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Using the American Board of Psychiatry and Neurology content outline for the Child and Adolescent Psychiatry board exam, starting with the most high yield, Dr. O'Leary has created this podcast for anyone interested in CAPS and also to help him study for the boards. Enjoy! Let Dr. O'Leary know what you think by going to https://psydactic.com/ and filling out the form there.
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PsyDactic

T. Ryan O'Leary

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A resource for psychiatrists and other medical or behavioral health professionals interested in exploring the neuroscientific basis of psychiatric disorders, psychopharmacology, neuromodulation, and other psychiatric interventions, as well as discussions of pseudoscience, Bayesian reasoning, ethics, the history of psychiatry, and human psychology in general. This podcast is not medical advice. It strives to be science communication. Dr. O'Leary is a skeptical thinker who often questions what ...
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The Art of Living is something we all have to learn — we’re not just born with it. This podcast will address questions and challenges we all face in living life more authentically, with greater peace and richer meaning. Subscribe today. Hosted by Dr. Mikael Thompson, doctor of psychology and professional counselor. Reach out to Dr. Mikael at http://bio.site/DrMikael to learn more. Dr. Mikael is also co-author of the DSJ (www.dailystructuredjournal.com). Support this podcast: https://podcaste ...
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Dr. William J. Librizzi, PsyD

Dr. William J. Librizzi, PsyD

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William Librizzi is the founder and director of The Wellspring Counseling Center and the Wellspring Communications Group in Manasquan, New Jersey. He, along with his team of Christian counselors, assist individuals in the areas of emotional and spiritual growth. They work with their clients integrating the word of God with sound, psychological principals. Reverend Librizzi is a Licensed Professional Counselor within the state of New Jersey and an ordained minister. Prior to counseling full t ...
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Dr. O'Leary introduces PsyDactic - Child and Adolescent Board Study edition by sharing the first of two episodes on behaviorism, that field of psychology that took the radical stance of completely ignoring the fact that we have a mind. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and …
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Let me know what you think! - This episode delves into the epidemiology, neurobiology, and differential diagnosis of Developmental Coordination Disorder (DCD), including its frequent co-occurrence with autism intellectual developmental disorder or ADHD, and stresses the importance of occupational and physical therapies to improve outcomes, highligh…
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Let me know what you think! - Enjoy today’s A.I. generated discussion of ADHD etiology, epidemiology, and diagnosis. Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com Feedback can be emailed to …
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Let me know what you think! - Dr. O'Leary tries something new by feeding an artificial intelligence a series of peer reviewed papers about autism spectrum disorder and having it generate an audio discussion of the content. This episode focusses on the differential diagnosis of ASD and how to rule out other neurodevelopmental disorders and even OCD …
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-- Dr. O'Leary explores how an artificial intelligence tool summarizes recent data on the use of nicotinic receptor modulators for the treatment of anxiety and PTSD. Please send any comments to [email protected]. Please leave feedback at https://www.psydactic.com or send any comments to [email protected]. References and readings (when ava…
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Let me know what you think! - This episode focuses on communication disorders in children, specifically language, speech sound, fluency, and social communication disorders. It differentiates these disorders through case vignettes, comparing and contrasting DSM-5 TR criteria, and highlighting key features of each disorder. Language Disorder is chara…
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"People are 14 times more likely to die during a hospital stay than outside of hospital for inpatient psychiatry." In the last episode, I shared an episode of Psychiatry Boot Camp, which is a podcast created by Dr. Mark Mullen to help medical students and junior residents hone their psychiatric skills. Mark interviews some of the most competent and…
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Let me know what you think! - This episode begins with a case vignette about a 7-year-old boy, Tommy, who exhibits global developmental delays and impaired adaptive functioning. Dr. O'Leary explores the DSM-5 criteria for ID, emphasizing deficits in intellectual functions and adaptive functioning during the developmental period. Severity levels are…
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Let me know what you think! - In the last episode, I introduced behaviorism, which took a strikingly different approach to human learning and development by basically assuming that everything we are on the inside is somehow learned from the environment, except for some of the most basic things we need for survival. Our inner life and the reasons we…
