EPPP Part 2 Skills cheat sheet

Neurotransmitter–behavior links: dopamine (mesolimbic/mesocortical reward and salience), serotonin (mood, impulse control, sleep), norepinephrine (arousal, vigilance), GABA (inhibitory tone; benzodiazepines are positive allosteric modulators at GABA-A), glutamate (primary excitatory transmitter; NMDA receptor involvement in learning).

Dose–response and half-life rule: steady-state plasma level is reached after roughly 4–5 elimination half-lives; a drug with a 24-hour half-life needs about 5 days to reach steady state and about 5 days to wash out.

Antidepressant mechanism lag: SSRIs block the serotonin transporter within hours, but clinical improvement typically emerges over 2–6 weeks, supporting downstream neuroplasticity (e.g., BDNF, hippocampal neurogenesis) rather than transporter blockade alone.

Lateralization: left hemisphere dominates language in most right-handers; right hemisphere contributes prosody, visuospatial attention, and emotional tone. Callosal transfer deficits can produce agnosia for left-sided stimuli.

Classic lesion syndromes: Broca (nonfluent, effortful speech, comprehension relatively spared), Wernicke (fluent but empty speech with poor comprehension), conduction aphasia (impaired repetition with preserved fluency and comprehension).

Sleep architecture: NREM stage 3/4 (slow-wave sleep) predominates in the first third of the night; REM periods lengthen toward morning. REM is linked to procedural memory consolidation and emotional processing.

Stress axis: hypothalamic CRH drives pituitary ACTH, which drives adrenal cortisol. Hippocampal glucocorticoid receptors provide negative feedback; chronic stress is associated with hippocampal dendritic atrophy and feedback impairment.

Neuroimaging decision rule: CT for acute hemorrhage and speed; MRI for soft-tissue and structural detail; fMRI for task-related hemodynamic activity; PET for metabolic or receptor mapping; EEG for seizure and temporal resolution.

Classical conditioning terms: acquisition, extinction, spontaneous recovery, generalization, discrimination, higher-order conditioning. Extinction is new inhibitory learning, not erasure of the original association.

Operant contingencies: positive reinforcement adds a stimulus to increase behavior; negative reinforcement removes one to increase behavior; punishment (positive or negative) decreases behavior. Schedules: fixed-ratio produces post-reinforcement pauses; variable-ratio produces high, steady rates.

Working memory model (Baddeley): central executive plus phonological loop, visuospatial sketchpad, and episodic buffer. Capacity estimates cluster around 4 chunks in current research, versus Miller's classic 7 plus or minus 2.

Levels of processing: semantic (deep) encoding yields better recall than phonemic, which beats structural (shallow). Encoding specificity means retrieval is best when context and cue match encoding conditions.

Piagetian stages: sensorimotor (0–2, object permanence), preoperational (2–7, egocentrism, conservation failure), concrete operational (7–11, conservation, reversibility), formal operational (11+, hypothetico-deductive reasoning).

Attribution biases: fundamental attribution error (overweighting disposition for others' behavior), actor–observer bias, self-serving bias, and ultimate attribution error for out-groups.

Cognitive distortions targeted in CBT: all-or-nothing thinking, catastrophizing, mind reading, overgeneralization, personalization, should statements, and discounting the positive.

Affect–cognition interactions: mood-congruent memory (better recall of mood-consistent material), mood-dependent retrieval, and the broaden-and-build account of positive affect expanding attentional scope.

Conformity: Asch line-judgment studies show public compliance rises with unanimous majority size and drops sharply with even one dissenting ally. Private acceptance differs from compliance.

Obedience: Milgram's paradigm found the highest obedience when the authority was legitimate and proximate, the victim was remote, and no disobedient peer model was present.

Group decision rules: group polarization shifts initial leanings to extremes; groupthink (Janis) arises with high cohesion, insulation, directive leadership, and stress, and is countered by devil's advocacy and outside review.

