Chapter 15: Treatments – Flashcards
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What does the choice of treatment depend on?
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type and severity of symptoms, diagnosis and motivational state of person needing treatment.
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What is psychotherapy?
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General name given to psychological methods of treatment; involves interactions between patient and doctor that help patients understand symptoms and provide solutions for them;
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What is one problem with psychotherapy?
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Sometimes patients' disorders are characterised by apathy therefore it is difficult to connect to them
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What is biological therapies?
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View that psychological disorders are caused by abnormalities in neural and bodily processes (e.g. malfunction in a brain region)
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What is psychopharmacology?
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the use of medications that effect the brain or body.
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What is one disadvantage of psychopharmacology?
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it is only unsuitable for long term success meaning patients have to take the drug indefinitely.
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What is the eclectic approach?
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Using a variety of techniques to treat a patient.
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Why is it important to have a good client to therapist relationship?
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Can foster an expectation of receiving help in patients.
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What is psychodynamic therapy?
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A therapist try to understand clients needs and motivations to figure out why they are distressed. Most proponents of psychodynamic theory still uses the conversational style although they remove the chairs.
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What are some features of contemporary psychodynamic theory?
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exploring the client's avoidance of distressing thoughts, looking for recurring themes and patterns in thoughts and feelings, discussing early traumatic experiences, focusing on interpersonal relations and childhood attachments, emphasizing the relationship with the therapist, and exploring fantasies, dreams, and daydreams
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How are psychodynamic theories not different to other forms of psychotherapy?
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focusing on patterns in thoughts and feelings and addressing interpersonal relationships, are common to most forms of psychotherapy,
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Why has traditional psychodynamic therapy been controversial?
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Time consuming; only promising for borderline personality disorder otherwise ineffective in most;
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What are the features of new psychodynamic approaches?
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Don't accept all of Freud's ideas but agree that there are underlying conflicts that need to be resolved such as relations with people; fewer sessions; focusing on current relationships instead of childhood experiences; short term; less time wasted.
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What is one criticism of newer psychodynamic approaches?
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Not sure if superior to simply talking to a caring therapist about problems.
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What is the client-centered therapy?
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encourage people to understand themselves more by create a positive and accepting environment so that clients can truly access their true feelings. This means not disregarding the client's actions and thoughts and instead strive to be empathetic. also engage in reflective listening.
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What does the humanistic approach to psychotherapy emphasize?
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personal experiences and the individual's belief system.
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What is reflective listening?
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The therapist repeats the clients problems to help him clarify his feelings.
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What is motivational interviewing?
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one form of client-centered treatment; emphasizes projecting the discrepancy between current state and the client's sense of where he wants to be in the future. This approach is normally used for ambivalent clients. e.g. wanna drink a lot but dont wanna die
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What is the premise of behavior therapy?
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Behaviours are learnt and can be unlearned; focused on treating the problem directly instead of figuring out childhood experience influences.
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What is exposure?
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common feature of cognitive-behavioral therapy; overcome fear of dogs by slowly increasing level of exposure to a dog.
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Whats is social skills training?
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show the client appropriate ways of behaving often through modelling. successful use of behaviors is rewarding and encourages the continued use.
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What is an effective treatment for ptsd?
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prolonged exposure; This treatment involves those with PTSD repeatedly revisiting and recounting their traumatic experience and page 659 gradually approaching situations that they have been avoiding because of reminders of their traumatic experience
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What is exposure and response prevention?
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when people avoid something out of fear, their reduction in fear is reinforcing. this prevention doesn't allow the person to avoid the stimulus or situation. This form is highly effective for OCD.
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What is systematic desensitization?
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In this method, the therapist exposes the client to increasingly anxiety-producing situations by having the client imagine them and then teaching the client to relax at the same time
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What is cognitive therapy?
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based on the fact that distorted thoughts product negative behaviour and emotions.
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What is cognitive restructuring?
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An approach to cognitive therapy advocated by Aaron T. Beck. Help identify maladaptive thought and replace them with ways of viewing the world that are more in tuned with reality.
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What is rational-emotive therapy?
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therapist act as a teacher explaining the client's errors in thinking and demonstrate more appropriate ways to think and behave.
