6066: NEUROBEHAVIORAL FUNCTIONING
Lecture: Network Approach and Depression
Cause:
- What public thinks is the common cause of depressive disorder – chemical imbalance
- According to APA:
o Biochemistry: Differences in certain chemicals in the brain
o Genetics
o Personality: low self-esteem, overwhelmed by stress, generally pessimistic
o Environmental factors: exposure to violence, neglect, abuse, or poverty
Treatment:
- Medication: antidepressants for 6+ months
- Psychotherapy with antidepressant
- Electroconvulsive therapy
- Self-help
Theory: Monoamine hypothesis of depressive disorder proposes that the underlying biological
or neuroanatomical basis for depression is a deficiency of central noradrenergic and/or
serotonergic systems, and that targeting this neuronal lesion with an antidepressant restores
normal function.
Conclusion: The main areas of serotonin research provide no consistent evidence of there being
an association between serotonin and depression, and no support for the hypothesis that
depression is caused by lowered serotonin activity or concentrations. Some evidence was
consistent with the possibility that long-term antidepressant use reduces serotonin
concentration.
Do antidepressants work better than placebo? The trimodal distributions (large, minimal, non-
specific) suggests that about 15% of participants have a substantial antidepressant effect
beyond a placebo effect in clinical trials, highlighting the need for predictors of meaningful
responses specific to drug treatment.
Symptoms of Depression: weight loss, feeling sad, lack of focus, insomnia, feeling guilty,
suicidal thoughts, loss of interest, fatigue, loss of libido
- If one individual has 3 symptoms and another person has 4 different symptoms – the
medical model treats the common cause – e.g. target alleged neurochemical imbalance,
, genes, deficits in brain circuits, other biological factors – one approach to studying
mental disorders
- Need to move away from monocausal explanations
o Mental disorders are multifactorial in causal background
o Maintenance mechanisms are transdiagnostic
o Require pluralist explanatory accounts
Network Model: If we know one’s critical/central nodes and particularly strong edges, we can
provide an individually tailored network-informed treatment – weaken central nodes and
weaken edges to bring back healthier state
Vulnerable versus Resilient:
- Temporal networks represent relationships or interactions that change over time
, - Contemporaneous networks, on the other hand, focus on the relationships or
interactions between variables that occur at the same point in time.
- Multilevel temporal and contemporaneous networks do not differ that much between
high versus low psychopathology groups
- Variability across individual temporal and contemporaneous networks is large
Targeting: Network-informed treatments
- Networks are highly individual
- Individually tailored, network-informed, treatment
- Independent from DSM diagnosis
- Focus on the network dynamics
- Focus on the – for this individual - critical (most central?) nodes (symptoms) and
strongest edges (connections)
TASK 1: A MATTER OF DEFINITION ... AND OF ASSESSMENT
1. What is neurobehavioral functioning (make a definition)?
a. Components and concepts
b. Assessments - how to assess it
2. What is the symptom network approach?
a. Discuss basic concepts (node, connections..)
3. Explain the figures 3 (network psychosis) and 4 (resilience…) in terms of the network
4. Dimensional approach, continuum approach (prevalence of 1-80%) -
a. development of the approaches
b. differences between them
c. pros and cons for each
5. RDoC and HiTop
a. What are these approaches?
b. Differences between them?
Neurobehavioral functioning refers to the
• Interaction between the brain (neurology) and behavior
• How cognitive, emotional, and motor processes are influenced by the structure and
function of the nervous system
• How neurological health impacts behavior, thought processes, and emotional regulation
• Studies brain injuries, neurological disorders, or developmental conditions
, Neurobehavioral Functioning:
- Interactions between neural systems and behaviours
- Cognitive, emotional and motor processes
- Reflects brain activity
- Attention, cognitive processing, executive functioning, memory, sensory processing, language
- Network pathways - evolving to cognitive processing and functions
- Malfunctions to certain brain regions
- Cognitive domain and behavioral domain
- Link between nervous system and behaviour
Assessment:
- Rivermead Behavioral Inattention Test (Wilson – battery for assessment of memory)
- For neglect – Behavioural Inattention Test
- For EF – Behavioural Assessment of the Dysexecutive Syndrome
- Matrix Consensus Battery (MCCB) - psychosis and schizophrenia
- hierarchical mediation model
- five levels of function, seen as representing points along a continuum rather than
discrete states; the lower end of this scale represents direct tests of real-world
performance, and the upper end represents cognitive abilities assessed by standard NP
tests. The intermediate links represent various simulated approaches to predicting
performance in real-life situations.
- What test is used when - check for expectations, observe the symptoms
- Historical approaches to NP Assessment:
- Psychometric (quantitative) – assessment based on fixed battery of standardized
tests - Diagnosis is based on norms, and classification of patients is derived from
the profile of the results.