Bystander intervention follows five steps (notice, interpret, assume responsibility, know how to help, decide to act); diffusion of responsibility explains larger effects in larger groups.

Social exchange and equity: relationships are evaluated by reward–cost balance; equity theory predicts distress when input–outcome ratios are perceived as unequal.

Cultural dimensions (Hofstede): individualism–collectivism, power distance, uncertainty avoidance, masculinity–femininity, long-term orientation. Individualism indexes the degree to which ties are loose versus integrated.

Cross-cultural assessment cautions: construct, method, and item bias can produce apparent group differences; measurement invariance (configural, metric, scalar) should be established before comparing means.

Stereotype threat: performance decrements occur when a negative group stereotype is salient and the task is relevant; effects are reduced by self-affirmation and by framing tasks as non-diagnostic.

Attachment classifications (Ainsworth Strange Situation): secure (distress at separation, comfort on reunion), avoidant (little distress, avoids caregiver), resistant/ambivalent (high distress, not soothed), disorganized (contradictory behavior).

Erikson's eight psychosocial stages pair a crisis with a virtue: trust/mistrust, autonomy/shame, initiative/guilt, industry/inferiority, identity/role confusion, intimacy/isolation, generativity/stagnation, integrity/despair.

Kohlberg's moral stages: preconventional (punishment, self-interest), conventional (approval, law and order), postconventional (social contract, universal principles). Gilligan argued the ethic of care was underweighted.

Temperament (Thomas and Chess): easy, difficult, and slow-to-warm-up patterns; goodness of fit between temperament and environment predicts adjustment better than temperament alone.

Language milestones: babbling around 6 months, first words near 12 months, two-word combinations near 18–24 months, vocabulary spurt in the second year. Delayed expressive language with normal comprehension has a better prognosis.

Maturation versus experience: visual deprivation effects, sensitive periods for language (phonology most affected), and the finding that early institutional care raises risk for disinhibited social engagement.

Aging: fluid abilities (processing speed, novel problem solving) decline earlier than crystallized abilities (vocabulary, knowledge). Working-memory and inhibition changes underlie many apparent memory declines.

Family and peer influences: authoritative parenting (high warmth, high demandingness) is associated with the best outcomes; permissive, authoritarian, and neglectful styles show distinct profiles. Peers gain salience in adolescence.

Reliability and validity relations: reliability is necessary but not sufficient for validity; a test can be reliable and invalid, but not valid and unreliable. Standard error of measurement, SEM = SD times the square root of (1 minus reliability).

Reliability coefficients: internal consistency (Cronbach's alpha, split-half with Spearman–Brown correction), test–retest, interrater (kappa corrects for chance agreement).

Validity types: face, content, construct (convergent and discriminant), criterion (concurrent and predictive). Incremental validity asks whether a measure adds prediction beyond existing data.

Standard scores: z has mean 0 and SD 1; T has mean 50 and SD 10; deviation IQ has mean 100 and SD 15; scaled scores have mean 10 and SD 3. Convert via z to compare across scales.

Diagnostic thresholds: intellectual disability requires significantly subaverage intellectual functioning (about 2 SD below the mean) plus adaptive deficits with onset in the developmental period; specific learning disorder requires academic skills below expectancy for age, education, and intelligence.

Differential diagnosis anchors: delirium (acute, fluctuating attention and awareness, often medical) versus dementia (progressive, memory first). Major depression versus persistent depressive disorder by duration (2 weeks versus 2 years).

Base rates drive predictive value: a test with high sensitivity and specificity can still have low positive predictive value when the disorder is rare. Screening tests are chosen for sensitivity; confirmatory tests for specificity.

Structured assessment: structured diagnostic interviews improve diagnostic reliability; actuarial (statistical) prediction generally equals or outperforms clinical judgment for defined outcomes.

