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BIOL 3020 (30)

biol chapter 11.7

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BIOL 3020
Scott Brandon

 Should be more focus on negative and cognitive symp since they are more strongly associated with social and occupational functioning  Neurocognitive deficits were assessed in 8 domains. The hypothesis that olazapine treatment would produce greater neurocognitve benefits after 52 weeks than risperidone or haloperidol tretannt was not confirmed since the 3 meds did not differ in their neurpognitve efficacy.  Olanzapienn and risperidone treated patients improved on several domains including executive function, learning/memory, processing speed, attention/vigilicamce, verbal working memory, and motor functions.  Risperidone treated patients improved on domains of visuosptail memory.  Haloperidol treated ppl improved only on domains of learning/memory  Concluding that patients benefit most from olamnzapine and risperidone  Aripiprzaole and perphenazine concludeed that both meds can improve the symp in treatment resistant pl who did not response to olazine or risperdine  There’s a huge urge to figure out whether high mortality in s is due to disorder itself or due to meds  Dopamine dysregualtion may provide the driving force but the subjects cognitive psychodynamic and cultural context gives form to the experience. ----Biopsychosocial model Psychological treatments  Recent evidence indicates that psych strategies can play an imp role in increasing the effectiveness of meds treatment and decreasing relapse rate Social skills training  designed to tech ppl with s beh that can help them succeed in a wide variety of interpersonal situations  Is usually a component of treatments for s that go beyond Family therapy and reducing expressed emotion  Show that high levels of expressed emotion (including being hostile, hypercritical, and overprotective within the family) have been linked to relapse and re hospitalization  Educate ppl and families about s specially about the bio vulnerability hat predisposes some ppl to the illness, cog problems inherent to s, the symp of the illness and signs of impending relapse  They provide info about an advice on the monitoring of the effects of antip meds  They encourage family members to blame neither themselves not the patient for the illness and the for the difficulties all are having in coping with it  They help improve communication and problem solving skills within the family  They courante ppl as well as their family to expand their social contact, esp their support networks  They instil a degree of hope that things can improve including the hope that the patient may not have to return to the hospital  Compared with standard treatment family therapy plus meds has typically lowered relapse over periods of 1-2 years. This positive finding is evident in studies in which the treatment lasts for at least 9 months Cognitive behavioural therapy  S can benefit from cog techniques designed to address their delusions and hallucinations  That CBT plus enriched treatment as usual is as effective as treatment as usual alone and that CBT seems to be particularly effective at reducing negative symp of s  Two key goals are to help the patient reframe the psychosis (help him or her develop a cognitive understanding of the psychosis ) and self identify triggers for the psyhcis  Other interventions involve teaching patients how to reduce physiological arousal, enhance their coping skills and modify aberrant beliefs directly  Support the efficacy of individualized CBT for ppl with persistent positive psychotic symp. However the efficacy of a group format is less clear cut  CBT is probably not the optimum treatment for reducing hallucinations and delusions though it possibly has imp benefits including feeling less negative about oneself and less hopeless for the future  Although education and family therapy types of programs were generally ineffective programs based on CBT principles were more effective Personal therapy  Personal therapy is a broad spectrum CBT ap
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