ICD Paper 4 Flashcards
explain techqniue of Imag D
- Technique involves teaching brief PMR procedure
- Cilents instructed to visulise hemselves being exposed to a situation that triggers the urge to carry out impulsive behaviour
- contemplating acting on urge but then leaving situation IN STATE of continued relaxation w/o acting on urges
- Sessions can be recorded on casette audiotape for practise
2 advanatges of Imag D
- Blaszinski and knower
- reduces strength of drive to carry out habitual behaviour
- ehances self efficacy by demonstaring that the client is in control of actions
- can be used anywhere once indiviudal has learnt technqiue
- empowers client by providing necessary skils to resist urges
suggets 2 problems of Relaxation monitoring tables
- patienst may forget to fill them in
- may fill in even if they didnt complete the session
- may lie about progress
- may misjudge ratings of feelings when planning the behaviour
- may not be able to complete sheets at appropriate time each day + forget what happened
Discuss adv and disadv of psychological treatments to treat ICDs
ADV
- Once trained, techniques can be applied anywhere/anytime (at home, clinic etc) by client
- no drugs taken so no side effects and no risk of addiction to drugs
- technqiues can be applied to many diff disorders e.g gambling/kleptomoania/ compulsive buying etc
Disadv:
- time w therapist is mcuh more than that given by a pshyciatrist prescring drugs
- a person may decide to withdraw from treatment to engage in impulsive behaviour
- any pshycological theraphy takes more time than drug treatment taken at same tiem each day
- patienst must be motivated and respoibsle to practise techniques if not treatment ineffective
- can be constly for some/inconveneinet
Pryomania Burton et al
Psycological:
- not all firesetters have commited arson; most do not meet diagnostic criteria for pyromania
- firesetting is a beahv…..
Glover
Grant
The biochemical treatment using nalmefene is believed by Grant et a to help reduce the urge to gamble.
- To test its effectiveness,
participants were assessed to ensure they were suitable to participate.
- They were then randomly allocated to either a group receiving nalmefene or to a group receiving a placebo.
Blazinsyk and nower
Miller feeling state methodlogy
- Miller 2010- ICDs as gambling,compulsive shopping, sex addiction causes suffering in ppls lives
- The FST of ICDs suggest these disorders caused when INTENSE POS feelings become linked w specific bheaviours
- The effect of the linkage is the need to generate the feeling so person compulsivley replicates the beavhiour realted to positive feeling event even if bad to their well being
- Impulse control disorder protoccol theraphy usuing EMDR to address fixations
explain feeling state theory
- The feeling state is when positive feelings are linked w specific events and from a state dependent memory
2 diff between ICDP and EMDR
EMDR= reduces negative beliefs caused by traumatic events
ICDP= involves trying to reduce pos beliefs associated w a feeling state
EMDR effectiveness is assede usuing Subjective units of disturbance SUDS
ICDP effectiveness assed by usuing Positive feeling scale PFS
describe 2 psychological CB tharpies for treating ICDS
**Covert sensetisation (Glover) **
- where an imagined aversive stimulus is paired w an undersirable behaviour so behaviour is not repeated
- e.g asking a gambling addict to imagine gambling then shwoing pictures of bankrupcy
Imaginal desensitization (Blaszczynski and Nower)
- Teaching PMR w person visualizing themeselves beinge exposed to situation that triggers drive to carry out impulsive behaviour
S+ W of usuing case studies to study ICDs
Strengths
- General principles of theraphy can apply to other ppl
- Case study give in depth qualative detail showing how therapy can work in specific cases
- If many case studies produce similiar results its possibel to generalise
Weakness:
- No standerdised method taken
- Theraphist was assesor
- Case study may not be generaisable to other ppl w gambling problems or other ICDs
- No objective behavioural assesements conducted
- A longer term follow up neccessary to determine if ICD problems return
Explain characteristics of kleptomania
- Not being able to resist the urge to collect/hoard things
- involves experiecing tension before thft then feelinsg of pleasure/relief when comminting theft
- uncontrollable urge to steal
suggest 2 limitations of the answer ppt may give to the question asking “how many hours a week do you think about stealing”