Empirically supported treatment logic: efficacy from randomized controlled trials, effectiveness in real-world settings, and clinical utility (feasibility, cost, acceptability) are separate questions.

Exposure-based treatments: graded exposure, flooding, and response prevention rely on extinction and inhibitory learning; within-session fear reduction is less predictive than expectancy violation.

Behavioral activation targets avoidance and reinforces contact with rewarding activity; it performs comparably to cognitive restructuring in depression trials.

Psychopharmacology anchors: SSRIs are first-line for many anxiety and depressive disorders; lithium for bipolar maintenance; clozapine for treatment-resistant schizophrenia with mandatory blood monitoring for agranulocytosis.

Motivational interviewing: collaborative, evoking, and autonomy-supporting; the decisional balance explores pros and cons. Confrontation tends to raise resistance.

Prevention levels: universal, selective, and indicated prevention (Institute of Medicine) versus primary, secondary, and tertiary prevention. Indicated prevention targets high-risk individuals with subclinical symptoms.

Supervision essentials: establish a written supervision contract, specify goals and methods, document sessions, evaluate trainee competence, and manage multiple relationships. Supervisors carry vicarious liability for trainees' work within the supervisory relationship.

Common factors: therapeutic alliance, therapist empathy, and client expectations account for substantial outcome variance; specific techniques contribute on top of, not instead of, these factors.

Validity of designs: internal validity concerns causal inference (confounds, history, maturation, regression to the mean); external validity concerns generalization; construct validity concerns whether the manipulation measures the intended construct.

Sampling and error: standard error of the mean equals SD divided by the square root of n. Increasing power comes from larger n, larger effect, lower variability, and better design (e.g., within-subjects).

Hypothesis testing: alpha is the Type I error rate (false positive); beta is the Type II error rate; power equals 1 minus beta. A p value is the probability of data at least this extreme given the null, not the probability the null is true.

Effect sizes: Cohen's d (small 0.2, medium 0.5, large 0.8), Pearson r, eta squared for ANOVA. Confidence intervals convey precision and can replace or supplement significance tests.

Statistical test selection: t test for two means, ANOVA for three or more, chi-square for categorical association, correlation for linear association, regression for prediction, and nonparametric tests when assumptions fail.

Correlation and causation: r ranges from -1 to 1, is symmetric, and is unaffected by linear transformation. Correlation does not establish direction or rule out third variables; mediation and moderation are distinct models.

Reliability–validity and measurement: attenuation means low reliability shrinks observed correlations toward zero; restriction of range likewise reduces observed correlations.

Research ethics: informed consent, confidentiality limits, debriefing after deception, minimal risk, and IRB review. Authorship requires substantial contribution; data fabrication is a distinct category from questionable practices like p-hacking.

Informed consent elements: purpose, procedures, risks and benefits, alternatives, limits of confidentiality, right to withdraw, and contact information. Assent plus guardian permission applies to minors.

Confidentiality exceptions: imminent danger to self or others, suspected child or elder abuse, court order, and client-initiated litigation placing mental state at issue. Tarasoff-type duties require reasonable care to protect identified victims.

Mandated reporting: reasonable suspicion, not proof, triggers a report to the designated agency; the clinician need not investigate.

Boundaries and multiple relationships: not all are unethical; risk rises when the relationship could impair objectivity or exploit. Sexual relationships with current clients are prohibited, and post-termination time limits apply (commonly at least 2 years under APA).

Competence and referral: practice within boundaries of competence based on education, training, supervised experience, or consultation; obtain competence or refer when a new area arises.

Records and test security: retain records per law and policy (APA advises retaining test data for the duration required to support decisions), release only with authorization or legal requirement, and protect test security from disclosure.

Ethical decision-making models: identify the dilemma, consult codes and law, consult colleagues, consider alternatives and consequences, act, and document. When law and ethics conflict, attempt resolution and document the conflict.

