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Multiple Choice Questions 1. Obesity 69% males and 60% are overweight Linked to hypertension, type 2 diabetes, hyperinsulinemia, dyslipidaemia, atherosclerosis, cancer There is an increased risk of death by 30% with BMI over 30 Due to an obesogenic environment (urbanisation, mechanisation and high energy foods) 36% of adult’s participants in sport once a week for 30 minutes Genes only explain 6-7%, but familial effects (10% increase risk of child obesity) Shift workers (20%) – affects biological rhythm, partial sleep deprivation (inc calories) Recommend a reduction in fat/sugar and increase exercise Drug treatments for high BMIs Behavioural – avoid maladaptive behaviours, encourage exercise, goal-setting Cognitive – challenge aversive thoughts After intervention ends people regain 1/3 of their weight Government interventions – Regulating adverts, prohibiting unhealthy foods in schools, taxing unhealthy food Counterproductive – ‘fat shaming’, motivating change is stressful Discrimination – 3 types (direct, environmental, indirect), talk of refusing treatment Microaggressions – “you look good have you lost weight?” Implications – 2-3 times more likely to attempt suicide, lows self-esteem 2. Hypersexuality 7.6% of American males had TSO more than 7 a week (1948) 12.1% of men had a monthly TSO of 17.4 and 6.8% females of 13 (2006) Men are more likely to have started sexual behaviours at an earlier age, separated from their parents, less satisfied with sex life and have a higher risk of STIS Women were similar but also reported more history of sexual abuse Comorbidity with smoking, drinking, drug use and gambling Diagnosis – 6 months, recurrent, intense, interferes, response to dysphoric mood/stressful life events, unsuccessful efforts to control or disregarding risk of harm Not due to effect of exogenous substance e.g. drugs

48%/51% pornography dependence 34%/56% compulsive masturbation Biological causes – frontal lobe damage, drugs that increase dopamine Developmental causes – weak parental attachment, insecure attachment Associated with mood disorders (71%), anxiety (96%), substance abuse (71%), impulsive control disorder (38%) Not included in the DSM-5 but is a section on sexual dysfunction For DSM – causes harm, offers hope, leads to more knowledge/treatment Against DSM – comorbidity, justification for sexual crimes, label normative behaviour Gender differences – 80:20 split Addictions have 6 components – Salience, mood modification, tolerance, withdrawal symptoms (98%), conflict, relapse Behavioural identifiers – dot probe test Treatment – CBT, relapse prevention, treating comorbidity 3. Ageing and Dementia (2015) life expectancy of 81 Fourth age – loss of autonomy, poor health, frail, exclusion Younger skills – being creative, older skills – understanding others’ views 47 million have dementia, 850,000 in the UK 1/3 is preventable by lifestyle changes DSM-5 – not dementia but major neurocognitive disorders 80% of dementias are in people 75+ - 35% due to old age Genetic cause – ApoE (7%) Psycho-social approaches – safe, raise awareness, supportive INTERDEM Manifesto – promote psycho-social research Engage – technology, graffiti 4. Depression Mood disorders – bipolar, depressive 25% common

