Treatment of Psychological Disorders

Question 1

Therapy

Answer 1

Means to cure or heal, and in a broader sense, to reduce distress and improve an individual’s ability to function in daily life

Question 2

Pharmacotherapy

Answer 2

Pharmacotherapy involves prescribing and managing medication—more specifically, psychopharmacotherapy is the administration of psychotropic medications to treat psychological disorders

Question 3

Psychotherapy

Answer 3

Commonly referred to as talk therapy, employs a variety of psychological techniques to help individuals identify and change troublesome thoughts, feelings, or behaviors. Psychotherapy also aims to improve relationships, social skills, and overall well-being as well as promote personal growth

Question 4

Who Provides Treatment?

Psychiatrists

Answer 4

Psychiatrists are medical doctors (M.D. or D.O.) who have specialized in the assessment and treatment of psychological disorders. As physicians, psychiatrists pay special attention to how physical conditions affect mental health and often prescribe medications to address mental health concerns. Although they are trained to provide psychotherapy (i.e., talk therapy), many psychiatrists prescribe and manage medications and refer to other mental health providers for psychotherapy

Question 5

Who Provides Treatment?

Psychologists

Answer 5

Psychologists have a doctorate (Ph.D. or Psy.D.) in psychology and are qualified to diagnose and treat disorders of behavior, emotion, and thought. Psychologists are “scientist–practitioners,” meaning they are trained to conduct and consume research as well as provide psychotherapy. There are three main areas of specialization for psychologists: clinical, counseling, and school

Question 6

Who Provides Treatment?

Types of Psychologists

Answer 6

Clinical psychologists typically treat individuals with more severe mental health concerns, while counseling psychologists tend to work with individuals who currently find it difficult to cope with and adjust to life crises and stressors. As the title implies, the focus of a school psychologist is on the learning and mental health needs of children and adolescents in the learning environment.

Question 7

History of Treatments

Answer 7

For much of history, mental illness, or “madness,” was explained by witchcraft and deals made with the devil. When individuals were accused of being under the influence of witchcraft or some other evil influence, they were often hanged or burned at the stake. Another widespread explanation of mental illness was possession by evil spirits, and treatment often aimed to cure the patient by releasing the demons. Prayers, incantations, and exorcism were common

Question 8

Asylums

Answer 8

Psychological treatments included isolation, physical restraints, beatings, bloodletting, and hydrotherapy. . As the number of patients grew, living and treatment conditions deteriorated. Patients were crowded into rooms where they slept on piles of straw and had no access to bathrooms, and many suffered from starvation due to inadequate food

Question 9

Bethlehem Hospital

Answer 9

Was one of the first such institutions dedicated to the treatment of mental illness (see Figure 15.6). Originally founded to provide medical care to the poor, its focus shifted over time to the management of psychological disorders

Question 10

Effiacy vs. Effectivness

Answer 10

The efficacy of a treatment shows that therapy to work under strictly controlled (laboratory) conditions, while the effectiveness of a treatment shows that therapy to work in the real world

Question 11

Psychopharmacotherapy

Answer 11

As previously discussed, the medical model seeks to understand mental illness from a biological perspective. These providers may use both pharmacological (drug-based) and non-pharmacological (not drug-based) techniques to treat psychological disorders. The majority of psychopharmacological interventions target brain chemicals called neurotransmitters.

Question 12

Unintentional Findings

Answer 12

In the 1800s, syphilis was a major public health issue. Early stages of this sexually transmitted infection are marked by skin lesions and sores. When it resurfaces, it attacks the brain, resulting in distorted thinking, hallucinations, paralysis, and eventually death. Interestingly, there were cases reported of people with late-stage syphilis who recovered and experienced mental stabilization—after contracting and surviving malaria.

Similar accidental discoveries in medical settings can be tracked throughout the 1900s. For example, in the late 1920s a psychiatrist discovered that high-dose insulin injections caused seizures. Insulin was occasionally used to stimulate the appetites of psychotic patients and even had a calming effect. When high doses of insulin were used to trigger seizures, Sakel observed that patients experienced temporary relief from their schizophrenia symptoms.

Question 13

Typical Antipsychotics

Answer 13

Work by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter associated with pleasure, motivation, and motor control; too much or too little dopamine in the brain can be a problem. Typical antipsychotics reduce the activity of dopamine in the brain.
Mild or moderate side effects include dry mouth, blurred vision, drowsiness, and dizziness. With long-term use, this class of drugs can cause extrapyramidal symptoms—disruption in an individual’s ability to consciously control their body movements (e.g., involuntary body tremors or rigidity)

Question 14

Atypical Antipsychotics

Answer 14

While still acting on dopamine pathways in the brain, these medications tend to act on serotonin as well. The first drug of this class introduced was clozapine. Other atypical antipsychotics commonly prescribed include risperidone, olanzapine, and aripiprazole. The medication can also decrease an individual’s white blood cell count, making them more susceptible to infection. Other side effects of atypical antipsychotics include difficulty with concentration, weight gain, and excessive grogginess.

