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Lecture 2

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Konstantine Zakzanis

Lecture 2: - The role of Paradigms: A set of basic assumptions a clinician will make. A general perspective that defines how to conceptualize, study a subject, patient, how to gather and interpret data and how to think about the subject. - Ex: psychiatrist  believes in medication alters neurochemistry to alter behaviour (their paradigm= a biological approach) - Ex: Psychotherapist  psychogenic original beliefs to problems - 4 main paradigms: 1. Biological Paradigm:  Medical model  Mental disorders arise due to some neurobiological antecedent  Behavioural genetics: study of individual difference in behaviour that are attributable to differences in genetic makeup. o Some sort of clue if a disease/ illness has a genetic component to it. o Genotype vs. Phenotype  Genotype: inherited and unobservable. Get it from biological parents  Phenotype: Observable behavioural characteristics  product of genotype and environmental factors (ex: anxiety level in person)  A disorder is not inherited genetically. Can have the genetics that leave you pre-disposed to presenting w/ the phenotypes of this disorder (schizophrenia, anxiety, depression) but not inherited.  One disorder that is inherited= Huntington’s disease o Know this b/c we use diff study methods. There are 4 methods: 1) Family Method 2) Twin Method a. Monozygotic twins (MZ Twins) 100% identical twins b. Dizygotic twins (DZ) 00> 50% identical 3) Adoptees method 4) Linkage Analysis Family Method: -If pre-disposition for a mental disorder can be inherited, study of family relationship should show relationship b/w # of shared genes in index case (person w/ disorder) & prevalence of disorder in probands (relatives) st - Ex: individual w. schizophrenia, learned from family method that if you are 1 degree relative, then 10% likelihood more of getting schizophrenia (norm pop 1% chance of getting it) - 1 degree relatives examples  siblings/ parents (10%) Twin Method: - Twin set, both have schizophrenia, known as concordance (similar diagnostically speaking) - Monozygotic twins (if they show a higher concordance level than dizygotic twins, then genetic obviously genetic component plays a role)  strong argument that characteristic is heritable Adoptee Method: - Twins grow up in an environment away from biological family (may rule out environmental factors) ex: if twins have schizophrenic mom and grow up w. adoptive parents and b/come schizo then envio of mom being schizo didn’t play a role. Linkage Analysis: - Look for a large collection of individuals w/in a family unit who might have a disorder (looking for biological or genetic markers) blood samples, urine samples etc. Try to see if anything is common - Neurotransmission & reuptake = key terms o Neurotransmission: molecules that move from 1 neuron to the next= neurotransmitters (transmitters detected that carry messages about pain, pleasure, anxiety etc) o Reuptake refers to process in the brain of neurons trying to retrieve chemicals that were not received by the next neuron.  Structure & function of the human brain  Cortical Brain structure impt higher order cognition (outer structure-frontal lobes, parietal lobes, occipital lobes, temporal lobes)  Sub-cortical lobes  movement (inner structure- hippocampus, pituitary etc).  Frontal Lobes  executive functioning (motor movement, planning, inhabitation, emotion) o Right-frontal lobe when lesioned can give rise to manic episode o Left- depressed like state (apathy) lack of motivation o Right- retrieval (exam time) & speech (broca’s area) o Left- encoding (trying to absorb info entering brain –lec time)  Temporal lobe  language centre o Wernicke’s area (left side) -> comprehension of verbal o Right-side comprehension of non-verbal (train coming…move) o Hippocampus -> consolidates information (Stamps info by solidifying it—allows for later retrieval)  Steps: 1) Encoding 2) Consolodation (hippocampus) -> Alzhimers disease, hippo affected) 3) Retrieval  Ppl w/ sizeures report hallucination (diff types of neuro imaging techniques, see problems with temporal lobes)  Parietal Lobes  touch (visual-spatial) o Left- difficulty understanding movement (ex: person told to brush teeth but combs hair instead) o Right- visual-spatial neglect (ignores left side, ex: plate of food but only eats right side)  Occipital Lobes  vision  Ways to investigate the brain when looking for these types of lesions (neuro-imaging instrumentation) 1) Structural imaging techniques (CT scans or MRI) 2) Functional neuro-imaging techniques (SPECT) & (PET) a. Looks at blood moving through the brain o Best of both worlds = Fmri (Structural functional)  Biological Paradigm approaches to treatment: psychoactive drugs  Anxiolytics  used for anxiety but also for sleep disorders, phobias, and pain disorders o Benzodiazepines  Antipsychotics  schizophrenia, behavioural disorders (severe brain injuries), dementia, pp; w/ degenerative conditions, sometimes also depression  Psycho-stimulants  ADHD, improves cognition, Alzheimers, dementia, cognitive disorders.  Different categories of drugs but psychiatrists use shotgun approach (may use drug b/c known to help w/ disorder or use multiple drugs until
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