4 types – MDD (most serious), Persistent depressive disorder (low mood, less severe), premenstrual dysphoric disorder (the week before menses), disruptive mood dysregulation disorder (severe temper outbursts) Types of MDD – episodic, recurrent, subclinical depression (for 10 days) MDD - Diagnosis – DSM-5 – Anhedonia (every day for 2 week) and 4 more common symptoms Persistent depressive disorder – at least 2 years and 2 other symptoms, do not clear for more than 2 months at a time, bipolar disorders are not present Premenstrual dysphoric disorder – 5 common symptoms for most cycles Disruptive mood dysregulation – 3x a week, negative mood between outbursts, for 1 year, onset before age 10, does not co-exist with adhd/bipolar 16% MDD (USA), 1.5% (Taiwan) Twice as common in women, 3 times as common in poverty Shorter distance from equator (longer days) and higher fish consumptions = low MDD Co-morbidity – 2/3 meet criteria for anxiety disorder Neurobiological causes – 90% bipolar, 37% MDD genetic, DRD4.2 gene – dopamine, low levels of norepinephrine, dopamine and serotonin, sensitive post-synaptic receptors Hormones – overactivity of HPA axis (adrenaline) triggers the release of cortisol = depression Life events – 42-67% depression onset due to stressful life events, lack of support, high levels of expressed emotion by family members causes relapse, cycle of depression Vulnerability – social support, neuroticism and cognitive theories (hopelessness theory, Beck’s theory, rumination theory Psychological treatment – IPT, cognitive therapy, mindfulness, behavioural activation therapy, behavioural couple’s therapy Biological treatment – MAO inhibitor antidepressants, Tricyclic antidepressants, SSRIs, ECT 5. Stress Acute stress, episodic stress, chronic stress Causes – Technology, social media, politics, terrorism, economy, lifestyles changes Disabilities report average stress level 5.5 and without a disability 4.8 LGBT report average stress level 6 non-LGBT is 5 Impacts – muscular, stomach/gut/bowel, blood pressure, heart attacks, death, chronic headaches, depression, harder to recover from sickness Interventions – “positive affect” (happiness, content) association with CHD, dropped by 22%

Identify cause, develop relationships, walk away when angry, rest your mind, get help 6. Cyberbullying Examples – inappropriate images/videos, viruses, abusive texts, threatening phone calls, comments on social network Cyberbullying is invisible/anonymous, reaches a wider audience, involved more people, 24 hours a day, victims are less likely to report it Impacts – Anxiety, lower self-confidence, lower trust, depression, lower school attendance. Long term (experienced mental health effects 40 years later / consequences for health, job prospects and relationships) Smith – more likely to become cyberbullies Hinduja – picture/video clips have a greater impact than words Cyberstalking/cyber-harassment – to control, intimidate or influence This is easier to carry out than in real-life, difficult to prevent 41.6% goes unreported (fear of escalation) Psychological explanations – anonymous, low risk of being identifies (media-based), lifting moral and social constraints (deindividuation), sadism/psychopathic/narcissm (personality) 7. Neuroscience Cognitive neuroscience – replied upon cognitive modularity and anatomical modularity TMS – Transcranial magnetic stimulation – weak electrical induces temporary localised depolarisation (activation) or hyperpolarisation (deactivation) of neurons in the brain Brain imaging techniques – fMRI, dead fish study – found activation in the spinal cord EEG – recording of electrical activity, multiple trials produces an average response to the stimulus (event related potentials) – less sensitive for deep structures MEG – synaptic activity produces a small magnetic field – ERFs Allure of neuroscience – 2 groups given slightly different information on an effect, rate how satisfying you found this explanation -3 to +3 – either had neuroscience or no neuroscience Neuroscience was found more satisfactory – sounds more scientific Allure of neuroscience in the jury decision making – guilty verdicts from fMRI Recent studies – no difference in judgments Phrenology – pseudo-science involving head measurements, biological basis for understanding the mind

Lombroso argued criminality was inherited Psychopathy – 11% less prefrontal brain volume Epiphenomenal activation – some activation in different locations will indirectly occur (because of association, not because that part of the brain is being used) Evaluation – small sample sizes, expensive, low replication rate Assisting CBT – exposed to negative stimuli, could see in real time the most effective strategies (anterior cingulate cortex activation) 8. Replication crisis Conceptual replication – confirm the theoretical idea and under what condition they will occur. Insight to how generalisable the findings are 1500 scientists – 70% failed to reproduce another scientist’s experiment, 50% failed to replicate their own 1/3 of studies are replicated – most common in social psychology 1.6% were replications in the top 100 psychology journals Discourage replication attempts – Time consuming, take away energy and resources from their own projects/original thinking, harder to publish as not viewed original, bring less recognition, reward and career security Why can you not achieve replication? Faking of results, small sample sizes, poorly conducted replication study, questionable research practices Questionable research practices – selective reporting, optional stopping, p-value rounding, nonpublication of data, manipulation of outliers 2000 psychologists admitted to using one QRP Solutions – original authors should be involved (methods are often to vague, higher success rate 91% compared to 64%), journals description should be submitted prior to undertaking the study, reviewed whether they followed protocols, promote replication attempts, students encouraged to replicate studies, reduce pressure from journals, larger sample sizes 9. Anxiety Apprehension about a future threat Physiological reaction – sympathetic nervous system Have a survival purpose – flight or flight, increase preparedness The most common psychiatric disorder 30% of people report symptoms, the most common category is phobias Specific phobias, social anxiety disorder, panic disorder, agoraphobia, generalised