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What is interpersonal therapy?
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integrates cognitive therapy with psychodynamic insight therapy; developed on psychodynamic ideas on how people relate to one another; uses cognitive techniques to help people gain insight into interpersonal relationships.
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What is the mindfulness-based cognitive therapy?
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Developed by John Teasdale; aim to prevent relapse psychological disorders following treatment; derived from mindfulness meditation; therapy has 2 goals: 1) help clients become more aware of their negative thoughts and feelingsand to disengage from those thoughts using meidtaiotion.
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What does CBT stand for and what is it?
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Cognitive-behavioural therapy; incorporates techniques from behavioural and cognitive therapy. Correct client;s faulty cognitions and train client to engage in new behaviours.
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What are the advantages of group therapy?
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Significantly less expensive than individual therapy. In addition members can learn from each other's experiences with the disorder and improve their social skills.
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What is the ideal number for a group therapy according to some practitioners?
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8 people.
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What do the structures of therapy groups look like?
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less structure in increasing insight and increasing social support; more structure in behaviorial and cognitive groups with specific goals and techniques designed to modify the thought and behaviors patterns of group member, this type of group is effective for bulimia and obsessive compulsive disorder.
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Why is group therapy often used to augment individual therapy?
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social support is the most beneficial thing about this type of therapy.
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What is the systems approach?
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an individual is part of a larger context; changes in individual behaviour affects the whole system.
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What is expressed emotions in the context of family members treatment towards people with schizophrenia?
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pattern of negative actions by a client's family members. these includes making critical comments, being hostile towards the person and being emotionally overinvolved (overprotective and pitying); level of expressed emotions corresponds to relapse rate for this with schizo
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How do patterns of expressed emotion affect relapse differ across different cultures?
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Because for instance some culture accept overinvolvement while some dont; those with schizophrenia are more likely to relapse when they belong to emotionally overinvolved families in Japan than when they belong to emotionally overinvolved families in India.
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How does societal definitions of psychological health and disorders have an influence of them?
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influence the way they are expressed; likelihood of recovery and willingness to seek help
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Do all countries accept psychotherapy the same way?
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No, accepted differently in different countries. Some countries like India have certain stigma against mental illness. Chinese distrust emotional expression and avoid seeking help for depression. The word anxiety is avoid and replaced by terms such as tensions and strain.
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How can religious beliefs influence the outcome of psychotherapy?
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Some psychotherapists change their therapy to be more culturally appropriate. Western psychotherapists adopt practices fro other cultures to enhance their own treatment.
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What are drugs that affect mental processors related to neurotransmitters or neurotransmitter receptors called?
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psychotropic medications.
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How do psychotropic medications act?
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They change neurochemistry - inhibit action potential or influence neurotransmitter connection to increase or decrease neurotransmitter activity.
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What are the three categories of psychotropic medications?
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1) anxiety drugs 2) antidepressants and 3) antisypchotics
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How are some drugs in one category used to treat disorders from another category?
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1) comorbidity: sometimes depression have some components of anxiety disorder 2) not clear evidence about brain chemistry and its relevance to disorders. still trial- and -error for different drugs.
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What are is another name for anti-anxiety drugs and how does this category of drugs work?
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tranquillisers; used for short term treatment of anxiety; One class pf anti-anxiety is benzodiazepines (Xanax and Ativan) which increase GABA activity, most pervasive inhibitory neurotransmitter ; reduce anxiety but produces drowsiness and addictive.
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Describe antidepressants and how they work.
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Primarily used to treat depression although can be used to treat other stuff including anxiety disorders; 1) first anti depressant discovered was MAO (Monoamine oxidise) inhibitors. They break down the activity of MAO who is an enzyme likes to destroy serotonin int he synapse. Also used to raise the level of dopamine and norepinephrine 2) tricyclic antidepressant blocks the reuptake of certain neurotransmitters. 3) antipsychotics (aka neuroleptics). Used to treats disorders with psychosis (delusions and hallucinations). They bind to dopamine receptors and make dopamine ineffective
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What are criticisms of SSRIs?
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They are used to treat people with low self-esteem. Effect doesn't last after the treatment.
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What is the side effect of SSRIs?
