Engrossment refers to the emotional connection that a father develops with his child. This term was coined by Greenberg and Morris in their 1974 study, which explored the impact of newborns on fathers. In contrast, Bowlby used the term ‘attachment’ to describe the bond that develops between a child and their mother. Bonding, on the other hand, refers to the process by which a mother develops a strong emotional connection with her child. Imprinting is a phenomenon observed in some animal species, where newborns acquire certain behavioral characteristics from their parents shortly after birth. Finally, sociability is a crucial aspect of attachment, as it involves the pursuit of social contact and connection with others.

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.

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.

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.

Strategic systemic therapy incorporates reframing and the domino effect. Haley’s approach assumes that symptoms are perpetuated by attempts to suppress them, and reframing involves giving negative emotions of behaviors a positive connotation. The domino effect refers to the improvement of additional problems after resolving an initial issue. Bowen’s family systems approach emphasizes the patient’s ability to maintain their individuality amidst familial tension. The Milan systemic approach uses circular questioning among family members, while Bateson’s paradoxical therapy involves intentionally engaging in undesirable behaviors. Minuchin’s structural model prioritizes the family hierarchy, rules, and boundaries.

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.

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.

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.

The concept of recovery in mental disorder goes beyond symptom resolution and focuses on developing a rewarding and meaningful life while accepting the impact of mental distress on the self. Clinical remission, on the other hand, refers to the cessation of symptoms and is often measured through clinical outcome scales. Chronic psychosis is the ongoing experience of psychotic symptoms. Recovery in mental disorder is a rephrasing of the conventional medical definition of remission and recognizes the need for a holistic approach to treatment while still involving clinicians and allied professionals. For further reading, Anthony’s Recovery From Mental Illness and Davidson and Roe’s Recovery from versus recovery in serious mental illness offer valuable insights.

Elevated serum prolactin levels are a known side effect of Risperidone. Similarly, Amisulpride, Haloperidol, Paliperidone, and Sulpiride are also antipsychotics that can cause increased prolactin levels. However, Aripiprazole, Clozapine, Olanzapine, and Quetiapine are typically not associated with elevated prolactin levels.

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.

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.

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.

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.

This individual is currently in the preparation phase of quitting smoking. According to Prochaska et al.’s stages of change model, this means they are currently smoking but have a strong intention to quit within the next 30 days and have been seriously considering quitting for the past six months. The stages of change are a spiral, meaning individuals may move back and forth between stages and even experience relapses. The other stages include precontemplation (not considering quitting within the next six months), contemplation (seriously considering quitting within the next six months but not within the next 30 days), action (currently not smoking and quit within the last six months), and maintenance (currently not smoking and quit more than six months ago).

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 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.

Recent clinical trials have shown that various psychotherapy approaches do not differ significantly in terms of effectiveness. This particular trial aimed to prove that psychodynamic psychotherapy was not inferior to other modalities at 22 weeks and one year follow-up. While non-inferiority was observed at 22 weeks, it could not be conclusively demonstrated at one year, despite no significant difference between interventions. Interestingly, individuals who received CBT appeared to require more additional treatment during the year following therapy, although this trend was not statistically significant.

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.

Patients who are not informed about the potential side effects of a medication may initially agree to treatment, but are less likely to follow through if they experience adverse effects. To improve adherence, healthcare providers can implement various strategies. These include educating patients about the treatment, discussing the benefits and drawbacks of different options, and promoting insight into the importance of prophylactic treatment. Encouraging patients to be open about any side effects they experience, even if they are embarrassing, can also help. Regular reviews of the medication plan, including discussions about side effects and the possibility of stopping medication if necessary, can further improve adherence. Simplifying the medication regimen and choosing medications with tolerable side effect profiles can also be helpful. Communication between the patient and their GP should be clear and in writing. Finally, the use of depot antipsychotics may be considered as an option.

Principles of Therapeutic Communities

Therapeutic communities are based on four main principles that guide their operations. The first principle is communalism, which emphasizes that staff and service users should not be separated by uniforms of behaviours. This means that everyone in the community is treated equally and with respect. The second principle is democratisation, which involves shared decision-making and unit management. This means that everyone in the community has a say in how things are run and decisions are made collectively. The third principle is permissiveness, which involves accepting and tolerating occasional unpredictable behaviour. This means that members of the community are encouraged to be themselves and express their emotions freely. The fourth principle is reality confrontation, which involves group members challenging self-deception among others. This means that members of the community are encouraged to be honest with themselves and others.

Group cohesion is another important aspect of therapeutic communities. It refers to the sense of belonging and acceptance that members of the community feel. This sense of belonging is fostered by the shared goal that the community is working towards. Members of the community understand that they are all in this together and that they need to support each other to achieve their goals. The sense of belonging and acceptance that comes with group cohesion is essential for the success of therapeutic communities.

Expressed emotion (EE) in schizophrenia was first introduced by Brown et al., which refers to the emotions exhibited by family members towards their loved one with the illness. The James-Lange theory is one of two fundamental theories of emotions, alongside the Cannon-Bard theory. Fromm-Reichmann coined the term ‘schizophrenogenic mother.’ Harris proposed a model of emotional development consisting of five stages. Plutchik identified eight primary emotions.

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.

The ‘strange situation’ has been utilized to depict different attachment styles exhibited by infants, with contributions from Bowlby’s observations of primate and human attachment behavior, Bateman’s work on psychotherapeutic models in personality disorder, Freud’s structural theory of the unconscious, and Jung’s exploration of archetypes and the collective unconscious.

The psychosocial theory of development, as described by Erikson, involves eight stages that continue into adulthood and require the resolution of a crisis at each stage. Bowlby is known for attachment theory and maternal deprivation, while Freud focused on psychosexual development. Kohlberg studied moral development, and Piaget developed the cognitive model of development.

René Spitz coined the term anaclitic depression to describe the negative impact on children who are separated from their primary caregiver, such as during a hospital stay. In extreme cases, this can lead to hospitalism. Although this type of depression can hinder a child’s development, recovery is likely if the separation from the mother does not exceed three months. Ainsworth is known for her work on the strange situation procedure, while Bowlby focused on attachment and maternal deprivation. Main is associated with the adult attachment interview, and Rutter distinguished between privation and deprivation, with the former referring to a failure to form attachments.

Across all medical specialties, it is typical for patients to take less than half of their prescribed doses of self-administered medications, indicating low adherence rates that have been shown to be around 50%.

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.

Mentalisation therapy is a psychotherapy approach that is particularly helpful for individuals with borderline personality disorder. It is psychodynamically-oriented and focuses on helping individuals develop the ability to mentalise, of understand their own and others’ thoughts, feelings, and intentions. This therapy approach aims to improve interpersonal relationships and reduce impulsive and self-destructive behaviors.