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In the last episode, Dr. O'Leary interviewed the creator and host of the Psychiatry Bootcamp Podcast, Dr. Mark Mullen, who is currently a psychiatry clerkship director at St. Louis University School of Medicine. He created this podcast after discovering a dearth of resources available for medical students and junior psychiatry residents to prepare …
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Dr. O'Leary is excited to introduce you to Psychiatry Boot Camp (PBC), a podcast created by Dr. Mark Mullen during his psychiatry residency to help prepare medical students for psychiatry residency. It covers fundamental topics in psychiatry and inspires young psychiatrists to think critically about their approach to the field. The curriculum is ba…
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Let me know what you think! - I have so far discussed some of the early psychosexual, psychosocial and cognitive approaches to child development, but I would be remiss if I did not also mention a group of theorists who attempted to study humanity by completely ignoring the fact that they have thoughts and emotions. The behavioralists tried to simpl…
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Let me know what you think! - In episode 8, I started discussing temperament theory with an introduction to Alexander Thomas and Stella Chess. They first developed a temperamental formulation by following 141 children longitudinally and proposed 9 dimensions of temperament that can be reduced to three basic categories: Easy, Difficult, or Slow-to-w…
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Let me know what you think! - While it may seem quaint today, the radical contribution that Alexander Thomas and Stella Chess made to child development was to look at children as unique individuals with very different innate approaches to the world that were present at birth. While processes like attachment and their psychosocial context help to de…
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--In today's episode, Dr. O'Leary explores agonists, inverse agonists, partial agonists, and antagonists. These terms describe how molecules bind to receptors and either increase, decrease, or prevent changes in receptor signaling. Agonists increase receptor activity, with full agonists like dopamine and serotonin raising activity to its maximum. P…
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Let me know what you think! - Attachment theory began when John Bowlby rebelled from the psychoanalytic establishment by, for the first time, observing families interacting in order to understand individuals. Bowlby was later joined by Mary Ainsworth who developed on of the most iconic clinical tools in the history of child psychology: The Strange …
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Let me know what you think! - Erik Erikson's psychosocial theory of development focuses on the social and emotional aspects of human growth. A child’s cognitive development underlies what Erikson describes and arguably, without the cognitive skills described by Piaget, the psychosocial stages that Erikson describes would not be possible. Erikson's …
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Let me know what you think! - Jean Piaget's description of cognitive development is markedly different from psychosexual and psychoanalytic approaches. He was concerned primarily with cognitive abilities. Instead of basically just making up a complex inner life and mode of relating to mommy’s breast, he described the kinds of cognitive tasks childr…
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Let me know what you think! - Following Freud, there were many researchers trying to make sense of child development using his psychosexual approach as a framework. Among those that adopted the psychoanalytic approach was his daughter, Anna Freud, who has been called “the mother of child psychoanalysis.” Other mothers include the developers of Obje…
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Let me know what you think! - Sigmund Freud's psychosexual approach proposes that human development unfolds in a series of stages, each focused on a different erogenous zone. Successful resolution of conflicts in each stage is crucial for healthy personality development. Dr. O'Leary gives a brief breakdown of Freud's psychosexual stages. Referenced…
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Let me know what you think! - Dr. O'Leary reviews the basic developmental milestones children are expected to reach by age 5. https://cdc.gov/ncbddd/actearly/milestones/milestones-2mo.html Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com Feedback can be emailed to [email protected] OR submi…
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Let me know what you think! - Dr. O'Leary introduces PsyDactic - CAPS Edition, explains the goal of this podcast, and how it was produced. This podcast is intended as a study aid for the American Board of Psychiatry and Neurology (ABPN) Child and Adolescent Psychiatry board exam. Referenced resources can be found within the show transcripts at http…
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--Dr. O'Leary discusses the term Transference, and if you listen until the end, he relates it to some computational neuroscience. Transference is a historically loaded term. Transference is supposed to be an unconscious process, so it can not really be observed, only inferred, so this means that both the definition of transference and any instance …
