Abnormal - examine biomedical, individual and group treatments Flashcards
Biomedical
- usually uses medications to alter activity of neurotransmitters in the brain
- assumes that biological changes can improve psychological conditions
- assumes that the cause of the problem is biological and therefore the solution should also be biological
uses of biomedical treatment
- antidepressant drugs are frequently used to treat anorexia and depression
- anorexia because eating disorder patients frequently suffer comorbidity (multiple disorders), often with depression
what are SSRIs?
Selective Serotonin Reuptake Inhibitors
- maintains high serotonin levels and consequently improves mood
- popular because they have relatively few side effects (e.g. headache, nausea, sleeplessness, agitation, and sexual problems)
study: Kirsch et al (2008)
Kirsch et al (2008)
- meta-analysis comparing placebos and SSRIs
- noted that there was virtually no difference in the effects of placebos and SSRIs on moderate depression
- but significant differences were observed between the effects of placebos and SSRIs on severe depression
- concluded that SSRIs are only really effective for severe depression
individual approach
- when a client meets alone with a therapist and the therapist uses psychological techniques to help the person with their symptoms
- assumes that the cause of the disorder is NOT biological; rather, that it’s purely psychological and simply connected with experience or cognition
- assumes that successful individual therapy will result in full recovery
individual approach: CBT
- linked to Beck’s cognitive triad (1976) where automatic negative thinking is assumed to cause depression
- aims to change negative thinking patterns (cognitive restructuring)
- aims to identify automatic negative thinking patterns and change them
individual approach: IPT
- sympathetic person discusses past experiences but without any theoretical guidance
- concentrates on helping the client develop and use positive social support networks as well as improve communication skills
- also helps adjust clients’ expectations to be more realistic
IPT vs CBT
IPT vs CPT
Fairburn et al. (1993) on bulimia:
- IPT less effective than CBT post-treatment
- but over time both treatments had the same cumulative effect
- Parker et al. (2006) suggest this is because psychotherapies do not have theoretical basis, so each patient’s experience is subjective
individual vs biomedical approach
IPT vs biomedical
Parker et al. (2006) on depression:
- IPT alone is not as quick as medication in relieving symptoms, but does provide substantial improvement later on
- found that a primary focus on IPT with some use of medication was the most effective treatment
- possibly because if it was the other way around patients would have expected medication to solve their problems – the main focus on IPT prevents them from being too reliant on medication
CBT vs biomedical
March et al. (2007) on depression:
- divided 300 depressed teenagers into 4 conditions: Prozac only, CBT only, Prozac + CBT, and placebo only
- after 12 weeks the improvements were: eclectic > Prozac > CBT > placebo
- but by 36 weeks all 3 group were approximately on the same level
- but it was noted that the Prozac only group experienced more suicidal thoughts than groups that received CBT
- March et al concluded that an eclectic approach was most effective
group therapy
- when a therapist works with several clients at the same time, encouraging them to talk to and help each other
- assumes that interpersonal contact with people in a similar situation will improve each individual’s condition
- assumes that when people are surrounded by others with similar emotional experiences, they are more likely to discuss about it
- assumes that discussing in a group helps develop important social skills that clients can use in real life
study: Hyun et al. (2005)
Hyun et al. (2005)
- randomly assigned depressed adolescents at a shelter for runaways to group CBT or no treatment
- found that group CBT significantly alleviated depression
criticism of group therapy
Truax (2001):
- notes that meta-analyses omitted group therapy results involving severely depressed patients
- dissatisfaction with the group might lead to drop-out
- could be counter-productive to treat depressed people by surrounding them with more depressed people