problems in different parts of the brain, that the cognitive problems they're associated w different disorders probably have something to do w the part off the brain disrupted in that disorder
- if you can find out what part of the brain cause symptoms then maybe that would give use pointers on how to treat them

\#nervous system

made up of central nervous system (CNS) & peripheral nervous system (PNS)

\#CNS

- command & control center that governs perception, thoughts, feelings, memories, decisions & behavior
- made up of: brain & spinal cord

\#PNS

- relays sensory info about world to CNS, carries commands from CNS to muscle & organs
- made up of: cranial nerves, spinal nerves & autonomic nervous system (ANS)

\#brain vasculature

- brain has blood supply (like all body organs)
- a stroke is brain damage caused by restriction of blood to brain by a burst or weak blood vessel or by a blockage

\#blood brain barrier (BBB)

- semi-permeable barrier btwn CNS & circulatory system helps regulate flow of nutrient rich fluid into brain
- substance must be actively transported across it

\#meninges

- series of layers btwn brain & skull that protect brain
- made up of: dura mater, arachnoid layer & pia mater
- meningitis: inflammation of meninges, usually caused by bacterial or viral infection

\#cerebrospinal fluid (CSF)

- circulates throughout the brain and spinal cord
- produced by tissue w/in ventricles (~500ml/day)
- CNS floats in this

\#brainstem

- all connections to the rest of the body pass through here (motor, sensory)
- key role in regulation of cardiac, respiratory & skeletal muscle tone & v basic functions like breathing & sleeping

\#case study: Jean-Dominque Bauby

- brainstem stroke lead to "locked-in" syndrome
- could only move eyelids
- wrote a book only by blinking

\#parts of brain in CNS

- cerebellum
- midbrain
- hypothalamus
- thalamus

\#cerebellum

- helps generate smooth, coordinated movement
- integrates visual, motor, vestibular & somatosensory info
- alcohol affects this

\#midbrain

- dopamine system is involved in addictions, schizophrenia & Parkinson's Disease
- region between the hindbrain and the forebrain
- important for hearing and sight

\#thalamus

- "gateway to cortex" or relay station
- all info passes through here

\#limbic system

- hippocampus
- amygdala
- hypothalamus

\#hippocampus

- seahorse
- memory: formation of new memories
- spatial memory & navigation (crating spatial maps of environment to use for navigation)
- very vulnerable: hypoxia & stress

\#amygdala

- almond
- emotion: fear
- emotional memory
- interacton w hippocampus leads to strengthen of emotional memories
- associated w PTSD

\#hypothalamus

- 4 "F's"
- controls hormone release by pituitary gland
- controls \# of diff drives including: sleep, sex, hunger, thirst, sleep/wake cycle

\#Case Study: H.M. (Henry Molaison)

- severe epilepsy
- removed hippocampus, parahippocampus & amygdala
- post op: could not form new declarative memories but could learn new skills

\#basal ganglia

- caudate nucleus
- putamen
- important for action selection & motor control

\#cerebral cortex

- covers brain
- grooves \= sulci (singular - sulcus)
- bumps \= gyri (singular - gyrus)

\#neuroanatomy landmarks

- central sulcus
- lateral fissure
- calcarne fissure

\#parts of the cerebral cortex

- occipital lobe
- frontal lobe
- temporal lobe
- parietal lobe
- cingulate

\#cingulate

motivation, emotion & attention

\#temporal lobe

hearing, taste, smell & memory

\#parietal lobe

motor control, planning, decision making & regulation

\#occipital lobe

vision

\#frontal lobe

somatosensation (touch) & spacial cognition

\#neurons and glial cells

- two types of cells in the nervous system
- neurons are cellular computers that process info in the brain
- glial cells don't directly participate in signal processing but perform vital support functions for neurons
- 90% of cells in brain are glial cells

\#the neuron

- soma: cell body
- dendrites: branches that receive messages from other neurons
- axon: trunk of neuron that sends messages to other neurons
- axon terminals: buds @ end of axon from which chemical messages are sent
- synapses: small gaps that separate neurons
- operate electrically but communicate chemically w neurotransmitters

\#white matter

- consist of fibers that carry info btwn one brain region & another
- contain lots of myelin

\#gray matter

- consists of neurons & synapses
- consists of little myelin

\#corpus callosum

- made entirely of white matter
- large bundle of fibers connecting the two hemispheres

