DBS

Map Branches

• Event !
  • Crisis
    • Failure
    • Death/Illness
    • Looming Test
    • Assault/Trauma
• Med-responsive
  • Explain to patient
    • Condition
    • Medications
      • Help with Therapy
  • Anxiety
    • hyperactive amygdala
    • underactive control circuits
    • pACC regulates
      • by dampening amygdala
    • cog reappraisal
      • via NuAcc
      • via amydala
  • Depression
    • slow onset of med results
      • due to neurogenesis and trophic factors in hippocampus
        • norepi activates hippocampal neurogenesis
        • alpha-2 blockers speed tx
    • reward enhances neurogenesis
    • high MAO-A
      • predicts relapse
        • so continue SSRI for a while
    • reduced reward response in NuAcc
      • increasing conflict with rewards
    • endogenous opioids amygdala
      • positive mood
    • infLammation
      • sickness-induced poor mood
    • low GABA
      • brain hyperactive
    • l PFC
      • predicts emotional regulation
    • scopolamine
    • DBS
      • bilat nucleus accumbens
        • acute improvement
      • sACC
        • predicts HPA activity
• Personality
  • DSM V
  • Patterns
  • Psychotherapies
• Developmental Hurdle
  • Separation Individuation
  • Pyschosocial Stages
    • Identity vs. Role Confusion
      • adolescents 13-19 yr
        • "who am I and where am I going?"
    • Intimacy vs. Isolation
      • young adults 20-34 yr
        • "am I loved and wanted?"
        • "shall I share my life with someone or live alone?"
  • Attachment
    • oxytocin
      • secure attachment mothers
        • greater response of reward system
        • greater oxytocin release
    • Reward System
      • maternal infant
      • romantic love
    • deactivate
      • negative emotions
      • social judgement
      • mentalizing

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