HUMAN DEVELOPMENT

MRCpsych Paper A Syllabus

HUMAN DEVELOPMENT MRCPsych   

Trainees should be able to show knowledge of:    

  1. Basic frameworks for conceptualizing development: nature and nurture, stage theories, maturational tasks. Definitions of maturity. Examination of gene-environment interactions with specific reference to intelligence. The relative influence of early versus later adversities. The relevance of a developmental framework for understanding the impact of specific adversities such as trauma.  Historical models and theories: Freud and general psychoanalytic; social-learning, Piaget.   
  2. Methodology for studying development: cross-sectional, cohort, and individual studies. Identification and evaluation of influences.   
  3. Bowlby attachment theory and its relevance to emotional development, affect regulation, and human relationships in childhood and later. Conditions for secure attachment. Types and clinical relevance of insecure and disorganized attachment. Early separation and its consequences. Consequences of failure to develop selective attachments. A brief consideration of attachment, maternal ‘bonding’ parental sensitivity.   
  4. Other aspects of family relationships and parenting practices. The influence of parental attitudes compared with parenting practices. Systemic theory including supportive systems in development, and aspects of distorted family function: e.g., discord, overprotection, rejection, and enmeshment. The impact of bereavement, parental divorce, and intra-familial abuse on subsequent development and mental health of the child. The relevance or otherwise of different family structures, including cultural influences on family and stages of family.   
  5. Individual temperamental differences and their impact on parent-child relationships. Origins, typologies, and stability of temperament and the evolution of character and personality. Childhood vulnerability and resilience regarding mental health.   
  6. Cognitive development with critical reference to key models such as the biopsychosocial model and Piaget’s model.  The impact of attributions and beliefs, and cultural, genetic, and other influences.    The relevance of preoperational and formal operational thought to communicate with children and adults.    
  7. A basic outline of language development in childhood with special reference to environmental influences and communicative competence.  
  8. Development of social competence and relationships with peers:  
    1. Acceptance, group formation, co-operation, friendships, isolation, and rejection. The components of popularity.  
  9. Moral development with critical reference to Kohlberg’s stage theory. Relationship to the development of social perspective-taking.   
  10. Development of emotional literacy and emotional regulation in childhood and adolescence including the development of fears in childhood and adolescence regarding age. Possible etiological and maintenance mechanisms.   
  11. Sexual development, including the development of sexual identity and preferences.   
  12. Adolescence as a developmental phase with special reference to pubertal changes, task mastery, conflict with parents and authority, affective stability, and ‘turmoil’. Normal and abnormal adolescent development.   
  13. Adaptations in adult life, such as pairing, parenting, illness, bereavement, and loss.   
  14. Pregnancy and childbirth and their stresses both physiological and psychological.   
  15. The development of personal (ego-) identity in adolescence and adult life. Work, ethnicity, gender, and other identities. Mid-life ‘crises.   
  16. Normal aging and its impact on physical, social, cognitive, and emotional aspects of individual functioning. Social changes accompanying old age, the importance of the loss, personality changes with aging.  Social and economic factors in old age; attitude, the status of the elderly, retirement, income, accommodation, socio-cultural differences.  
  17. Genetic influences on development, including gene-environment interactions.  
  18. Neuroimaging and its role in understanding development.  Up-to-date findings in this field.  

3.7.  Genetics  

  • Brief explanations of methodologies for identifying genes. Basic concepts: chromosomes, cell division, gene structure, transcription, and translation, the structure of the human genome, patterns of inheritance. Traditional techniques: family, twin, and adoption studies. The distinction between direct gene analysis and gene tracking. Genetic markers, linkage studies, lod scores. Genome-wide association studies, genetic variants. Genetic influences on development, including gene-environment interactions.
  • Types of genetic abnormalities. Conditions associated with chromosome abnormalities. Principal inherited conditions encountered in psychiatric practice and the genetic contribution to specific psychiatric disorders. Prenatal identification. Genetic counseling. The organization of clinical genetic services, DNA banks.
  • Methods to identify genetic disorders. Techniques in molecular genetics: restriction enzymes, molecular cloning and gene probes, Southern blotting, restriction fragment length polymorphisms, recombination.
  •  Molecular and genetic heterogeneity. Phenotype/genotype correspondence. Endo phenotypes/Biotypes.
  • Epigenetics. The types of cause and effects of epigenetic modification and the transmission of these changes through generations. How drugs, psychotherapy, good and adverse experiences can modify epigenetics.
  • Gene modification/editing. The emerging techniques using CRISPR (Clustered Regularly Interspersed Short Palindromic Repeats) and CRISPR-associated (Cas) genes and similar tools for precision genome engineering.

 

Neurodevelopment and neuroplasticity  

  • The development and localization of cerebral functions throughout the lifespan from the fetal stages onwards  
  • Neurodevelopmental models of psychiatric disorders 3.8.3. Neurobiology of attachment  
  • Neuroplasticity including:
  • Neurobiological effects of stress: pre-, peri- and postnatally, developmentally, and in adults.
  • Neurobiological effects of learning and psychological therapies.
  • Intelligence and learning disability
  • Effects of injury at different ages on the brain and mental function (including traumatic brain injury, inflammatory lesions e.g., multiple sclerosis, and neoplastic lesions)  

Integrated Neurobiology of the following specific syndromes and states 

  • Autism
  • ADHD
  • Drug use, addiction, tolerance, withdrawal, relapse
  • Anxiety Disorders
  • Post-Traumatic Stress Disorders
  • Obsessive-Compulsive and Related Disorders
  • Major Depressive Disorders
  • Bipolar Affective Disorders
  • Psychosis  
  • Neurocognitive deficits in psychotic disorders
  • Self-harm and suicidality
  • Medically unexplained symptoms
  • Delirium

Neurodegeneration  

  • Controversies in the pathophysiology of neurodegeneration
  • Alzheimer’s Disease
  • Vascular dementia
  • Pick’s Disease and Frontotemporal Dementias
  • Lewy Body diseases including Parkinson’s Disease
  • Prion Diseases
  • HIV brain disease        

Preparing for exams | Royal College of Psychiatrists (rcpsych.ac.uk)