PSY100H1 Lecture Notes - Electric Generator, Fluoxetine, Neuroscience

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29 Nov 2012
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CHAPTER 15 TREATMENT OF PSYCHOLOGICAL DISORDERS
-psychologists use psychological and biological techniques:
-Psychotherapy: generic name given to formal psychological treatment
-Biological Therapies: medical approaches to illness and to disease
Psychopharmacology: use of medications that affect brain/body functions
Psychotherapy
-aimed at changing patterns of thought/ behavior
Psychodynamic Therapy
-Freud believed disorders were caused by prior experiences and early traumatic experiences; pioneered the method of
psychoanalysis:
treatment involved uncovering unconscious feelings and drives that were thought to lead to maladaptive
thoughts/behaviors
general goal is for patient to gain insight: awareness of unconscious processes and how they affect daily
functioning
-now, psychodynamic therapy involves examining patient’s needs, defences and motives
-use of this therapy is controversial: evidence for effectiveness in most mental disorders is weak
Humanistic Therapies
-goal is to treat the person as a whole, not collection of behaviors or repository of repressed thoughts
-Client-Centered Therapy (Rogers): an empathic approach to therapy; encourages personal growth through self-
understanding
therapists are empathic, taking client’s perspective and accept client w/ unconditional positive regard
uses reflective listening: therapist repeats client’s concerns to help person clarify feelings
motivational interviewing: CCT use for short period of time; effective for drug/alcohol abuse
Cognitive-Behavioral Therapy
-most successful therapies involve trying to change ppl’s behaviors and cognition directly
-in behavioral therapy, behavior modification involves rewarding desirable behaviors and punishing undesirable ones
social-skills training for interpersonal difficulties; begins w/ modelling (therapist acts out appropriate behavior)
-Cognitive Therapy: based on the theory that distorted thoughts can produce maladaptive behavior and emotions;
treating the thought patterns should eliminate the maladaptive behaviors
Cognitive Restructuring (Beck): clinicians help client recognize maladaptive thought patterns and replace them
w/ more realistic, positive ones
Rational-Emotive Therapy (Ellis): therapists act like teachers who explain and demonstrate more adaptive ways
of thinking
-Cognitive-Behavioral Therapy (CBT): incorporates behavioral and cognitive techniques; tries to correct faulty
cognitions and train client to engage in new behaviors
E.g. person w/ social phobia is taught social skills and also made to see that his appraisals of other ppl’s reactions
to him might be inaccurate
One of the most effective forms of psychotherapy for many mental disorders, esp. anxiety and mood disorders
Include Exposure: behavioral therapy technique that involves repeated exposure to anxiety-producing stimulus;
reliable technique for many phobias and can be tried at home for mild cases
Group Therapy
-benefits for group therapy includes cost and opportunity to learn from one another’s experiences; believed that 8 is ideal
-structured groups (behavioral and cognitive-behavioral groups) effective for bulimia and OCD
-less structured groups focus on increasing insight and providing social support
Family Therapy
-Systems Approach: says that an individual is part of a larger context, and change in individual behavior will affect
whole system
-type of family involvement important to therapy outcome:
Negative expressed emotion (emotional over-involvement, critical comments, hostility by family) correspond to
the relapse rate for patients w/ schizophrenia
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Confession is Good For the Spirit
-Aristotle coined the term Catharsis to describe the way certain msgs evoke powerful emotional reactions and subsequent
relief
-talking about or writing about emotionally charged events reduces blood pressure, muscle tension during disclosure and
immediately afterwards; just the act of telling someone about problems can have healing power
Effects of Culture
-psychotherapy and definitions of mental health are based on the dominant cultural paradigm
Medication
-Psychotropic Medications: drugs that affect mental processes; act by changing brain neurochemistry (e.g. by inhibiting
action potentials or altering synaptic transmission)
-fall into three categories:
Anti-Anxiety Drugs (Tranquilizers): used for short-term treatment of anxiety; e.g. Benzodiazepines increase
