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Inleiding psychologie > H16 Treatment of Psychological Disorders > Flashcards

H16 Treatment of Psychological Disorders Flashcards

1
Q

What is clinical psychology?

A

Field of practice and research that is directed toward helping people who suffer from psychological problems and disorders

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2
Q

How has Western society’s response to people with serious psychological disorders changed over the centuries?
What were the goals of the deinstitutionalization movement?

A

Severely disturbed people were once considered to be allies of the devil.
In the 18th centry and continuing into the 20th, people with severe mental illness were hospitalized, often under inadequate conditions.
Deinstitutionalization begun in the 50s in the US, was a response to both the gross failure of large mental institutions and the apparent success of antipsychotic drugs.

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3
Q

How do the assertive community treatment programs attempt to help the severely mentally disordered and their families?

A

ACT was aimed at helping individuals with severe mental illness wherever they are in the community. A multidisciplinary treatment team is available to patient and family. 24/7 one of the team members is available.
ACT can be highly effective in reducing the need for hospitalization and increasing patients’ satisfaction with life.

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4
Q

What are the major categories of mental health care providers?

A
  1. Psychiatrists
  2. Clinical psychologicsts
  3. Counseling psychologists
  4. Mental health counselors
  5. Psychiatric social workers
  6. Psychiatric nurses
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5
Q

Do antipsychotic drugs cure people?

What kind of neurotransmitter do they act on?

A

No they treat psychotic symptoms in e.g. schizophrenia. All such drugs decrease the effectiveness of the neurotransmitter dopamine and the newer (atypical) drugs affect other neurotransmitters. They have unpleasant side effects, some quite serious.

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6
Q

What are benzodiazepines and what do they do in the brain?

A

Antianxiety (=tranquilizers) drugs that are mainly used for generalized anxiety disorder and panic disorder with moderate effectiveness. They increase inhibitory activity in the brain via GABA, thus reducing excitability; but they are addictive, have potentially harmful side effects, and cause unpleasant withdrawal symptoms.

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7
Q

What do antidepressant drugs including tricyclics and selective serotonin reuptake inhibitors (SSRIs) do in the brrain?

A

The former prolong action of serotonin and norepinephrine in the brain by blocking the reuptake, while the latter affect only serotonin by blocking reuptake. SSRIs are equally effective in treating depression and have milder side effects, therefore they are more often prescribed. But SSRIs have moe side effects than older benzo’s. SSRIs are also used to treat anxiety disorders.

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8
Q

Studies that classify patients’ improvement after taking an antidepressant drug into three categories - …, …, and … - reveal that much if not most of the improvent is due to the ….. . …. , provided by a sense of being treated, may be the principal ingredient of any treatment for depression.

A
  1. Spontaneous recovery (in people who received no treatment)
  2. Placebo effect
  3. Drug effect
  4. Placebo effect
  5. Hope
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9
Q

In electroconvulsive therapy (ECT) used to treat … not helped by other means, electrical current is applied to the skull to induce … It is quite safe and effective but can cause … Before treatment the patient is put under … and given a … drug so that no pain will be felt and no damaging muscle contractions will occur.

A
  1. Depression
  2. Brain seizures
  3. Memory loss (both retrograde and anterograde)
  4. General anesthesia
  5. Muscle-blocking
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10
Q

…, once common, are no longer performed.
Today psychosugery involving small, localized .. is used occasionally for incapacitating obsessive-compulsive disorder. It is often effective but can produce harmful side effects.

A
  1. Prefrontal lobotomies

2. Lesions

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11
Q

.., is a possible alternative to psychosurgery, uses electrical current to … rather than destroy tissue at specific brain locations. A hair-thin wire electrode is implanted … into the brain. For …, it is implanted in the … or in the … It helps to treat …., …, …. and …

A
  1. Deep brain stimulation
  2. Disrupt activity
  3. Permanently
  4. cingulum
  5. Basal ganglia
  6. OCD
  7. Depression
  8. intractable pain in cancer patients
  9. some motor symptoms in Parkison disease
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12
Q

…. sends a pulse of electricity through a coil held just above a person’s head, inducing an electriccal current in neurons … , and can be effective in treating … by focusing on the ..

