1
Q
```csv
A
2
Q
What are executive functions? (exam-safe definition)
A
Executive functions are higher-order cognitive processes that allow a person to plan, organise, initiate, monitor, and inhibit behaviour to achieve goals. They represent the brain’s control system.
3
Q
In simple terms, how can executive function be described?
A
Executive function is “thinking about thinking” and acts as the brain’s control centre for goal-directed behaviour.
4
Q
What everyday abilities depend on intact executive function?
A
Executive function enables planning, working memory, response inhibition, cognitive flexibility, and error monitoring.
5
Q
What happens clinically when executive function is impaired?
A
Loss of executive function leads to disorganised behaviour, impulsivity, poor planning, and cognitive inflexibility.
6
Q
What is working memory?
A
Working memory is the ability to hold and manipulate information online over short periods to guide behaviour.
7
Q
What is inhibitory control?
A
Inhibitory control is the ability to suppress automatic, inappropriate, or impulsive responses.
8
Q
What is cognitive flexibility?
A
Cognitive flexibility is the capacity to shift between tasks, rules, or perspectives when circumstances change.
9
Q
What is planning and organisation in executive function?
A
It is the ability to sequence steps, anticipate outcomes, and organise actions toward a goal.
10
Q
What is error monitoring?
A
Error monitoring is the ability to detect mistakes, recognise conflict, and adjust behaviour accordingly.
11
Q
Which brain region acts as the main hub for executive function?
A
The prefrontal cortex (PFC) is the primary neural hub for executive control.
12
Q
What is the role of the dorsolateral prefrontal cortex (dlPFC)?
A
The dlPFC supports working memory, planning, abstract reasoning, and cognitive flexibility.
13
Q
What happens when the dlPFC is dysfunctional?
A
dlPFC dysfunction causes poor planning, disorganisation, and concrete thinking.
14
Q
What is the role of the ventromedial prefrontal cortex (vmPFC)?
A
The vmPFC mediates decision-making, emotional regulation, and value-based choices.
15
Q
What are the effects of vmPFC dysfunction?
A
vmPFC damage leads to poor judgement, risky decision-making, and emotional dysregulation.
16
Q
What is the role of the orbitofrontal cortex (OFC)?
A
The OFC is crucial for inhibitory control, reward–punishment evaluation, and social behaviour regulation.
17
Q
What results from orbitofrontal cortex dysfunction?
A
OFC dysfunction causes disinhibition, impulsivity, and socially inappropriate behaviour.
18
Q
What is the function of the anterior cingulate cortex (ACC)?
A
The ACC is involved in error detection, conflict monitoring, motivation, and effort allocation.
19
Q
What happens when the ACC is impaired?
A
ACC dysfunction results in apathy, reduced initiation, and poor persistence.
20
Q
How does executive function depend on brain circuits rather than single regions?
A
Executive control depends on cortico–striato–thalamo–cortical loops, linking the PFC, striatum, thalamus, and PFC again.
21
Q
What is the role of frontal–subcortical loops in behaviour?
A
These circuits select actions, suppress competing responses, and maintain goal-directed behaviour.
22
Q
What is hypofrontality? (exam-safe definition)
A
Hypofrontality is reduced functional activity of the prefrontal cortex, particularly during executive tasks.
23
Q
How is hypofrontality typically detected?
A
Hypofrontality is identified using functional imaging such as PET or fMRI, not structural scans.
24
Q
Is hypofrontality structural brain damage?
A
No. Hypofrontality is functional under-activation, not permanent structural damage.
25
**What biological mechanisms contribute to hypofrontality?**
Key contributors include **dopamine D1 dysfunction**, **NMDA receptor hypofunction**, **reduced cortical connectivity**, and **developmental abnormalities**.
26
**What executive deficits are seen in schizophrenia-related hypofrontality?**
Schizophrenia shows **reduced dlPFC activation**, **poor working memory**, **disorganised thinking**, and **negative symptoms**.
27
**What is the underlying pathophysiology of hypofrontality in schizophrenia?**
There is **low dopamine tone in the PFC**, **NMDA hypofunction**, and **failure of top-down control**.
28
**What is impulsivity? (exam-safe definition)**
**Impulsivity** is a tendency to **act without adequate forethought or inhibition**, with poor consideration of consequences.
29
**What is the core executive deficit underlying impulsivity?**
Impulsivity reflects **failure of inhibitory control**.
30
**What are the main types of impulsivity relevant to psychiatry?**
Impulsivity can be **motor**, **cognitive**, or **emotional**.
31
**What is the core neurobiological imbalance in impulsivity?**
Impulsivity arises from **weak prefrontal inhibition** combined with **overactive limbic and striatal reward systems**.
32
**Which neurotransmitters are implicated in impulsivity?**
Key contributors include **low serotonin**, **dysregulated dopamine**, and **reduced GABAergic inhibition**.
33
**How does executive dysfunction present in schizophrenia?**
Schizophrenia shows **hypofrontality**, **poor working memory**, **disorganisation**, and **impaired planning**, especially in negative symptoms.
