PSY240H1 Lecture Notes - Lecture 4: Obsessive–Compulsive Disorder, Agoraphobia, Comorbidity

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12 Oct 2012
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Lecture 4
Oct 3, PSY240
Finishing off Lecture 3
Treatment
Somatic approaches
These are frequently radical and invasive
With the exception of drug therapy, these are not frequently used
ECT
Electroconvulsive Shock Therapy (convulsive= it involves a seizure)
Used extensively in the past, but currently not so much (still happens though)
Used particularly to treat schizophrenia (as were ice bathed, wrapping, etc.)
Severe depression is still treated with ECT
It is effective, but sometimes depression comes back
Not a psychosis but it looks psychotic. They do not eat, drink, move, or do
anything. This isn’t common but not that rare either
Usually, medication and psychotherapy are the standard method of
treatment
But the problem is consent; someone who isn’t responding cannot provide
consent and therefore ECT is typically administered without patient consent
The main side effect is memory loss, called “retrograde amnesia”, meaning
that past long-term memories are lost
(Anterograde amnesia means that you can’t build new memories)
ECT now is preformed unilaterally
In the past, electrodes are put on both sides of the head to make all of
the neurons fire at the same time (this is a seizure)
Now, an electrode is only applied on one side of the head (usually right
side). This still causes the brain to seize but there is a reduction in
memory loss
Psychosurgery
Has been used in the past and is still used (most frequently in children)
Epilepsy
Split-brain surgery to cure severe epilepsy
An epileptic focus may be found where the seizures originate and
sometimes the treatment is to remove the focus of the seizure
Not conducted for psychoses anymore after drug therapy
One of the world-famous places for children psychosurgery is Sick Children’s
here in Toronto
A surgical technique usually used to separate or remove parts of the brain, and
they are permanent
Lobectomy = removal of a lobe
Lobotomy = separation of a lobe (and therefore they have no function
anymore)
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Lobotomy (one of the brain lobes are removed, usually a frontal lobe which has
the modification of emotional output. So if you remove this you eliminate the
affective part of the psychosis, making them emotionless or “flat affect [while
depression is “sad affect”])
Ice pick procedure through the eye socket, to the front of the brain, swipe
it, and it disconnects the front of the brain from the rest
Frontal lobe processes not taken into account that were also being
eliminated by the frontal lobotomy: judgement, decision-making,
problem-solving
Psychoactive drug therapy
Most commonly used somatic or biologic approach to treating psychopathology
Psychoactive substances are divided into four classes
Stimulants
Stimulate your CNS (Central Nervous System)
Depressants
Slow down your CNS
Used for epilepsy
Cannibinoids
Marijuana
Has both or all of the effects of other classes of drugs; stimulant,
depressive, and hallucinogen qualities
Hallucinogens
More frequent in experimental research than therapeutic research
Lecture 4
Anxiety
Most common psychopathologies
Involves the increased physiological arousal, feelings of apprehension, fear, dread (although
fear and anxiety are psychologically/physiologically separate)
Anxiety is not a bad thing, it’s a necessary [negative] emotional response
It’s a basic, built-in emotion that either motivates us towards or away from a stimulus
Motivation is dictated by the hypothalamus
Other basic emotions: happy, sad, fear, disgust, and surprise. All are cross-cultural,
hard-wired, and have adaptive features
Emotion has both a cognitive (you realise that frightens you) and a physiological
component (hyperventilating)
They are adaptive and help us function in the everyday world
Anxiety can be maladaptive if the intensity, duration, and frequency are higher than meant
to be adaptively and interferes with certain aspects of life
Anxiety attacks can become psychotic-like where the person can lose touch with reality,
depersonalise, and even forget her own name. S/he feels like they’re having a heart attack is
a panic attack
Many drugs to treat anxiety are habit-forming
Slideshow: What is Anxiety:
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