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
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