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sexual dysfunction;
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What is SSRIs?
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most recently SSRIs (selective serotonin reuptake inhibitors) are available, best known is Prozac. They inhibit reuptake of serotonin; useful for social anxiety disorder.
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What is a side effect and a disadvantage of antipsychotics?
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Side effect: tardive dyskinesia, the involuntary twitching of muscles, especially in the neck and face that can be irreversible Disadvantage: not useful to treat negative symptoms of schizo which is apathy and social withdrawal.
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What is clozapine?
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Newer antipsychotics; acts on dopamine receptors as well as serotonin, norepinephrine, acetylcholine, and histamine receptors. Also known as an atypical antipsychotic medication meaning those who don't respond to other antipsychotic improve on clozapine.
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What is a disadvantage of clozapine?
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Cause problems with white blood cells; newer drugs such as Risperdal and Zyprexa are more effective than clozapine but they may not be as effective.
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What are some of the drugs that don't fall into the traditional category?
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Lithium was for a long time considered an effective treatment for bipolar disorder Anticonvulsants are used to stabilise moods in bipolar disorder. Many of them are mood stabilizers
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How do we alleviate disorders of those that are treatment resistant?
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brain surgery, use of magnetic fields and electrical stimulation used as last resort because they are dangerous.
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What is trepanning?
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Centuries ago people understood that the brain has something to do with the mind and especially the sick mind. So they perform surgery on the brain by punching holes into them. many tribes in pacific and africa still use this method
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What is psychosurgery?
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In the early twentieth century, people went beyond just carving holes into the skull and manipulate the brain by selectively damage certain parts of the frontal cortex; used to treat severe disorders such as schizophrenia, major depression and anxiety disorders. Lack of progress in treating mental illness at the time was what lead to such drastic measures.
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Who was credited to bringing the practice of brain surgery to the world and when? And what was the damaging effect after these surgeries have been performed?
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Egaz Moniz in 1930s; his technique was called frontal lobotomy. After patients received lobotomies, they were often listless and had flat affect. Moreover, the procedure often impaired many important mental functions, such as abstract thought, planning, motivation, and social interaction. With the development of effective pharmacological treatments in the 1950s, the use of lobotomy was discontinued.
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What does ECT stand for?
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Electroconvulsive therapy; placing an electrical current on the brain strong enough to create a seizure.
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What are the criticisms of ECT and brain lobotomy and how are reforms implemented?
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Cruel as depicted in movies and books; ECT now occurs under anaesthesia relaxing muscles and reduce motor convulsions confining seizures to the brain only.
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What is TMS?
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Transcranial magnetic stimulation; An electric current flows through a wire connected to a device placed on top of our head. It in turn creates a magnetic field 40000x that of the Earth. When switched on and off continuously it creates an electric current in the brain in the region directly below the coil. This works to interrupt the neuro fucntion in the region effected
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What occurs during a single-pulse TMS?
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Disruption of brain activity occur only during the brief period of simulation. E.g. if placed over the speech region you may not be able to speak momentarily.
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What is repeated TMS?
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It is when TMS is repeated over an extended of time where the disruption lasts beyond period of stimulation.
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What is deep brain stimulation?
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KAK DBS; Surgically implanting electrodes in the brain; mild electricity is used to stimulate the brain to an optimal intensity and frequency. This is like how a pacemaker stimulates the heart.
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What is an only way to know whether treatments are valid?
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compares treatment with a controlled condition such as having supportive listeners
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What is randomized clinical trials?
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client-participants randomly assigned to conditions
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What are the ways to show that treatment is effective using placebos?
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Results have to illustrate that treatment effects are stronger than placebo. Because placebo can also activate the same brain regions that real drugs activate.
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What are the complications of placebos for psychotherapy?
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Therapist knows if he or she was providing the treatment or control procedure. Longstanding debate, therapies are effective because of common factors or specific factors?
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What is the difference between psychotherapy and psychological treatments?
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the latter has undergone evidence-based scientific research.
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What are three features that characterise psychological treatments?
