The idea of filial imprinting was initially observed in domestic chickens by Douglas Spalding in the 1800s, and later discussed by Heinroth before being made well-known by Lorenz. Additionally, Immelmann discussed sexual imprinting, while Westermarck introduced the concept of reverse sexual imprinting, which suggests that individuals who spend their early years in close proximity are less likely to be sexually attracted to each other later in life.

Across all medical specialties, it is typical for patients to take less than half of their prescribed doses of self-administered medications, indicating low adherence rates that have been shown to be around 50%.

The fear of new things, such as unfamiliar people, can be observed in infants as young as 6 months old. Children between the ages of 3-5 years may develop fears of animals, monsters, and the dark. Around 6-11 years old, children may start to fear social embarrassment. Adolescents may begin to experience fear of death.

Behaviour change theories can be categorized into two main groups: social cognition models and stage models. Stage models involve progression through specific stages, while social cognition models focus on beliefs and attitudes as drivers of behaviour change. Examples of social cognition models include the health belief model, protection motivation theory, and self-efficacy theory.

Cognitive behavioural therapy aims to address specific disorders by challenging negative thought patterns through conscious cognitive processes. Behavioural experiments are conducted with therapist guidance to gather evidence for and against interpretations of experiences. Analytic psychotherapy involves the therapist interpreting the client’s experiences based on joint experiences. Cognitive analytic therapy involves exploring past relationships and identifying repetitive behavioural patterns. Interpersonal theory focuses on problem areas in the client’s life, such as grief of role disputes. Motivational interviewing helps clients identify motivation for change and move through the stages of change.

Harry Harlow conducted controversial experiments with rhesus macaque monkeys and surrogate ‘mothers’ made of inanimate objects, revealing that the infants preferred comfort and warmth over food.
Mary Ainsworth created the Strange Situation classification to categorize infants’ attachment behaviors.
John Bowlby coined the term ‘attachment’ to describe a child’s bond with their mother.
Konrad Lorenz studied imprinting in geese that were hatched in incubators.
Mary Main played a role in the development of the Adult Attachment Interview, which evaluates an individual’s early attachment experiences.

René Spitz coined the term anaclitic depression to describe the negative impact on children who are separated from their primary caregiver, such as during a hospital stay. In extreme cases, this can lead to hospitalism. Although this type of depression can hinder a child’s development, recovery is likely if the separation from the mother does not exceed three months. Ainsworth is known for her work on the strange situation procedure, while Bowlby focused on attachment and maternal deprivation. Main is associated with the adult attachment interview, and Rutter distinguished between privation and deprivation, with the former referring to a failure to form attachments.

Brain Regions and Functions

The brain is a complex organ with various regions that perform different functions. One of the key regions involved in the reward system is the nucleus accumbens (NA). This region receives input from the ventral tegmental area, which uses dopamine as a neurotransmitter. The NA is responsible for processing reward-related information and is often referred to as the pleasure center of the brain.

The limbic cortex, on the other hand, is not part of the reward circuit. It is involved in emotion, memory, and motivation.

Another important gland in the brain is the pituitary gland. This endocrine gland secretes nine hormones that are involved in maintaining homeostasis in the body.

The substantia nigra is part of the basal ganglia and is involved in movement, learning, and addiction. Although it has a role in reward-seeking, it is not considered to be part of the classic reward pathway.

Finally, the tegmentum is a region of the brainstem that contains several cranial nerve nuclei. It is involved in various functions such as movement, sensation, and autonomic control.

The WAIS-III provides results for verbal IQ, performance IQ, and full scale IQ, which are compared to the average scores of the population. The average IQ for adults is 100, with a standard deviation of 15 points. However, the Wisconsin card sorting test, which is used to evaluate frontal lobe impairment, is not included in the WAIS-III.

The health belief model is a social cognition model that aims to predict and understand health-related behaviors. It consists of four main constructs: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Perceived severity refers to an individual’s understanding of the seriousness of a disease. Perceived susceptibility, also known as perceived vulnerability, refers to an individual’s perception of their risk of contracting the disease if they continue with their current behavior. Perceived benefits refer to an individual’s perception of the advantages of adopting a different course of action, including the extent to which it reduces the risk of the disease of its severity. Perceived barriers refer to an individual’s perception of the disadvantages of adopting the recommended action, as well as any obstacles that may hinder its successful implementation.

