Unit 11

General Information

• Good Morning and Welcome Back!
• Device Required!
• Last EBQs are almost done; lowest will be dropped by End of Day (EOD)!
• Retakes: Start today and continue through the end of the week. Sign up if needed.
• Treatment Methods: 3 days, then done with content.
• In-Class Review: Six days dedicated to review.
• FINAL EXAM: May 2nd
• AP Exam: May 16th

Science Practice

• Question: State one way the independent variable could be operationally defined.
• Scenario: A study investigates the effects of a psychoactive drug on memory function. Participants were randomly assigned to either receive the drug or a placebo.

Operational Definition of Independent Variable

• Specify the dosage and method of administration of the psychoactive drug.
• Example: Experimental group receives a specific dosage of the drug orally in capsule form.
• Control group receives identical-looking capsules containing an inert substance.
• This ensures standardization and control.
• Allows for a clear comparison between the experimental and control conditions.

Psychoactive Drugs

• Substances that alter brain function.
• Lead to changes in:
  • Perception
  • Mood
  • Consciousness
  • Cognition
  • Behavior
• Act on the central nervous system.
• Categories:
  • Stimulants
  • Depressants
  • Hallucinogens
  • Opioids

Dependence vs. Addiction

• Dependence: Body has adapted to the drug, requiring the user to take the drug to simply feel normal (physiological).
• Addiction: Chronic brain disorder characterized by compulsive drug seeking/craving and use, despite harmful consequences (psychological).
• Involves changes in brain structure and function.
• Leads to loss of control over drug consumption.
• Example Scenario:
  • Individual starts taking prescription pain medication for legitimate medical reasons (e.g., post-surgical pain).
  • Develops a tolerance, requiring higher doses for the same pain relief.
  • Experiences withdrawal symptoms when trying to cut down or stop.
  • Feels compelled to continue using opioids despite recognizing harm (financial strain, strained relationships, declining health).
  • Spends significant time and effort obtaining and using the drug, prioritizing it over other responsibilities and activities.
  • Drug use may escalate to risky behaviors (doctor shopping, obtaining opioids from illicit sources).
  • Inability to control opioid use despite negative consequences indicates addiction.

Substance Use Disorders

• Characterized by:
  • Impaired control
  • Social impairment
  • Use in spite of risks and hazards
  • Drug action – tolerance and withdrawal
• First three represent substance abuse.
• Addition of the fourth is substance dependence.

TEDED - How Do Drugs Affect the Brain?

Agonists vs. Antagonists

• Agonists: Substances that bind to neurotransmitter receptors and mimic their effects, enhancing neural activity. "AGonists ACTivate"
• Antagonists: Substances that bind to neurotransmitter receptors without activating them, blocking the effects of neurotransmitters "ANTagonists ANTagonize"

Reuptake Inhibitors

• Medications that block the reabsorption of neurotransmitters by the sending neuron.
• Increase the concentration of neurotransmitters in the synaptic cleft.
• Enhance neurotransmission.
• Example: Fluoxetine (Prozac)
  • In the brain, serotonin regulates mood, emotions, and behavior.
  • After serotonin is released into the synapse, it binds to receptors on the receiving neuron, transmitting its signal.
  • To terminate the signal and recycle serotonin, the releasing neuron typically reabsorbs the serotonin through reuptake.
  • Fluoxetine inhibits the reuptake of serotonin by blocking the transporter protein responsible for bringing serotonin back into the releasing neuron.
  • Increases serotonin concentration in the synapse, enhancing its effects and improving mood regulation.
  • Helps alleviate symptoms of depression and other mood disorders.