34
**How does executive dysfunction present in ADHD?**
ADHD involves **delayed PFC maturation**, **dopamine and noradrenaline deficits**, **poor sustained attention**, and **impulsivity**.
35
**How is executive dysfunction involved in addiction?**
Addiction features **impaired inhibitory control**, dominance of **reward circuits**, and **habitual behaviour overriding goals**.
36
**How does executive dysfunction present in personality disorders?**
Personality disorders show **poor impulse control**, **reduced OFC function**, **emotional dysregulation**, and **low serotonergic inhibition**.
37
**How does executive dysfunction differ between depression and mania?**
Depression causes **executive slowing and poor initiation**, while mania causes **disinhibition**, **poor judgement**, and **impulsive decisions**.
38
**How do antipsychotics affect executive function?**
Antipsychotics **reduce salience** and may improve organisation, but **high doses can worsen apathy and executive slowing**.
39
**Why do stimulants improve executive function in ADHD?**
Stimulants increase **dopamine and noradrenaline in the PFC**, strengthening executive control.
40
**How do psychological therapies improve executive control?**
They **strengthen top-down regulation**, improve **monitoring**, and enhance **planning and inhibition**.
41
**What is a key exam trap regarding executive dysfunction?**
Executive dysfunction is **not low intelligence** and impulsivity is **not a personality flaw**.
42
**What is a key exam trap regarding hypofrontality?**
Hypofrontality does **not** mean structural brain damage; it reflects **functional under-activation**.
43
**What is a key exam trap regarding schizophrenia and dopamine?**
Schizophrenia is **not dopamine excess everywhere**; it involves **low PFC dopamine and high subcortical dopamine**.
44
**Give the one-sentence exam-perfect summary.**
**Executive dysfunction reflects impaired prefrontal control over behaviour; hypofrontality represents functional under-activation of PFC circuits; and impulsivity arises from weak top-down inhibition with overactive reward systems across multiple psychiatric disorders.**
45
```
46
**What are executive functions? (exam-safe definition)**
• **Higher-order cognitive processes**
• Enable **planning, organisation, initiation, monitoring, and inhibition**
• Allow behaviour to be **goal-directed**
• Represent the brain’s **control system**
47
**How can executive function be described in simple terms?**
• “**Thinking about thinking**”
• The brain’s **control centre**
• Oversees behaviour rather than generating content
48
**What everyday abilities depend on executive function?**
• **Planning ahead**
• **Working memory** (holding information online)
• **Inhibiting inappropriate responses**
• **Switching strategies flexibly**
• **Monitoring errors and adjusting behaviour**
49
**What happens clinically when executive function is impaired?**
• **Disorganised behaviour**
• **Poor planning**
• **Impulsivity**
• **Cognitive inflexibility**
• Difficulty achieving goals
50
**What is working memory?**
• Ability to **hold and manipulate information**
• Information is kept **online**
• Essential for reasoning and planning
51
**What is inhibitory control?**
• Ability to **suppress automatic or impulsive responses**
• Prevents inappropriate actions
• Core to self-control
52
**What is cognitive flexibility?**
• Ability to **shift between tasks, rules, or perspectives**
• Allows adaptation to changing situations
53
**What is planning and organisation in executive function?**
• Ability to **sequence steps**
• Anticipate outcomes
• Organise actions toward a goal
54
**What is error monitoring?**
• Ability to **detect mistakes**
• Recognise conflict
• Adjust behaviour accordingly
55
**Which brain region is the main hub of executive function?**
• **Prefrontal cortex (PFC)**
• Coordinates control over behaviour, thought, and emotion
56
**What is the role of the dorsolateral prefrontal cortex (dlPFC)?**
• **Working memory**
• **Planning**
• **Abstract reasoning**
• **Cognitive flexibility**
57
**What happens when the dlPFC is dysfunctional?**
• **Poor planning**
• **Disorganisation**
• **Concrete thinking**
• Working memory deficits
58
**What is the role of the ventromedial prefrontal cortex (vmPFC)?**
• **Decision-making**
• **Emotional regulation**
• **Value-based choices**
59
**What results from vmPFC dysfunction?**
• **Poor judgement**
• **Risky decision-making**
• **Emotional dysregulation**
60
**What is the role of the orbitofrontal cortex (OFC)?**
• **Inhibitory control**
• **Reward and punishment evaluation**
• **Social behaviour regulation**
61
**What happens when the OFC is impaired?**
• **Disinhibition**
• **Impulsivity**
• **Socially inappropriate behaviour**
62
**What is the role of the anterior cingulate cortex (ACC)?**
• **Error detection**
• **Conflict monitoring**
• **Motivation and effort allocation**
63
**What are the effects of ACC dysfunction?**
• **Apathy**
• **Reduced initiation**
• **Poor persistence and effort**
64
**How does executive function depend on neural circuits?**
• Depends on **cortico–striato–thalamo–cortical loops**
• Flow: **PFC → striatum → thalamus → PFC**
