Brain and Behaviour

• Upon completion of this problem, students will be able to describe the concept and importance of normal parent-child attachment.
• Upon completion of this problem, students will be able to describe the concept of normal and abnormal childhood behaviour.
• Upon completion of this problem, students will be able to describe the stress-diathesis model of depression, under which depression is understood as a natural consequence of sustained stress, marked by disordered vegetative, cognitive and mood functions.
• Upon completion of this problem, students will understand the physical symptoms of panic disorder and contrast the symptoms of anxiety and panic from other conditions or disorders.
• Upon completion of this problem, students will have begun to explore the Mind-Body Interaction.
• Upon completion of this problem, students will be able to describe the fundamentals of the concept of psychosis and will have begun to explore psychotic disorders.
• Upon completion of this problem, students will be able to describe the role and characteristics of a personality disorder and its effect on psychosocial functioning.
• Upon completion of this problem, students should understand the medical and social consequences of alcohol-related disorders including alcohol use disorder, alcohol intoxication, alcohol withdrawal, other alcohol-induced disorders and unspecified alcohol-related disorder (DSM-5), the neurological underpinnings of substance use disorders and the identification and treatment of alcohol withdrawal.
• Identify depression and that depression does not always present as depressed mood, often as irritability and disturbances in vegetative function (sleep, appetite, energy).
• Recognize that depression is not just an emotional, but also cognitive and physiological disorder.
• Recognize that stress is a significant risk factor for developing depression.
• Describe physiological changes in the HPA axis which are common in stress and depression.
• Identify common cognitive distortions common in depression.
• Recognize that sleep hygiene and depression are closely linked, with, for instance, high rates of depression in patients with sleep apnea and vice versa.
• Be able to generalize from the physiology of hyperarousal in depression to that in anxiety disorders, and thereby understand why depression is often the final common pathway for anxiety disorders.
• Explain the physical symptoms of anxiety and panic with reference to sympathetic and parasympathetic nervous system functioning.
• Explain how unusual and uncomfortable physical sensations have adaptive value.
• Distinguish panic disorder from other conditions that may produce similar physical symptoms.
• Describe the influence of perceptions of threat and behavioural responses on the maintenance of panic symptoms.
• Describe the process of interoceptive conditioning.
• Describe the various environmental and physical stimuli that may trigger symptoms at random.
• Review terminology in this area such as psychosomatic, "mind-body", and functional somatic syndromes.
• Discuss the complexity in understanding various models and mechanisms that may account for somatic symptom presentations including the following factors: Stress; Cognitive Factors (somatosensory amplification & attribution of symptoms); Developmental, Personality, Interpersonal Factors; Behavioural Factors (Illness behaviour).
• Explore how one should approach patients with such presentations including a cursory introduction to the role of reassurance, avoiding "it's all in your head" messages, elements of evidence-based treatment approaches such as cognitive-behavioural therapy and "consultation-letter" interventions.
• Explore stress-related medical disease and its psychological and neurochemical mechanisms.
• Describe normal parent-child attachment.
• Identify childhood and parenting factors associated with the development of typical and atypical attachment.
• Describe developmental regression.
• Identify environmental injury risks for very young children.
• Describe assessment of normal and abnormal childhood behaviour.
• Recognize childhood behavioural problems, in particular aggression.
• Describe healthy childhood behavioural development including socialization of aggression.
• Identify childhood and parenting risk factors associated with the development of abnormal childhood behaviour.
• Identify strategies for childhood behavioural assessment.
• Define the concept of psychosis.
• Describe the key features of psychosis.
• Review the types of psychotic disorders and, where known, their causes.
• Describe the role of insight in the understanding of psychotic disorders and their management.
• Recognize the characteristics of a personality disorder.
• Explain the role of childhood factors contributing to the development of a personality disorder.
• Describe how environmental factors can contribute to the development and maintenance of a personality disorder.
• Contrast the symptoms of a personality disorder with those of other psychiatric disorders.
• Explain the difference between alcohol tolerance and withdrawal.
• Identify the medical consequences of alcohol misuse and its varied presentation.
• Explain the neurobiology of the reward system.
• Identify common drugs (prescription and recreational) that can cause delirium.
• Explain the role of the Ontario Mental Health Act to apprehend someone against their will and to treat someone against their will.
• Describe an approach to the management of psychosis.
• Explain how regular cannabis use among youth can increase risk of psychosis.
• Describe the mechanism of action, indications and adverse effects of common anti-depressants, including SSRI, SNRI, TCA.
• Upon completion of this problem, students will be able to describe common presentations and treatments of bipolar disorder and binge eating disorder.
• Compare and contrast major depressive disorder (‘unipolar’ depression) versus bipolar depression.
• Identify the treatments of bipolar disorder for mania and depression, as well as the adverse effects of those treatments.
• Explain the effects of mood stabilizers and antipsychotic medications on metabolic disturbances.
• Explain the symptom dimensions of bipolar depression.
• List the medical complications of bipolar disorder, obesity, and binge eating disorders.
• Describe how the HPA axis is affected by mood disorders and how this impacts obesity and the endocrine system.
• Compare and contrast Cluster A, Cluster B and Cluster C personality disorders.
• Describe how benzodiazepines work to treat anxiety. Describe the clinical effects, and adverse effects of benzodiazepines. Identify the different half-lives for commonly used benzodiazepines.
• Explain the spectrum of “mind-body” somatic symptoms, from mood and anxiety disorders to painful somatic conditions like fibromyalgia.
• Explain the use of naltrexone as an anti-craving therapy for alcohol use disorder.
• Upon completion of this problem, students will analyze how social determinants of health might impact a young person's psychiatric management who is from a Black racialized community. Students will demonstrate sensitivity and responsiveness to a diverse population and explore the impact of intersectionality on mental health. Upon completing this problem, students will explain the symptoms of obsessive-compulsive disorder and discuss treatment approaches to help manage young adults with mild intellectual disability and comorbid obsessive-compulsive disorder in the community.
• Describe challenges related to the transition from youth to adult services for young people with mild intellectual disability.
• Summarize how barriers to accessing social supports and care impact the severity of psychiatric symptoms experienced by young adults with mild intellectual disability.
• Use effective and engaging strategies for interviewing and communicating treatment plans for individuals with a mild intellectual disability.
• Identify strategies to help manage mental health and behavioural crises among people with mild intellectual disability.
• Analyze how race (as a social construct), social support, and access to resources impact people from racialized backgrounds.
• Apply an equity lens and systems framework to conceptualize the social and historical factors contributing to challenges with medication adherence and IQ testing involving people from Black racialized communities.
• Identify the best-evidence pharmacologic and non-pharmacologic treatments for obsessive-compulsive disorder, and recognize important medication adverse effects.