A
  1. Transcranial magnetic stimulation
  2. immediately below the coil
  3. Depression
  4. PFC
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13
Q

What are the 3 main types of biological treatments?

A
  1. Drugs
  2. ECT
  3. Psychosurgery
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14
Q

What is the difference between typical and atypical antipsychotic drugs?

A

Typical: the first ones developed. Only act on dopamin
Atypical: the newer ones. Seem to be more effective, and are more expensive. They act on dopamine and other neurotransmittes.

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15
Q

What is tardive dyskinesia? By what can it be caused?

A

Involuntary jerking of tongue, face and sometimes other muscles. Antipsychotics.

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16
Q

The psychodynamic approach of psychotherapy assumes that psychological disorders arise from .., that though unconscious, strongly influence….

A
  1. unresolved mental conflicts

2. conscious thought and action

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17
Q

The psychodynamic therapist’s job is to identify the unconscious conflict from …, such as …, …, …, and … The goal is to help the patient become aware of .. and … and thus be able to deal with them.

A
  1. observable clues
  2. dreams
  3. fee association
  4. mistakes
  5. slips of the tongue
  6. the conflicting beliefs
  7. wishes
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18
Q

The patient’s resistance to the … suggests that the psychodynamic therapist is on the right track. …. of feelings about significant persons in the patient’s life to the theapist helps the patient to become aware of these strong emotions.

A
  1. uncovering of unconscious material

2. Transference

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19
Q

Humanistic therapists strive to help clients… , a prerequisite for…

A
  1. accept their owns feelings and desires

2. self-actualization (positive, self-directed psychological growth

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20
Q

According to humanistic therapists, clients may fail to accept (deny and distort) their feelings and desires becasue…

A

they perceive that these are disproved of by valued others

21
Q

By what three things is the approach of the humanistic therapists characterized?

A
  1. clients take the lead
  2. listen carefully
  3. provide unconditional but genuine positive regard
22
Q

Define psychotherapy

A

Any theory-based, systematic procedure conducted by a trained therapist for helping people overcome or cope with mental problems through psychological rather than diectly physiological means.

23
Q

What is the focus of the behavioral psychotherapy approach?

A

Focuses on the roles of basic learning processes in the development and maintenance of adaptive and maladaptive ways of responding to the environment.

24
Q

What is the focus of the cognitive approach of psychotherapy?

A

Focuses on the idea that people’s ingrained, habitual ways of thinking affect their moods nd behaviors.

25
Q

What is the difference between psychoanalysis and psychodynamic therapy?

A

Psychoanalysis is a form of therapy that adheres closely to ideas of Freud.
Psychodynamic therapy includes psychoanalysis and is more loosely based on ideas of Freud.

26
Q

According ot psychodynamic therapists, what is the relationship between symptoms and disorders?

A

Symptoms are surface manifestations of the disorder. The disorder is buried in the person’s unconscious mind and must be unearthed before it can be treated.

27
Q

What is person-centered theapy?

A

Focuses on the abilities and insights of the client rather than those of the therapists. Core principles have to do with the relationship between therapist and client.

28
Q

What are the goals of behavior therapy (2x)?

A
  1. Extinguish maladaptive responses

2. Condition healthier responses by exposing clients to new environmental conditions

29
Q

What are contigency menagement programs based on? How do they modify behavior?

A

Operant conditioning principles

By modifying behavior-reward contingencies

30
Q

What are exposure treatments based on?
What are they used for?
Name 3 techniques

A

Classical conditioning
Habituate or extinguish reflexive fear responses in phobias
Imaginal exposure, in vivo (real life) exposure (more expensive, time consuming and not practical) and VR exposure

31
Q

What is cognitive therapy based on?

A

The idea that psychological distress results from maladaptive beliefs and thoughts. Generally centers on conscious thoughts.

32
Q

What is the approach of the cognitive therapist (3x)?

A
  1. Identify maladdaptive thoughts and beliefs
  2. Convince client of their irrationality
  3. Help client eliminate them along with the unpleasant emotions they provoke
33
Q

What are the 2 most common types of behavior therapy?

