Klinische Psychologie Bonus

•  Entdeckung des Zusammenhangs zwischen eigener Aktivität und Effekt auf die Umwelt („sekundär“)
• Vorformen des intentionalen Handels: Mittel-Zweck-Relationen
  • Eine zufällige Handlung hat einen Effekt auf die Umwelt
  • Effekt auf die Umwelt steht im Vordergrun

• Kombination von Schemata, um ein Ziel zu erreichen
• Intelligent aussehende Mittel-Zweck-Verbindungen
• Schemata der Stufe 3 (zufällige Handlung) dienen als Mittel und werden gezielt eingesetzt

• Aktive Variation bekannter Schemata, systematisches Ausprobieren -> Entdecken neuer Mittel
• dominierende Akkomodation

• Antizipation Ergebnisse des eigenen Handelns, Handlung geistig ausführen  -> Kognitive Repräsentation 
• Charakteristisch: Fähigkeit der Objektpermanenz (Wissen, dass ein Objekt auch existiert, wenn es nicht mehr sichtbar ist)

• Large part of lives
• Central source personal meaning, Influences self esteem, contributes to overall life satisfaction
• Identity-forming function
• Facilitates social contacts

• Risks to health, physical wear
• Identity-threatening experiences
• Workplace bullying
• Stress & pressure
• Changing world of work (globalization etc, less physically demanding jobs, rising expectations for employee flexibility/ mobility

• 130/140%
• Increasing rates of absenteeism due to mental health conditions (weeks-months)

• Activity & competence
• Structure
• Cooperation & contact
• Social recognition/ status
• Identity

• Effort: demands, obligations placed on individual
• Reward: returns expected in form of salary, recognition, career opportunities
• Effort > reward = health issues, chronis stress

Factors that influence risk to mental health issues

• Individual dispositions
• Workplace triggers & contextual factors
• Non-work-related stressors
• Underlying mental or psychosomatic disorders

Forms: work-related anxiety disorder, psychological processese of anxiety development -> workplace phobia

• Potential reinforcers related dto work, actually available reinforcers, individual skills & competences -> low rate of positive reinfordecement -> reinforment/ maintenance of symptoms
• Social reinforment might help to stop

• Early: irritable, impatient, nervous, sad, overwhelmed, social behavior (withdrawal, instruive, causes conflicts, arrives late)
• Early stage of illness: angry, anxious, very sad, desperate
• Ill: outburst of anger, aggressiveness, severe anxiety/ panic attacks, depressed, suicidal thoughts

• A sense of energy loss/ exhaustion
• Increased mental distance from ones job/ feelings of cynicism to work
• Reduced professional efficiency, diminished sense of achievement

• Common not to seek treatment at an early stages
• Stigmatization of mental illness
• Illness is concealed, help avoided due to fear of further public labelling

• Confidential/ anonymous support service
• Less stigmatization
• Awareness not only one affected
• Interventions at workplace (counselling, mental health professional etc)

unpleasant sensory & emotional experience

typically actual / potential tissue damage

multimodae Reaktion: Verhalten, Emotionen, Biol. Prozesse, Kognitionen

Biopsychosocial circle: biological - social - psychological (downwardsspiral)

• Detection of damaging events through specifit sensors & processing in a specialized part of somatosensory system 
• Pain is only conscious perception of the sensory impression after cognitive & emotional evaluations from nociceptive system

Placebo: positive reasion without active ingredient, triggerd by expectations

Nocebo: negative health changes in response to an agent (unwanted side effects to e.g. palcebo)

thorugh classical conditioning

instructions& expectations

social learning

• Higher Empathy = stronger placebo effects
• higher social status/ higher self confidence = stronger palcebo effects
• male = stronger nocebo effects

=> cognitive processes are involved

Symbolic Modelin: Higher pain raitings in conditions with painful facial expression

• expectation
• experience/ treatment history
• price
• model leaming 
• type of instruction 
• personality 

explain neuronal activity patterns, using biologically plausible computational models that perform complex cognitive tasks

Exolain behavioral data

• accuracy
• soeed
• latent cognitive processes 
  • initial bias towas one option
  • response cautiousness (speed over accuracy/ vice cersa)
  • speef of information processing
  • seperate processes from time needed for encoding & motor execution
• link to neural processes
• impaired in clinical populations

• Subcategory of Sequential Sampling Models
• Originally developed to describe how parti ipants make rapid decisions between two respone alternatives  (yes, no respone) in an item recognition test
• Nowadays apllied to range of different cognitive tasks

Assumptions:

• decision mkaing is a (noise) accumulation of evidence from a stimulus
• evidence accumulates at a constant rate during time it takes to make decision
• decision is made when accumulation process reaches a specific threshold/ boundary

Reaction time: 

• time to detect/ encode stimulus (Te)
• time to reach decision (Td)
• Time to execute motor respone (Tr)
• Te & Tr usually pooled into non-decision time (Ter, griech. T)

Decision time:

• results from accumulation process
• more information is accumulated -> evidence in favour of one respone will push the decision process closer to the boundary
• boundary seperation = alpha
• starting point = beta
• av. rate of evidence accumulation across trials "drift rate" = gamma

major depressive disorder

e.g. Drift rate

use of group-level information to improve subject level estimates

(stimulus/ context -> conflict -> risk assessment -> decision -> approach/ avoidance -> expeerience -> deccision/ conflict)

degree of aversiveness/ amount of points influence reaction time

in DDM: 

• no correct/ false answers (= no speed-accuracy trade-off)
• prfrence based decision making (speed-consistency trade-off)

DDM + fMRI:

• ROI (Regions of interest)
  • pregenual anterior cingulate cortex
  • caudate nucelus & ncl. accumbens 
  • subthalamic ncl.

Classifier 1: used raw brain activity, reaction times, approach behavior

classifier 2: used DDM paramets & how they changed with brain activity (regressors on neural data)

Reduces Reward Sensitivity: MDD participants less sensitive to changes in offered reward

No Group Differences in Aversiveness Sensitivity 

Lower Performance: MDD participants earned fewer reward points 

Starting Point Bias: Controls: Bias toward approach, MDD: no clear bias / possible lack of optimism bias

Promising links found between DDM parameters & clinical symptoms -> need larger samples to confirm robustness 

Null findings (e.g. no link between reward sensitivity & anhedonia scale) may reflect insufficient statistical power

Diagnosis used as binary (MDD vs. HC) -> dimensional data could provide richer insights

Study sample was entirely femlae, limiting generalizability

Low retention & remission rates may reflext selection bias (e.g. remitters less likely to return)

only a limited set of brain regions &  model variants were tested -> alt. models may explain data better

• solve approach-avoidancae conflicts differently, mainly due to dampened reward sensitivity
• Computational paramters 
  • differentiated MDD from controls
  • related to symptom severity 
  • predicted future outcomes (for 6 months follow ups)

=> findings support promise of computational psychiatry (clarify altered decision-making in affective disorders, identify mechanistic biomarkers, potetnially guide personalized interventiosn)

implications: help tailor treatments, appraoch bridges (behavior, neural mechanisms, clinical outcomes), aligns with findings from animal models (translational value)

• loss dopaminergic neurons in substantia nigra pars compacta -> slower drift rates, higher decision thresholds, increased reaction times 
• difficulty in accumulatin enough evidence -> indecisiveness & motor symptoms (e.g. freezing of gait)
• Medication reduces thresholds -> can lead to premature decisions -> explains umpulsivity in PD patients