treatments
Chapter 15 Treatment of Psychological Disorders
15.1 Various Methods Have Been Used to Treat Psychopathology
Biological Therapies:
Definition: Treatments for psychological disorders based on medical approaches to disease and illness.
Concept: Psychological disorders arise from abnormalities in neural and bodily processes.
Psychopharmacology: The use of medications that affect brain or body functions.
Current focus: Combining biological therapies with other approaches for optimal client treatment.
Psychotherapy:
Definition: The generic name for formal psychological treatment.
Variability in Techniques: Depends on practitioner’s training; involves interactions between practitioner and client.
15.5 Medication Is Effective for Certain Disorders
Psychotropic Medications:
Definition: Drugs that affect mental processes.
Categories:
Anti-anxiety drugs (e.g., Valium)
Antidepressants (e.g., Prozac)
Antipsychotics (mainly treat schizophrenia)
Monoamine Hypothesis of Depression
Concept:
Low brain activity among serotonin and/or norepinephrine neurons leads to major depression.
Goal of Antidepressants: Increase one or both neurotransmitters to improve brain function.
Neurotransmitters: Chemicals necessary for neuronal communication that are released in the synapse.
Antidepressant Treatment
Types of Antidepressants:
MAO inhibitors
Tricyclics
Reuptake inhibitors (SSRIs & SNRIs)
Function: Inhibit neurotransmitter reuptake.
SSRIs & SNRIs are preferred due to fewer side effects and greater prevalence.
Reuptake Inhibitors
Process: Serotonin is deactivated in the synapse by reuptake into the presynaptic neuron.
Example: Prozac blocks the reuptake of serotonin, thus enhancing serotonin receptor activation.
Transcranial Magnetic Stimulation
Definition: A technique that induces an electrical current in the brain when a magnetic field is rapidly switched on and off.
Types:
Single-pulse TMS: Disruption of brain activity occurs only during stimulation.
Repeated TMS: Multiple TMS pulses over an extended period.
Use in Treatment: May be beneficial for depression.
Deep Brain Stimulation (DBS)
Definition: Involves surgically implanting electrodes deep in the brain. Mild electricity stimulates the brain at optimal frequency/intensity.
Applications:
Proven successful for Parkinson's disease.
Currently being tested for severe mental disorders such as OCD and depression.
Success Rate: At least half of participants in trials for treatment-resistant depression show improvement.
Electroconvulsive Therapy (ECT)
Definition: A procedure that administers a strong electrical current to induce a seizure in the brain; effective for treatment-resistant severe depression.
History: Developed in Europe in the 1930s, initially used for schizophrenia and depression during the 1950s and 1960s.
15.12 Many Effective Treatments Are Available for Depressive Disorders
Prevalence: Depression, becoming more common, is one of the most widespread mental disorders.
Research Findings: Various effective treatments exist, but no single best approach has been determined for all individuals.
Alternative Treatments for Depression
Regular aerobic exercise and good diet may alleviate symptoms and reduce recurrence.
ECT is noted for its efficacy in severely depressed patients unresponsive to conventional treatments.
TMS applied to the left frontal region significantly reduces depression symptoms.
Seasonal Affective Disorder (SAD)
Definition: Episodes of depression occurring primarily in winter, with prevalence increasing at higher latitudes.
Symptoms: Include depression, carbohydrate cravings, and weight gain.
Treatment: Many respond well to phototherapy, involving exposure to high-intensity light daily.
Antipsychotic Drugs
Dopamine Hypothesis of Schizophrenia: Excessive dopamine activity is associated with schizophrenia (particularly positive symptoms).
Antipsychotic Medications:
Function: Decrease dopamine activity in the brain.
Side Effects: Older antipsychotic drugs can cause tardive dyskinesia, resulting in involuntary muscle twitching.
Prognosis in Schizophrenia
General Outcome: Approximately 1 in 7 individuals achieve favorable results in symptom reduction and social functioning over two years.
Factors Influencing Prognosis: Age of onset, gender, cultural background, and the duration of untreated psychotic symptoms.