• Circuits select and regulate behaviour
65
**What is the function of frontal–subcortical loops?**
• **Select actions**
• **Suppress competing responses**
• Maintain **goal-directed behaviour**
66
**What is hypofrontality? (exam-safe definition)**
• **Reduced functional activity of the prefrontal cortex**
• Especially during **executive tasks**
• Seen on **PET or fMRI**
67
**Is hypofrontality structural brain damage?**
• **No**
• It is **functional under-activation**
• Not permanent structural loss
68
**What biological factors contribute to hypofrontality?**
• **Dopamine D1 dysfunction** in PFC
• **NMDA receptor hypofunction**
• Reduced cortical connectivity
• Developmental abnormalities
69
**How does hypofrontality present in schizophrenia?**
• **Reduced dlPFC activation**
• **Poor working memory**
• **Disorganised thinking**
• **Negative symptoms**
70
**What is the pathophysiology of hypofrontality in schizophrenia?**
• **Low dopamine tone in PFC**
• **NMDA hypofunction**
• Failure of **top-down control**
71
**What is impulsivity? (exam-safe definition)**
• Tendency to **act without adequate forethought**
• Poor consideration of consequences
• Core deficit in **inhibitory control**
72
**What types of impulsivity are relevant to psychiatry?**
• **Motor impulsivity** (acting too fast)
• **Cognitive impulsivity** (poor planning)
• **Emotional impulsivity** (reactive behaviour)
73
**What is the core neurobiological imbalance in impulsivity?**
• **Weak prefrontal inhibition**
• **Overactive limbic and striatal reward systems**
74
**Which neurotransmitters are involved in impulsivity?**
• **Low serotonin** → poor inhibition
• **Dysregulated dopamine** → reward bias
• **Reduced GABA** → poor filtering
75
**How does executive dysfunction present in schizophrenia?**
• **Hypofrontality**
• **Poor working memory**
• **Disorganised behaviour**
• Impaired planning
76
**How does executive dysfunction present in ADHD?**
• **Delayed PFC maturation**
• **Dopamine and noradrenaline deficits**
• Poor attention
• **Impulsivity and hyperactivity**
77
**How is executive dysfunction involved in addiction?**
• **Impaired inhibitory control**
• Dominance of **reward circuits**
• Habitual behaviour overrides goals
78
**How does executive dysfunction present in personality disorders?**
• **Poor impulse control**
• **Reduced OFC function**
• Emotional dysregulation
• **Low serotonergic inhibition**
79
**How does executive dysfunction differ in depression and mania?**
• **Depression**: executive slowing, poor initiation
• **Mania**: disinhibition, poor judgement, impulsivity
80
**How do antipsychotics affect executive function?**
• Reduce **aberrant salience**
• May improve organisation
• High doses can worsen **apathy and executive slowing**
81
**Why do stimulants improve executive function in ADHD?**
• Increase **dopamine and noradrenaline in PFC**
• Strengthen **top-down control**
82
**How do psychological therapies affect executive function?**
• Strengthen **top-down regulation**
• Improve monitoring, planning, and inhibition
83
**What is a key exam trap about executive dysfunction?**
• Not the same as **low intelligence**
• Reflects control failure, not knowledge deficit
84
**What is a key exam trap about hypofrontality?**
• Does **not** mean brain damage
• Represents **functional under-activation**
85
**What is a key exam trap about schizophrenia and dopamine?**
• Not dopamine excess everywhere
• **Low PFC dopamine**, **high subcortical dopamine**
86
**Give the exam-perfect one-sentence summary.**
• **Executive dysfunction reflects impaired prefrontal control**
• **Hypofrontality = reduced functional PFC activity**
• **Impulsivity arises from weak top-down inhibition with overactive reward systems**
87
**What are empathy and Theory of Mind (ToM) in simple terms?**
• **Empathy** = feeling what someone else feels
• **Theory of Mind (ToM)** = thinking about what someone else thinks
• Empathy = **emotion**
• ToM = **thinking about minds**
• They are **not the same process**
88
**Do empathy and ToM live in one brain area?**
• **No**
• They rely on a **distributed social brain network**
• Multiple connected regions
• Each region performs a **simple, specific role**
89
**What are the two main systems of the social brain?**
• **Mentalising system** → supports **Theory of Mind**
• **Emotional resonance system** → supports **empathy**
• One thinks about minds
• One feels with others
90
**What is the medial prefrontal cortex (mPFC)’s main job?**
• Answers: **“What is this person thinking or intending?”**
• Builds a **mental model of another person**
• Core region for **mentalising**
91
**What happens in the mPFC physiologically?**
• Integrates **memory**, **context**, and **social cues**
• Simulates others’ thoughts
• Enables **perspective-taking**
• Focuses on thinking, not feeling
92
**What happens if the mPFC is dysfunctional?**
• Poor understanding of intentions
• Difficulty seeing other perspectives
• **Egocentric thinking**
• Seen in **autism** and **schizophrenia**
93
**What is the temporoparietal junction (TPJ)’s main job?**
• Answers: **“Is this belief mine or someone else’s?”**
• Separates **self from other**
