7b: Psychological Intervention

Question 1

What is pacnick attack

Answer 1

Sudden onset of intense apprehension and terror, ass. with feeling of impending doom. SoB, palpitations, chest pain, choking or something sensation

Question 2

Agoraphobia

Answer 2

Complication of panic attack.

Fear of having panic attack in a setting from which escape is hard

Question 3

3 schools of thought for psychological therapy

Answer 3

1. Psychodynamic therapy (freud)
2. Behavioural (behaviours ARE the problem, not just symptoms)
3. Cognitive

Same ways as normal behaviour. Classical conditioning

Question 4

What is exposure approach influenced by

Answer 4

Exposure therapy= based on behavioural theory

both classical and operant conditioning approaches

Question 5

How does exposure approach work from classical conditioning perspective

Answer 5

CLASSICAL CONDITIONING APPOACH:
Give them the CS (i.e. the car after an accident) without the UCS. This reduces assocation between stimulus and the negative response

Then reduce the operant learning that takes place when avoidance reduces fear (=2 factor theory of maintenance)

Response prevention is used to keep the operant avoidant response from occurring

Graded (systematic desensitisation)

Question 6

What does the cognitive theory account for

Answer 6

Behavioural is stimulus–> response

Cogntive is stimulus–>cognition–> response

Question 7

Clarke’s model

Answer 7

Internal/external trigger –> perceived threat –> anxiety –> cognitive/physical symptoms –> misinterpretation –> anxiety

Question 8

CBT therapy for cardiac anxiety

Answer 8

Psychoeducation
Relaxation techniques
Cognitive restructuring
Behavioural experiments
Graded exposure
Relapse prevention

Put rubbish crap behind gary’s rabbit

Question 9

What does CBT focus on (learn)

Answer 9

Problematic beliefs and behaviours maintaining disorder

Goal oriented

Collaborative between therapist and patient

Brief

Scientific approach

Question 10

What is depression

Answer 10

a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks

Question 11

Symptoms of depression for diagnosis

Answer 11

difficulty concentrating,

feelings of worthlessness

excessive or inappropriate guilt,

hopelessness,

recurrent thoughts of death or suicide,

changes in appetite or sleep,

psychomotor agitation or retardation,

reduced energy or fatigue.

Question 12

NICE treatment reccommendations for depression

Answer 12

CBT first line treatment for mild to moderate depression, anxiety, schiz, OCD, bulimia

Do not use antidepressants routinely to treat persistent subthreshold depressive symptoms or mild depression because the risk–benefit ratio is poor

Question 13

How should you test for depression

Answer 13

Particularly in people with a past history of depression or a chronic physical health problem with associated functional impairment.

Consider asking people who may have depression two questions, specifically:
During the last month, have you often been bothered by feeling down, depressed or hopeless?
During the last month, have you often been bothered by having little interest or pleasure in doing things?

Question 14

When should antidepressants be considered

Answer 14

a past history of moderate or severe depression or
subthreshold depressive symptoms present for a long time or
subthreshold depressive symptoms or mild depression that persist(s) after other interventions.

Question 15

What is recommended for depression relapse

Answer 15

Individual CBT:
for people who have relapsed despite antidepressant medication
for people with a significant history of depression and residual symptoms despite treatment.

Mindfulness-based cognitive therapy:
for people who are currently well but have experienced three or more previous episodes of depression.

Question 16

ACT and chronic pain (acceptance and commitment therapy)

Answer 16

Contact with present moment

Values
-clarity of what is meaningful

Committed action

Self as context

Defusion

Acceptance