Criteria – interferes with functioning, causes distress, not caused by drugs or another mental condition, symptoms persist for 6 months or more (1 month for panic disorder) Diagnosis for phobias – disruptive, disproportional, causes distress/avoidance, persist for at least 6 months, is endured with intense anxiety Diagnosis of social anxiety – persistent, avoidance, embarrassed, 1/3 are also diagnosed with avoidant personality disorder, persist for at least 6 months Diagnosis of panic disorder – recurrent, unexpected panic attacks, 1/4 will experience a panic attack Diagnosis of agoraphobia – anxiety about inability to flee anxiety-provoking situations, in DSM-4 it was a subtype of panic disorder (reclassification was done as only half of agoraphobics did not suffer panic attacks), disproportionate fear of at least 2 situations, avoidance, persist for at least 6 months Diagnosis of generalised anxiety disorder – uncontrollable worry, restlessness, poor concentration, tiring easily, irritability and muscle tension, for at least 50% of days about at least two life domains, finds it hard to cope with the worry, worries sustained for at least 3 months, avoidance Comorbidity – 50% of those with one subtype meet criteria for another, 75% meet criteria for another psychological disorder, 60% also have depression Women are twice as likely (more likely to report symptoms, men are encouraged to face their fears, women are more likely to experience childhood sexual abuse, women show more physiological stress reactivity), Japan there is a strong fear of offending or embarrassing others Risk factors – conditioning, genes (20-40% for all phobias, 50% for panic), decreased GABA and serotonin (over-activity in the amygdala, PFC deficits), behavioural inhibition (distressed, crying), neuroticism (linked to anxiety and depression) and cognitive factors (lack of control, attention to threat) Treatment – Systematic desensitisation (70-90%) 10. Sex Offenders More likely to commit at least one sexual reoffence More likely to commit at least one child image reoffence Sexual offences act 2003 – prove absence of consent – rape, assault by penetration, sexual assault, causing a person to engage in sexual activity (act intentionally) Rape/assault by penetration/sexual assault/causing a person to engage in sexual activity - of a child under 13 Children under 18 having sexual relations with persons in a position of trust Children under 18 having relations with family members over 18

Mental disorder/threatened/deceived/with care workers Categorised by age of offender, age of victim, gender, physic vs cyber offences Compensatory/sadistic/power or control/opportunistic Rapists all have a negative view of women, condone violence, hyper identification with masculine role, low self-esteem, high prevalence of substance abuse, anger management problem Child molesters – extent they are fixated with children, social competence, amount of contact with children, meaning of contacts, force used. All have poor social skills, frustration with adult relationships, potency problems, low self-esteem, feelings of worthlessness, sense of humiliation and loneliness Female offenders are less likely to use force, more likely to commit the offence with others, less likely to offend prior to adulthood Juvenile sex offenders are characterised by their first offence, age of the victims, offence continuity after adolescence, invasiveness. 90% are male, 60% penetrated the victim, history of non-sexual offenses, problems with impulse control, high prevalence of disabilities/mental illness, deviant sexual arousal patterns Cyber sex offences – pornographic images of children, sending children pornographic images, luring children online. Characterised by actions, frequency and age of victim. Benefits of typologies – useful in investigation, useful as assessment of treatment tool Problems with typologies – not mutually exclusive, not all offenders fit into a category, better to use a continuum 11. Psychopathy Laypersons perceptions of psychopathy – all are violent, they are psychotic, cold/remorseless/manipulative, born not made, cannot be treated Ted Bundy case – confessed to murdering 30 women, abducted them, necrophile, decapitated at least 12 victims, studies psychology, executed in 1989 Contradictions in defining – e.g. impulsive yet calculating, aggressive yet unemotional DSM-5 – ‘anti-social personality disorder’ 0.2-3.3% prevalence Defining ASPD – pervasive, disregard/violation of rights of others, failure to conform to social norms, deceitfulness, impulsive, irritability/aggressiveness, disregard for safety, consistent irresponsibility, lack of remorse. Must be 18 years or older. There is evidence of conduct disorder with onset before aged 15. Not during schizophrenia or bipolar. Dark triad – Psychopathy, Machiavellianism, Narcissism. It is linked to cheating, soft drug use, no considering future consequences and high desire for power