Question 15

Antidepressants

Monoamine Oxidase Inhibitors

Answer 15

The role of this enzyme is to chemically break down monoamines in the synapse, thereby disposing of serotonin, norepinephrine, and dopamine. By inhibiting this enzyme, monoamine oxidase inhibitors (MAOIs) allow these mood-influencing neurotransmitters to remain in the synapse for longer periods of time.
Phenelzine, tranylcypromine, and isocarboxazid are prescribed as a last resort, after other classes of antidepressants have failed to reduce depressive symptoms. This is because of dangerous (even lethal) food and drug interactions

Question 16

Tricyclic Antidepressants

Answer 16

named for their three-ring chemical structure; TCAs, such as imipramine, amitriptyline, and nortriptyline. TCAs affect brain chemistry by inhibiting reuptake of serotonin and norepinephrine. Reuptake is a kind of neurotransmitter recycling process. When reuptake is inhibited, serotonin and norepinephrine are more available in the synapse

Question 17

Selective Serotonin Reuptake Inhibitors

Answer 17

SSRIs include fluoxetine, citalopram, escitalopram , and sertraline. SSRIs function in a fashion similar to TCAs. As the name implies, SSRIs target serotonin and have very little effect on norepinephrine and dopamine. By inhibiting reuptake of serotonin in the synapse, the concentration of serotonin is enhanced. (Less toxic & first-line treatment.)

Question 18

Anxiolytics

Benzodiazepines

Answer 18

The neurotransmitter gamma-aminobutyric acid (GABA) is the main inhibitor of the central nervous system, meaning that its major responsibility is to calm the brain. As such, drugs that increase the amount of GABA available in the synapse are effective treatments for symptoms of anxiety. chlordiazepoxide. Benzodiazepines were so well received because of their fast-acting effect. Individuals report anxiety symptom relief within 20–40 minutes after they are ingested, and even quicker when taken sublingually

Question 19

Mood Stabilizers

Answer 19

Lithium, a naturally occurring mineral, is the most efficacious and commonly prescribed mood stabilizer (toxic). Lithium increases the production of serotonin and enhances neural plasticity, which allows the brain to be more flexible

Question 20

Pros and Cons of Psychopharmacotherapy

Answer 20

Cons- cost, not a “cure”, carefully monitored (affects body chemistry).
Pros- progress towards discovery, make one’s life better

Question 21

Electroconvulsive Therapy

Answer 21

This treatment involves the use of electrical currents delivered to the brain to induce seizures.

Question 22

Transcranial Magnetic Stimulation

Answer 22

Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses electromagnetic currents to stimulate portions of the brain

Question 23

Psychosurgery

Answer 23

Trepanation was one of the earliest forms of psychosurgery. Many years later, the prefrontal lobotomy was developed to treat severe cases of psychosis. The procedure severs the connections between the prefrontal lobe and the rest of the brain. Side effects include seizures, cognitive deficit, and even death. Deep brain stimulation (DBS) is a more modern form of psychosurgery. This invasive technique involves implanting electrodes into the brain to electrically stimulate certain areas

Question 24

Schools of Psychotherapy

Insight Therapy

Answer 24

A major focus of Freud’s style of psychotherapy was helping people to understand why they think, feel, and behave the way they do. He wanted people to have more insight, but he argued that the reasons for human thoughts, feelings, and behaviors lie outside of conscious awareness.

Question 25

Psychoanalysis

Answer 25

An insight therapist’s job is to closely examine, or analyze, an individual’s unconscious processes (e.g., their fantasies, dreams, sexual desires) in order to bring them to conscious awareness—thus the term psychoanalysis. Psychoanalysis is an intensive form of psychotherapy that can involve multiple sessions each week over the course of many months or years.

During a session, the patient is encouraged to engage in free association, saying everything that comes to mind, without censoring themselves.

Question 26

Freudian slip

Answer 26

Refers to an error in speech, memory, or action that is thought to reveal an unconscious thought, feeling, or belief.

Question 27

Resistance

Answer 27

Occurs when a patient stops cooperating in psychoanalysis. Resistance may take the form of missed appointments or forgotten dreams (repression), insistence that they have recovered and no longer need therapy (denial), or expressing the desire to return to previously resolved problems (regression).

Question 28

Transference

Answer 28

Transference occurs when the patient redirects feelings (such as love or anger) for another person onto the therapist. Although quite difficult (and often uncomfortable) to navigate, transference indicates that the patient’s hidden memories and conflicts are getting close to conscious awareness

Question 29

Behavior Therapy - Operant Conditioning Therapies

Answer 29

By implementing rewards and punishments, a behavior therapist attempts to modify maladaptive behavior. Specifically, desirable behaviors are rewarded (i.e., reinforced) and undesirable behaviors are punished.
contingency management, which involves the use of tangible rewards to reinforce appropriate behaviors or token economy.

Question 30

Pavlovian Conditioning Therapies

Answer 30

Pavlovian conditioning (also called classical conditioning) involves learning that is based on the association of behaviors and environmental stimuli. A behavior therapist employing Pavlovian conditioning techniques attempts to teach their patient about the predictive properties in the environment.

Question 31

Person Centered Therapy

Answer 31

​Unconditional positive regard: The therapist is accepting, respectful, and caring toward the patient. Even when the therapist does not agree with the patient’s views or behaviors, they should demonstrate that they believe the patient is doing the best he or she can.
Empathy: The therapist shows an understanding of the patient’s problems and emotions. This is different from sympathy, which is feeling sorry for the patient.
Congruence: The therapist is genuine and authentic. It is important that the therapist’s body language matches the words the therapist says. For example, saying “I’m sorry to hear that” while smiling is incongruent.