Types of Psychoactive Drugs

• Ecstasy/MDMA
• Marijuana
• Caffeine
• Nicotine
• Cocaine
• Meth
• LSD
• Alcohol
• Barbiturates (Tranquilizers)
• Heroin (Opiates)

Mouse Party Activity

• "Complete the Mouse Party" Activity
• Use headphones if available.
• Try out each mouse.
• Recognize the description of drug action/mechanism in the far right column.
• Fill out the drug column and agonist/antagonist column.
• Fill out effects together after

Stimulants

• Drugs that increase neural activity and arousal.
• Lead to heightened alertness, attention, and energy levels.
• Examples:
  • Caffeine (coffee, tea, energy drinks)
  • Amphetamines (Adderall, Dexedrine)
  • Methamphetamine (crystal meth)
  • Cocaine (powder cocaine, crack cocaine)
  • Methylphenidate (Ritalin, Concerta)
  • MDMA (Ecstasy, Molly)
  • Nicotine (tobacco products)
  • Modafinil (Provigil)
  • Ephedrine (cold medications, dietary supplements)
  • Phentermine (prescription weight-loss medication)

Caffeine

• A natural stimulant found in coffee, tea, and some sodas.
• Acts on the central nervous system.
• Increases alertness and reduces fatigue by blocking the neurotransmitter adenosine.
• When you drink a cup of coffee containing caffeine, you may feel more awake and focused within minutes, making it a common choice for many people to kick-start their day or stay alert during periods of fatigue or drowsiness.
• By blocking adenosine receptors, caffeine prevents adenosine from exerting its inhibitory effects on the central nervous system.
• As a result, the activity of excitatory neurotransmitters like dopamine and norepinephrine increases, leading to enhanced arousal, improved concentration, and heightened alertness.

Cocaine

• A powerful stimulant derived from the coca plant.
• Increases neural activity, leading to euphoria, increased energy, and alertness.
• Works by blocking the reuptake of dopamine, serotonin, and norepinephrine.
• When ingested, typically by snorting, smoking, or injecting, cocaine rapidly enters the bloodstream and crosses the blood-brain barrier.
• Once in the brain, cocaine blocks the reuptake of neurotransmitters such as dopamine, serotonin, and norepinephrine.
• As a result of these neurochemical changes, individuals who use cocaine may experience a rapid onset of intense euphoria, heightened alertness, increased energy, and a sense of invincibility.
• These effects contribute to cocaine's high potential for abuse and addiction.

Depressants

• Drugs that slow down neural activity and bodily functions.
• Induce relaxation, sedation, and can lower inhibitions
• Examples:
  • Alcohol
  • Benzodiazepines (e.g., Xanax, Valium, Ativan)
  • Barbiturates
  • Antipsychotics (e.g., chlorpromazine, haloperidol) - Primarily used to treat psychotic disorders, antipsychotics can also have sedating effects.
  • Antidepressants (e.g., trazodone, amitriptyline) - Certain antidepressants, particularly those with sedative properties, can act as depressants.
  • Antihistamines (e.g., diphenhydramine, doxylamine) - Some over-the-counter antihistamines have sedating effects and are used as sleep aids.

Alcohol

• A depressant drug that slows down neural activity in the central nervous system.
• Can impair judgment, coordination, and cognitive functions.
• Leads to relaxation, euphoria, and in higher doses, intoxication.
• Alcohol, chemically known as ethanol, is a depressant drug that acts primarily on the brain.
• When consumed, alcohol quickly enters the bloodstream through the stomach and small intestine and travels to the brain.
• In the brain, alcohol enhances the activity of inhibitory neurotransmitters such as gamma-aminobutyric acid (GABA) while inhibiting the activity of excitatory neurotransmitters like glutamate.
• This dual action results in a slowing down of brain activity and a reduction in neural signaling.

Hallucinogens

• Drugs that alter perception, mood, and cognitive processes.
• Often causing hallucinations or profound changes in consciousness.
• Examples:
  • LSD (Lysergic acid diethylamide)
  • Psilocybin (Magic mushrooms)
  • DMT (Dimethyltryptamine)
  • Mescaline (Peyote, San Pedro cactus)
  • Ayahuasca
  • Salvia divinorum (Salvia)
  • PCP (Phencyclidine)
  • Ketamine
  • 2C-B
  • MDMA (Ecstasy, Molly) - While MDMA is primarily known as an empathogen and stimulant, it can also produce hallucinogenic effects at higher doses.