A
  1. Contingency management therapy

2. Exposure therapy

34
Q

What is the difference between habituation and extinction in exposure treatments to unwanted fears?

A

Habituation: Uncontioned fear reflex
Extinction: Conditioned fear reflex

35
Q

How is behavior therapy distinguished from cognitive therapy?

A

If a behavior therapist is a trainer, a cognitive therapist is a teacher. While behavior therapy deals directly with maladaptive behaviors, cognitive therapy deals with maladaptive habits of thought.

36
Q

Cognitive therapy

What is the Ellis’s ABC theory of emotions?

A

A is the activating event in the environment
B is the belief that is triggered in the client’s mind when the event occurs
C is the emotional consequence of the triggered belief

37
Q

In what sense is a cognitive therapist initially a teachter and later a consultant?

A

As the client can assume more responsibility, the therapist becomes less directive.

38
Q

Many conrolled experiments, comparing patients in psychotherapy with comparable others not in psychotheapy have shown that psychotherapy…

A

helps

39
Q

Research indicates that no form of psychotherapy is more effective overall than any other, perhaps becasue they differ less in … than in …

A

practice

Theory

40
Q

Some psychotherapies are better than others for particular situations, however. For example, behavioral exposure theapy is more effective than other treatments for….

A

specific phobias

41
Q

…., shared by all standard psychotherapies, may account for much of the effectiveness of pyschotherapy. These include …, …, and …

A

Common factors
Support
Hope
Motivation

42
Q

Support (…, … and….) helps to build the client’s …. Research suggests that support and of itself has considerable….

A 
acceptance
empathy
encouragement
confidence
therapeutic value
43
Q

Hope comes in part from …. in the process, bolstered by the therapist’s own … in it. People who believe….. have a greater chance of getting better.

A

faith
faith
they will get better

44
Q

Hieronder staat een aantal geneesmiddelen genoemd die gebruikt kunnen worden bij de behandeling van psychische stoornissen. Tevens vindt u een aantal beschrijvingen van de werking van een bepaald geneesmiddel. De opdracht is om het juiste geneesmiddel (cijfer) bij de werking van dat geneesmiddel (letter) te plaatsen.

Tofranil
Thorazine
Valium
Prozac
Dit medicijn blokkeert de normale heropname van serotonine en noradrenaline.
Dit medicijn verhoogt de werking van de neurotransmitter GABA (gamma-aminobutyric acis).
Dit medicijn verhoogt het niveau van serotonine in de synaptische spleet.
Dit medicijn vermindert de werking van de neurotransmitter dopamine.

A

Het juiste antwoord is 1-a, 2-d, 3-b, 4-c

Tofranil is een tricylisch antidepressivum dat de normale heropname van zowel serotonine als noradrenaline blokkeert door de vurende neuron, waardoor deze neurotransmitters langer in de synaptische spleet aanwezig blijven en zo langer de tijd hebben om zich te binden aan de receptoren van de ontvangende cel.

Thorazine is een antipsychotica dat de activiteit van de neurotransmitter dopamine vermindert, waardoor psychotische symptomen verminderd worden.

Valium is een geneesmiddel tegen angst dat de werking van de neurotransmitter GABA verhoogt. GABA is de belangrijkste inhiberende neurotransmitter in de hersenen; een verhoogde activiteit van GABA vermindert de prikkelende werking van andere neuronen in zo’n beetje het gehele brein.

Prozac is een antidepressivum dat de heropname van serotonine door de vurende neuron blokkeert, waardoor de serotoninemoleculen langer aanwezig blijven in de synaptische spleet en zo meer kans hebben om zich te binden aan de receptoren van de ontvangende cel en hun positieve effect op stemming uit te oefenen.

45
Q

essentie humanistische benadering

A

Binnen de humanistische benadering worden problemen gezien als voortkomend uit moeilijkheden in het dagelijkse leven, met name een gebrek aan betekenisvolle relaties en belangrijke doelen. Getracht wordt om het potentieel van mensen te vergroten door hun ervaringen in het dagelijkse leven tot in detail door te spreken, daarbij oog houdend voor hun individualiteit en capaciteiten.