- Halstead-Reitan Neuropsychological Test battery
- Luria-Nebraska Neuropsychological battery
- Clinical (qualitative) approach – emphasis on individual differences rather than
norms – flexible and adjusted to particular patients
- Boston Process Approach: flexible testing based on the patient's performance, focusing not only
on test scores but also on how the patient arrived at answers - the tests used are standardized,
but at the same time the assess- ment is not based just on the quantitative aspects of
performance but also on its qualitative aspects
- Psychoaffective evaluation, psychosocial assessment, cognitive assessment – attention,
perceptual processing, learning and memory, abstract thinking & EF
- Pre-assessment:
- Reason for referral
- Timing of the assessment – not conducted in initial stages of recovery TBI
Lecture: Network Approach and Depression
Cause:
- What public thinks is the common cause of depressive disorder – chemical imbalance
- According to APA:
o Biochemistry: Differences in certain chemicals in the brain
o Genetics
o Personality: low self-esteem, overwhelmed by stress, generally pessimistic
o Environmental factors: exposure to violence, neglect, abuse, or poverty
Treatment:
- Medication: antidepressants for 6+ months
- Psychotherapy with antidepressant
- Electroconvulsive therapy
- Self-help
Theory: Monoamine hypothesis of depressive disorder proposes that the underlying biological
or neuroanatomical basis for depression is a deficiency of central noradrenergic and/or
serotonergic systems, and that targeting this neuronal lesion with an antidepressant restores
normal function.
Conclusion: The main areas of serotonin research provide no consistent evidence of there being
an association between serotonin and depression, and no support for the hypothesis that
depression is caused by lowered serotonin activity or concentrations. Some evidence was
consistent with the possibility that long-term antidepressant use reduces serotonin
concentration.
Do antidepressants work better than placebo? The trimodal distributions (large, minimal, non-
specific) suggests that about 15% of participants have a substantial antidepressant effect
beyond a placebo effect in clinical trials, highlighting the need for predictors of meaningful
responses specific to drug treatment.
Symptoms of Depression: weight loss, feeling sad, lack of focus, insomnia, feeling guilty,
suicidal thoughts, loss of interest, fatigue, loss of libido
- If one individual has 3 symptoms and another person has 4 different symptoms – the
medical model treats the common cause – e.g. target alleged neurochemical imbalance,
, genes, deficits in brain circuits, other biological factors – one approach to studying
mental disorders
- Need to move away from monocausal explanations
o Mental disorders are multifactorial in causal background
o Maintenance mechanisms are transdiagnostic
o Require pluralist explanatory accounts
Network Model: If we know one’s critical/central nodes and particularly strong edges, we can
provide an individually tailored network-informed treatment – weaken central nodes and
weaken edges to bring back healthier state
Vulnerable versus Resilient:
- Temporal networks represent relationships or interactions that change over time
, - Contemporaneous networks, on the other hand, focus on the relationships or
interactions between variables that occur at the same point in time.
- Multilevel temporal and contemporaneous networks do not differ that much between
high versus low psychopathology groups
- Variability across individual temporal and contemporaneous networks is large
Targeting: Network-informed treatments
- Networks are highly individual
- Individually tailored, network-informed, treatment
- Independent from DSM diagnosis
- Focus on the network dynamics
- Focus on the – for this individual - critical (most central?) nodes (symptoms) and
strongest edges (connections)
TASK 1: A MATTER OF DEFINITION ... AND OF ASSESSMENT
1. What is neurobehavioral functioning (make a definition)?
a. Components and concepts
b. Assessments - how to assess it
2. What is the symptom network approach?
a. Discuss basic concepts (node, connections..)
3. Explain the figures 3 (network psychosis) and 4 (resilience…) in terms of the network
4. Dimensional approach, continuum approach (prevalence of 1-80%) -
a. development of the approaches
b. differences between them
c. pros and cons for each
5. RDoC and HiTop
a. What are these approaches?
b. Differences between them?
Neurobehavioral functioning refers to the
• Interaction between the brain (neurology) and behavior
• How cognitive, emotional, and motor processes are influenced by the structure and
function of the nervous system
• How neurological health impacts behavior, thought processes, and emotional regulation
• Studies brain injuries, neurological disorders, or developmental conditions
, Neurobehavioral Functioning:
- Interactions between neural systems and behaviours
- Cognitive, emotional and motor processes
- Reflects brain activity
- Attention, cognitive processing, executive functioning, memory, sensory processing, language
- Network pathways - evolving to cognitive processing and functions
- Malfunctions to certain brain regions
- Cognitive domain and behavioral domain
- Link between nervous system and behaviour
Assessment:
- Rivermead Behavioral Inattention Test (Wilson – battery for assessment of memory)
- For neglect – Behavioural Inattention Test
- For EF – Behavioural Assessment of the Dysexecutive Syndrome
- Matrix Consensus Battery (MCCB) - psychosis and schizophrenia
- hierarchical mediation model
- five levels of function, seen as representing points along a continuum rather than
discrete states; the lower end of this scale represents direct tests of real-world
performance, and the upper end represents cognitive abilities assessed by standard NP
tests. The intermediate links represent various simulated approaches to predicting
performance in real-life situations.
- What test is used when - check for expectations, observe the symptoms
- Historical approaches to NP Assessment:
- Psychometric (quantitative) – assessment based on fixed battery of standardized
tests - Diagnosis is based on norms, and classification of patients is derived from
the profile of the results.
- Halstead-Reitan Neuropsychological Test battery
- Luria-Nebraska Neuropsychological battery
- Clinical (qualitative) approach – emphasis on individual differences rather than
norms – flexible and adjusted to particular patients
- Boston Process Approach: flexible testing based on the patient's performance, focusing not only
on test scores but also on how the patient arrived at answers - the tests used are standardized,
but at the same time the assess- ment is not based just on the quantitative aspects of
performance but also on its qualitative aspects
- Psychoaffective evaluation, psychosocial assessment, cognitive assessment – attention,
perceptual processing, learning and memory, abstract thinking & EF
- Pre-assessment:
- Reason for referral
- Timing of the assessment – not conducted in initial stages of recovery TBI