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1) treatments vary according to the particular psychological disorder and the person's specific psychological symptoms. Just as treatment for asthma differs from that for psoriasis, treatments for panic disorder are likely to differ from those for bulimia nervosa. 2) developed by psychologists especially behavioural, cognitive and social psychologists 3) No overarching theory that guides treatment, instead it is based on evidence of effectiveness.
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How do some false treatments do harm rather than good?
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there are also called fringe therapy or alternative therapy 1) trauma debrief can lead to more PTSD; scare straight show increase in children likelihood of smoking and drinking; hypnosis intended to recover repressed memories can produce false memory. 2) some self-help books promote questionable claims;
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What are the types of specialised health practitioners and describe their degree as well as placement
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Page 669 CCPPPP
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What is one central problem with treating disorder that has something to do with trained practioners
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Not enough practitioners; some programs such as hotlines have broaden the span a little bit.
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What is technology based treatment?
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Provide treatment for those who are not physically present. Rely on smart phones, computer programs and software. App on phone that help keep track of moods and mental state and recommend exercises to deal with what they are thinking and feeling. Website moderatedrinking.com help those who are not heavy drinkers abstain from alcohol. Can also be sued to treat anxiety disorders such as panic disorder.
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What is the mainpoint behind the article How Do I Find a Therapist Who Can Help Me?
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1) DO not need to be 100% sure that you need therapy before you visit one. You can view first sessions to see whether therapy is an appropriate solution. 2) Therapist can help student make some lifestyle changes or provide treatments if student has disorder 3) Choose the right therapist make sure you trust him and that he is reliable in the first few sessions; also look for his experience with ur particular problem. 4) Question of ability to prescribe medication should only play a minor role is seeking a therapist ====> most important thign is rapport, shop around for someone yoou connect with like finding a date.
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How are behavioral and cognitive treatments more effective than drugs?
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Their effects still last long after treatment whereas drugs only give out the effect during usage
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How do phobias develop?
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experiencing a trauma or observing others; but most phobias develop with the absence of any trigger events.
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What is systematic desensitisation?
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clients make a fear hierarchy in ascending order and are exposed to them. The idea is that as they form neutral associations with these fears, they will no longer appear threatening.
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How do we expose clients without putting them to danger?
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using virtual environment or virtual reality.
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How are some cognitive strategies used along with behavioural methods?
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Cognitive strategies can let the client know what their fear is irrational by making them aware of the thought processes that maintain the fear.
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How do successful treatment with cognitive-behavioural therapy change the way the brain processes fear stimulus?
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decreased activation in the frontal brain region involved with emotions; findings suggest the brain is rewired after treatment and medication. experiment done by comparing the way the brain processes stimulus before and after successful treatment.
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What are the ways that people normally react to panic attacks?
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Some shrug off; heart palpitations as the beginnings of a heart attack; hyperventilation as a asign of suffication.
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What is imipramine and what does it do for panic disorders?
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it is a tricyclic antidepressant prevents panic attacks but doesn't reduce the fear people have when they think they are about to have an attack. Therefore, cognitive and behavioural therapy may be effective in breaking this association between physical symptoms and impending doom.
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How does cognitive therapy help reduce panic attacks?
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When people have panic attacks, they increase the importance of danger which makes the panic attack worse. Cognitive therapy points out to the patient that what she fears don't come true. For example, out of 100 panic attacks, 85 of them were because she fears that she will faint. But this is actually 0% because according o the therapist because you simply can't faint if your heart races which is what happens during a panic attack.
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Why if people recognise the irrationality of their fears they will still suffer attacks and what does a therapist do to fix this?
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conditioned response to a trigger (e.g. shortness of breath); therapist goal is to break the connection between the trigger symptom and resulting panic; this breakage can be done by exposure treatment to make the client habituate to the fear. For example, bringing about hyperventilation by breathing in and out of a straw to induce shortness of breath.
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What is the treatment of choice for panic disorders? and Why?
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cognitive - behavioural; those who received psychotherapy were less likely to relapse 6 months after treatment ended than those who used medications.
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Why does the DSM-5 separate OCD from anxiety disorders?
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People with OCD don't respond to drugs treatment. They are completely ineffective
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What is the drug of choice for OCD?
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Clomipramine; not your typical SSRI because it does block the reuptake of other neurotransmitters as well but it also so powerfully enhance the effects of serotonin.
