Learning & behavior

Ayman Alfrookh MD., MPH., PD

Conditioning
Classical pavlov .stimulation generalize Stim Extinction chemo at home Operant ( instrumental ) reinforcement of old behavior with a new stim. +ve or ve reinforcement both lead to increase in response frequency or strength Punishment like -ve conditioning aversive comes back later aggressive behavior

conditioning
Continous Fast learning..fast extinction Intermittent reinforcement..slower learning! e.g tantrum Fixed interval schedual Variable interval fixed or variable ratio Variable ratio Reinforcement no extinction

Personality
Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, and schizophrenia. Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation. Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

Defense mechanism
1. narcessistic: Projection, denial, splitting 2.Immature: Blocking, Regression, somitization..extreme is somatoform disorder according to DSM IV, introjection 3. Anxiety defense: displacement, repression, isolation of affect, inellectulization, rationalize,

Defense
Reaction formation to opposite impulse Undoing.. Acting out the reverse of un acceptable behavior fixes it e.g buying flowers by adultrous to spouse! Passive aggressive unaware of behavior Dissociation.. Separate self from one s experience extreme..fuge, amnesia, MPD.etc Transference Vs. Countertransference

Personality & Disorder

Mature: Humor, sublimation, alturisim & supression Personility: A paranoid has hallucination & delusions, schizoid, scchizotypal odd think look!, B Histrionic attention seductive Narcissitic..self importance grandiose! Borderline Antisocial

Personality
Cluster C Avoidant..sensetive to rejection..same job classic Obsessive compulsive .. Perfectionist, inflexible..no change stubborn! Dependent can t care of self subordinate..momy boy

Orga.nic Dis
Tourette S. Motor & vocal tics not OCD nor ADHD ttt haloperidol, clonidine Delerium: acute, less cognition & reversible Dementia:less cognition & sociality only 15 % reversible e.g Vascular, HIV, pick s Huntingtons

Psych Health & testing

Type A ( coronary prone behavior pattern ) More CAD 2 folds even after control of risk factors After 1st attack ..survive ..less chance of 2nd Vs Type B Struggle More things , short time Competitive , deadlines, more job person How people deal with hostility is key factor!

Stress
Holmes & Rache scales..higher scale people more ill in next 6 months 1. death of a spouse, divorce , fired also +ve things..marraige, holidays 2. Belief more than social support F > M in use of support 3. Widows M& F higher rates of heart attack Key is hypoth-pit- adrenal axis

IQ
70% inherited.. Most from mother, more in talkative communities, play! X is 100 st. dev 15 MA/CA x 100 IQ is not related to suicide Autism < 70 IQ no decrease with age verbal holds up best, perception & ,motor decrease WAIS, WISC kids, WPPSI, Stanford-Binet scale most used now 2-6 impaired & bright

Personality tests
Objective tests MMPI USMLE Projective test Roscharch ink blot TAT them aperc. Test Sentence completion test Projective drawings

Neuropsych tests
Halsted-Reitan localize brain dysfunction Luria Nebraska level of impairment & dysfunction Bender Gestalt .. Motor, visual Weschler mem. scale

Develop.
.social smile .. Birth to face 8 wks to mother more Hand & feet first reach adult size Grasp Vs release/ palm up Vs down/ proximal Vs distal/ ulnar Vs radial progression Circle 3/ + 4/ Square 5/Traingle 6/ Diamond 7 1st word 10 mo/ 1st step 13 mo/ Early memo 2-4 yrs

follow
Sep. anxiety 8-12 .. Gone 2 yrs Stranger anxiety 6 mo gone 12 mo interaction lead to school phobia ttt parents Interaction rather school activity Tanner stages ( pubic hair ) 10 no hair, 11 small downy, 12 coarse & curly, 13 adult like but no thighs, > 14 extend to thighs - Imprinting:

Miscellaneous
Greif; Anorexia Bulemia Sleep: REM : sex, visual, pons ., NREM ( 1,2, ( 3,4 delta ..duaration 60% inherited ) first half of night People spend more in stage 2 least in stage 1 Sleep latency insomnia have long sleep latency REM latency 90 min Narcolepsy, catalepsy