Treating Psychopathology Flashcards

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1
Q

What are the four main goals of treating pathological issues?

A

providing relief from distress
increasing self awareness/insight into problems
Teaching coping skills to manage distress (i.e. in CBT)
Identifying and resolving “root causes” (i.e. in psychodynamics)

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2
Q

What is the main concept of psychoanalytic treatment?

A

Unconscious conflicts originate from early life experiences (i.e. with Little Albert being afraid of his Dad), causing us to create defence mechanisms (Albert displacing this onto his fear of horses) which then cause observable symptoms of mental disorder

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3
Q

What are the six defence mechanisms in psychoanalysis?

A

Repression, minimisation, denial, displacement, projection and sublimation

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4
Q

What is sublimation?

A

When we channel unacceptable urges or thoughts into a more socially acceptable. productive outlet (i.e. getting back in shape after a break up)

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5
Q

What is projection in psychoanalysis?

A

When we attribute unacceptable feelings, urges and self-attitudes within ourselves to or onto someone else- i.e. you accuse your partner of cheating after you have cheated

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6
Q

What is displacement in psychoanalysis?

A

When an individual discharcges their tension occuring due to an internal or external large threat onto a less threatening target (i.e. shouting at your kids after your boss threatens to fire you).

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7
Q

What is denial in psychoanalysis?

A

Rejecting fact as it makes us too uncomfortable

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8
Q

What is minimisation in psychoanalysis?

A

When an objective fact is too hard to accept so we minimise unpleasant features/effects of it `

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9
Q

What are the aims in psychoanalysis?

A

Identify unconscious conflicts and make the patient consciously aware of these. The therapist and client will then work on strategies to resolve these conflicts.

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10
Q

What are two techniques of psychoanalytic therapy?

A

Free association and dream analysis.

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11
Q

what is free association?

A

When the therapist gives a word or idea as a prompt, and the patient will then immediately respond with the first word that comes to their mind. This is in aim of observing the mechanisms of the unconscious, which could help identify conflicts.

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12
Q

What is dream analysis?

A

Freud believed that dreams reflected our unconscious desires and conflicts. Patients would therefore share their dreams with the therapist in hope of identifying these

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13
Q

How is psychoanalysis more talking/introspection based and less behavioural-modification based?

A

It does not view symptoms of mental disorder as something to be “recoded” as more acceptable behaviour but as a tool to observe the unconscious conflicts and past experiences that cause these behaviours.

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14
Q

Is psychoanalysis a long term or short term therapy?

A

Long term- it can last years

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15
Q

What is the main concept of behavioural therapy?

A

It suggests that we learn mental disorder by erroneously associating specific stimuli with responses- which then influences our response to that stimulus/behaviour.

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16
Q

What is behavioural treatment/therapy based around?

A

Associative learning principles- re-associating the stimuli with different responses. therefore hoping that this association becomes extinct

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17
Q

What is contingency management?

A

It is a therapy based around operant conditioning where you give money to people for desired behaviour (positive reinforcement)

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18
Q

What is flooding?

Definition, conditioning type and uses

A

When we rapidly expose and individual to an anxiety-inducing stimulus, hoping that the plateau in anxiety that they experience after the inevitable initial terror will be re-associated with the stimulus. It is based on classical conditioning and is often used for anxiety disorders)

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19
Q

What is aversion therapy?

A

When we manipulate a positive or negative response to a stimulus in hopes of new association with this experience and the stimulus (i.e. rapid smoking)

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20
Q

What is response shaping?

A

Rewarding people for desired behaviour- often used with learning disabilities (operant conditioning)

21
Q

What is the main concept of CBT?

A

Mental disorder is caused by cognitive distortions or biases, we can therefore alleviate symptoms and distress caused by the disorder by changing these distortions.

22
Q

What is the cognitive distortion of minimisation?

A

We downplay the importance of positive events and features of ourselves/lives

23
Q

What is the cognitive distortion of personalisation?

A

We assume everything is our “fault” attributing everything to ourselves, even if it is out of our control.

24
Q

What is the cognitive distortion of arbitrary inference?

A

Drawing conclusions about situations (especially attributing causes or outcomes) with little/no evidence

25
Q

What is the cognitive distortion of magnification?

A

Blowing things out of proportion

26
Q

What is the cognitive distortion of overgeneralisation?

A

Making sweeping conclusions that apply the outcomes/contents of very specific events/situations to larger, incomparable situations.

27
Q

What are two types of CBT?

A

Mindfulness based CBT

Acceptance commitment therapy

28
Q

What is the main concept of family and systemic therapies?