\#neurotransmitters

- chemical messengers that cross the synaptic gaps between neurons

\#Main types of neurotransmitters

- Serotonin (5-HT): relevant for depressive disorder
- Glutamate: main EXCITATORY neurotransmitter
- Gamma aminobutyric acid (GABA): main INHIBITORY neurotransmitter
- Norepinephrine: relevant for anxiety
- Dopamine: relevant for substance abuse & schizophrenia

\#chemicals that can affect neurotransmitters

- agonists: drugs that facilitate the effects of a particular neurotransmitter on postsynaptic cell
- antagonists: drug that OPPOSES or inhibits effects of a particular neurotransmitter on postsynaptic cell

\#fear

the emotional response to real or perceived imminent threat

\#anxiety

anticipation of future threat

\#anxiety

- not necessarily bad
- helps prepare us to meet challenge posed by threats
- varies in severity: mild uneasiness to extreme distress
- varies in frequency: occasional to constant

\#what happens when you're anxious?

- pay attention to: danger, threat; in absence of "real" threat, pay attention to neg aspects of environment
- feel: heart racing, sweating, tense, nauseated

\#autonomic nervous system (ANS)

\#three main approaches to abnormal psych

- supernatural
- biological
- psychological

\#supernatural

- deviance \= battle of "good v evil"
- source of illness \= devil, witchcraft
- how to treat people? trepanation (drill hole in skull to let demon out); exorcism; blame behavior on witches, lead to Salem Witch Trials

\#biological

- search for physical cause & physical treatment
- Galen: normal functioning related to 4 bodily fluids (aka humors) (blood, black bile, yellow bile & phlegm) related to heat, dryness, moisture, and cold; disease \= too much or too little of one of the humors; treatment \= regulating environment, bleeding, induced vomiting
- Hippocrates: father of Western medicine; etiology \= physical disease: breath pathology; head trauma; genetics; psychosocial factors: stress, family
- syphilis: early example that changed thinking; STD caused by bacteria; in late stages neurosyphilis can present w psychosis-like symptoms: delusions, hallucinations, resulted in death; Louis Pasteur's germ theory developed
- understanding illness as medical disorder lead to practice of hospitalization

\#psychological

- reflects change towards mental illness as having an environmental, social & interpersonal context
- two new psychological approaches emerged: psychoanalysis (Freud) & behaviorism (Pavlov: CC & Skinner: OC)

\#what is abnormal psychology?

- the branch of psychology that studies unusual patterns of behavior, emotion and thought
- deals with behavior in a clinical context

\#integrative approach to abnormal psychology

- defining & studying psychopathology requires broad approach
- multiple, interactive influences: biological, psychological & social factors
- scientific emphasis: neuroscience; cognitive, behavioral sciences

\#what is a psychological disorder?

- disturbances in cognition, emotion, regulation or behavior: reflects psychological, developmental or biological dysfunction
-unexpected in cultural context, outside cultural norms
- personal distress and/or substantial impairment in functioning: problem w job, relationships, daily routine
- socially deviant behavior (ex. political, sexual) & conflicts btwn individuals & society are not mental disorders unless it results in individual dysfunction

\#psychological dysfunction

- breakdowns in different kinds of behavior: cognitive (how we think); behavior (what we do); emotional (how we feel)

\#cultural context

- response is not typical or culturally expected

\#DSM-5: Cultural Considerations

- diagnostic criteria updated to reflect cross-cultural variations in clinical presentations
- glossary of cultural concepts of distress ("cultural syndromes" aka "cultural-bound syndromes" or "cultural idioms of distress;" "cultural explanations of distress")
- cultural difference btwn clinician & client may lead to both OVER diagnosis & UNDER diagnosis of psychopathology

\#distress & impairment in functioning

- individuals v others: if it doesn't bother you then it's not distress; society forgives eccentricity if a person doesn't have impairment ex mathematical genius)
- appropriateness to situation ex death of loved one
- suffering & distress are absent from some disorders; may be still be impairment w/o distress ex mania
- degree of impairment: are symptoms interfering w work or school?