Marijuana

• A psychoactive drug derived from the cannabis plant.
• Contains THC, which alters mood, perception, and cognition.
• Effects include relaxation, altered perception of time, and heightened sensory experiences.
• Marijuana can produce some hallucinogenic-like effects in certain individuals, but it is not typically considered a true hallucinogen.
• Marijuana contains chemicals called cannabinoids, such as THC and CBD, which interact with receptors in the brain known as cannabinoid receptors.
• When THC binds to these receptors, it can disrupt the normal balance of chemicals in the brain, leading to changes in mood, perception, and memory.
• CBD also interacts with these receptors, but its effects are more subtle.
• Overall, marijuana affects how messages are sent and received in the brain, which can produce a variety of effects on thoughts, feelings, and behavior.

Opioids

• Psychoactive drugs that act on opioid receptors in the brain and body.
• Producing pain relief, euphoria, and sedation.
• Examples:
  • Morphine
  • Codeine
  • Oxycodone (OxyContin, Percocet)
  • Hydrocodone (Vicodin, Norco)
  • Hydromorphone (Dilaudid)
  • Fentanyl (Duragesic, Actiq)
  • Methadone
  • Tramadol (Ultram)
  • Buprenorphine (Suboxone, Subutex)
  • Heroin

Heroin

• A highly addictive opioid drug derived from morphine.
• Produces intense euphoria, pain relief, and sedation by binding to opioid receptors in the brain.
• Heroin, like other opioids, binds to opioid receptors in the brain, primarily the mu-opioid receptors.
• When heroin binds to these receptors, it activates them, leading to a cascade of effects on neural transmission.
• This activation reduces the inhibition of dopamine.
• It also inhibits the release of neurotransmitters such as GABA and reduces the activity of neurons that transmit pain signals.
• As a result, heroin produces feelings of euphoria, pain relief, and sedation.
• However, prolonged heroin use can lead to changes in the brain's reward system, tolerance, and dependence.

Tolerance

• A condition where increasing amounts of a psychoactive substance are needed to achieve the same effects.
• Occurs due to the brain's adaptation to the drug.
• Leads to reduced sensitivity to its effects over time.
• An example of tolerance is when a person who regularly uses prescription pain medication for chronic pain finds that over time, they need to take higher doses to achieve the same level of pain relief.
• For instance, let's say a person initially takes 10 \text{mg} of oxycodone to manage their pain effectively. However, after several weeks or months of consistent use, they notice that the 10 \text{mg} dose no longer provides the same level of pain relief. As a result, their doctor may increase their dosage to 15 \text{mg} to achieve the desired effect. This pattern may continue over time, with the person requiring progressively higher doses of medication to achieve the same therapeutic effect.

Withdrawal

• The onset of symptoms when a person stops using a psychoactive substance after prolonged use.
• Symptoms can include physical discomfort, psychological distress, and cravings for the drug.
• Consider a person who has been using prescription opioid painkillers, such as oxycodone, to manage chronic back pain for several months. Due to concerns about the long-term use of opioids and potential side effects, they decide to stop taking the medication without consulting their healthcare provider.
• Within a day or so of discontinuing oxycodone, the person begins to experience withdrawal symptoms.
• These symptoms may include:
  • Flu-like symptoms such as muscle aches, joint pain, and sweating
  • Gastrointestinal discomfort, including nausea, vomiting, diarrhea, and abdominal cramping
  • Anxiety, restlessness, and irritability
  • Insomnia or disturbed sleep patterns
  • Dilated pupils and tearing of the eyes
  • Yawning and runny nose
  • Goosebumps and chills
  • Increased heart rate and blood pressure.

