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Lecture 4

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University of Toronto Scarborough
Zachariah Campbell

Lecture 4 – Jan. 28 Continuing lecture 3 Environmental/Industrial Sources 800 known substance with neurotoxic effects • Solvents/fuels • Pesticides: this is very prevalent in older generations • Metals Oxygen Deprivation Oxygen is one of the fastest ways to take out the nervous system Types • Anoxia: complete absence of oxygen to the brain • Hypoxia • Anoxemia Causes: COPD, sleep apnea, altitude sickness, trauma, CO poisoning Nutritional Deficiencies Adequate nutrition is necessary for CNS development Deficits during early development present clinically and may be irreversible AN (anorexia nervosa) and BN (bulimia nervosa) – eating disorders can affect cognitive functions by lack of food Geriatric populations are vulnerable to nutritional deficiencies that feature across age- related disorders • Won’t take care to eat nutritional food (early stages of Alzheimer’s) • Diminished income Medications can impact on nutritional intake • Some drugs can affect the metabolic processes of absorbing certain nutrients Seizure Disorders Acquired type • Brain trauma, substance abuse, etc CNS injury or disease • Susceptibility for SD Infection Multiple etiologies/causative agents Examples • HIV (and AIDS) • HSE (Herpes Simplex Encephalitis) – cold sores o People with immune disorders are more affected by this o It hides in the peripheral nervous system, in the ganglions attached to oral. o When people are ill, the virus pops back up o It hides in the spine, essentially. It can climb into the brain and pretty much destroy it Lecture 4: Clinical Issues Ethical Issues Ethical Principles of Psychologists and Code of Conduct (APA, 2002) • Protects the public/users of service • Concerns all forms of contact One of several sources that define and/or legislate appropriate behaviour/action • E.g. local privacy laws Ethical Principles of Psychologists and Code of Conduct (APA, 2002) Preamble General Principles Ethical Standards – is the one that you can be charged with • Resolving ethical issues • Competence • Human relations • Privacy and confidentiality • Advertising and other public statements • Record keeping and fees • Education and training • Research and publication • Assessment • Therapy Ethical Standards and Sanctions Sanctions are imposed by state boards of psychology Each state/provincial board varies regarding interpretation of APA Ethics Code The sanctions vary by the seriousness of the infraction • Minor violations may require education and proof of learning o Inadvertently making an insensitive comment • Next level of severity could lead to restriction of practice o Going above level of competency • Most serious infractions could lead to loss of license to practice o Sexual relationship with clients Renumeration for NP Services Def.: getting paid for engaging the services • In Canada, neuropsychologists are mostly employed by lawyers and insurances Insurance providers (vehicular) Disability Insurance Workman’s Compensation OHIP (limited contexts) Academic/Research Grants Private (by the individual) Demographic/Personal Factors Gender differences Age Ethnicity/Language Premorbid Estimates of Function Social supports Illness/Injury Characteristics Type and Nature of Problem • Tailor evaluation to the specifics of each type of trauma • Obvious impairment may expedite treatment • Referral for comprehensive assessment is
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