Lecture 24: Models And Therapy Of Psychopathology Flashcards by Nancy Hu

What is Freud’s contribution to psychopathological therapies?

Recognised conscious preconscious and unconscious processes,
Developmental stages
Oedipal crisis
Drive theory
Psychoanalysis, psychodynamic theory
Ongoing contribution to psychotherapies today.

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What is the brief history of treatment for Psychopathological disorders?

1970s- the beginnings of asylum care
1780s- mesmer, trance states
1793- pinel- moral therapy
Charcot- use of hypnosis in hysteria
Schopeneur, Nietzshce, Jewish mystics talk of the unconscius, understanding that we are irrational beings who hide things from ourselves

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What are the forms of psychodynamic therapy?

Psychoanalysis

Psychodynamic psychotherapy

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What is psygchoanalysis?

Patient lies on a couch with therapist seated behind them. Patients are encouraged to free associate

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What is psychodynamic psychotherapy?

Patient and therapist are face to face
The techniques used are more goal directed than those used in psychoanalysis
Many styles: therapies in children, art therapies, skills, used in indivudals, couples, families and groups

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What is the psychodynamic approach?

Mental symptoms are a reflection of unconscious conflicts which induce anxiety
The goal of therapy is to gain insight into these conflicts

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What is insight?

It refers to the situation in a person coming to understand their unconscious conflicts

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What does psychodynamic therapy require?

An alliance (relationship) between the patient and therapist

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What are psychodynamic techniques?

Relaxed atmosphere
Free association
Resistance, dream analysis and parapraxis
Interpretation
Analysis of transference

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What is free association?

Technique in which the patient is encouraged to say whatever comes to mind to reveal the unconscious processes of the patient

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What is interpretation?

The therapist interprets the thoughts and feelings of the patient in order to reveal the hidden conflicts and motivations

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What is analysis of transference?

Patients bring into therapy their past troubled relationships, these ar transferred to the therapist

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What is behaviourism?

A more scientific approach based on observation.

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Who contributed to behaviourism?

Ivan Pavlov - conditioning reflex in dogs, pairing of stimuli
BF skinner - operant comditiojijg, reward and punishment shape behaviour
Watson- behaviour can be studied without consideration of learning etates

These contributions remain highly relevant to learning theory and shaping behaviour

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What are behavioural approaches to treat psychopathology

Desensitisation- classical conditioning in the treatment of phobias

Contingency management- positive reinforcement strategies promote repetition of behaviour e.g. Praise, and
Extinction strategies diminish dysfunctional behaviours e.g. Dog training, disruptive behaviour management in classrooms

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What is cognitive behavioural therapy?

When behavioural therapies are blended with cognitive psychology

What is cognitive psychology?

Attention
Language use
Memory
Perception
Problem solving
Thinking

What is the cognitive behavioural perspective?

Bech- 1970
Proposed that thoughts are connected to feelings

Many psychological disorders reflect thinking errors such as dysfunctional attitudes, faulty thinking and cognitive distortions

Thinking errors can lead to psychopathology

What is CBT like?

Usually short term and focused in the current behaviours of a person and careful analysis of thinking and feeling associated with this

Therapists are more directive
Solid evidence base exists based on RCT for depression, anxiety, eating disorder, chronic fatigue, psychotic disorders

Now CBT can be computerised, group delivery also available

What is the focus of cognitive therapies?

Changing dysfunctional thought patterns (automatic thoughts) through rational approaches such as looking for evidence and challenging this

What does rational emotive therapy focus on?

The irrational thought patterns of the patient (rational thinking is the key to eliminating symptoms)

What does Beck’s cognitive therapy focus on?

Changing patent’s cognitive distortions

What are family therapies?

This began in 1950s with the central notion that an individuals symptoms were not pathology but rather symptoms of dysfunction in the family.

This theory was reinforced by the cybernetics and systems theory which states that causality can be non-linear e.g. Child’s symptoms may function to keep the two parents together, who are otherwise in conflict.

What is the biological perspective on psychopathology.

Seeks roots of abnormal behaviour within the brain.

Can be due to neurotransmitter dysfunction
-depression due to low levels of serotonin

Can be due to abnormality of brain structures
-frontal lobe differences in schizophrenia

Can be due to disrupted neural pathways
- e.g. OCD

Can be due to genetics

What are some biological treatments?

These have arisen from the view that psychological disorders reflect pathology of the brain Treatments include Pharmacotherapy Electroconvulsive therapy Psychosurgery These can only be administered by physicians

What is psychopharmacology?

The use of drugs to treat symptoms of mental illness Drugs predictably alter symptoms in a particular mental disorder or illness

What are psychotropic medications?

Drugs that act on the brain to alter mental function Before 1956, schizophrenia was virtually untreatable with many patients confined for life in mental hospitals Chlorpromazine was found to reduce the severity of psychotic thought, allowing people to live outside of mental institutions

What are neurotransmitters.

These are chemicals which transmit information from one cell to another They are stored in the vesicles of the presynaptic cell Released in response to the action potential from the presynaptic membrane Molecules diffuse across the synaptic cleft and bind to post synaptic receptors.

What are some common neurotransmitters and their effects?

Glutamate - excitation of neurons throughout the nervous system GABA - inhibition of neurons in the brain Glycine - inhibition of neurons in the spinal cord and lower brain Dopamine - emotional arousal, pleasure and reward, voluntary movement, attention Serotonin - sleep and emotional arousal, aggression, pain regulation, mood regulation Acetylcholine - learning and memory Endorphins and Encephalins - pain relief and elevation of mood Epinephrine and norepinephrine - emotional arousal, anxiety and fear

What are antipsychotic medicines?

These refer to drugs that alleviate schizophrenia They inhibit dopamine which has been implicated in the positive symptoms of schizophrenia However, can result in side effects like tardis dyskinesia, which is involuntary movements such as tics and twitching

What are antidepressant medications?

Drugs which reduce depression by correcting for the depletion of norepinephrine and serotonin E.g. Monoamine oxidase inhibitors allow the neurotransmitter to work for longer periods Selective serotonin reuptake inhibitors block the reuptake of each serotonin

What antianxiety meds are used?

Benzodiazepines increase the activity GABA to dampen the neural activity of the brain Antianxiety medications can result in physical and psychological dependence

How are treatments evaluated?

Drug treatments are evaluated by randomised controlled trials with blinding, and measured against placebo.

What is a difficulty in evaluating psychological treatments?

The difficulty lies in the definition of success and variability in the disorder. Research needs to consider the length of treatment, cost, symptom reduction and relapse rates.

What do efficacy studies do?

They assess treatment outcomes under controlled experimental conditions

What do effectiveness studies do?

They assess treatments as practiced by clinicians

What are the genetics like in mental illness?

Research has shown that: Autism, schizophrenia and biopolar disorder have 60% concordance in identical twins and 5% in fraternal twins Coronary artery disease have a 40% concordance in identical twins and 10% in fraternal twins Depression has a 50% concordance in identical twins and 15% in fraternal twins.

What is the Diathesis stress model for mood disorders.

Diathesia- hereditary with or without early environmental experiences, along with Stress- precipitating event like a death in the family In combination, can contribute biologically to low serotonin/norepinephrine levels, This in turn results in psychological negative cognitions- learned helplessness. Which causes the symptoms like depressed mood/energy