Your Body on Drugs

• "Your Body on Drugs | Curiosity Robin Williams, who experienced both the highs and lows of substance abuse, hosted a groundbreaking experiment in which four heavy users on four of America's most abused drugs performed a series of physical tests to show exactly how drugs work. Curiosity: Your Body on Drugs "

Formative Multiple-Choice Practice Questions

Question 1

• Question: After consuming alcohol at a party, Lisa notices a decrease in her anxiety levels and an overall feeling of relaxation. Alcohol is classified as a:
  • (A) Stimulant
  • (B) Depressant
  • (C) Hallucinogen
  • (D) Opioid

Question 2

• Question: A drug treatment program educates participants that a drug which mimics the action of neurotransmitters in the brain is known as a(n):
  • (A) Agonist
  • (B) Antagonist
  • (C) Reuptake Inhibitor
  • (D) Enzyme Inhibitor

Question 3

• Question: After years of using heroin, a person may need to increase their dosage to achieve the same effect. This phenomenon is best described as:
  • (A) Addiction
  • (B) Withdrawal
  • (C) Tolerance
  • (D) Dependence

Question 4

• Question: When Joe tries to quit smoking, he experiences anxiety, irritability, and cravings. These symptoms are best categorized as:
  • (A) Tolerance
  • (B) Addiction
  • (C) Psychoactive effects
  • (D) Withdrawal

Question 5

• Question: Tom drinks several cups of coffee throughout his morning to help him feel more alert and focused. The primary psychoactive component in caffeine that acts as a stimulant by blocking this neurotransmitter:
  • (A) acetylcholine
  • (B) adenosine
  • (C) GABA
  • (D) glutamate

Thursday, April 10th

• Finish documentary
• Biological Interventions in Mental Health Treatment Lecture
• Go over EBQs
• Explain interventions derived from the biological perspective in treating psychological disorders.
  • You need a device today
  • Retakes continue today and tomorrow. If you didn’t get a spot, you need to tell me today.

Science Practice

• Using the source provided, respond to all parts of the question in your warm-up:
  • In a recent psychology research study on antidepressants, researchers investigated the efficacy of a new medication in treating depression symptoms. Participants diagnosed with depression were randomly assigned to receive either the new medication or a placebo pill. The medications were identical in appearance, and participants were instructed not to discuss their treatment with the researchers. This approach aimed to minimize bias and placebo effects. However, participants and researchers remained unaware of which treatment each participant received, enhancing the study's internal validity. Yet, a potential limitation is the difficulty in maintaining blindness, as participants may notice side effects or differences in treatment effectiveness, which could affect their responses.
    (A) Explain how the researchers ensured that participants or researchers were unaware of certain information during the study.
    (B) What potential advantages or limitations might this approach have had on the study's results?

Answers To Warm-up Questions

• (A) The researchers ensured participant and researcher unawareness by implementing a double-blind procedure, where neither group knew who received the new medication or placebo.
• (B) This approach reduces bias and placebo effects but may still be influenced by participants noticing differences in treatment effectiveness, impacting the study's validity.

Psychotropic Medication Therapy

• Involves the use of medications to treat mental health disorders by affecting brain chemistry.
• Aims to alleviate symptoms and improve functioning.
• Example: Client with severe depression prescribed an antidepressant Outcome: Client reports improvement in depressive symptoms, such as:
  1. Improved Mood
  2. Increased Energy
  3. Better Sleep
• A client who has been struggling with severe depression and has not responded to psychotherapy alone might be referred to a psychiatrist for evaluation. After a thorough assessment, the psychiatrist prescribes an antidepressant
  medication. The client begins taking the medication and continues attending therapy sessions. Over time, the client reports
  a significant reduction in depressive symptoms, such as improved mood,
  increased energy, and better sleep patterns. This improvement in symptoms
  allows the client to engage more effectively in therapy, where they work on
  underlying issues and develop coping strategies to manage their depression.
  This integrated approach enhances the overall treatment effectiveness and
  supports the client's journey toward recovery.

