Abnormal Psychology: Treatment of Abnormality

DRUG THERAPIES

Antipsychotic Drugs

• helps reduce symptoms of psychosis, which include hallucinations (unreal perceptual experiences) and delusions (fantastic, unrealistic beliefs)
• First Group: Phenothiazines
    * Extremely helpful in reducing psychotic symptoms, but they carry a number of dangerous side effects
    * Side effects include: severe sedation, visual disturbances, and tardive dyskinesia (a neurological disorder characterized by involuntary movements of the tongue, face, mouth, or jaw)
• Atypical Antipsychotics: seem to be effective in treating psychosis without inducing some of the side effects

Antidepressant Drugs

• reduce symptoms of depression (sadness, low motivation, and sleep and appetite disturbance)
• Selective Serotonin Reuptake Inhibitors: most frequently used antidepressants; affect the serotonin neurotransmitter system
• Selective Serotonin-norepinephrine Reuptake Inhibitors (SNRIs): designed to target both serotonin and norepinephrine
    * Common Side Effects of SSRIs and SNRIs: nausea, diarrhea, headache, tremor, daytime sedation, sexual dysfunction, and agitation
• Lithium
    * a metallic element present in the sea, in natural springs, and in animal and plant tissue
    * Widely used as a mood stabilizer, particularly in the treatment of bipolar disorder, which involves swings back and forth from depression to mania (highly elevated mood, irritability, grandiosity, and involvement in dangerous activities)
    * Side Effects: extreme nausea, blurred vision, diarrhea, tremors, and twitches
    * Anticonvulsants
      * used in the treatment of mania and has fewer side effects than lithium

Antianxiety Drugs

• First Group: Barbiturates
    * Effective in inducing relaxation and sleep
    * Highly addictive
    * Withdrawal from them can cause life-threatening symptoms such as increased heart rate, delirium, and convulsions
• Benzodiazepines
    * Appears to reduce the symptoms of anxiety without interfering substantially with an individual’s ability to function in daily life
    * Sleeping pills: most frequent use of this drug
    * Highly addictive
    * Withdrawal symptoms include: heart rate acceleration, irritability, and profuse sweating

Electroconvulsive Therapy and Newer Brain Stimulation Techniques

Electroconvulsive Therapy (ECT):

• introduced as a treatment for schizophrenia
• consists of a series of treatments in which a brain seizure is induced by passing electrical current through the patient's brain
• Full series of treatments consists of 6 to 12 sessions
• Side Effects: confusion and memory loss

Repetitive Transcranial Magnetic Stimulation (rTMS)

• exposes patients to repeated, high-intensity magnetic pulses focused on particular brain structures

Deep Brain Stimulation

• electrodes are surgically implanted in specific areas of the brain
• These electrodes are then connected to a pulse generator placed under the skin that delivers stimulation to the specific brain areas

Vagus Nerve Stimulation

• electrodes are attached to the vagus nerve, a part of the nervous system that carries information to several areas of the brain, including the hypothalamus and amygdala
• These electrodes are connected to a pulse generator that delivers stimulation to the vagus nerve, which in turn travels to targeted areas of the brain

Psychosurgery

• Prefrontal Lobotomy
    * Antonio de Egas Moniz
    * the frontal lobes of the brain are severed from the lower centers of the brain in people with psychosis
    * Patients would often experience severe and permanent side effects: inability to control impulses or an inability to initiate activity, extreme listlessness and loss of emotions, seizures, and sometimes even death