• Essential for mental perspective switching
94
**Why is the TPJ essential for false-belief tasks?**
• Requires ignoring what **you** know
• Representing what **someone else** believes
• Enables **self–other distinction**
95
**What happens if TPJ function is impaired?**
• Confusion between self and others
• Difficulty understanding others’ beliefs
• Literal or egocentric interpretations
• High-yield for **autism** and **psychosis**
96
**What is the superior temporal sulcus (STS)’s main job?**
• Answers: **“What is this person doing right now?”**
• Reads **social signals**:
• Gaze
• Movement
• Facial expression
• Voice tone
97
**Why is the STS important for empathy and ToM?**
• Provides **raw social data**
• Feeds information to higher social brain areas
• Without STS input, social reasoning is impaired
98
**What happens if STS processing is poor?**
• Misreading social cues
• Awkward or inappropriate interactions
• Poor gaze interpretation
• Seen in **autism** and **schizophrenia**
99
**What is the amygdala’s main job in empathy?**
• Answers: **“Is this emotionally important?”**
• Detects **fear**, **distress**, and **emotional salience**
• Flags emotionally relevant stimuli
100
**How does the amygdala support empathy?**
• Rapid detection of emotional expressions
• Prioritises others’ distress
• Directs attention to emotional signals
101
**What happens if the amygdala is underactive?**
• Poor recognition of fear and distress
• Blunted emotional responses
• Reduced **affective empathy**
• Seen in **psychopathy** and some autism profiles
102
**What is the anterior insula’s main job?**
• Answers: **“What am I feeling in my body?”**
• Generates **emotional awareness**
• Links bodily states to feelings
103
**How does the anterior insula enable empathy?**
• Maps bodily sensations (pain, discomfort)
• Activates when observing others in pain
• Creates **shared feeling states**
• Core to **affective empathy**
104
**What happens if insula function is reduced?**
• Emotional numbness
• Poor awareness of internal states
• Reduced empathic concern
• Seen in **alexithymia** and **psychopathy**
105
**What is the anterior cingulate cortex (ACC)’s main job in empathy?**
• Answers: **“This matters — I care.”**
• Links emotion to **motivation and action**
• Generates concern and response readiness
106
**How does the ACC contribute physiologically to empathy?**
• Activates during personal pain
• Activates when seeing others in pain
• Produces **empathic distress and concern**
107
**What happens if ACC function is impaired?**
• Reduced emotional resonance
• Low concern for others
• Social detachment
• Seen in **psychopathy** and frontal lobe damage
108
**How does the social brain work as a sequence?**
• **STS** → detects social cues
• **TPJ** → separates self vs other
• **mPFC** → infers intentions
• **Amygdala** → flags emotional salience
• **Insula + ACC** → feel and care
109
**Can Theory of Mind be intact while empathy is impaired?**
• **Yes**
• Example: **psychopathy**
• Understands others’ thoughts
• Does not emotionally resonate
110
**Can empathy exist without full Theory of Mind?**
• **Partially**
• Emotional contagion without belief understanding
• Feeling without mentalising
111
**What are common exam traps about empathy and ToM?**
• Empathy ≠ ToM
• Amygdala ≠ fear only
• mPFC ≠ emotion centre
• Empathy and ToM are dissociable systems
112
**Give the exam-perfect one-sentence summary.**
• Empathy and Theory of Mind arise from **distributed social brain networks**
• **mPFC and TPJ** support mentalising and perspective-taking
• **STS** extracts social cues
• **Amygdala, insula, and ACC** generate emotional salience and shared feeling
• Selective impairments occur across psychiatric disorders
113
**What are empathy and Theory of Mind (ToM) in simple terms?**
• **Empathy** = feeling what someone else feels
• **Theory of Mind (ToM)** = thinking about what someone else thinks
• Empathy = **emotion**
• ToM = **thinking about minds**
• They are **distinct processes**, not the same
114
**Do empathy and ToM live in one brain area?**
• **No**
• They rely on a **distributed social brain network**
• Multiple connected regions
• Each region performs a **specific, simple role**
115
**What are the two main systems of the social brain?**
• **Mentalising system** → Theory of Mind (thinking about minds)
• **Emotional resonance system** → Empathy (feeling with others)
• One is cognitive
• One is affective
116
**What is the medial prefrontal cortex (mPFC)’s main job?**
• Answers: **“What is this person thinking or intending?”**
• Builds a **mental model of another person**
• Core region for **mentalising and perspective-taking**
117
**What happens in the mPFC physiologically?**
• Integrates **memory**, **context**, and **social cues**
• Simulates others’ thoughts
• Supports **perspective-taking**
• Focused on **thinking**, not emotional feeling
118
**What happens if the mPFC does not function well?**
• Poor understanding of intentions
• Difficulty adopting another perspective
• **Egocentric thinking**
• Seen in **autism** and **schizophrenia**
119
**What is the temporoparietal junction (TPJ)’s main job?**
• Answers: **“Is this belief mine or someone else’s?”**