activity of GABA (reduce anxiety and promote relaxation, but induce drowsiness and addictive)
Antidepressants: used to treat depression; includes monoamine oxidase inhibitors (monoamine oxidase converts
serotonin into another form), also may raise levels of dopamine and norepinephrine; tricyclic antidepressants
inhibit reuptake of certain neurotransmitters; like SSRI (Prozac), also used for anxiety disorders
Antipsychotics (Neuroleptics): used to treat schizophrenia and other disorders involving psychosis; reduce
symptoms like hallucinations and delusions; bind to dopamine receptors and block effects of dopamine; have
siginificant side effects like tardive dyskinesia (twitching of muscles); not useful for treating negative symptoms
of schizophrenia (like apathy, social withdrawal)
-other drugs include Lithium (most effective treatment for bipolar disorder); Anti-Convulsants prevent seizures and can
also regulate moods in bipolar disorder
Alternative Biological Treatments Used in Extreme Cases
-in prehistoric times, holes were made in skulls (“trepanning”) to let out evil spirits believed to cause unusual behavior
-in early 20th century, patients w/ severe mental illness underwent psychosurgery, in which areas of front cortex were
selectively damages; used for treatment of schizophrenia, major depression and anxiety disorders
-in prefrontal lobotomy, nervefibre pathways in prefrontal cortex are severed; made ppl flat and listless; discontinued in
1950’s
-Electroconvulsive Therapy (ECT) involves placing electrodes on patient’s head and administering electrical current
strong enough to produce a seizure ; effective for some cases of severe depression
-Transcranial Magnetic Stimulation (TMS) uses a powerful magnetic field that induces electrical current in brain
region directly below coil, interrupting neural function in that region; may be useful for depression
-Deep Brain Stimulation (DBS) involves using electrodes planted deep within brain; electrical generator placed under
skin below collarbone sends continous stimulation to implanted electrodes; very successful to treat symptoms of
Parkinson’s disease (reverse movement problems associated w/ disease)
-counterproductive treatments include encouraging ppl to describe experiences after major trauma, using hypnosis to
recover painful memories, having polive run drug education programs like DARE
Ppl debriefed after natural disasters more likely to develop PTD, hypnosis can produce false memories
Most Effective Treatments
-highly effective treatments exist for anxiety disorders, mood disorders and sexual dysfunction but few treatments for
alcoholism
-three features characterize psychological treatments (evidence-based treatment as opposed to generic term of
psychotherapy): 1) they vary according to particular mental disorder; 2) techniques have been developed in the lab; 3) no
overall grand theory guides treatment; treatment is based on evidence of its effectiveness
Treatment for Anxiety Disorders
-cognitive-behavioral therapy works best to treat most adult anxiety disorders; psychoanalytic theory is not useful
-effects of CBT persist long after treatment; tranquilizers and antidepressant drugs that block reuptake of serotonin and
norepinephrine effective for treating generalized anxiety disorder but limited to period during which the drug is taken
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Document Summary

Psychotherapy: generic name given to formal psychological treatment. Biological therapies: medical approaches to illness and to disease. Psychopharmacology: use of medications that affect brain/body functions. Freud believed disorders were caused by prior experiences and early traumatic experiences; pioneered the method of psychoanalysis: treatment involved uncovering unconscious feelings and drives that were thought to lead to maladaptive thoughts/behaviors. General goal is for patient to gain insight: awareness of unconscious processes and how they affect daily functioning. Now, psychodynamic therapy involves examining patient"s needs, defences and motives. Use of this therapy is controversial: evidence for effectiveness in most mental disorders is weak. Goal is to treat the person as a whole, not collection of behaviors or repository of repressed thoughts. Client-centered therapy (rogers): an empathic approach to therapy; encourages personal growth through self- understanding therapists are empathic, taking client"s perspective and accept client w/ unconditional positive regard. Uses reflective listening: therapist repeats client"s concerns to help person clarify feelings.

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