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 and explore systemic factors that influence diagnosis and treatment.
• 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, and begin to differentiate common behavioural disorders in childhood.
• Describe healthy childhood behavioural development including socialization of aggression.
• Describe the impact of parenting, family structure, and early childhood experiences on emotional regulation and aggression modulation.
• 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.
• Recognize the role of systemic bias in behavioural disorder diagnoses, particularly how racialized children are more likely to be diagnosed with disruptive behaviour disorders, and how this affects access to care and long-term outcomes.