How does this vary based on the therapist?

A

They assume disorders arise from dysfunctional relationships and communications amongst family, so the treatment focuses on changing behaviour and communication within the whole family, not just the patient.

This can vary based on the therapists theoretical orientation (i.e. humanist or cognitive)

29
Q

What does pharmacotherapy assume?

A

that psychological therapies are caused by brain dysfunction

30
Q

What are the 5 main ways therapy can be delivered?

A

1-1
Group therapy
Online/via computerised programmes (i.e. C-CBT)
E-therapy (E-CBT)
Via mobile apps (i.e. apps to quit smoking treating SUD)

31
Q

What are two popular measures for what counts as a therapy having “worked”?

A
Complete remission (the patient no longer meets the diagnostic criteria for the disorder after treatment)
Change in emotion, cognition and/or behaviour (even if they still meet some criteria)
32
Q

Ideally, why should therpeutic treatments work

A

because of their construction, not rapport between therapist and patient

33
Q

What are two ways to test treatment efficiency?

A

Case studies- detailed reports of the treatment of one individual patient and whether or not the therapy “worked”
Case series- A descriptive report of treatment efficacy in groups of patients who have recieved different type of treatment

34
Q

How are both case studies and series vulnerable to selection biases?

A

Though they aim to judge efficacy of the therapy alone, the patients will have voluntarily which treatment to carry out. Therapy works better if you choose to do it/want or believe it will succeed. This could make it a less subjective measure of efficacy

35
Q

What is spontaneous remission (and a statistical example)?

A

People getting better on their own. 30% of people with anxiety ot depression will get better with no formal treatment.

36
Q

What is one theory for why spontaneous remission occurs?

A

Those who seek treatment tend to be seriously unwell- not the mean. People with more average symptoms (the mean, of whom there may be a lot of people) may be more capable of getting better on their own

37
Q

What is the placebo effect?

A

When an effect occurs with no treatment simply by mental construction- can occur with both pharmaceuticals and talking therapies. This can play a strong role in recovery/efficacy of treatment

38
Q

What is one way that therapy may more show a placebo effect than actual efficacy?

A

Structured social support- Most therapies offer unstructured attention, understanding and caring

39
Q

What is a waitlist control trial?

A

When we compare a group recieving treatment with a group kept on a waitlist to see if the recovery shown is due to the therapy or other factors (i.e. the same would occur without the therapy )

40
Q

What is one ethical issue in waitlist control trials?

A

It involves withholding treatment from patients, which could be harmful

41
Q

What is befriending

A

When we don’t offer therapy but create the social support associated with therapy through special programmes in order to show the impact of this and test spontaneous remission (but not test placebo effects of treatment)

42
Q

What is an active control trial?

A

When, for instance, one group gets a real version of CBT and one condition gets a fake one, both structured the same. This then tests placebo effetcts, the impact of social support AND spontaneous recovery if done correctly (though this is difficult as making convincing “fake” psychotherapy can be hard)

43
Q

What is a randomized control trial?

A

We randomly assign patients into a treatment group and a control group and compare their prognosis and recovery.

44
Q

What are four issues with RCTs?

A

Dropout rates can be very high (especially if patients figure out they are in the control trial)
It is very expensive
It doesn’t consider which treatment the patient would prefer, which could be argued to not respect their autonomy
It often focuses on recover that can be statistically significant, but does not take into account the individuals long-term prognosis
The findings may not generalize to typical settings or populations (for instance due to specific inclusion or exclusion criteria that make the sample very specific )

45
Q

What are two bias that can affect RTCs?

A

The findings may not generalize to typical settings or populations (for instance due to specific inclusion or exclusion criteria that make the sample very specific/biased )
Publication bias- the investigator or researchers may not report science or data as accurately as they should in hope of being published. This can especially occur if the treatment is proved to be ineffective/placebo.

46
Q

What are the three ways (and their limitations) that we can combine evidence from accross different studies?

A

Narrative summaries- when we summarise via description the efficacy of a treatment/a control. This is prone to bias and can’t give quantiattive data for efficacy
Meta-analysis- Can compare RTCs, even if they used different methodology/design and can give quantifying data for treatment efficacy
Meta-meta analysis- umbrella reviews comparing lots of meta analyses of trials with more popular therapies

47
Q

What therapies have no evidence of being more effective than placebos?

A

Homeopathic therpaies

48
Q

How much of therapy efficacy is theorised to be due to patient/therapist rapport (therapeutic alliance)?

A

7%

Only 1% attributed to therapeutic-specific principles or therapeutic techniques