The reverse-learning theory, which explains how the brain eliminates unnecessary information, was introduced by Crick and Mitchison. Foulkes believed that dreams reflect a person’s current preoccupations, while Freud viewed them as a means of expressing repressed thoughts and desires, famously calling them the royal road to the unconscious. Hobson and McCarley proposed the activation-synthesis theory. Jung was known for his work on dreams and symbolism, and his autobiography was titled Memories, Dreams, Reflections.

Erikson’s psychosocial theory of development includes eight stages of crises, while Freud’s psychosexual theory of development consists of five stages. However, there is some overlap between the two theories. For example, Freud’s phallic stage, which focuses on the development of sexual identity, broadly coincides with Erikson’s ‘initiative versus guilt’ stage, which focuses on the development of a sense of purpose and direction.

Erikson’s stages are as follows: trust vs. mistrust (0-18 months), autonomy vs. doubt (18-36 months), initiative vs. guilt (3-6 years), competence vs. inferiority (6-12 years), identity vs. confusion (12 years to adulthood), intimacy vs. isolation (adulthood), generativity vs. stagnation (middle-age), and integrity vs. despair (maturity).

Freud’s stages are: oral (0-18 months), anal (18-36 months), phallic (3-6 years), latency (6-12 years), and genital (12 years to adulthood).

While there are similarities between the two theories, it is important to note that they approach development from different perspectives and emphasize different aspects of human growth and development.

Within the psychodrama setting, the patient takes on the role of the protagonist and actively delves into their emotional conflict. This therapeutic approach was created by Jakob Moreno and involves the dramatisation of emotional struggles in a group setting. The group leader of therapist, known as the director, plays an active role in guiding the process.

Irvin Yalom identified 11 therapeutic factors that are unique to group therapy, including universality, altruism, instillation of hope, imparting of information, corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, group cohesiveness, existential factors, catharsis, and interpersonal learning. Group therapy has been practiced by various pioneers in the field, such as Bion at the Tavistock Clinic, Foulkes who developed group analysis, Moreno who is associated with psychodrama, and Pratt who was an early advocate of group therapy in the United States.

Assimilation refers to the process in which immigrants adopt the practices and values of their new culture while abandoning their own cultural heritage. Marginalization, on the other hand, occurs when immigrants neither adopt the new culture nor retain their own cultural values, resulting in social exclusion and isolation. These two outcomes are on opposite ends of the spectrum in terms of the degree of adoption and retention of cultural values.

The psychosocial theory of development, as described by Erikson, involves eight stages that continue into adulthood and require the resolution of a crisis at each stage. Bowlby is known for attachment theory and maternal deprivation, while Freud focused on psychosexual development. Kohlberg studied moral development, and Piaget developed the cognitive model of development.

Transitional objects were conceptualized by Winnicott as items that infants between 4-18 months of age select to aid in their separation and individuation process. These objects, such as a soft toy of blanket, serve as a source of comfort and help reduce anxiety. Object relations theory was also supported by Balint and Fairbairn. Meanwhile, Kleinian theory placed significant emphasis on the interpretation of play.

René Spitz’s Study on Anaclitic Depression in Children

René Spitz conducted a study on children who were deprived of their primary caregiver and found that they experienced a type of depression known as anaclitic depression. This type of depression is characterized by a lack of interest in the environment, a decrease in physical activity, and a failure to thrive. Spitz’s study highlights the importance of a primary caregiver in a child’s development and the negative effects of deprivation on their emotional and physical well-being. The study emphasizes the need for children to form secure attachments with their caregivers to promote healthy development.

Traps refer to circular patterns of interaction that create ‘vicious circles’. For instance, when we feel uncertain, we may try to please others, but this can result in others taking advantage of us, which reinforces our uncertainty.

Schwartz et al. identified five types of errors in drug adherence. These include errors of omission, errors of purpose, errors of dosage, errors of timing and sequence, and taking additional medication not prescribed by the doctor. An example of errors of purpose is when a patient takes medication for the wrong reason. Other types of errors include not taking the medication, taking the wrong dosage, and taking medications at the wrong time and sequence.

The recommended treatment for emotionally unstable personality disorder (borderline type) does not involve a single psychological therapy of drug treatment as a first line of defense. However, for women who prioritize reducing self-harm, DBT is recommended. Drug treatments may be considered for comorbid conditions. According to NICE guidelines on Borderline personality disorder (BPD) (CG78), a comprehensive dialectical behaviour therapy programme should be considered for women with borderline personality disorder who prioritize reducing recurrent self-harm. Brief psychological interventions of less than 3 months’ duration should not be used specifically for borderline personality disorder of for the individual symptoms of the disorder. Drug treatment should not be used specifically for borderline personality disorder of for the individual symptoms of behavior associated with the disorder, such as repeated self-harm, marked emotional instability, risk-taking behavior, and transient psychotic symptoms. If sedatives are used for crisis intervention in a patient with EUPD, they should be prescribed for a maximum period of one week.