Drug Therapies

• Interact with brain chemistry
• A quick review of some common neurotransmitters. Try this section w/ your groups first…
  • Acetylcholine: memory, movement
  • Dopamine: movement, reward-based learning, delusions/hallucinations
  • GABA: major inhibitory neurotransmitter, reduces anxiety
  • Glutamate: major excitatory neurotransmitter, memory
  • Norepinephrine/noradrenaline: sympathetic response, boosts mood
  • Serotonin: calm/tranquil feelings
• For antipsychotics, antianxiety and antidepressants which neurotransmitters would you target? Agonist or Antagonist?

Antidepressants

• Psychoactive medications used to treat depressive disorders by altering brain chemistry.
• Primarily increasing the levels of neurotransmitters like serotonin and norepinephrine to improve mood and emotional state.
• Consider a scenario where a client has been experiencing persistent sadness, loss of interest in activities they once enjoyed, and significant fatigue. After a detailed evaluation, the clinician diagnoses the client with major depressive disorder and collaborates with a psychiatrist to start a course of antidepressants. As the client begins the medication, they continue to attend regular therapy sessions. Over several weeks, the client notices an improvement in mood, increased energy, and a renewed interest in hobbies and socializing. This therapeutic progress enables them to participate more actively in therapy, where they explore underlying emotional issues and develop coping strategies, thereby enhancing their recovery process and overall well-being.

Antidepressants Medication Types

• Fluoxetine (Prozac)
  • Type: SSRI
  • Common Uses: Depression, OCD
  • Key Characteristics: Increases serotonin, well-tolerated, fewer side effects.
• Sertraline (Zoloft)
  • Type: SSRI
  • Common Uses: Depression, anxiety disorders
  • Key Characteristics: Increases serotonin, often used for PTSD and social anxiety.
• Citalopram (Celexa)
  • Type: SSRI
  • Common Uses: Depression
  • Key Characteristics: Increases serotonin, used for mild to moderate depression.
• Escitalopram (Lexapro)
  • Type: SSRI
  • Common Uses: Depression, anxiety disorders
  • Key Characteristics: Increases serotonin, fewer side effects.
• Venlafaxine (Effexor)
  • Type: SNRI
  • Common Uses: Depression, anxiety disorders
  • Key Characteristics: Increases serotonin and norepinephrine, effective for severe depression.
• Bupropion (Wellbutrin)
  • Type: NDRI
  • Common Uses: Depression, seasonal affective disorder
  • Key Characteristics: Increases norepinephrine and dopamine, fewer sexual side effects.
• SSRI (Selective Serotonin Reuptake Inhibitor): A class of medications used to treat depression and anxiety disorders by increasing the levels of serotonin in the brain. SSRIs are commonly prescribed due to their effectiveness and generally favorable side effect profile.

Lithium

• Psychoactive medication commonly used to treat bipolar disorder by stabilizing mood swings.
• Reduces the frequency and severity of manic and depressive episodes.
• A client diagnosed with bipolar disorder experiences intense manic episodes characterized by risky behaviors, rapid speech, and reduced need for sleep. After undergoing a thorough assessment, the psychiatrist prescribes lithium due to its effectiveness in stabilizing mood. The client starts taking lithium and observes a notable decrease in the
  frequency and intensity of manic episodes. This stabilization allows the client to maintain more consistent daily routines and relationships. Alongside medication, the client continues psychotherapy to address triggers, develop coping mechanisms for stress, and improve emotional regulation. This integrated treatment approach helps the client manage their condition more effectively and maintain long-term stability.

Antianxiety Drugs

• Psychoactive drugs used to alleviate anxiety symptoms by affecting neurotransmitters in the brain.
• Promoting relaxation and reducing excessive nervousness or worry.
• Consider a scenario where a client experiences severe anxiety attacks that significantly impair their ability to function in daily life, such as attending work or interacting socially. After a detailed psychological evaluation, the clinician collaborates with a psychiatrist who prescribes an antianxiety medication. As the client begins taking the medication, they notice a reduction in the
  frequency and intensity of their anxiety attacks. This decrease in
  symptoms enables the client to engage more effectively in cognitive-behavioral
  therapy sessions, where they learn techniques to manage anxiety, such as deep
  breathing exercises and cognitive reframing. Over time, this combined approach
  of medication and therapy helps the client regain control over their anxiety,
  improving their overall quality of life and ability to participate in everyday
  activities.