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How is CBT used to treat OCD? What are the two most important components of this form of therapy?
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1) Exposure and response prevention; Based on the premise that a stimulus action triggers anxiety that is reduced by the compulsive action. In CBT, patients are instructed to do an action that would normally make them perform compulsive behaviours but don't allow them to do so. 2) Some other cognitive theories involve telling the client that unwanted thoughts and compulsions are part of normal human experience.
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What is the best treatment for OCD?
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Even though exposure and prevention is more effective than clomipranine, adding CBT to SSRI treatment may improve outcomes. Therefore we use a combination of both types of treatment.
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What happens if both CBT or medications don't work?
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DBS (deep brain stimulation)
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What is the success rate of DBS?
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increases the daily functioning in about two thirds of those receiving treatment.
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Is there a best way to treat depressive disorders?
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Nope; there are many validated ways that works for different people.
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What are the functions of iproniazid?
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- reduce bacteria associated with TB in patients' saliva - stimulate patients' appetites, increase their energy levels and gave them an overall sense of well being
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Why are MAO inhibitors reserved for people who do not respond to other antidepressants?
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Iproniazid are MAO inhibitors ;Because they may interact with other substances that cause harm to the body. Patients taking these drugs must not ingest tyramine found in various foods, red wine, cured meat and aged cheese. If these two meet, people get an increase in blood pressure. In addition, MAO inhibitors also interact with other over the counter drugs.
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What are tricyclics?
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They are another type of antidepressant; one of these called imipramine was fund effective in relieving clinical depression; act on neurotransmitters and histamine system. They are extremely effective antidepressants.
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What are the side effects of tricyclics?
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drowsiness; weight gain, sweating, constipation, heart palpations, dry mouth or any combinations of such problems.
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What are the drugs that don't have the side effects that iproniazid and tricyclics carry?
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Prozac - does not affect histamine or acetylcholine; bupropion - doesn't cause sexual dysfunction, but not effective for panic disorder and OCD.
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What are the side effects of Prozac?
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insomnia, headache, weight loss, and sexual dysfunction
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Do antidepressant help treat the underlying cause of depression?
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No; it helps treat the symptoms only. And symptoms are not causes of depression.
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What does the decision of which drugs to use depend on for depression?
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A person's overall health and side effects of each medication; severity of depression
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What is depression according to a cognitive point of view?
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According to Aaron beck's cognitive distortion model, depression is the result of the three self detrimental thoughts including those about the oneself, situation and the future.
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How do the patterns of worry differ amongst people who have anxiety disorder and people with depression?
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anxiety worry about the future but depression worry about the past problems and how poorly they are dealing with current problems and how bad their futures will turn out to be.
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What is the goal of cognitive-behavioral treatment of depression
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Helpt he person think more adaptively; intended to improve mood and behavior
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What are the general principles to CBT?
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People are asked to recognise and record negative thoughts, can be difficult because it is automatic and hard to recognise; once the patterns is recognised. clinician can help the client recognise and alter these dysfunctional thoughts.
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When do we choose which medications or therapy to administer in depression?
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Cognitive-behavioral therapy can be effective on its own, but combining it with antidepressant medication can be more effective than either one of these approaches alone (Cuijpers et al., 2014). In addition, the response rates and remission rates of the combined-treatment approach are extremely good (Keller et al., 2000; Kocsis et al., 2003). The issue is not drugs versus psychotherapy. The issue is which treatment provides—or which treatments provide—relief for each individual. For instance, drug treatment may be the most effective option for those who are suicidal, in acute distress, or unable to commit to regular sessions with a therapist. For most people, especially those who have physical problems such as liver impairment or cardiac problems, psychotherapy may be the treatment of choice because it is long-lasting and does not have the side effects associated with medications (Hollon et al., 2006). Treatment selection also depends on the severity of the depressive disorder. In general, people who have chronic major depressive disorder receive the most benefit from combined drug and psychotherapies (Craighead & Dunlop, 2014).
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What are the supporting evidence that shows effects of psychotherapy and drugs are largely dependent on one another?
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Studies show that even though psychotherapy and drugs activate the same brain region, the brain activity in those regions differ. Therefore a combination of drugs and psychotherapy would produce greater effectiveness.