• Separates **self from other**
• Essential for representing others’ beliefs
120
**Why is the TPJ essential for false-belief tasks?**
• Requires suppressing what **you** know
• Representing what **another person** believes
• Enables **perspective switching**
121
**What happens if TPJ function is impaired?**
• Confusion between self and others
• Difficulty understanding others’ beliefs
• Literal or egocentric interpretations
• High-yield for **autism** and **psychosis**
122
**What is the superior temporal sulcus (STS)’s main job?**
• Answers: **“What is this person doing right now?”**
• Extracts **social cues**:
• Gaze direction
• Movement
• Facial expression
• Voice tone
123
**Why is the STS important for empathy and ToM?**
• Provides the **raw social data**
• Feeds higher social brain regions
• Without STS input, social reasoning fails
124
**What happens if STS processing is poor?**
• Misreading social cues
• Awkward or inappropriate interactions
• Poor gaze interpretation
• Seen in **autism** and **schizophrenia**
125
**What is the amygdala’s main job in empathy?**
• Answers: **“Is this emotionally important?”**
• Detects **fear**, **distress**, and **emotional salience**
• Flags emotionally relevant stimuli
126
**How does the amygdala support empathy?**
• Rapid detection of emotional expressions
• Prioritises others’ distress
• Directs attention to emotionally salient cues
127
**What happens if the amygdala is underactive?**
• Poor recognition of fear and distress
• Blunted emotional responses
• Reduced **affective empathy**
• Seen in **psychopathy** and some autism profiles
128
**What is the anterior insula’s main job?**
• Answers: **“What am I feeling in my body?”**
• Generates **emotional awareness**
• Links bodily states to feelings
129
**How does the anterior insula enable empathy?**
• Maps bodily sensations (pain, discomfort)
• Activates when observing others in pain
• Creates **shared feeling states**
• Core mechanism of **affective empathy**
130
**What happens if anterior insula function is reduced?**
• Emotional numbness
• Poor awareness of internal states
• Reduced empathic concern
• Seen in **alexithymia** and **psychopathy**
131
**What is the anterior cingulate cortex (ACC)’s main job in empathy?**
• Answers: **“This matters — I care.”**
• Links emotion to **motivation and action**
• Generates concern and response readiness
132
**How does the ACC contribute physiologically to empathy?**
• Activates during personal pain
• Activates when observing others in pain
• Produces **empathic distress and concern**
133
**What happens if ACC function is impaired?**
• Reduced emotional resonance
• Low concern for others
• Social detachment
• Seen in **psychopathy** and frontal lobe damage
134
**How does the social brain operate as a sequence?**
• **STS** → detects social cues
• **TPJ** → separates self vs other
• **mPFC** → infers intentions
• **Amygdala** → flags emotional salience
• **Insula + ACC** → feel and care
135
**Can Theory of Mind be intact while empathy is impaired?**
• **Yes**
• Example: **psychopathy**
• Cognitive understanding without emotional resonance
136
**Can empathy exist without full Theory of Mind?**
• **Partially**
• Emotional contagion without belief understanding
• Feeling without mentalising
137
**What are common exam traps about empathy and ToM?**
• Empathy ≠ Theory of Mind
• Amygdala ≠ fear only
• mPFC ≠ emotion centre
• These systems are **dissociable**
138
**Give the exam-perfect one-sentence summary.**
• Empathy and Theory of Mind arise from **distributed social brain networks**
• **mPFC and TPJ** support mentalising and perspective-taking
• **STS** extracts social cues
• **Amygdala, insula, and ACC** generate emotional salience and shared feeling
• Selective impairments occur across psychiatric disorders
139
```csv
140
**What are empathy and Theory of Mind (ToM) in simple terms?**
• **Empathy** = feeling what someone else feels
• **Theory of Mind (ToM)** = thinking about what someone else thinks
• Empathy = **emotion**
• ToM = **thinking about minds**
• They are **distinct processes**, not the same
141
**Do empathy and ToM live in one brain area?**
• **No**
• They rely on a **distributed social brain network**
• Multiple connected regions
• Each region performs a **specific, simple role**
142
**What are the two main systems of the social brain?**
• **Mentalising system** → Theory of Mind (thinking about minds)
• **Emotional resonance system** → Empathy (feeling with others)
• One is cognitive
• One is affective
143
**What is the medial prefrontal cortex (mPFC)’s main job?**
• Answers: **“What is this person thinking or intending?”**
• Builds a **mental model of another person**
• Core region for **mentalising and perspective-taking**
144
**What happens in the mPFC physiologically?**
• Integrates **memory**, **context**, and **social cues**
• Simulates others’ thoughts
• Supports **perspective-taking**
• Focused on **thinking**, not emotional feeling
145
**What happens if the mPFC does not function well?**
• Poor understanding of intentions
• Difficulty adopting another perspective
• **Egocentric thinking**