Antianxiety Drugs Medication Types

• Alprazolam (Xanax)
  • Type: Benzodiazepine
  • Common Uses: Anxiety disorders, panic attacks
  • Key Characteristics: Quick relief, can be habit-forming, short-term use.
• Diazepam (Valium)
  • Type: Benzodiazepine
  • Common Uses: Anxiety disorders, muscle spasms
  • Key Characteristics: Long-acting, used for various anxiety-related conditions, potential for dependency.
• Lorazepam (Ativan)
  • Type: Benzodiazepine
  • Common Uses: Anxiety disorders, insomnia
  • Key Characteristics: Short to medium duration, often used for acute anxiety episodes.
• Buspirone (Buspar)
  • Type: Azapirone
  • Common Uses: Generalized anxiety disorder
  • Key Characteristics: Non-sedative, less risk of dependency, slower onset of action.
• Clonazepam (Klonopin)
  • Type: Benzodiazepine
  • Common Uses: Panic disorder, seizure disorders
  • Key Characteristics: Long-acting, used for chronic anxiety and panic attacks.
• Benzodiazepines: A class of medications that act on the central nervous system to produce a calming effect by enhancing the effect of the neurotransmitter GABA. They are commonly used for quick relief of anxiety and panic symptoms but can be habit-forming.
• Azapirones: A class of medications that are non-sedative and less likely to cause dependency. They work differently from benzodiazepines, typically having a slower onset of action and are primarily used for long-term management of generalized anxiety disorder.
• SSRIs: Typically used to treat depression, but also commonly prescribed to people with GAD.

Antipsychotic Medications

• Psychoactive medications used to treat symptoms of schizophrenia and other severe mental disorders by altering neurotransmitter activity in the brain.
• Helps to reduce delusions, hallucinations, and disorganized thinking.
• A client presents with symptoms including auditory hallucinations, delusional thinking, and severe disorganization in thought processes. After a thorough assessment, the psychiatrist prescribes an antipsychotic medication to help manage these symptoms. The client starts the medication regimen and gradually notices a reduction in hallucinations and delusions, which leads to clearer thinking and improved social interactions. Concurrently, the client engages in regular therapy sessions to develop social skills, manage day-to-day challenges, and learn strategies to cope with stress. This comprehensive treatment approach helps the client achieve a better quality of life and maintain stability in their daily functioning.

Antipsychotic Medications Medication Types

• Risperidone (Risperdal)
  • Type: Atypical Antipsychotic
  • Common Uses: Schizophrenia, bipolar disorder, irritability in autism
  • Key Characteristics: Effective for both positive and negative symptoms, fewer motor side effects.
• Olanzapine (Zyprexa)
  • Type: Atypical Antipsychotic
  • Common Uses: Schizophrenia, bipolar disorder
  • Key Characteristics: Effective for a range of symptoms, can cause weight gain and metabolic issues.
• Quetiapine (Seroquel)
  • Type: Atypical Antipsychotic
  • Common Uses: Schizophrenia, bipolar disorder
  • Key Characteristics: Sedative effects, often used for sleep issues and anxiety.
• Aripiprazole (Abilify)
  • Type: Atypical Antipsychotic
  • Common Uses: Schizophrenia, bipolar disorder, depression
  • Key Characteristics: Partial dopamine agonist, fewer side effects, used as an add-on for depression.
• Haloperidol (Haldol)
  • Type: Typical Antipsychotic
  • Common Uses: Schizophrenia, acute psychosis
  • Key Characteristics: Effective for positive symptoms, higher risk of motor side effects.
• Atypical Antipsychotics: Also known as second-generation antipsychotics, these medications are newer and typically have fewer motor side effects compared to typical antipsychotics. They are effective for both positive and negative symptoms of schizophrenia.
• Typical Antipsychotics: Also known as first-generation antipsychotics, these are older medications primarily effective for positive symptoms of schizophrenia but have a higher risk of motor side effects such as tardive dyskinesia.