Measuring psychopathy – Psychopathy Checklist-Revised (PCL-R) includes 20 statements 0-2. A score of 30+ means a diagnosis. Measures interpersonal affective domain and antisocial domain – by Hare Twin study – (psychopathic personality inventory) fearless dominance and impulsive Antisociality were strongly correlated in MZ twins Amygdala, orbitofrontal cortex, anterior and posterior cingulate cortex, limbic structures 7.7% male prison inmates have PCL-R more than 30 Sentence under mental health act 1983/2007 Successful – perform better on tests of frontal lobe, linked to careerism, 1 in 10 managers, senior positions, communication, charisma and presentation skills Lack of empathy, risk-taking, aggression and superficial charm, single-minded, selfish and driven, positive attitudes to performance enhancing drugs (predictor of doping) Psychopathy and Machiavellianism is linked to doping attitudes Link between trolling and psychopathic traits 12. Split personality Dissociative disorder – some aspects of cognition or experience becomes inaccessible to consciousness resulting in a sudden disruption in continuity affects consciousness, emotions, motivation, memory or identity Separated into depersonalisation/derealisation, dissociative amnesia, dissociative identity disorder DID is when an individual exhibits at least two distinct personalities that act independently of each other (alters) Onset is typically during childhood More common in women Comorbidity – PTSD, depression, somatic symptoms 0.5-1% prevalence Higher in USA (3x more than Japan), Canada, Netherlands, Norward and Turkey Lower in India, Germany and Japan Causes – post-traumatic model, socio-cognitive model (role play, iatrogenic) Evidence for theories – can be role played (hypnosis), patients show partial implicit memories (alters share memories), symptoms emerge after therapy begins DID is caused by the environment rather than more biologically Early trauma – 97% cases report a history of abuse

May be a coping mechanism or a defence mechanism, trauma of a mother within two years of birth, disorganised attachment style, lack of support Treatment – Psychotherapy to integrate alters, improve coping skills, eye movement desensitisation, hypnosis 13. Schizophrenia A major disturbance in thought, emotion, behaviour – disrupts interpersonal relationships 10% increased rates in suicide DSM-5 – two or more symptoms for 1 month, delusions, hallucinations, disorganised speech, catatonic behaviour, negative symptoms Functioning, relationships or self-care has declined since the onset Affects more men, men are diagnosed earlier, more frequent in African/Caribbean origins Types of delusions – persecutory, thought insertion, outside control, grandiose Related disorders – Schizophreniform (1-6 months), brief psychotic (1 day – 1 month), schizoaffective (schizophrenia and a mood disorder), delusional disorder Genes – 45%+ component (DID has no evidence for genetics) Twin studies – 44% risk MZ and 12% risk DZ Genes associated – DTNGP1, NGR1, COMT, BDNF Dopamine – an excessive, serotonin/GABA/glutamate must be involved Enlarged ventricles, prefrontal cortex, reduced grey matter (temporal cortex) Environment – damage during gestation or birth (birth complications), viral damage to foetus, reaction to stress, socioeconomic status (poor/cities) Treatment – neuroleptics antipsychotics (effect on positive symptoms) side effects include tardive dyskinesia (involuntary movements) and neuroleptic malignant syndrome (fever, muscular rigidity); clozapine antipsychotics (act on serotonin receptions) side effects include impaired immune system, seizures, dizziness, fatigue, drooling, weight gain; social skills training; family therapy; CBT; cognitive remediation training or enhancement therapy...