• Seen in **autism** and **schizophrenia**
146
**What is the temporoparietal junction (TPJ)’s main job?**
• Answers: **“Is this belief mine or someone else’s?”**
• Separates **self from other**
• Essential for representing others’ beliefs
147
**Why is the TPJ essential for false-belief tasks?**
• Requires suppressing what **you** know
• Representing what **another person** believes
• Enables **perspective switching**
148
**What happens if TPJ function is impaired?**
• Confusion between self and others
• Difficulty understanding others’ beliefs
• Literal or egocentric interpretations
• High-yield for **autism** and **psychosis**
149
**What is the superior temporal sulcus (STS)’s main job?**
• Answers: **“What is this person doing right now?”**
• Extracts **social cues**:
• Gaze direction
• Movement
• Facial expression
• Voice tone
150
**Why is the STS important for empathy and ToM?**
• Provides the **raw social data**
• Feeds higher social brain regions
• Without STS input, social reasoning fails
151
**What happens if STS processing is poor?**
• Misreading social cues
• Awkward or inappropriate interactions
• Poor gaze interpretation
• Seen in **autism** and **schizophrenia**
152
**What is the amygdala’s main job in empathy?**
• Answers: **“Is this emotionally important?”**
• Detects **fear**, **distress**, and **emotional salience**
• Flags emotionally relevant stimuli
153
**How does the amygdala support empathy?**
• Rapid detection of emotional expressions
• Prioritises others’ distress
• Directs attention to emotionally salient cues
154
**What happens if the amygdala is underactive?**
• Poor recognition of fear and distress
• Blunted emotional responses
• Reduced **affective empathy**
• Seen in **psychopathy** and some autism profiles
155
**What is the anterior insula’s main job?**
• Answers: **“What am I feeling in my body?”**
• Generates **emotional awareness**
• Links bodily states to feelings
156
**How does the anterior insula enable empathy?**
• Maps bodily sensations (pain, discomfort)
• Activates when observing others in pain
• Creates **shared feeling states**
• Core mechanism of **affective empathy**
157
**What happens if anterior insula function is reduced?**
• Emotional numbness
• Poor awareness of internal states
• Reduced empathic concern
• Seen in **alexithymia** and **psychopathy**
158
**What is the anterior cingulate cortex (ACC)’s main job in empathy?**
• Answers: **“This matters — I care.”**
• Links emotion to **motivation and action**
• Generates concern and response readiness
159
**How does the ACC contribute physiologically to empathy?**
• Activates during personal pain
• Activates when observing others in pain
• Produces **empathic distress and concern**
160
**What happens if ACC function is impaired?**
• Reduced emotional resonance
• Low concern for others
• Social detachment
• Seen in **psychopathy** and frontal lobe damage
161
**How does the social brain operate as a sequence?**
• **STS** → detects social cues
• **TPJ** → separates self vs other
• **mPFC** → infers intentions
• **Amygdala** → flags emotional salience
• **Insula + ACC** → feel and care
162
**Can Theory of Mind be intact while empathy is impaired?**
• **Yes**
• Example: **psychopathy**
• Cognitive understanding without emotional resonance
163
**Can empathy exist without full Theory of Mind?**
• **Partially**
• Emotional contagion without belief understanding
• Feeling without mentalising
164
**What are common exam traps about empathy and ToM?**
• Empathy ≠ Theory of Mind
• Amygdala ≠ fear only
• mPFC ≠ emotion centre
• These systems are **dissociable**
165
**Give the exam-perfect one-sentence summary.**
• Empathy and Theory of Mind arise from **distributed social brain networks**
• **mPFC and TPJ** support mentalising and perspective-taking
• **STS** extracts social cues
• **Amygdala, insula, and ACC** generate emotional salience and shared feeling
• Selective impairments occur across psychiatric disorders
166
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167
**Why do neurotransmitters matter for empathy and social behaviour?**
• Social understanding requires **emotional connection**, **impulse control**, and **motivation**
• Neurotransmitters determine **how strongly we feel**
• Decide **whether we care**
• Influence **whether we act appropriately** in social contexts
168
**Which three neurotransmitters are most important for empathy and social cognition?**
• **Oxytocin** → bonding and emotional empathy
• **Serotonin** → inhibition and moral control
• **Dopamine** → social salience and motivation
• This trio is **high-yield for MRCPsych Part A**
169
**What is oxytocin’s one main job in social behaviour?**
• Signals: **“This person is safe and important”**
• Promotes **social bonding**
• Increases **trust**
• Supports **emotional closeness and attachment**
170
**Where does oxytocin come from?**
• Produced in the **hypothalamus**
• Released via the **posterior pituitary**
• Also released **directly within the brain** to act on social circuits
171
**How does oxytocin support empathy physiologically?**
• Enhances attention to **social cues**
• Increases sensitivity to **others’ emotions**
• Reduces fear and threat responses