15.14 Lithium and Atypical Antipsychotics Are Most Effective for Bipolar Disorder
Category: Bipolar and Related Disorders in DSM-5 are positioned between schizophrenia-related and depression-related disorders.
Optimal Treatment: Lithium is the clear preferred treatment for bipolar disorder.
Risks: Atypical antipsychotic quetiapine (Seroquel) is frequently prescribed, but antidepressants may trigger manic episodes and are not generally recommended.
Treatments for Anxiety Disorders
Cognitive-Behavioral Therapy (CBT): Most effective method for adult anxiety disorders, with short-term anxiety-reducing drugs providing benefits in some cases.
Behavior Therapy: Based on learning theory; components may include:
Exposure Therapy: Involves repeated exposure to anxiety-inducing stimuli.
Social Skills Training: Aims to teach clients appropriate behaviors in social situations through modeling and observation.
Specific Phobias and Treatments
Phobias often spontaneously develop; treatment relies heavily on behavioral techniques, especially exposure therapy.
Techniques include:
Virtual environments to expose clients safely.
Systematic Desensitization: Involves progressive muscle relaxation combined with a fear/anxiety hierarchy approach, effective for phobias and anxiety disorders.
The Treatment Experience for Panic Disorder
Panic disorder has diverse treatment components; cognitive restructuring helps clients understand and address irrational reactions during panic attacks.
CBT is shown to be as effective or more effective than medication for panic attacks.
Obsessive-Compulsive Disorder Treatments
Standard anti-anxiety drugs are ineffective for OCD; instead, clomipramine (a potent SSRI) is used.
Cognitive-Behavioral Therapy: Crucial for effective treatment, focusing on exposure and response prevention to reduce obsessive thoughts and compulsive actions.
Chapter 15 Treatment of Psychological Disorders
15.1 Various Methods Have Been Used to Treat Psychopathology
Biological Therapies:
Definition: Treatments for psychological disorders based on medical approaches to disease and illness.
Concept: Psychological disorders arise from abnormalities in neural and bodily processes.
Psychopharmacology: The use of medications that affect brain or body functions.
Current focus: Combining biological therapies with other approaches for optimal client treatment.
Psychotherapy:
Definition: The generic name for formal psychological treatment.
Variability in Techniques: Depends on practitioner’s training; involves interactions between practitioner and client.
15.5 Medication Is Effective for Certain Disorders
Psychotropic Medications:
Definition: Drugs that affect mental processes.
Categories:
Anti-anxiety drugs (e.g., Valium)
Antidepressants (e.g., Prozac)
Antipsychotics (mainly treat schizophrenia)
Monoamine Hypothesis of Depression
Concept:
Low brain activity among serotonin and/or norepinephrine neurons leads to major depression.
Goal of Antidepressants: Increase one or both neurotransmitters to improve brain function.
Neurotransmitters: Chemicals necessary for neuronal communication that are released in the synapse.
Antidepressant Treatment
Types of Antidepressants:
MAO inhibitors
Tricyclics
Reuptake inhibitors (SSRIs & SNRIs)
Function: Inhibit neurotransmitter reuptake.
SSRIs & SNRIs are preferred due to fewer side effects and greater prevalence.
Reuptake Inhibitors
Process: Serotonin is deactivated in the synapse by reuptake into the presynaptic neuron.
Example: Prozac blocks the reuptake of serotonin, thus enhancing serotonin receptor activation.
Transcranial Magnetic Stimulation
Definition: A technique that induces an electrical current in the brain when a magnetic field is rapidly switched on and off.
Types:
Single-pulse TMS: Disruption of brain activity occurs only during stimulation.
Repeated TMS: Multiple TMS pulses over an extended period.
Use in Treatment: May be beneficial for depression.
Deep Brain Stimulation (DBS)
Definition: Involves surgically implanting electrodes deep in the brain. Mild electricity stimulates the brain at optimal frequency/intensity.
Applications:
Proven successful for Parkinson's disease.