Tardive Dyskinesia

• Potential side effect of long-term use of antipsychotic medications.
• Characterized by repetitive, involuntary movements, such as grimacing, tongue movements, and jerking of the limbs.
• A client who has been treated for chronic schizophrenia with
  antipsychotic drugs begins to show involuntary, repetitive movements
  such as lip smacking, blinking, or other facial grimacing. These symptoms
  are identified as tardive dyskinesia, a condition that sometimes persists
  even after the medication is stopped or changed. Upon recognizing these
  signs, the psychiatrist works with the client to adjust their medication
  regimen, potentially exploring newer antipsychotics that have a lower risk
  of such side effects. The client is also referred to a specialist for
  treatment specific to managing and mitigating the symptoms of
  tardive dyskinesia, aiming to improve their quality of life and maintain
  their overall treatment progress.

Psychosurgery

• Medical procedure that involves surgically altering brain tissue to treat severe mental disorders.
• Typically used as a last resort when other treatments have failed.
• In clinical psychology, psychosurgery encompasses various procedures, including more modern and targeted interventions such as deep brain stimulation (DBS). An example of this involves a client suffering from severe, treatment-resistant obsessive-compulsive disorder (OCD). Traditional therapies and medications had not sufficiently alleviated the client's symptoms, leading to significant impairment in daily functioning. As a result, the treatment team, including neurosurgeons and psychiatrists, decided to implement DBS. This procedure involves implanting electrodes in specific areas of the brain known to be involved in OCD. The electrodes deliver controlled electrical impulses to regulate abnormal impulses that contribute to OCD symptoms. Following the surgery, the client reported a substantial reduction in compulsive behaviors and obsessive thoughts, which significantly improved their quality of life and ability to engage in everyday activities.

Lobotomy

• Surgical procedure that involves severing connections in the brain's prefrontal cortex.
• Historically used to treat severe mental disorders but now largely abandoned due to its severe and often harmful side effects.
• In clinical psychology, psychosurgery, such as a lobotomy, is an invasive procedure that has been historically used to treat severe mental disorders when other treatments have failed. For instance, in the mid-20th century, a client with severe, treatment-resistant schizophrenia underwent a lobotomy, aimed at reducing symptoms by severing connections in parts of the brain. Post-surgery, the client exhibited reduced agitation and aggression, which were initially seen as positive outcomes. However, the client also experienced significant and permanent changes to personality, emotional responsiveness, and cognitive function, leading to a decline in overall quality of life. This example underscores the drastic nature of psychosurgery and its profound effects, both positive and adverse. It serves as a critical reminder of the ethical considerations and the evolution of treatment standards in mental health care.

Lesioning

• Procedure that involves creating small, targeted damage to specific areas of the brain to treat neurological or psychological disorders.
• Often used to alleviate symptoms when other treatments are ineffective.
• Consider a client with severe, drug-resistant epilepsy who experiences frequent, debilitating seizures that significantly impair daily functioning. After exhaustive evaluation and when other treatments have failed, the treatment team decides to
  proceed with a surgical intervention involving lesioning. This procedure
  targets specific areas of the brain identified as the focal points of
  seizure activity. By carefully lesioning these regions, the frequency and intensity
  of the seizures are significantly reduced. Post-surgery, the client experiences a
  marked improvement in quality of life, with fewer seizures interrupting daily
  activities and enabling a return to more normal functioning. This example
  highlights the role of lesioning as a critical option in managing severe cases where
  other interventions have not been effective.

TMS (Transcranial Magnetic Stimulation)

• Non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain.
• Commonly used to treat depression by improving mood and cognitive function.
• Consider a client diagnosed with major depressive disorder who has not responded well to antidepressants and psychotherapy. The clinician recommends TMS as a next step. During TMS treatment, the client sits in a comfortable chair while a device placed near the head generates brief magnetic pulses, stimulating nerve cells in the region of the brain involved in mood regulation. The client undergoes several sessions per week over the course of 4 to 6 weeks. Over time, the client notices a significant improvement in mood, increased energy levels, and a renewed interest in activities they once enjoyed. This improvement allows the client to engage more actively in daily life and continue with therapeutic practices to maintain mental health. This scenario demonstrates how TMS can serve as an effective alternative for treating depression, particularly when traditional methods have been ineffective.

