psych 105 chp 16: treatment of psychological disorders

biological and psychological treatment, and treatment effectiveness

anti anxiety meds

Drugs that help reduce a person’s experience of fear or anxiety 

• Work by facilitating GABA action

Withdrawal from anti anxiety meds

• symptoms of anxiety

• heart palpitations, insomnia

• not supposed to quit cold turkey

Most common antianxiety medications are

benzodiazepines

ex: Diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax)

what are Antidepressants and how do they work

help lift mood

• act on neurotransmitters such as serotonin, dopamine, and norepinephrine by inhibiting their breakdown and blocking reuptake

SSRI and SNRI

• most common used antidepressants used today

• Selective serotonin reuptake inhibitors (SSRI)

• Serotonin and norepinephrine reuptake inhibitor (SNR

what is bipolar treated with

• mood stabilizers

• lithium and valporate

• dont recommend antidepressants bc only treat depression not mania

phototherapy

repeated exposure to bright light

used for people w SAD depression

omega 3

some studied suggest it can lower depression and suicide rates

effects of medication and therapy in brain

• decrease lvl of amygdala activity (stress area)

Electroconvulsive therapy (ECT)

• Sometimes used to treat severe mental disorders that do not respond to psychological treatment or medication

• Treatment involves inducing a mild seizure by delivering an electrical shock to the brain.

• May be used to treat severe depression and/or mania

Transcranial magnetic stimulation (TMS)

• placing a powerful pulsed magnet over a person’s scalp, which alters neuronal activity in the brain

• used to treat depression.

• more effective than ECT and less side effects

Psychosurgery and example

• Involves surgical destruction of specific brain areas to treat severe and unresponsive psychological disorders; rarely used today

• Cingulotomy

• Ex: Severe cases of OCD; involves very precise destruction of brain tissue to disrupt the brain circuits known to be involved in generating obsession

Deep brain stimulation (DBS)

insertion of battery-powered electrodes that deliver electrical pulses to specific brain areas believed to be causing a person’s mental disorder

how many canadians suffer from mental disorders at some point in their life

1 in 5

potential illusion of treatment

• natural improvement

• placebo effects

• reconstructive memory

natural improvement

Tendency of symptoms to return to their mean or average level

placebo effect

Inert substance or procedure that has been applied with the expectation that a healing response will be produced

reconstructive memory

client’s motivation to get well causes errors in memory for the original symptoms

treatment outcome studies

evaluate whether treatment works (often in comparison to another treatment or control condition)

Hans eysenck

latrogenic illness

• Disorder or symptom that occurs as a result of a medical or psychotherapeutic treatment itself

• dangers of psychotherapy are subtle

treatments and ethnicity

Treatments that are effective in research studies (which often include only a small percentage of ethnic minority patients) have been found to work equally well with people of different ethnicities

personal and social costs

significant impairments in the person’s ability to carry out daily activities

financial costs

inability to hold employment or poor job performance and cost of treatment can create large personal and societal burdens.

who can get treatment

• only about ½ of ppl w depression get adequate care

• 1/3 get treatment for general mental health

• ¾ Canadian children do not get access to care

why do some people not get treatment

• don’t know they have a treatable disorder

• barriers like beliefs and circumstances

• structural barriers

• psychologists and others are not publically funded and private coverage only for people w good employment

psychological treatment

people interact w clinicians

environment used to change client’s brain and behaviour

biological treatment

brain treated w drugs, surgery, or other direct intervention

psychotherapy

Interaction between a socially sanctioned clinician and someone suffering from a psychological problem

• Goal: Provide support or relief from problem

Eclectic psychotherapy

Involves drawing on techniques from different forms of therapy

• Therapy form depends on client and problem.

Psychodynamic psychotherapies

Explore childhood events and encourage individuals to use this understanding to develop insight into their psychological problems

Psychoanalysis

• Assumes that humans are born with aggressive and sexual urges that are repressed during childhood by use of defense mechanisms

• client to understand the unconscious in a process called developing insight

• Limited evidence for effectiveness

what is Interpersonal psychotherapy (IPT) and the treatment focus

• psychotherapy that focuses on helping clients improve current relationships

• effective for depression and anxiety

• focus: Interpersonal functioning, believing symptoms will subside as interpersonal relations improve.

ex: Grief, role disputes, role transitions, interpersonal deficits

humanistic and existential therapies think

psychological problems stem from feelings of alienation and loneliness

humanistic approach of therapy

• feelings can be traced to failure to reach one’s potential

• client centered therapy

existential approach to therapy

• Feelings stem from failure to find meaning in life

• Gestalt therapy

Person-centred therapy (or client-centred therapy)

Form of psychotherapy that assumes all individuals tend to growth

Therapist qualities: congruence, empathy, unconditional positive regard

Gestalt therapy

help the client become aware of thoughts, behaviours, experiences, and feelings and owning or take responsibility for them

technique: empty chair, feelings into actions

Behaviour therapy

• Involves changing maladaptive behaviour patterns

• Assumes that disordered behaviour is learned

• symptom relief is achieved through changing maladaptive behaviours into more constructive behaviours

how to eliminate unwanted behaviour

operant conditioning:

how to promote desired behaviour

token economy:

how to reduce unwanted emotional responses

exposure therapy:

cognitive therapy

Helps a client identify and correct any distorted thinking about self, others, or the world

Cognitive restructuring

teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative thinking with more realistic and positive beliefs

Mindfulness meditation

Teaches an individual to be fully present in each moment; to be aware of their thoughts, feelings, and sensations; and to detect symptoms before they become a problem

Cognitive-behavioural therapy (CBT)

Blend of cognitive and behavioural therapeutic strategies

• Problem-focused

• Action-oriented

• Encourages transparency between therapist and client

Self-help and support groups

• Involve discussion or Internet chat groups that focus on a particular disorder or difficult life experience

• Groups are often run by peers who have struggled with the same issues

• cost effective

• can also encourage counter therapeutic behaviours

Kazdin and Blase

• time for a rebooting of psychotherapy research and practice

• update patient treatment passports w technology

  • Online conferencing apps; remote treatment

  • Facebook; group-based CBT

  • YouTube; DBT

how do drugs work

target specific neurotransmitters for desire effects

antipsychotic meds and first drug

• used to treat schizophrenia and related psychotic disorders

• first was chlorpromazine

how do antipsychotics work and how well

• Block dopamine receptors in certain parts of the brain, such as the mesolimbic pathway

• Work well for positive symptoms, but not negative ones that require increase in dopamine at synapse