PSYCHOLOGICAL APPROACHES

Behavioral Approaches

• focus on the influence of reinforcements and punishments in producing behavior
• 2 core principles:
    * Classical Conditioning
      * Ivan Pavlov
      * Unconditioned Stimulus (US): stimulus that naturally produces a response
      * Unconditioned Response (UR): response created by the unconditioned stimulus
      * Conditioned Stimulus (CS): previously neutral stimulus
      * Conditioned Response (CR): response that CS elicits
      * has been used to explain people's seemingly irrational responses to a host of neutral stimuli
    * Operant Conditioning
      * E.L. Thorndike observed that behaviors that are followed by a reward are strengthened, whereas behaviors that are followed by a punishment are weakened
      * Shaping of behaviors by providing rewards for desired behaviors and providing punishments for undesired behaviors
      * B.F. Skinner showed that a pigeon will learn to press on a bar if pressing it is associated with the delivery of food and will learn to avoid pressing another bar if pressing it is associated with an electric shock
      * Continuous Reinforcement Schedule: behaviors will be learned most quickly if they are paired with the reward or punishment every time the behavior is emitted; consistent response
      * Partial Reinforcement Schedule: behaviors can be learned and maintained in which the reward or punishment occurs only sometimes in response to the behavior
      * Extinction: eliminating a learned behavior; more difficult when the behavior was learned through a partial reinforcement schedule than when the behavior was learned through a continuous reinforcement schedule
    * Learning can occur through modeling and observational learning
      * Albert Bandura argued that people also learn behaviors by watching other people, a view that came to be known as social learning theory
      * Modeling:
        * People learn new behaviors from imitating the behaviors modeled by important people in their lives
        * more likely to occur when the person modeling the behavior is seen as an authority figure or is perceived to be like oneself
      * Observational Learning:
        * takes place when a person observes the rewards and punishments that another person receives for his or her behavior and then behaves in accordance with those rewards and punishments

Behavioral Therapies:

• focus on identifying those reinforcements and punishments that contribute to a person's maladaptive behaviors and on changing specific behaviors
• Behavioral Assessment: foundation of behavioral therapy
• Systematic Desensitization Therapy: a gradual method for extinguishing anxiety responses to stimuli and the maladaptive behavior that often accompanies this anxiety
    * Often combined with modeling
    * Vivo Exposure: asked to experience these stimuli directly; generally has stronger results than exposure only in the client’s imagination

COGNITIVE APPROACHES

• Argue that it is not simply rewards and punishments that motivate human behavior
• Cognitions (thoughts or beliefs) shape our behavior and the emotions we experience
• Causal Attribution: the “why”
• Global Assumptions: broad beliefs about ourselves, our relationships, and the world
• Aaron Beck and Albert Ellis

Cognitive Therapies

• help clients identify and challenge their negative thoughts and dysfunctional belief systems
• Designed to be short-term, on the order of 12 to 20 weeks in duration with 1-2 sessions per week
• 3 Main Goals in Cognitive Therapy
    * Assist clients in. Identifying their irrational and maladaptive thoughts. A client might be asked to keep a diary of thoughts she has whenever she feels anxious.
    * Teach clients to challenge their irrational or maladaptive thoughts and to consider alternative ways of thinking. A client might be asked to evaluate the evidence for a belief or to consider how other people might think about a difficult situation.
    * Encourage clients to face their worst fears about a situation and recognize ways they could cope.
• Often combined with behavioral techniques known as ^^cognitive-behavioral therapy (CBT)^^

PSYCHODYNAMIC APPROACHES

• suggest that all behaviors, thoughts, and emotions, whether normal or abnormal, are influenced to a large extent by unconscious processes
• Began with Sigmund Freud; developed ^^psychoanalysis^^
• Psychoanalysis
    * A theory of personality and psychopathology
    * A method of investigating the mind
    * A form of treatment for psychopathology
• Anna O.
    * Extensive symptoms of hysteria—physical ailments with no apparent physical cause—including paralysis of the legs and right arm, deafness, and disorganized speech
    * hysteria is the result of traumatic memories that have been repressed from consciousness because they are too painful
    * defined ^^repression^^ as the motivated forgetting of a difficult experience
      * Does not dissolve the emotion associated with the memory or wish
• ID, EGO, AND SUPEREGO
    * 2 basic drives that motivate human behavior
      * Libido: sexual drive
      * Aggressive drive

\