Electroconvulsive Therapy (ECT)

• Medical treatment that involves sending small electric currents through the brain to induce a brief seizure.
• Often used to treat severe depression and other mental disorders when other treatments have been ineffective.
• A client who has severe depression with suicidal ideation, and who has not responded to medications or psychotherapy. After thorough evaluation and obtaining informed consent, the treatment team decides to proceed with ECT. During the procedure, the client is put under brief anesthesia and a small series of electrical currents are applied to the brain, inducing a brief seizure. The client undergoes several sessions over a few weeks. Following the treatment, the client experiences a significant reduction in depressive symptoms, including a lift in mood and decreased thoughts of suicide. This change enables the client to resume daily activities and participate more fully in ongoing psychotherapy and rehabilitation, illustrating ECT’s potential as a life-saving intervention when other treatments have failed.

Interactive Therapy Plan

• This assignment requires students to create a comprehensive integrative therapy plan for a hypothetical client, combining various therapeutic approaches

Formative Multiple-Choice Practice Questions#2

Question 1

• Question: A patient diagnosed with bipolar disorder is prescribed a medication that helps stabilize mood swings by altering sodium transport in nerve and muscle cells. This medication is likely:
  • (A) Lithium
  • (B) An Antidepressant
  • (C) An Antianxiety Medication
  • (D) An Antipsychotic Medication

Question 2

• Question: For a patient experiencing severe depression unresponsive to medication, a psychiatrist might recommend a procedure that involves passing an electric current through the brain to trigger a brief seizure, which is known as:
  • (A) Psychosurgery
  • (B) Electroconvulsive Therapy (ECT)
  • (C) Transcranial Magnetic Stimulation (TMS)
  • (D) Lobotomy

Question 3

• Question: A patient with schizophrenia exhibits involuntary jerky movements, facial grimacing, and rapid eye blinking years after prolonged use of medication. These symptoms are indicative of:
  • (A) Tardive Dyskinesia
  • (B) TMS (Transcranial Magnetic Stimulation)
  • (C) Lithium toxicity
  • (D) Psychosurgical effects

Question 4

• Question: A person suffering from major depressive disorder is treated with a non-invasive procedure where magnetic fields are used to stimulate nerve cells in the brain. This treatment is known as:
  • (A) Lesioning
  • (B) Electroconvulsive Therapy (ECT)
  • (C) Transcranial Magnetic Stimulation (TMS)
  • (D) Lobotomy

Question 5

• Question: When traditional treatments for anxiety fail, a healthcare provider might prescribe a type of medication known to reduce symptoms of anxiety by enhancing the effect of a neurotransmitter. These medications are referred to as:
  • (A) Antidepressants
  • (B) Antianxiety Medications
  • (C) Antipsychotic Medications
  • (D) Psychostimulants

Monday, April 14th

• 11.3 Lecture: Insight Therapies
• 11.3 Activity
• 11.4 Lecture/Videos: Cognitive and Behavioral Therapies
• Kahoot!
• Explain interventions derived from the biological perspective in treating psychological disorders.
  • You need a device today!
  • Practice Exam next class

Revisiting the Psychoanalytic/Psychodynamic Approach

• The mind consists of three parts: the conscious, the preconscious, and the unconscious.
• Your personality emerges as your ego tries to negotiate conflicts between your id and your superego.
• Unacceptable thoughts, memories, and desires get locked away in the unconscious, in a process called repression.
• The most famous psychoanalytic psychologist was Sigmund Freud.

Psychodynamic Therapies

• Focus on uncovering unconscious conflicts and past experiences to understand current behavior and emotions.
• Aim to increase self