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-- More recently I have faced the diagnostic conundrum of catatonia in autism, and that is what I want to explore in more excruciating detail today. There is surprisingly little literature on the subject, and that is concerning because being able to identify and treat catatonia can be life-saving, not to mention life-altering for patients and their…
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-- Dr. O’Leary interviews forensic psychiatrist and author Dr. Michael Schirripa about his career as a forensic psychiatrist, the release of his first thriller, Mindhunt, and his podcast Mindhunting. Dr. Shirripa explores how his love of literature influenced his decision to pursue forensic psychiatry and ultimately resulted in his creation of an i…
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- - In the world of psychotropic medication, the question is not just whether it works or not, but whether it works better than a placebo and whether the effect size is clinically significant and the benefits outweigh the risks. In the case of MDMA (aka molly or ecstasy), the effect size for improving post-traumatic stress disorder symptoms reporte…
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The Narrative Fallacy describes our tendency to find meaning, connections, and causal relationships where they do not necessarily exist. In this episode, Dr. O'Leary had the pleasure of interviewing Dr. Alexey Tolchinsky. He recently published a paper called “Narrative fallacy and other limitations of psychodynamic case formulation.” Dr. Tolchenski…
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Dr. O'Leary discusses a variety of concerns that all clinicians should have in mind when using psychometrics. In the end, he hopes you come away with some level of agreement with the statement: “Our primary concern should not be with the quantity of data, but with the quality of the data.” Statistics are conceptual machines that will produce result…
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In this episode, Dr. O'Leary discusses a word that he has struggled to understand since medical school. The word is aphasia. The root “phasia” comes from the Greek phanai which means “to speak.” When aphasia is used medically, it refers to an inability to speak, although not always. More generally it is often used to mean a failure to understand or…
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I did not until recently even consider the cerebellum when thinking about psychiatric conditions, but the more I read, the more I wonder why the cerebellum is not considered a potential important player in nearly every psychiatric disorder. Although it can be said that all brain regions primarily function to make predictions, the cerebellum is espe…
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The thalami are bilaterally symmetrical structures in the subcortical part of the brain that are cradled by the basal ganglia. They are major hubs of pretty much everything your brain does and all of the sensory information coming into the brain with the exception of smell. More primitive models of the brain visualized it as a bunch of relatively i…
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In this episode, I discuss a medication that patients who saw a psychiatrist or their primary care provider between about 1997 and 2015 were very likely to find themselves prescribed. More recently, it has been taken down a notch or two on prescribers lists of preferred meds. This medication is quetiapine, marketed as Seroquel by AstraZeneca in the…
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This episode continues an intermittent series called “In a Word.” Past episodes have explored words like Akathisia, Dissociation, Perseveration, and even the difference between Impulsive and Compulsive. This episode explores Confabulation, including some of the brain circuits involved, and what might differentiate confabulation from other kinds of …
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In 2012 the Supreme Court heard two related cases involving adolescents convicted of murder and sentenced to life in prison without parole because of mandatory minimum sentencing guidelines in their states. One of the boys, Evan Miller along with an accomplice, had beat a man unconscious with a baseball bat after a fight that ensued when the man aw…
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I am lucky today to be able to bring you an interview with Dr. Zac Brooks who is passionate about serious mental illness (SMI). “What is serious mental illness?” you might ask. That is one of the things we are going to discuss, and you may be surprised when Dr. Brooks explains how it was first formally defined. We also discuss the numerous ways the…
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PsyDactic welcomes Dr. Jon Lindefjeld for a discussion of the history of HIV and AIDS. In particular, we discuss the development of effective antiretroviral therapies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), highlighting the CDC guidelines for use and monitoring, need to treat psychiatric com-morbidities, and …
