Chapter 16

Question 1

1400s-1900s

Answer 1

Mentally ill patients were sent to asylums, segregated from general public

Question 2

Deinstitutionalization (mid 1900s)

Answer 2

Movement of large number of psychiatric inpatients from care facilities back to society
Made possible by development of effective treatment of some disorders, management of symptoms

Question 3

Residential Treatment Centers

Answer 3

-Housing facilities where residents receive psychological therapy and life skills training with goal to reintegrate residents into society
-When required, patients’ freedom restricted
-many previously hospitalized patients had no family/social supports to return to

Question 4

Community Psychology

Answer 4

Focuses on identifying how an individual’s mental health is influenced by their community
Emphasizes community-level variables like social programs, support networks and community resource centers
Research may involve environmental and neighbourhood factors that contribute to stress, anxiety, depression…

Question 5

Barriers to Psychological Treatment

Answer 5

40% of adults with high anxiety or depression receive therapy
2/3 of people with mental health issues don’t get help
2/3 people diagnosed with mood/anxiety disorders wait 1+ years to seek/receive diagnosis

Question 6

Avoidance of Help

Answer 6

-Difficulty defining or recognizing disorder
-Stigma around mental illness and therapy
-Skepticism surrounding treatment, psychological/psychiatric professionals
-Gender roles
-Cultural barriers
-Geographical barriers
-Financial barriers

Question 7

Insight Therapies:

Answer 7

General term referring to therapy involving dialogue between patient and therapist to gain awareness and understanding of psychological problems and conflicts

Began with Freud’s psychoanalysis evolving to:
Psychodynamic therapies>Form of insight therapy that emphasizes need to discover and resolve unconscious conflicts

Question 8

Psychoanalysis

Answer 8

Intended to help patients become aware of unconscious urges

Question 9

Modern Psychodynamic Therapies

Answer 9

Focused more on patient’s conscious experience than unconscious experience

Question 10

Objects Relations Therapy

Answer 10

Variation of psychodynamic theory that focuses on how early childhood experiences and emotional attachments influence later psychological functioning
Focuses on “objects” >Clients’ mental representation of themselves and others
Early relationships between child and “objects” lead to development of mental models that influence future relationships

Question 11

Humanistic-Existential Psychotherapy

Answer 11

Human nature is fundamentally positive
Focus on conscious experience
Phenomenological Approach: Address clients’ feelings and thoughts as they unfold in present moment rather than looking for unconscious motives or focusing on past events

Question 12

Humanistic-Existential Psychotherapy cont.

Answer 12

Considers behaviours to be freely chosen by individual
Emphasizes peoples’ strengths
Tries to clarify patients’ issues
Unconditional positive regard toward patients’ healing

Question 13

Client-Centered Therapy

Answer 13

‘Person-centered therapy’
Focuses on individuals’ abilities to solve their own problems and reach full potential with encouragement of therapist
Dealing with ‘conditions of worth’
Emotion-focused Therapy (EFT): Helps clients face and accept difficult emotions

Question 14

Behavioural Therapies

Answer 14

Attempt to directly address problem behaviours and the environmental factors that trigger them
Use principles of classical and operant conditioning to change behaviour
eg.aversive conditioning

Question 15

Aversive Conditioning

Answer 15

Behavioural technique that involves replacing a positive response to a stimulus with a negative response

Question 16

Systematic Desensitization

Answer 16

Gradual exposure to feared stimulus or situation is couple with relaxation technique
-can involve building an ‘anxiety hierarchy’: list of fearful stimuli ranging from least to most fearful
-flooding: exposing client to most challenging, anxiety inducing aspect of behaviour/situation

Question 17

Cognitive Behavioural Therapies (CBT)

Answer 17

Consists of procedures like cognitive restructuring, stress inoculation training and exposure to experiences client may tend to avoid
Focused on helping clients recognize their thoughts, emotions and behavioural patterns to build more functional cognitive and behavioural habits

Question 18

Group Therapy

Answer 18

Grouping people together based on similar issues
Participants benefit from bonding and support provided by other group members
Cost effective, accessible

Question 19

Family Therapy

Answer 19

Helpful when client difficulties reinforced by unhealthy family dynamics
May help families with specific members with disruptive or dysfunctional behavioural issues
Systems Approach: Views an individual’s symptoms as being influenced by multiple interacting systems (friends, family…) and influences

Question 20

Biomedical Approach

Answer 20

Use of drugs, surgery, or other medical procedures to alter central nervous system functioning to correct problems thought to be biological in nature

Question 21

Psychopharmacotherapy

Answer 21

Use of drugs to manage or reduce symptoms
Usually paired with other form of therapy (ex CBT)
Psychotropic Drugs: Medications to alter psychological functioning

Question 22

Monoamine Oxidase Inhibitors (MAOIs)

Answer 22

Deactivates monoamine oxidase (MAO), enzyme that breaks down serotonin, dopamine and norepinephrine in the synapse>results in increased amount of neurotransmitter
Can cause dangerous side effects (not widely used)

Question 23

Selective Serotonin Reuptake Inhibitor (SSRI)

Answer 23

Ex Fluoxetine (Prozac)
Block reuptake of serotonin, leaving larger amount in synapse
Most common antidepressant since 1980s
Can change sleep patterns and sex drive

Question 24

Mood Stabilizers

Answer 24

Prevent or reduce severity of mood swings for bipolar people
Ex Lithium
Side effects: toxicity (kidneys, endocrine system)>no longer popular

Question 25

Antianxiety Drugs

Answer 25

Influence GABA activity (inhibitory neurotransmitter that reduces neural activity)
ex. Xanax, Valium, Ativan
Side effects: Drowsiness, impaired attention, memory impairments, depression, decreased sex drive, potential for abuse and withdrawal

Question 26

Antipsychotic Drugs

Answer 26

Treat symptoms of psychosis (delusions, hallucinations, disturbed/disorganized thoughts)
First gen severe side effects: seizures, anxiety, nausea, impotence
Tardive Dyskinesia: Movement disorder characterized by involuntary movements and facial tics
Second gen (Atypical Antipsychotics)
Target dopamine and serotonin transmission
Less likely to produce side effects of first gen, but only work for 50%, less effective over time, compromises white blood cells (immune system)

Question 27

Surgery

Answer 27

Early techniques involved surgically destroying brain tissues in prefrontal cortex
-ex leucotomy (lobotomy)
>for psychoses and other disorders in 1900s
Modern Focal Lesioning Surgery
-small areas of brain tissue destroyed
-only used in extreme cases
ex. Anterior Cingulotomy
>brain imaging used to target and guide precise location of lesion

Question 28

Electroconvulsive Therapy (ECT)

Answer 28

Passing electrical current through brain to induce temporary seizure
Only used in extreme cases
May alter activity of certain networks in brain
Promotes neurogenesis in hippocampus

Question 29

Repetitive Transcranial Magnetic Stimulation (rTMS)

Answer 29

Expose particular area of brain to powerful magnetic field to stimulate or inhibit brain activity in that region
10-25 sessions
Stimulation of left prefrontal cortex (positive emotion) and inhibition of right prefrontal cortex (negative emotion) associated with improvement of depressive symptoms

Question 30

Deep Brain Stimulation (DBS)

Answer 30

Electrical stimulation of specific brain region using thin electrodes inserted in brain
Results immediate
Risk with surgical insertion of electrodes
May produce unexpected temporary behaviours