Forensic and legal distinctions: confidentiality, privilege, and privacy differ; privilege belongs to the client and can be waived. In custody evaluations, the evaluator serves the court, not either parent, and uses multiple methods and sources.

Neurotransmitter–behavior links: dopamine (mesolimbic reward and salience), serotonin (mood, impulse control, sleep), norepinephrine (arousal), GABA (inhibitory tone; benzodiazepines modulate GABA-A), glutamate (primary excitatory transmitter; NMDA involvement in learning).

Dose–response rule: steady state is reached after roughly 4–5 elimination half-lives, so a drug with a 24-hour half-life needs about 5 days to reach steady state or wash out.

Antidepressant lag: SSRIs block the serotonin transporter within hours, but clinical improvement typically emerges over 2–6 weeks, implicating downstream neuroplasticity rather than transporter blockade alone.

Lateralization: left hemisphere dominates language in most right-handers; right hemisphere contributes prosody, visuospatial attention, and emotional tone.

Classic aphasias: Broca (nonfluent, effortful speech, comprehension relatively spared), Wernicke (fluent but empty speech with poor comprehension), conduction (impaired repetition with preserved fluency and comprehension).

Sleep architecture: slow-wave sleep predominates in the first third of the night; REM periods lengthen toward morning, with REM linked to procedural memory consolidation and emotional processing.

Stress axis: hypothalamic CRH drives pituitary ACTH, which drives adrenal cortisol; hippocampal glucocorticoid receptors provide negative feedback, and chronic stress is associated with feedback impairment and hippocampal dendritic atrophy.

Neuroimaging decision rule: CT for acute hemorrhage and speed; MRI for soft-tissue and structural detail; fMRI for task-related hemodynamic activity; PET for metabolic or receptor mapping; EEG for seizure and temporal resolution.

Classical conditioning terms: acquisition, extinction, spontaneous recovery, generalization, discrimination, higher-order conditioning. Extinction is new inhibitory learning, not erasure of the original association.

Operant contingencies: positive reinforcement adds a stimulus to increase behavior; negative reinforcement removes one to increase behavior; punishment decreases behavior. Fixed-ratio schedules produce post-reinforcement pauses; variable-ratio schedules produce high, steady rates.

Working memory model (Baddeley): central executive plus phonological loop, visuospatial sketchpad, and episodic buffer. Current capacity estimates cluster near 4 chunks, versus Miller's classic 7 plus or minus 2.

Levels of processing: semantic (deep) encoding yields better recall than phonemic, which beats structural (shallow). Encoding specificity means retrieval is best when context and cue match encoding conditions.

Piagetian stages: sensorimotor (0–2, object permanence), preoperational (2–7, egocentrism, conservation failure), concrete operational (7–11, conservation, reversibility), formal operational (11+, hypothetico-deductive reasoning).

Attribution biases: fundamental attribution error (overweighting disposition for others' behavior), actor–observer bias, self-serving bias, and ultimate attribution error for out-groups.

Cognitive distortions targeted in CBT: all-or-nothing thinking, catastrophizing, mind reading, overgeneralization, personalization, should statements, and discounting the positive.

Affect–cognition interactions: mood-congruent memory (better recall of mood-consistent material), mood-dependent retrieval, and the broaden-and-build account of positive affect expanding attentional scope.

Conformity: Asch line-judgment studies show public compliance rises with a unanimous majority and drops sharply with even one dissenting ally; private acceptance differs from compliance.

Obedience: Milgram's paradigm found the highest obedience when the authority was legitimate and proximate, the victim was remote, and no disobedient peer model was present.

Group decision rules: group polarization shifts initial leanings to extremes; groupthink (Janis) arises with high cohesion, insulation, directive leadership, and stress, and is countered by devil's advocacy and outside review.

Bystander intervention follows five steps (notice, interpret, assume responsibility, know how to help, decide to act); diffusion of responsibility explains larger effects in larger groups.