46
Q

Madelief van vier heeft door haar autisme enkele schadelijke gewoontes opgebouwd. Eén daarvan is het bonken van haar hoofd tegen de muur naast haar bed als ze ’s avonds moet gaan slapen. Haar ouders maken zich zorgen dat ze zichzelf bezeert en het slapengaan is bovendien een moeizaam onderdeel van de dag geworden. Ze weten zich geen raad meer en vragen een professional om hulp.

Na het bespreken van de situatie met een therapeut, en het nauwkeurig doorlopen van de stappen in het avondritueel van Madelief, stelt de therapeut een techniek voor om het probleem aan te pakken. De therapeut vraagt de ouders om Madelief te belonen met een sticker, elke keer dat ze haar hoofd niet tegen de muur bonkt bij het slapengaan. Wanneer ze haar stickervel vol heeft mag ze een nieuwe knuffel uitzoeken in de speelgoedwinkel.

Haar ouders zijn verbaasd over de resultaten. Al na enkele weken stopt Madelief volledig met het bonken van haar hoofd waardoor het slapengaan een stuk aangenamer wordt voor kind en ouders.

Welke techniek binnen de gedragstherapie heeft de therapeut gebruikt om Madelief en haar ouders te helpen?

A

De therapie die hier gebruikt wordt heet Contingency Management Therapie. In dit geval gaat het specifiek over Parental Management Training waarbij de ouders leren om de gedrag-consequentie samenhang te veranderen om zo positief gedrag te bekrachtigen. Belangrijk bij deze vorm van therapie is dat goed gekeken wordt naar de bestaande mechanismen omtrent het gekozen gedrag, om te voorkomen dat negatief gedrag beloond wordt (met bijvoorbeeld aandacht). In plaats daarvan worden de ouders geleerd om alleen het positieve gedrag te belonen. Contingency Management Therapie is gebaseerd op het mechanisme van operante conditionering en gaat ervan uit dat mensen (en dieren) gedrag met positieve consequenties zullen herhalen en gedrag met negatieve consequenties zullen vermijden.

47
Q

Daniel, 36 jaar, heeft sinds het afgelopen jaar huwelijksproblemen. Zijn vrouw wil niet met hem naar een relatietherapeut, dus heeft hij therapeutische hulp voor zichzelf gezocht. Na een eerste interview heeft zijn therapeut hem in een groep geplaatst met andere cliënten in een zelfde situatie. Tijdens elke groepssessie vertellen de groepsleden aan elkaar hoe het de afgelopen week gegaan is. De therapeut stelt daarbij niet veel vragen, maar past een techniek toe die actief luisteren wordt genoemd. Hierbij fungeert de therapeut als een soort spiegel door steeds in eigen bewoordingen terug te geven wat de therapeut de cliënt hoort zeggen. Cliënten zouden zich op deze manier meer bewust worden van hun gedachten en gevoelens. De therapeut probeert geen waardeoordeel te geven en probeert een sfeer van oprechtheid en openheid te creëren in de groep. Ook probeert de therapeut geen advies te geven, ook niet als daar expliciet om gevraagd wordt. In plaats daarvan probeert de therapeut de cliënt het vertrouwen te geven dat hij of zij in staat is om problemen zelf op te lossen.

Welke therapievorm heeft Daniel gekregen?

A

De cliëntgerichte therapie. De therapeut werkte vanuit de cliëntgerichte benadering om Daniel meer grip te laten krijgen op zijn gedachten en gevoelens en hem te laten zien en voelen dat hij het in zich heeft om zijn leven op een positieve manier te veranderen. Cliëntgerichte therapie, waarvan Carl Rogers de grondlegger is, is het meest bekend binnen de humanistische therapieën.

48
Q

Overdracht (‘transference’) is het verschijnsel waarbij

A

de cliënt onbewust huidige en vroegere gevoelens ten opzichte van belangrijke figuren opnieuw beleeft in de relatie met de therapeut.

Inleiding psychologie (16 decks)

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