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What is SAD?
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Seasonal affective disorder. Episodes of depression occur during winter; rate of disorder increases with latitude
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What is a milder form of SAD called?
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Winter blues; rate of disorder increases with latitude
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What do many patients of SAD and Winter blues respond favourably to?
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Phototherapy, which involves exposure to high intensity light source of each part of day.
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How can regular aerobic exercise reduce symptoms of and prevent recurrence of depressive disorders?
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Releases endorphins whichis related to another neurotransmitter called norepinephrine which is to be involved depression; release of endorphins create a general sense of well-being; regularize bodily rhythms - make them stable and not jumping around; improve self-esteem and provide social support.
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What is ECT?
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Electroconvulsive therapy; MOST IMPORTANLY : it is useful when all other therapies fail; takes efect immediately as opposed to severeal weeks like antidepressants, therefore it is useful for a suicidal person; also works for pregnent women with depression because other dedications can create birth defecs.
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What are some of the limitations of ECT?
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high relapse rate and memory impairments. most cases memory losos for the day of treatment but some experience permanent memory loss; one way to reduce memory loss is to perform unilateral ECT only the hemisphere not dominant for language.
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Why is TMS over left frontal regions result in reduction in depression?
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does not involve anesthesia or have any major side effects (other than headache), it can be administered outside hospital settings. cannot replace ECT.
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Can TMS replace ECT?
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No, they all use different mechanisms and therefore might be appropriate for different types of patients.
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How can DBS treat depression?
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In fact, some of them felt relief as soon as the switch was turned on. For all four, it was as if a horrible noise had stopped and a weight had been lifted These studies demonstrate that DBS is useful for helping people lead more productive lives. For instance, in the study just mentioned, only 10 percent of the people were able to work or engage in meaningful activities outside the house (e.g., volunteering) before DBS, whereas two-thirds were able to do so after DBS
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how does DBS differ from other treatments?
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researchers can easily alter the electrical current without the person knowing to demonstrate that DBS is responsible for improvements in psychological functioning.
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Who are the primary consumers of psychotherapy?
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women
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What's in the Guidelines for Psychological Practice with Girls and Women? ANd who prublisheds it?
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APA; they include factors that interfere with therapeutic processes; be ware of gender specific stressors such a familial duties on women and also the effects of menopause and reproduction that women experience; women of color, lesbians, and women with disabilities are especially disregarded for the struggles they face and the choices they make
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What is meant by "a conspiracy of silence that has long surrounded depression in men"?
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Men's tendency to hide their depression and seek appriapte therapy. They tend to mask depression with albohol, irritibility and isolation. Men are uch less likely than women to admit depression
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How is bipolar disorder similar to schizo and depression?
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Manic phase is linked to alterations in thought that link to psychotic states found in schizophrenia; depressive episodes link to depressio
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Is a clear optimal treatment for bipolar disorder? if yes, what is it?
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Yes there is a clear optimal treatment for bipolar; psychotropic medications - especially the mood stabiliser lithium.
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Describe the discovery of lithium for the treatment of bipolar disorder.
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In 1941, John Cade found that urine of manic patients was toxic to guinea pigs. So he believed uric acid caused mania, which explains why people stop mania when they peed. Then he had the guinea pigs eat lithium urate, a salt in uric acid and it proved non toxic. Not only that it also protected them against toxic effect of patient's urine. Gave to people.
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What are the mechanisms by which lithium stabilises mood?
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modulate neurotransmitter levels, balancing excitatory and inhibitory activities.
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What are the side effects of Lithium?
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thirst, hand tremoes, excessive urination and memory problems; these disappear after a few weeks on the drug.
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What is effective for intense bipolar episodes?
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anti convulsive medications.
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How have recent antipsychotic medications been found to be effective in stabilising moods and reducing episodes of mania?
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Quetiapine (or Seroquel); evidence shows combining mood stabilisers, lithum, with atypical antipsychotic improves treament outcomes
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What are the effects of reserpine? and what is its synthetic version called?
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Reserpine has a sedative effect and it was also effective in treating symptoms of schizophrenia such as delusions and hallucinations.