• Makes empathy feel **safe and approachable**
172
**Which brain regions are influenced by oxytocin?**
• **Amygdala** → reduces threat and fear
• **Insula & ACC** → emotional sharing
• **Prefrontal cortex** → social judgement and regulation
173
**What happens when oxytocin signalling is reduced?**
• Social detachment
• Reduced trust
• Blunted **emotional empathy**
• Seen in **autism spectrum conditions** and attachment difficulties
174
**What is serotonin’s one main job in social behaviour?**
• Signals: **“Stop, think, don’t act on impulse”**
• Provides **inhibitory control**
• Regulates emotions
• Suppresses aggression
175
**How does serotonin support empathy and moral behaviour?**
• Inhibits aggressive impulses
• Allows reflection before action
• Supports **rule-based, prosocial behaviour**
• Enables socially appropriate responses
176
**Which brain regions rely on serotonin for social control?**
• **Prefrontal cortex** → impulse inhibition
• **Amygdala** → dampens emotional reactivity and threat
177
**What happens when serotonin levels are low?**
• Increased impulsivity
• Aggression
• Poor emotional regulation
• Seen in **personality disorder**, impulsive violence, and depression
178
**What is dopamine’s one main job in social cognition?**
• Signals: **“This social interaction matters”**
• Assigns **importance and salience**
• Drives **motivation to engage socially**
179
**How does dopamine affect social attention?**
• Increases salience of faces and voices
• Makes social cues stand out
• Drives curiosity and engagement
• Without dopamine, social interaction feels **flat or unrewarding**
180
**Where does dopamine act in social behaviour?**
• **Ventral striatum** → social reward
• **Prefrontal cortex** → goal-directed interaction
• **Limbic system** → emotional relevance
181
**What happens when dopamine is low in social contexts?**
• Reduced motivation to engage
• Social withdrawal
• Apathy
• Seen in **depression** and negative symptoms of schizophrenia
182
**What happens when dopamine is too high in social contexts?**
• Over-interpretation of social cues
• Paranoia
• Misreading others’ intentions
• Seen in **psychosis**
183
**How do oxytocin, serotonin, and dopamine work together?**
• **Oxytocin** → emotional closeness and trust
• **Serotonin** → control and restraint
• **Dopamine** → interest and motivation
• Healthy social behaviour requires **balance of all three**
184
**What happens if oxytocin is low but dopamine is intact?**
• Social interest without emotional warmth
• Detached or calculated interactions
• Seen in some **autistic** or **psychopathic traits**
185
**What happens if serotonin is low but dopamine is high?**
• Strong urges and drives
• Poor impulse control
• Aggressive or socially inappropriate behaviour
186
**What are common exam traps about social neurotransmitters?**
• Oxytocin ≠ childbirth only
• Serotonin ≠ mood only
• Dopamine ≠ pleasure only
• Correct framing: bonding, inhibition, salience
187
**Give the exam-perfect one-sentence summary.**
• Social cognition and empathy are shaped by **oxytocin-mediated bonding**, **serotonin-mediated inhibitory and moral control**, and **dopamine-mediated salience and motivation**, with imbalance producing characteristic psychiatric presentations
188
**What are the two types of empathy used by the brain?**
• **Cognitive empathy** = understanding what someone else thinks or intends
• **Affective empathy** = emotionally feeling what someone else feels
• Cognitive empathy relies on **Theory of Mind networks**
• Affective empathy relies on **emotional resonance networks**
189
**Why is the distinction between cognitive and affective empathy critical in psychiatry?**
• Different disorders damage **different empathy systems**
• This produces **distinct behavioural profiles**
• Explains contrasts between **autism**, **psychopathy**, and **schizophrenia**
190
**What is the core social deficit in autism spectrum disorder?**
• Primary impairment in **Theory of Mind**
• Deficit in **cognitive empathy**
• Difficulty understanding others’ thoughts and intentions
191
**How does impaired Theory of Mind present clinically in autism?**
• Difficulty inferring others’ thoughts
• Problems understanding intentions
• Literal interpretation of language
• Difficulty with sarcasm, irony, and deception
• Social situations feel **confusing and unpredictable**
192
**Which brain networks are primarily affected in autism?**
• **Mentalising / Theory of Mind network**
• **Medial prefrontal cortex (mPFC)**
• **Temporoparietal junction (TPJ)**
193
**What goes wrong biologically in autism-related ToM networks?**
• Atypical neurodevelopment
• Reduced activation during social tasks
• Altered connectivity between social brain regions
• Social information is processed **inefficiently**
194
**How does autism affect information-processing style?**
• Greater reliance on **sensory-driven processing**
• Preference for rules and patterns
• Reduced use of social context and inferred mental states
195
**What is the key exam pearl about empathy in autism?**
• **Cognitive empathy is reduced**
• **Affective empathy may be intact**
• Individuals may care deeply but struggle to understand others’ minds