This individual is currently in the preparation phase of quitting smoking. According to Prochaska et al.’s stages of change model, this means they are currently smoking but have a strong intention to quit within the next 30 days and have been seriously considering quitting for the past six months. The stages of change are a spiral, meaning individuals may move back and forth between stages and even experience relapses. The other stages include precontemplation (not considering quitting within the next six months), contemplation (seriously considering quitting within the next six months but not within the next 30 days), action (currently not smoking and quit within the last six months), and maintenance (currently not smoking and quit more than six months ago).

While Mary Rothbart, Rudolf Steiner, and Jerome Kagan are known for their theories on the stability of personality traits in children, they were not involved in the New York Longitudinal Study conducted in the 1970s. However, Solomon Diamond, who focused on personality and temperament and conducted research on various animal studies, is also associated with this field.

The term ‘schizophrenogenic mother’ was proposed by Fromm-Reichmann, a contemporary of Freud, who believed that defective parenting caused the disorder. However, this concept has since been proven to be unfounded. Lidz later examined the impact of parents’ socialization on a child’s psychological health, further exploring this concept. Bleuler is credited with coining the term ‘schizophrenia’, while Kraepelin had previously described ‘dementia praecox’.

The culture of empowerment in a therapeutic community involves democratisation, which is demonstrated through voting, decision-making, and achieving seniority. This is essential in developing an individual’s sense of agency and ability to carry out meaningful actions. Rapoport’s four principles, which define the work of a therapeutic community, include permissiveness, democracy, reality confrontation, and communalism. These principles are updated by Haigh, with containment corresponding to permissiveness, communication to communalism, involvement to reality confrontation, and agency to democracy. Overall, the therapeutic community aims to provide support, establish rules and boundaries, confront reality, and foster a sense of shared responsibility among its members.

Engrossment refers to the emotional connection that a father develops with his child. This term was coined by Greenberg and Morris in their 1974 study, which explored the impact of newborns on fathers. In contrast, Bowlby used the term ‘attachment’ to describe the bond that develops between a child and their mother. Bonding, on the other hand, refers to the process by which a mother develops a strong emotional connection with her child. Imprinting is a phenomenon observed in some animal species, where newborns acquire certain behavioral characteristics from their parents shortly after birth. Finally, sociability is a crucial aspect of attachment, as it involves the pursuit of social contact and connection with others.

Malan’s research centered on the development of the client’s challenges using two ‘triangles’ – the triangle of person and the triangle of defence.

Bowlby is recognized for his work on attachment theory, while Anna Freud is known for her work on defence mechanisms and object relations.

Sigmund Freud is linked to time-limited psychotherapies, and Ryle created cognitive analytic therapy.

Strategic systemic therapy incorporates reframing and the domino effect. Haley’s approach assumes that symptoms are perpetuated by attempts to suppress them, and reframing involves giving negative emotions of behaviors a positive connotation. The domino effect refers to the improvement of additional problems after resolving an initial issue. Bowen’s family systems approach emphasizes the patient’s ability to maintain their individuality amidst familial tension. The Milan systemic approach uses circular questioning among family members, while Bateson’s paradoxical therapy involves intentionally engaging in undesirable behaviors. Minuchin’s structural model prioritizes the family hierarchy, rules, and boundaries.

Mentalisation therapy is a psychotherapy approach that is particularly helpful for individuals with borderline personality disorder. It is psychodynamically-oriented and focuses on helping individuals develop the ability to mentalise, of understand their own and others’ thoughts, feelings, and intentions. This therapy approach aims to improve interpersonal relationships and reduce impulsive and self-destructive behaviors.

The Drug Attitude Inventory assesses the subjective effects of antipsychotic drugs in patients with schizophrenia. The ASK-20 Adherence Barrier Survey measures barriers to treatment adherence with 20 clinical items. The Brief Evaluation of Medication Influences and Beliefs (BEMIB) Scale is an eight-item Likert-type scale that evaluates the costs and benefits of medication use based on the health belief model. The Medication Adherence Rating Scale (MARS) is a 10-item self-report scale that combines elements of the Drug Attitude Inventory and Medication Adherence Questionnaire for use in patients with schizophrenia and psychosis. The Rating of Medication Influences (ROMI) Scale is a 20-item interviewer-rated scale that assesses adherence attitudes in psychiatric patients, particularly those with schizophrenia, with good inter-rater reliability.