4.5: Other treatments

Question 1

What does psychosurgery involve doing?

Answer 1

Psychosurgery involves destroying brain tissue to disrupt the cortico-striatal circuit by the use of radio-frequency waves

Question 2

Psychosurgery involves destroying brain tissue to disrupt the cortico-striatal circuit by the use of radio-frequency waves.
This has an effect on the orbital frontal cortex, the thalamus and the caudate nucleus brain areas and is associated with a reduction in symptoms.
What has there been a recent movement towards using?

Answer 2

There’s been a recent movement towards using deep-brain stimulation

Question 3

Psychosurgery involves destroying brain tissue to disrupt the cortico-striatal circuit by the use of radio-frequency waves.
This has an effect on the orbital frontal cortex, the thalamus and the caudate nucleus brain areas and is associated with a reduction in symptoms.
There’s been a recent movement towards using deep-brain stimulation, which involves using magnetic pulses on the supplementary motor area of the brain, with is associated with doing what?

Answer 3

There’s been a recent movement towards using deep-brain stimulation, which involves using magnetic pulses on the supplementary motor area of the brain, with is associated with blocking out irrelevant:

1. Thoughts
2. Obsessions

Question 4

Psychosurgery - Severe cases who don’t respond to drugs can have surgery to alter what?

Answer 4

Psychosurgery - Severe cases who don’t respond to drugs can have surgery to alter the communication between:

1. The orbital frontal cortex
2. Other areas of the brain

Question 5

Psychosurgery - Severe cases who don’t respond to drugs can have surgery to alter the communication between the orbital frontal cortex and other areas of the brain or what?

Answer 5

Psychosurgery - Severe cases who don’t respond to drugs can:
1. Have surgery to alter the communication between the orbital frontal cortex and other areas of the brain
Or,
2. New experimental techniques

Question 6

Psychosurgery - Severe cases who don’t respond to drugs can have surgery to alter the communication between the orbital frontal cortex and other areas of the brain or new experimental techniques, including deep brain stimulation - what are placed in the brain?

Answer 6

Psychosurgery - Severe cases who don’t respond to drugs can:
1. Have surgery to alter the communication between the orbital frontal cortex and other areas of the brain
Or,
2. New experimental techniques, including deep brain stimulation - electrodes are placed in the brain

Question 7

Psychotherapy research:
Richter et al. (2004) reported that 30% of OCD patients had a 35% or greater reduction in symptoms, but there were occasional complications, such as urinary incontinence and seizures.
As these were patients at risk of suicide who hadn’t responded to drug therapies, the treatment can be considered relatively effective.

Mallett et al. (2008) evaluated deep brain stimulation as a therapy for treatment-resistant OCD, comparing it with sham (pretend) stimulation and found significant symptom reduction, which suggests that the treatment is effective.

Answer 7

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Question 8

Psychotherapy evaluation:
For:
1. Although psychosurgery has a relatively small success rate and can cause serious side-effects, it can be seen as an acceptable treatment, as it’s only used on severe forms of OCD that have not responded to other treatments, such as drug therapies, for about 10 years and where there is severely diminished quality of life and/or risk of death to the patient.

2. About 10% of OCD patients actually get worse over time, even with drug treatments (and psychological therapies), and so psychosurgery can be deemed a valid treatment for such patients.

Answer 8

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Question 9

CBT:

What is CBT focused on changing?

Answer 9

CBT is focused on changing obsessional thinking

Question 10

CBT:

CBT is focused on changing obsessional thinking, like with what?

Answer 10

CBT is focused on changing obsessional thinking, like with habituation training (HT)

Question 11

CBT:

CBT is focused on changing obsessional thinking, like with habituation training (HT), where sufferers do what?

Answer 11

CBT is focused on changing obsessional thinking, like with habituation training (HT), where sufferers relive obsessional thoughts repeatedly to reduce the anxiety created

Question 12

CBT:
CBT is focused on changing obsessional thinking, like with habituation training (HT), where sufferers relive obsessional thoughts repeatedly to reduce the anxiety created.
What are intrusive thoughts shown to be?

Answer 12

Intrusive thoughts are shown to be normal

Question 13

CBT:
CBT is focused on changing obsessional thinking, like with habituation training (HT), where sufferers relive obsessional thoughts repeatedly to reduce the anxiety created.
Intrusive thoughts are shown to be normal and what do patients come to understand?

Answer 13

Intrusive thoughts are shown to be normal and patients come to understand that thinking about a behaviour isn’t the same as actually doing it

Question 14

CBT:
CBT is focused on changing obsessional thinking, like with habituation training (HT), where sufferers relive obsessional thoughts repeatedly to reduce the anxiety created.
Intrusive thoughts are shown to be normal and patients come to understand that thinking about a behaviour isn’t the same as actually doing it.
Sufferers are taught to focus on their estimations of potential risks and realistically do what?

Answer 14

Sufferers are taught to:

1. Focus on their estimations of potential risks
2. Realistically assess the likelihood of them occurring

Question 15

CBT:

Although CBT is seen as the most effective treatment for OCD, when are even higher success rates found?

Answer 15

Although CBT is seen as the most effective treatment for OCD, even higher success rates are found when it is combined with drug treatments

Question 16

CBT research:
O’Connor et al. (1999) assessed the effect of combining CBT with drug medication.
Patients received either drugs and CBT together, CBT only, drugs only or no treatment.
Patients in all groups, except the no-treatment group, showed improvements, but most symptom reduction was seen when drugs were combined with CBT, especially if the drugs were given for a period first.
This suggests that the most effective treatment is to first administer drugs to reduce symptoms, especially anxiety levels, so that CBT can then have a more beneficial effect.

O’Kearney et al. (2006) assessed the ability of CBT to treat children and adolescents with OCD, finding it effective, but more so when combined with drug treatments, demonstrating how drugs and CBT can work together to alleviate the condition.

Jonsson and Hougaard (2009) found that CBT was better than drug treatments in reducing OCD symptoms, which suggests that it’s a more effective treatment than drug therapy.

Answer 16

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Question 17

CBT evaluation:
For:
1. Although drugs may not ‘cure’ OCD, they may reduce anxiety and symptoms sufficiently for CBT to be successfully introduced, showing how the 2 treatments can be successfully combined.

2. Drug treatments are lengthy in comparison to CBT.
   Even if a patient shows improvements with drugs, they should continue taking the medication for at least 12 months to ensure that their symptoms continue to improve.

Against:
1. Although CBT was acknowledged to be more effective and not to have the side effects of other treatments associated with OCD, it isn’t suitable for patients who have difficulties talking about inner feelings, or for those who dont possess the verbal skills to do so.
Maybe such patients would be more suited to drug therapies.

Answer 17

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