treatment of disorders

Question 1

how do you asses the quality of a treatment

Answer 1

response rates: decrease in scores of distress
remission rate: reduction or disappearance of symptoms
relapse dates: deterioration after improvement

Question 2

btfd SEROTONIN

Answer 2

Antidepressants: depression can be caused by a chemical imbalance in neurotransmitters.
- a serotonin deficiency
- depression could be treated by increasing serotonin levels.
- SSRIs selective serotonin reuptake inhibitors

Question 3

study on antidepressants***

Answer 3

Arnone et al, 2013

grey matter loss MRI
control healthy
depressed participants
8 weeks in citalopram
increase in grey matter some experience a decrease in depressive symptoms

Question 4

what is cbt

Answer 4

cognitive-based therapy believes that depression could be treated with a therapy that replaces maladaptive thoughts and adjusts behavior to the environment.
- self monitnoring, thought records, questions assumptions
- exposure, pleasant activity

Question 5

study on different treatments***

Answer 5

march et al, 2007
439 adolescents with major depression. cbt, fluoxetine, none or both

all participants aside control improved significantly
12 weeks: bad cbt
at 36 weeks cbt = fluoxetine
best = combination

Question 6

study on long lasting effects***

Answer 6

Hollon et al, 2005
104 patients
patients withdrawn from CBT were less likely to relapse than those withdrawn from medication 31% vs 76%, and even less likely than the group that continued medication 47%.

symptoms vs cause

Question 7

changes in the brain

Answer 7

antidepressants seem to limit amygdala activity while CBT uses the PFC to quiet its actity.

Question 8

ethical considerations in treatment research

Answer 8

placebo conditions
unkown exposure to side effects

Question 9

role of culture in treatment

Answer 9

cultural factors can influence compliance with treatment
- beliefs about mental illness
- beliefs about treatment
- beliefs about the relationship with therapist.

Question 10

study on culture and treatment**

Answer 10

Kinzie et al,
- south asians tricyclic antidepressants TCA
- theraputic level medicine found in 15%
- no dectable TCA in 61%
culture affects compliance

Question 11

what is cultural negotiation

Answer 11

common interpretation in culturally appropriate terms
The treatment must make sense to the patient
1. language
2. persons (ethnic similarities)
3. metaphors (culturalitvie relevant forms)
4. content (clients knowledge, values and traditions)
5. method

Question 12

study on cultural negociation**

Answer 12

griner and smith
meta analysis
when therapists spoke in the clients native language therapy was 2x more effective.
group interventions: treatments in same-race participants were 4x more effetice than mixed groups

Question 13

what are ssris

Answer 13

Selective serotonin reuptake inhibitors. Have been found to relieve depressive symptoms in 70% of patients, after 4-8 weeks of treatment. Citalopram, fluoxetine

side effects: weight changes, sexual problems, insomnia

Question 14

effectiveness of treatment

Answer 14

1. severity
2. difficult to measure at an individual level
3. it is not clear what might be driving the change

Question 15

methodological considerations

Answer 15

correlation is not causation
changes in behavior are difficult to measure (bias: patient wanting to get better, psychologist wanting him to improve)
confounding variables (THERAPY)