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Psychological Treatment Nov 28.docx

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University of Toronto St. George
Wagner Denton

PSY100 Psychological Disorders: Treatment November 28, 2013 Anxiety Disorders: Treatment • Phobic Disorder: Behavioral techniques are the treatment of choice for specific phobias • Can be unlearned through classical and operant conditioning - Systemic desensitization therapy: fear hierarchy (make a list of least fearful to most fearful), relaxation training (learn how to relax themselves to deal with negative feelings), exposure therapy (exposing the person to the things they are afraid of) • Cognitive Behavioral Therapy (CBT): Incorporates techniques from both cognitive therapy and behavioral to correct faulty thinking and change maladaptive behaviors and thought patterns • E.g. Cognitive restructuring, exposure and response prevention (ERP) Mood Disorders: Treatment • Depression: There is no “best” way, many effective approaches are available • Antidepressants, cognitive-behavioral therapy • Under-activity in the brain as a whole, particularly in the prefrontal cortex, particularly true of the left-side (positive emotions). • Alternative treatments include phototherapy (seasonal affective disorder), exercise, electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation • Bipolar Disorder: Alternating periods of depression and mania. Can use the same treatments to treat the depressive symptoms as depression. For mania, Lithium is very effective. • Unclear of how lithium works Alternative Biological Treatments • Electroconvulsive therapy (ECT): Involves administering a strong electrical current to the patient’s brain. This can help people suffering from severe forms of depression, not responding to medication or CBT • Transcranial magnetic stimulation (TMS): Creates an electrical current in the brain region directly below the coil. More localized treatment • Deep Brain Stimulation (DBS): Involves implanting electrodes within certain parts of the brain. Electrical generator placed under the skin to determine how often the electrical current is going to be. Newer treatment that can also be used for other disorders (OCD) Schizophrenia: Treatment • Pharmacological treatments are the most effective • Anti-psychotics haloperidol and chlorpromazine revolutionized the treatment of schizophrenia. They tackle the positive symptoms, really serious side effects associated with them • Little to no effect on negative symptoms • Significant side effects-tardive dyskinesia: you lose control over different parts of your body (speech, arm movements) It seems to be irreparable • Clozapine: acts on numerous neurotransmitter receptors, also treats negative symptoms, no signs of motor impairment, though it does have it’s own significant side effects (white blood cell count dropped, immune system stopped functioning normally) • Second Generation Anti-psychotics: Try to reduce the side effects so we don’t get any severe side effects. • Also: Social skills training, intensive form of CBT Personality Disorders: Treatment • All personality disorders are notoriously difficult to treat, don’t respond as well to treatment as other disorders • Borderline Personality Disorder: Problems with impulsivity, emotional behavior, wild mood swings. • Dialectal behavior therapy (DBT): Version of CBT, want to target the maladaptive behaviors and also work on their cognition (thoughts that they are having that are leading to unfortunate events for them). First step, looking at specific symptoms that they are having, helping them deal with their emotions, working on the identity issues by building up their self-respect and independence • Anti-social Personality Disorder: Psychopathy, almost impossible to treat. Problem with these patients, superficially charming and don’t care about the long- term consequences of anything, instant gratification, lac
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