Currently being tested for severe mental disorders such as OCD and depression.
Success Rate: At least half of participants in trials for treatment-resistant depression show improvement.
Electroconvulsive Therapy (ECT)
Definition: A procedure that administers a strong electrical current to induce a seizure in the brain; effective for treatment-resistant severe depression.
History: Developed in Europe in the 1930s, initially used for schizophrenia and depression during the 1950s and 1960s.
15.12 Many Effective Treatments Are Available for Depressive Disorders
Prevalence: Depression, becoming more common, is one of the most widespread mental disorders.
Research Findings: Various effective treatments exist, but no single best approach has been determined for all individuals.
Alternative Treatments for Depression
Regular aerobic exercise and good diet may alleviate symptoms and reduce recurrence.
ECT is noted for its efficacy in severely depressed patients unresponsive to conventional treatments.
TMS applied to the left frontal region significantly reduces depression symptoms.
Seasonal Affective Disorder (SAD)
Definition: Episodes of depression occurring primarily in winter, with prevalence increasing at higher latitudes.
Symptoms: Include depression, carbohydrate cravings, and weight gain.
Treatment: Many respond well to phototherapy, involving exposure to high-intensity light daily.
Antipsychotic Drugs
Dopamine Hypothesis of Schizophrenia: Excessive dopamine activity is associated with schizophrenia (particularly positive symptoms).
Antipsychotic Medications:
Function: Decrease dopamine activity in the brain.
Side Effects: Older antipsychotic drugs can cause tardive dyskinesia, resulting in involuntary muscle twitching.
Prognosis in Schizophrenia
General Outcome: Approximately in individuals achieve favorable results in symptom reduction and social functioning over two years.
Factors Influencing Prognosis: Age of onset, gender, cultural background, and the duration of untreated psychotic symptoms.
15.14 Lithium and Atypical Antipsychotics Are Most Effective for Bipolar Disorder
Category: Bipolar and Related Disorders in DSM- are positioned between schizophrenia-related and depression-related disorders.
Optimal Treatment: Lithium is the clear preferred treatment for bipolar disorder.
Mechanism: Functions as a mood stabilizer, reducing both manic and depressive episodes.
Efficacy: Highly effective in preventing relapse and decreasing the severity of mood swings.
Monitoring: Requires careful monitoring of blood levels due to a narrow therapeutic window.
Atypical Antipsychotics: Often used, particularly when lithium is not tolerated or as an adjunct.
Examples: Quetiapine (Seroquel), olanzapine, and aripiprazole.
Function: Help manage acute manic or depressive episodes and can serve as maintenance therapy.
Risks: Antidepressants, while treating depressive symptoms, may trigger manic episodes and are generally not recommended as monotherapy for bipolar disorder due to this risk.
Treatments for Anxiety Disorders
Cognitive-Behavioral Therapy (CBT): Most effective method for adult anxiety disorders, with short-term anxiety-reducing drugs providing benefits in some cases.
Behavior Therapy: Based on learning theory; components may include:
Exposure Therapy: Involves repeated exposure to anxiety-inducing stimuli.
Social Skills Training: Aims to teach clients appropriate behaviors in social situations through modeling and observation.
Specific Phobias and Treatments
Phobias often spontaneously develop; treatment relies heavily on behavioral techniques, especially exposure therapy.
Techniques include:
Virtual environments to expose clients safely.
Systematic Desensitization: Involves progressive muscle relaxation combined with a fear/anxiety hierarchy approach, effective for phobias and anxiety disorders.
The Treatment Experience for Panic Disorder
Panic disorder has diverse treatment components; cognitive restructuring helps clients understand and address irrational reactions during panic attacks.
CBT is shown to be as effective or more effective than medication for panic attacks.
Obsessive-Compulsive Disorder Treatments
Standard anti-anxiety drugs are ineffective for OCD; instead, clomipramine (a potent SSRI) is used.
Cognitive-Behavioral Therapy: Crucial for effective treatment, focusing on exposure and response prevention to reduce obsessive thoughts and compulsive actions.