\#models of approach

- one-dimensional
- multidimensional

\#models of approach: one-dimensional

- single cause, operating in isolation
- linear cause model

\#models of approach: multidimensional

- several independent factors contribute to onset of a disorder
- causes can't be considered out of context or isolation

\#categorial v dimensional approaches

- many med disorders are considered to be @ extreme end of a continuum ex obesity, hypertension
- a categorial divison is imposed @ point @ which it seems useful to initiate treatment
- idea of a dimension is clinically useful in that it stops us from having futile arguments about whether or not someone has a disorder or is normal
- CATEGORICAL: individuals w 4 or more symptoms receive diagnosis of "GAD"
- DIMENSIONAL: everyone has GAD on some part of curve

\#continuums w/in & between diagnoses

- we have a continuum or spectrum of symptom severity w/in a diagnosis
- can have a continuum or spectrum of symptoms ACROSS diagnoses, like mood symptoms that exist across disorders in varying degrees of severity

\#assessing psychological disorders

- purposes of clinical assessment to: understand the individual, predict behavior, plan treatment, evaluate treatment plan
- analogous to a funnel: starts broad, multidimensional in approach, narrow to specific problem areas

\#Key Concepts in Assessment

- reliability
- validity
- standardization

\#Key Concepts in Assessment: reliability

- degree to which a measurement is consistent
- "agreement"
- several types: test-retest (measure is consistent over time): only useful when testing constructs that don't change over time; inter-rater (agreement across two or more raters)

\#Key Concepts in Assessment: validity

- does the test measure what it's supposed to be measuring?

\#Key Concepts in Assessment: standardization

- how easily able are you to do things consistently across different measurements

\#psychological assessment

- mental status exam
- clinical interview
- questionnaires
- IQ testing

\#psychological assessment: mental status exam

- big picture
- gives basic idea of overall picture of patient including issues that may or not seem as important to patient or clinician

\#psychological assessment: clinical interview

- structured/unstructured (SCID)
- structured clinical interviews for DSM-V
- go methodically through diagnostic criterial for all major illnesses (takes 1-2 hours)
- what is good about this approach? standardized & reliable

\#psychological assessment: questionnaires

- individual can fill out @ home, online or in waiting room
- pros/cons in terms of reliability/validity/standardization: easy & feels private, ppl could be more honest or not so honest, using knowledge base of person filling out questionnaire, standardized to degree everyone is getting same Qs

\#psychological assessment: IQ testing

- overall
- INTELLIGENCE TESTS: originally developed as a measure of degree to which children's performance diverged form others in their grade
- DEVIATION IQ: compare a person's scores against those of other ppl same age
- verbal & performance domains

\#psychological testing & neuropathology: what do neuropsychological tests assess?

- broad base of skills & abilities
- brain-behavior relations
- assets & deficits
- assess things like: memory, attention, planning abilities, impulsivity, intellectual ability

\#why care about neurophysical functioning when studying psychopathology?

- let you see exactly where there might be some trouble

\#neuropsychological testing

- very standardized sets of tests
- way in which we can consistently measure things like: memory, attention, impulsivity, etc.
- POTENTIAL PROBLEMS: false positives (shows a prob where there is none) & false negatives (fails to detect a prob that is present)

\#key concepts in research

- hypothesis
- dependent v independent
- control group
- randomization

\#different research approaches

- questionnaire-based studies
- cognitive studies
- neuroimaging
- animal models
- genetic research techniques

\#neuroimaging

- two objectives: understand brain structure & brain function

\#neuroimaging: brain structure

- CAT/CT scans: X-rays of brain structure, pics in slices from different angles
- MRI: uses magnetic fields & radio waves to construct 3D structural images (better resolution than CT); can look @ volumes of specific brain regions; can locate tumors, injuries, structural abnormalities

\#neuroimaging: brain function

- PET: injection of radioactive isotopes; can give you sense of the \# of receptors/amount of neurotransmitters in various brain regions
- fMRI: brief changes in brain activity; can measure acitivy while performing a cognitive task (ex games, stress, social tasks)

\#animal models

- critical component of research
- GENETIC MODELS: knock out mice allow study of specific genes, in isolation, to understand how they may contribute to mental illness
- studies of neurotransmitter functions provides info about cellular mechanisms needed to understand how to create new meds
- BEHAVIORAL MODELS: human beings are v complex, w incalculable influences from environment accumulated over a lifetime that make isolating specific effects difficult or impossible
- DEVELOPMENT: human beings take decades to develop, making it v difficult to study, while animals develop over much shorter time periods

\#genetic research techniques

- want to try to look @ people w different amounts of genetic relatedness to see effects of genes (adoption/family/twin studies)
- other methods can identify genetic variations involved in disorder

\#correlational v experimental studies

- correlational: all participants complete same measures
- experimental: all participants randomly assigned

\#important issues in research

- informed consent
- replication

\#informed consent

an ethical principle that research participants be told enough to enable them to choose whether they wish to participate