196
**Give a one-sentence exam summary for autism.**
• **Autism is characterised by impaired Theory of Mind due to atypical development and connectivity of mentalising networks, leading to difficulty understanding others’ thoughts despite preserved capacity for emotional concern.**
197
**What is the core deficit in psychopathy?**
• Impaired **affective empathy**
• Reduced emotional resonance
• Lack of concern for others’ pain or distress
198
**How does impaired affective empathy present in psychopathy?**
• Lack of guilt or remorse
• Callousness
• Exploitation of others
• Shallow or blunted emotional responses
• Others’ suffering does not register emotionally
199
**Is Theory of Mind impaired in psychopathy?**
• **No**
• Theory of Mind is often **intact or enhanced**
• Individuals can understand and predict others’ thoughts
• Enables manipulation
200
**Which brain regions are dysfunctional in psychopathy?**
• **Amygdala**
• **Anterior insula**
• **Anterior cingulate cortex (ACC)**
• Core emotional empathy circuits
201
**What goes wrong in the amygdala in psychopathy?**
• Reduced response to fear and distress cues
• Weak fear conditioning
• Others’ pain does not feel emotionally important
202
**What is impaired emotional learning in psychopathy?**
• Normally: harming others → discomfort → learning
• In psychopathy: punishment lacks emotional impact
• Behaviour is not emotionally corrected
203
**Give a one-sentence exam summary for psychopathy.**
• **Psychopathy involves impaired affective empathy due to reduced limbic and insular responsiveness to distress, with preserved Theory of Mind allowing understanding without emotional concern.**
204
**What is the single best exam contrast between autism and psychopathy?**
• **Autism**: “I don’t understand how you feel”
• **Psychopathy**: “I understand how you feel — I just don’t care”
205
**What empathy-related problem occurs in schizophrenia?**
• Impaired **Theory of Mind**
• Misinterpretation of others’ intentions
• Difficulty understanding motives and beliefs
206
**How does Theory of Mind impairment contribute to paranoia in schizophrenia?**
• Neutral actions are misinterpreted
• Others’ behaviour feels threatening
• Incorrect intention attribution
• Leads to persecutory beliefs
207
**What is the neurobiological basis of ToM impairment in schizophrenia?**
• Frontal lobe dysfunction
• Temporal lobe dysfunction
• Dopamine-mediated **aberrant salience**
• Incorrect meaning assigned to social cues
208
**How does schizophrenia differ from autism in ToM impairment?**
• Autism → **developmental** Theory of Mind impairment
• Schizophrenia → **distorted** Theory of Mind due to psychosis
209
**Why is empathy clinically important?**
• Impaired empathy increases aggression risk
• ToM deficits contribute to social isolation
• Different empathy profiles imply different management needs
210
**Why is empathy distinction important in forensic psychiatry?**
• Psychopathy → higher risk of instrumental aggression
• Autism → social vulnerability rather than malice
• Biology explains behavioural risk
211
**Give the one-sentence MRCPsych summary for empathy disorders.**
• **Autism shows impaired cognitive empathy with preserved emotional concern due to atypical Theory of Mind networks, psychopathy shows intact mentalising with impaired affective empathy from reduced limbic responsiveness, and schizophrenia involves distorted Theory of Mind driven by frontal–temporal dysfunction and aberrant salience.**
Cranial nerves
flashcards
Decks in class (64)
# Cards
-
CN3 OCCULOMOTOR55
-
CN4 TROCHLEAR51
-
Trigemnial nerve154
-
FACIAL NERVE75
-
VESTIBULOCOCHLEAR NERVE94
-
GLASSOPHARYNGEAL50
-
VAGAS78
-
ACCESSORY59
-
Hypoglossal84
-
Midbrain65
-
PONS80
-
Medulla151
-
Cerebellum100
-
Dexcending pyrMIDl trCT17
-
Cerebellar tract95
-
Cerebellar cells44
-
Efferent Cerebellar tract59
-
Cerebellar lesions92
-
Spinal chord anatomy132
-
Cerbrovascular circ151
-
CNS Cells236
-
Cerebral neocortex cells249
-
Bloodbrain barrier29
-
CSF system55
-
Action potential and synapse115
-
white matter tracts71
-
Cerbral cortex layers225
-
Synapses47
-
plasticity etc83
-
meurogenesis and migration0
-
Cortisol + CCK35
-
Ghrehlin/Leptin103
-
Endocannabinoids31
-
Endokephalin/Endorphins73
-
Orexin49
-
3.3.6 Links between neurotransmitter systems and findings from genetic association studies in psychiatry.178
-
high yeild31
-
neural circuit - appetite175
-
neural circuit - thirst72
-
neural circuit - aggression153
-
neural circuit - pain111
-
learning100
-
Habit and compulsions148
-
Motivation, reward and pelasure147
-
emotional regulation109
-
perception135
-
executive function + empathy/tom211
-
DMN and Salience118
-
Basic concepts: chromosomes, cell division, gene structure, transcription and translation,19
-
structure of the human genome, patterns of inheritance.29
-
Neurodevelopmental models40
-
neurodev model88
-
neurobiology of attatchment102
-
neurodev model88
-
stress182
-
CBT128
-
attatchment53
-
Learning and therapy41
-
neurobio learning39
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LEARNING THERAPY40
-
LEARNING41
-
Brain injury86
-
Alzheimer's58
-
Vascular0