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What are the drawbacks of Haloperidol and chlorpromazine?
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They don't reduce the negative symptoms of schizo; has side effects: chlorpromazine: constipation and weight gain, cardiovascular damage. Haloperidol doesn't have such symptoms but these two drugs both have motor effects that resemble Parkinson's disease: immobility of facial muscles, trembling extremites, muscle spasms, uncontrollable salivation, and a shuffling walk.— Tardive dyskesia as discussed earlier, involuntary movements of the lips, tongue, page 687 face, legs, or other parts of the body—is another devastating side effect of these medications and is irreversible once it appears. Despite these side effects, haloperidol and chlorpromazine were the only available options.
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How is Haloperidol different from chlorpromazine?
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chemically different and had less of a sedating effect.
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How is clozapine different from previous antipsychotic medications? why is it called atypical antipsychotic?
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1) acts on receptors for dopamine, serotonin, norepinephrine, acetylcholine and histamine. 2) Beneficial in treating positive as well as negative symptoms. 3) no signs of tardive dyskinesia
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What is Tardive dyskesia?
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involuntary movements of the lips, tongue, page 687 face, legs, or other parts of the body
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What are the side effects of clozapine?
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fewer side effects than chlorpromazine or haloperidol but they are serius: seizures, heart arrhythmias and substantial weight gains. most fatally a redction in white blood cells. Frequent blood tests plus costs of medication has made this drug treatment option expensive for many.
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How good are the latest line of atypical antipsychotics?
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Risperdal and Zyprexa; These drugs are now the first line of defense in the treatment of schizophrenia; clozapine now reserved for more severe cases. these new drugs have about on fifth the chance of producing tardive dyskenia compared to their predecessors.
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How do people with schizophrenia benefit from psychosocial treatment?
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midaction+ social skills or self care skills such as bathing and financial planning; these have proven to decrease relapse rate
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What is the prognosis for people with schizo?
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depends on age of onset, gender and culture; people diagnosed later in life have a better prognosis; women have better prognoses perhapse b/c schizo appear later in women; culture: developed countries with extensive family networks schzo not as severe compared to developed coutnries.
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How does shazo improve with age?
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find most effective regime; changes in the brain such as decraese in dopamine levels.
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What makes personality disorder hard to engage in therapy?
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people rarely seek therapy because people see the environment being the cause of their problems rather than their own behaviours being the cause of their problems.
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What is the most successful treatment for borderline personality disorder to date?
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DBT (dialectical behaviour therapy) ; combines elements of the behavioural and cognitive treatment with mindfulness approach based on Eastern mediative practices.
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What are the 3 stages of DBT?
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1)target the person's most dysfunctional behavior to replace it with appropriate ones (e.g. self-cutting and suicidal attempts); this stage is when the rpson leanr problem solving techniques that help them better cope with their emotions; in addition they also taught to focus their attention on the present 2) in this stage therapists help uncover child hood issues that lead to this problem 3) help develop self-respect and independent solving because they aer very depedent on other people for validation; they must have the right attitudes or they will revert back to original behaviors.
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What are symptoms experienced by those with borderline simialr to?
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psychosis - Schizo or depression.
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What is often prescribed with CBT to reduce feelings of depression?
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SSRIs
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Why is treatingthose with antisocial personality disorder extremely difficult?
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they lie without thinking twice; care little about other's feelings; live for the present; narcissistic; don't want to change themselves; more interested in manipulating therapists than changing themselves.
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How efective are psychotropic medications in treating antisocials?
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people who are antisocial have diminised cortical arousal so they are prescribed to nromal levels; beneficial in ST only; lithium may be useful in reducing impulsive and violent behaviours; anti-anxiety somewhat lower anxiety levels =>> overall they are not useful
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What conditions are there so that behavioral and cognitive approaches are useful to antisocials?
answer
Person cannot leave treatment and must be part of a group; for these reasons more effective in residential treatment facility
question
How are cognitive appraoches used on antisocials?
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Try to demonstrate that the person can meet their goals much easier by following the rules of society rathe than going against them.
question
How does antisocial personality disorder improve after age 40?