- Question is ambigious as 1-4 hrs appears twice so which to choose
- what catgeorises thinking abt stealing, vague thoughts or planning in detail
- ppt may give socially desirable answers to hide their symptoms to show theraphy is working
- only quant data
suggest how reliability of KSAS can be assessed
- Relibaility use retest by giving same test to same person at a later date
- relibaility use split half
suggest how validity of KSAS can be assessed
Concurrent validity- compared w alternative measure
- Face validity- looks like it measure kleptomania
* criterion validity: by comparing the KSAS to other measures of kelptomania + if 2 scores have a strong correlation the test is valid
**- construct validity **by seeing if seeing if the KSAS matches up 2 theoretical ideas about what it is supposed to be measuring + if it does the KSAS is valid
* ecological validity: does the scale apply to real life, do the questions reflect real life experiences of people
* temporal validity: test the KSAS over time to see if the person shows any improvement
Discuss S+W of using self report questionnares to measure klepto
Strengths
- questionnares usuing quantative data provides therapist w useful info so they an asses extent of the problem
- The KSAS question may show that person may spend over 10hrs per week thinking abt stealing
- Asking ppl directly means that ppl given opportunity to express their feelings + explain their behaviour RATHER than the researcher trying to work out reasons for their behaviour from other methods
- large numbers of ppt can be done easily
- questionnares easy to replicate
- data can be qual or quant depending on questions
Weaknesses
- Socailly desirable response: not truthful respond to demand C
- closed/fixed questions may force ppl into choosing answers that dont reflect their true opnion + lowers validity
- researchers may ask leading questions so affects validity of data collected
Describe term placebo
- a substance liek pill/injection of sugar or saline
- given to ppt that has NO therpautic effect BUT ppt responds as if they have recieved active ingredients
outline 2 testing procedures used to asses ppt gambling severity in study by Grant
- gambling severity assesed w Yale Brown obsessive compulsive scale modified for pathological gambling PG-YBOCS
- first 5 items of PG- YBOCS consists of the gambling thought/urge subscale
- final 5 consists of conisist of the gambling behaviour upscale
- “Studies enrolled only individuals w DMS-IV PG combormbidity was assessed usuing the structural clinical interview for DSM-IV
- Semi ss interview: rater administered questionnare used to collect info
outline 2 reasons why this assements (GRANT) excluded some ppt from study
- infrequent gambling that did not DMS-IV criteria for PG
- unstable medical illness
- pregnancy/lactation currently
- a need for meds other than nalmefene and naltrexone w possibel psychotropic effects/unforavle interctions
- lifetime history w bipolar disorder type 1/2, dementia, schizo
- previous nalmefene/naltrexone treatment
- clinially sig suicudilaity
S+ W of using biochemicals to treat gambling
Strengths
- easy to take/swallow a pill
- means gambler is passive in their treatment so good for working ppl
- prevent production of endorphins/nueorchemical releated w pleasure
**Weakness:
- addictive + aim is to REDUCE addictive behaviour
- may not be taken as prescribed
- ignore role of alternative reasons a gambler may be addicted
Explain whats meant by EMDR
- treatment involving identifying trauma + negative feelings/beliefs associated w the trauama
- Eye movements then used to process trauama + feelings + install pos beliefs/feelings
Outline procedure of EMDR used by Miller
- Obtain history, frequency and context of compulsive behaviour
- Identify specific aspect of the compulsive behaviour that has MOST emotional intensity associated with it
- Identify specific positive feelings linked w compulsive behaviour along w its rating on PFS
- Locate/identify any physical sensations created by pos feelings
- Client combines an image of perforiming compulsive bevahiour, pos feelings, physical s
- eye movement sets perfromed while client focuses on material e.g memory, feeling, image that was identified in prior set
- Homework
- Second sesson for reeval sepeating steps 2-8 if needed
Suggets 1 similairty and 1 diff between ICD theraphy and Imaginal desen
- Both ICT and ID treatments for ICDs
- Both ICT and ID involve a therapist conducting treatment
- Both ICT and ID require patient to imagine exposure to trauma
- ICT is eye movements vs ID is PMR