Social exchange and equity: relationships are evaluated by reward–cost balance; equity theory predicts distress when input–outcome ratios are perceived as unequal.

Cultural dimensions (Hofstede): individualism–collectivism, power distance, uncertainty avoidance, masculinity–femininity, long-term orientation. Individualism indexes the degree to which ties are loose versus integrated.

Cross-cultural assessment cautions: construct, method, and item bias can produce apparent group differences; measurement invariance (configural, metric, scalar) should be established before comparing means.

Stereotype threat: performance decrements occur when a negative group stereotype is salient and the task is relevant; effects are reduced by self-affirmation and by framing tasks as non-diagnostic.

Attachment classifications (Ainsworth Strange Situation): secure (distress at separation, comfort on reunion), avoidant (little distress, avoids caregiver), resistant/ambivalent (high distress, not soothed), disorganized (contradictory behavior).

Erikson's eight psychosocial stages pair a crisis with a virtue: trust/mistrust, autonomy/shame, initiative/guilt, industry/inferiority, identity/role confusion, intimacy/isolation, generativity/stagnation, integrity/despair.

Kohlberg's moral stages: preconventional (punishment, self-interest), conventional (approval, law and order), postconventional (social contract, universal principles). Gilligan argued the ethic of care was underweighted.

Temperament (Thomas and Chess): easy, difficult, and slow-to-warm-up patterns; goodness of fit between temperament and environment predicts adjustment better than temperament alone.

Language milestones: babbling around 6 months, first words near 12 months, two-word combinations near 18–24 months, vocabulary spurt in the second year. Delayed expressive language with normal comprehension has a better prognosis.

Maturation versus experience: visual deprivation effects, sensitive periods for language (phonology most affected), and the finding that early institutional care raises risk for disinhibited social engagement.

Aging: fluid abilities (processing speed, novel problem solving) decline earlier than crystallized abilities (vocabulary, knowledge). Working-memory and inhibition changes underlie many apparent memory declines.

Family and peer influences: authoritative parenting (high warmth, high demandingness) is associated with the best outcomes; permissive, authoritarian, and neglectful styles show distinct profiles. Peers gain salience in adolescence.

Reliability and validity relations: reliability is necessary but not sufficient for validity; a test can be reliable and invalid, but not valid and unreliable. Standard error of measurement, SEM = SD times the square root of (1 minus reliability).

Reliability coefficients: internal consistency (Cronbach's alpha, split-half with Spearman–Brown correction), test–retest, interrater (kappa corrects for chance agreement).

Validity types: face, content, construct (convergent and discriminant), criterion (concurrent and predictive). Incremental validity asks whether a measure adds prediction beyond existing data.

Standard scores: z has mean 0 and SD 1; T has mean 50 and SD 10; deviation IQ has mean 100 and SD 15; scaled scores have mean 10 and SD 3. Convert via z to compare across scales.

Diagnostic thresholds: intellectual disability requires significantly subaverage intellectual functioning (about 2 SD below the mean) plus adaptive deficits with onset in the developmental period; specific learning disorder requires academic skills below expectancy for age, education, and intelligence.

Differential diagnosis anchors: delirium (acute, fluctuating attention and awareness, often medical) versus dementia (progressive, memory first). Major depression versus persistent depressive disorder by duration (2 weeks versus 2 years).

Base rates drive predictive value: a test with high sensitivity and specificity can still have low positive predictive value when the disorder is rare. Screening tests are chosen for sensitivity; confirmatory tests for specificity.

Structured assessment: structured diagnostic interviews improve diagnostic reliability; actuarial (statistical) prediction generally equals or outperforms clinical judgment for defined outcomes.

Empirically supported treatment logic: efficacy from randomized controlled trials, effectiveness in real-world settings, and clinical utility (feasibility, cost, acceptability) are separate questions.