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many theories suggest that they gain insight into their behaviours or they may just get worn out; however, eventhough antisoaicl behviours are worn out, their narcissism callousness and manipulativenness dont change especially for Psychopaths. They change only some aspects of their behaviour.
question
What is Conduct disorder?
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this is a precursor to antisocial personality disorder exhibit in childhood (e.g. bullying); since we cant cure antisocial it is best to treat those with conduct disorder to prevent it.
question
How are medications used to treat emotional and behavioural problems in children?
answer
Medication is often used to treat emotional and behavioral problems in children. A recent study found that just over 7 percent of children (ages 6-17) were prescribed medications for psychological problems during the preceding six months in 2012 (Howie, Pastor, & Lukacs, 2014). Boys were more likely to receive medications than girls, and minorities were less likely to receive medications than non-Hispanic white children
question
What is the most common treatment for ADHD?
answer
Central nervous system stimulant (e.g. methylphenidate brand name Ritalin or Concerta); another drug to cure AHHD is adderall =>>> all of this go to stimulate the brain because kids with ADHD have under stimulated brain.
question
What do Ratilin and Adderall doe?
answer
at small doses, Adderall and Ratilin decrease overactivity and distractibility -> increase attention. Children who take take RAitin are happier, more successful acadecmicalle, adept socially, interact positvely with parents - more likely to comply with requests.
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What are the drawbacks of Ratilin?
answer
sleep problems, reduced appetite, body twitches, and the temporary suppression of growth ; effects only last int he short term; risk of abuse of drugs; may lead to ADHD kids abuse stimulants as adults but studies have shown that they dont'
question
Is a combination of medications and behavioral therapy beneficial in treating ADHD?
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Yes; a study shows drugs+ therapy > just drugs; after 3 years; After three years, however, the advantage of the medication therapy was no longer significant. The children who received behavioral therapy improved over the three years, whereas those who received medication improved quickly but then tended to regress over the three year
question
How are children with ASD (autism spectrum disorder) a unique challenge to health professionals?
answer
impaired communication, restrcited interest, social interaction deficit; extreme behaviours and self-stimulation including rocking, waving, jumping up and down and humming these behaviours are needed to get rid of at the beginning for treatment but its hard because these children don't respond to normal treats - food may be the only effective reinforcement.
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How are children with ASD disturbed by over selectivity of attention?
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they focus on details so much that they can't extend their knowledge to similar stimuli or situations. For example, children who learns to set the table with plates doesn't know what to do when presented with bowls instead; Generalization must be taught therefore, there needs to be structured interventions instead of unstructured interventions like play with toys while learning.
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What is the most effective treatment so far for ASD?
answer
Applied behavioral analysis (ABA); based on operant conditioning: Behaviors that are reinforced should increase in frequency. Behaviors that are not reinforced should diminish : high success rate if started early in life
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What determines a better result in ABA?
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1) treatment early in life 2) better language skills before entering treatment 3) the longer hours spent in treatment
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What other tasks can improve ABA treatment?
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1) teach children to engage in joint attention (having the parent imitate child's actiona dn work to maintain eye contact 2) symbolic play; imagning sumthing such as dol driving car or an object as something else
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What are he drawbacks of ABA?
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time commitment; parents have to commit a lot time to cure children giving up their jobs; jealous siblings b/c a lot of time spent on the other one; the other children also neglected leading to more problems.
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How can drugs help treatASD?
answer
antiseptics such as Risperdal reduce repetitive behaviours caused by abnormal serotonin functioning
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How is oxytocin speculated to play a role in ASD?
answer
deficit in deficit is related to autism; mice lacking can't even detect their own mother's scent; a nasal spray of oxytocin make people feel like they can connect better with others
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Can oxytocin improve social functioning?
answer
Yes, they show general increase in social recognition tasks and decrease in repetitive order but we cannot make an empirical conclusion yet. This is the same for all pharmaceutical treatments of ASD
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What leads a better prognosis for ASD?
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1) early language ability 2) higher IQ because they are better at generalising therapeutic setting to the real world.
question
Is SSRI Prozac effective in treating adolescent depression?
answer
Yes; but only when combined with pyschotherapy;
question
What is the best advice to give practitioners when using SSRIs?
answer
start low go slow