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Dr. O'Leary discusses some of the history of the borderline personality, how different perspectives have attempted to explain its origin, how to treat it and how not to treat it. He starts in 1947 with some colorful descriptions of patients living with borderline personality disorder that would never get published today, and highlights some of the …
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Our current diagnostic criteria for personality disorders have failed to demonstrate validity or reliability. The DSM 5 encouraged psychiatrists to start considering a broad range of personality features adapted from the Five Factor Model. These are combined with global functioning measures to build a personality inventory for any patient who is ha…
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Humans have a history of tattooing that stretches millennia into prehistory. The western ban on tattoos by the early church resulted in a systematic effort to paint tattooed individuals as pagan, primitive, vulgar, criminal, and mentally ill. Psychiatrists have historically contributed to this characterization but are in a position to help reframe …
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The brain understands the world by building models that predict the future. One of the ways that it does this is by utilizing attractor networks. These small world networks are constantly trying to determine what is a true signal from the constant noise in the neural net. Dr. O'Leary explores how attractor networks have been hypothesized to explain…
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When I started to make this episode, I thought I would try to do a comprehensive review of all of the various functions of serotonin across its 15 or more receptor types, but I soon found myself overwhelmed. More importantly, I found that some stories are more interesting to tell than others, so here I discuss serotonin and focus on how a few 5-HT …
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Frequently I have complained that the terms "typical and atypical" or "first generation and second generation" antipsychotics were not very helpful. When I give chalk talks to junior residents and interns about antipsychotics, this is one of the first things that I note. It is the medicines relative affinities for different receptors that appear to…
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This episode explores side effects of antipsychotics at the molecular level. It starts by exploring receptors and their ligands and takes a turn into the dorsal striatum where dopamine, acetylcholine, serotonin, and glutamate work together to help us dance the mamba. Dr. O'Leary explores what happens when the complex pathways of the cortico-striata…
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The authors of the famous sequenced treatment alternatives to relieve depression trial or STAR*D reported that about two-thirds or 67% of patients had achieved remission after 4 trials of antidepressant medication. This remission rate has been questioned over the years and in October of 2023, the journal BMJ Open published an article that reports t…
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This episode is about dopamine. In episode 32, I discussed the pseudoscientific trend of the “dopamine detox” or "dopamine fasting." Instead of talking about pseudoscience in this episode, I discuss the actual science surrounding dopamine and its relationship with the neuroleptics or antipsychotics as they are more commonly known. The effects and s…
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In this Episode, I continue an intermittent series called “In A Word.” The difference between prior episodes and this one is that today I have two words. I chose these words because I don’t really know the difference between them, and even after reading and trying to understand the difference, I am not sure that there is a clear difference. The two…
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I discuss something that is likely to present itself to a physician long after the fact: a single mild brain injury. This episode focuses on how to classify the severity of a single brain injury. While working in a brain injury unit, I noticed that some providers used the term severe brain injury when referring patients to neurology or neuropsychia…
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This episode continues a series on the prefrontal cortex, a complex region of the brain that gives us the ability to have the kinds of thoughts no other species on earth is known to have. The medial (or mesial) prefrontal cortex is especially important for emotional and autonomic regulation, attention and goal-directed behaviors (including addictio…
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In this episode, I am sliding down and under the front part of the brain and consider the orbital frontal cortex, that part of the brain right above and a little behind your eyes. It is much smaller than the lateral gyri on the prefrontal cortex, but appears to be an important probability generator in our brain when we need to consider different op…
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We seem to understand the specializations of the the dorsolateral prefrontal cortex on the left better than the right side of our brain. That is because most of us do a lot more language processing on the left or dominant side. The more inferior and caudal parts of the dorsolateral PFC on the left side are more specialized for speech. The more supe…
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