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.

Frontal lobe pathology can result in the elicitation of frontal release signs, such as palmomental reflexes. Ataxia may be present in conditions like normal pressure hydrocephalus, while cogwheel rigidity is commonly found in extrapyramidal syndromes. Contralateral hemisphere dysfunction can lead to postural arm drift. These signs occur when the frontal lobe’s normal inhibition of these responses is released. For more information, see Kipps and Hodges’ article Cognitive assessment for clinicians.

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.

Developmental Psychologists and Their Contributions

Mary Ainsworth, a developmental psychologist, discovered that the interaction between a mother and her baby during the attachment years is crucial in the development of the baby’s behaviour. She identified four types of attachments: secure, anxious-resistant, anxious-avoidant, and disorganised.

John Bowlby, a British psychoanalyst, studied infant attachment and separation and emphasised the importance of mother-child attachment in human interaction and later development.

Harry Harlow, an American psychologist, demonstrated the emotional and behavioural effects of isolating monkeys and preventing them from forming attachments from birth.

Donald Winnicott, an English paediatrician and psychoanalyst, developed the object relations theory, which focuses on the relationship between an infant and their primary caregiver.

BF Skinner developed the theory of learning and behaviour known as operant conditioning, which emphasises the role of reinforcement and punishment in shaping behaviour.

Fortnightly injections are required for Risperidone depot antipsychotic. Flupenthixol decanoate injections can be given every two to four weeks. Fluphenazine decanoate injections can be given every 14-35 days. Olanzapine embonate and paliperidone injections are given every four weeks.

Chomsky is known for his nativist theory and introduction of the language acquisition device (LAD) in the 1960s. Empiricism theory is often attributed to Locke, while parsing was described by Saffran. Skinner is associated with behaviourism, and Werker studied how infants distinguish between phonemes.

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.

The Henderson hospital model exemplifies the four principles that underlie the therapeutic community, which include communalism, permissiveness, democratisation, and reality confrontation. These principles are reflected in the way staff and inmates interact, with a focus on mutual support and learning, tolerance of unpredictable behavior, shared decision-making, and open and honest communication about distortions from reality.

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.

Family therapy has been shaped by various influential figures, each with their own unique approach. Salvador Minuchin is known for his structural model, which emphasizes the importance of family hierarchy, rules, and boundaries. Gregory Bateson, on the other hand, is associated with paradoxical therapy. Murray Bowen is linked to the family systems approach, while Jay Haley is known for his strategic systemic therapy. Finally, the Milan systemic approach is associated with Mara Selvini Palazzoli. Each of these figures has contributed to the development of family therapy, and their approaches continue to be used and adapted by therapists today.

It is estimated that around 10% of individuals diagnosed with borderline personality disorder will ultimately take their own lives. While there may be some variation in the findings of different studies, this figure is widely accepted as the general rate of completed suicide among this population over an extended period of time.

Delayed language development is often linked to various factors, such as being male, belonging to a larger family, coming from a lower social class (IV and V), and experiencing neglect.

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.

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.

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.

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.

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.

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.

The therapy being discussed is dialectical behaviour therapy (DBT), which was created by Marsha Linehan, who had a personality disorder diagnosis and multiple hospital admissions. DBT involves mindfulness practice and the development of interpersonal skills through individual and group therapy sessions. All of the therapies mentioned are recognized treatments for personality disorders. Cognitive analytic therapy focuses on past relationships and object relations, while mentalisation-based therapy aims to improve mentalisation capacity through individual and group therapy. Schema-focused therapy builds on CBT to challenge cognitive coping strategies, and transference-focused therapy uses the therapist-client relationship to assess internal representations of past relational experiences.

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.

The concept of ‘goodness of fit’ was introduced by Thomas and Chess, which refers to the interdependent relationship between a child’s temperament and their environment that impacts their development. The strange situation procedure is linked to Ainsworth, while Bowlby is known for his research on attachment and maternal deprivation. Main is recognized for developing the adult attachment interview. Winnicott coined the term ‘good-enough mother’.

The Millon Clinical Multiaxial Inventory-III (MCMI-III) is a self-report questionnaire that can be utilized to evaluate personality disorders. It is designed to provide information on a patient’s personality traits, clinical syndromes, and overall psychological functioning.

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computer-based cognitive assessment system that measures various cognitive functions such as attention, memory, and executive function. It is commonly used in research and clinical settings to assess cognitive impairment in patients with neurological disorders.

The Hayling-Brixton tests are neuropsychological tests that evaluate executive function, specifically response inhibition and initiation. These tests are often used to assess patients with brain injuries of neurological disorders.

The Luria-Nebraska Battery is a comprehensive neuropsychological battery that assesses various functions such as motor skills, memory, rhythm, reading, and writing. It is commonly used to evaluate patients with brain injuries of neurological disorders.

The Stanford-Binet test is an intelligence test that measures cognitive abilities such as verbal and nonverbal reasoning, spatial perception, and quantitative reasoning. It is commonly used in educational and clinical settings to assess intellectual functioning.

For further reading on these assessments, additional information can be found through Pearson, the publisher of the MCMI-III.

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.

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.

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.

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.

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.

While adherence, compliance, and capacitance all refer to how well a patient follows a doctor’s instructions, they do not have the same meaning as concordance, which specifically refers to the agreement between patient and doctor on a treatment plan.

The recommended treatment options for obsessive-compulsive disorder and body dysmorphic disorder, according to NICE guidelines, include the use of selective serotonin reuptake inhibitors (SSRIs) of cognitive behavioural therapy (CBT), of a combination of both. Other therapies such as cognitive analytical therapy, interpersonal therapy, and psychodynamic psychotherapy have not been found to have sufficient evidence to support their use in managing OCD. Additionally, referral to an anxiety management group would not provide targeted treatment for OCD.