Exposure-based treatments: graded exposure, flooding, and response prevention rely on extinction and inhibitory learning; within-session fear reduction is less predictive than expectancy violation.

Behavioral activation targets avoidance and reinforces contact with rewarding activity; it performs comparably to cognitive restructuring in depression trials.

Psychopharmacology anchors: SSRIs are first-line for many anxiety and depressive disorders; lithium for bipolar maintenance; clozapine for treatment-resistant schizophrenia with mandatory blood monitoring for agranulocytosis.

Motivational interviewing: collaborative, evoking, and autonomy-supporting; the decisional balance explores pros and cons. Confrontation tends to raise resistance.

Prevention levels: universal, selective, and indicated prevention (Institute of Medicine) versus primary, secondary, and tertiary prevention. Indicated prevention targets high-risk individuals with subclinical symptoms.

Supervision essentials: establish a written supervision contract, specify goals and methods, document sessions, evaluate trainee competence, and manage multiple relationships. Supervisors carry vicarious liability for trainees' work within the supervisory relationship.

Common factors: therapeutic alliance, therapist empathy, and client expectations account for substantial outcome variance; specific techniques contribute on top of, not instead of, these factors.

Validity of designs: internal validity concerns causal inference (confounds, history, maturation, regression to the mean); external validity concerns generalization; construct validity concerns whether the manipulation measures the intended construct.

Sampling and error: standard error of the mean equals SD divided by the square root of n. Increasing power comes from larger n, larger effect, lower variability, and better design (e.g., within-subjects).

Hypothesis testing: alpha is the Type I error rate (false positive); beta is the Type II error rate; power equals 1 minus beta. A p value is the probability of data at least this extreme given the null, not the probability the null is true.

Effect sizes: Cohen's d (small 0.2, medium 0.5, large 0.8), Pearson r, eta squared for ANOVA. Confidence intervals convey precision and can replace or supplement significance tests.

Statistical test selection: t test for two means, ANOVA for three or more, chi-square for categorical association, correlation for linear association, regression for prediction, and nonparametric tests when assumptions fail.

Correlation and causation: r ranges from -1 to 1, is symmetric, and is unaffected by linear transformation. Correlation does not establish direction or rule out third variables; mediation and moderation are distinct models.

Reliability–validity and measurement: attenuation means low reliability shrinks observed correlations toward zero; restriction of range likewise reduces observed correlations.

Research ethics: informed consent, confidentiality limits, debriefing after deception, minimal risk, and IRB review. Authorship requires substantial contribution; data fabrication is a distinct category from questionable practices like p-hacking.

Informed consent elements: purpose, procedures, risks and benefits, alternatives, limits of confidentiality, right to withdraw, and contact information. Assent plus guardian permission applies to minors.

Confidentiality exceptions: imminent danger to self or others, suspected child or elder abuse, court order, and client-initiated litigation placing mental state at issue. Tarasoff-type duties require reasonable care to protect identified victims.

Mandated reporting: reasonable suspicion, not proof, triggers a report to the designated agency; the clinician need not investigate.

Boundaries and multiple relationships: not all are unethical; risk rises when the relationship could impair objectivity or exploit. Sexual relationships with current clients are prohibited, and post-termination time limits apply (commonly at least 2 years under APA).

Competence and referral: practice within boundaries of competence based on education, training, supervised experience, or consultation; obtain competence or refer when a new area arises.

Records and test security: retain records per law and policy (APA advises retaining test data for the duration required to support decisions), release only with authorization or legal requirement, and protect test security from disclosure.

Ethical decision-making models: identify the dilemma, consult codes and law, consult colleagues, consider alternatives and consequences, act, and document. When law and ethics conflict, attempt resolution and document the conflict.

Forensic and legal distinctions: confidentiality, privilege, and privacy differ; privilege belongs to the client and can be waived. In custody evaluations, the evaluator serves the court, not either parent, and uses multiple methods and sources.