TREATMENTS

Question 1

What is the biochemical treatment of ICD and NSAs? (Biological - drugs) How does it work?

Answer 1

Opioid antagonists: blocks opioid receptors from being activated –> knocks off other opioid agonists and prevents body to respond to addictive substances

Question 2

Evaluate the biochemical treatment to ICDs and NSA in terms of its strengths

Answer 2

• Large and varied sample - 284 ps + various psychiatric centres - increase population validity, can be generalised to clients with compulsive gambling tendencies
• Method: various data collection methods - PG-YBOCS self-report, observation by ‘blind’ investigators, family history assessment interview - increases internal validity of study
• Evidence for long term effectiveness - Grant et al. on alcoholic patients with a family history - create sense of hope (can treat genetically predisposed disorders)

Question 3

What are the 3 cognitive behavioural treatments to manage ICDs and NSAs?

Answer 3

Covert sensitisation, Imaginal desensitisaton, ICT (impulse control treatment)

Question 4

What is covert sensitisation and how does it work? (Cognitive behavioural treatment)

Answer 4

Expose to aversive stimuli + associate with unwanted behaviour
e.g. GLOVER - Kleptomania: shopping + imagine vomitting

Question 5

What is imaginal desensitisation and how does it work? (Cognitive behavioural)

Answer 5

Fearful situation + relaxation techniques (PMR)
e.g Blaszczynski: gambling after work to avoid loneliness in apartment (fearful situation)

1. Creating hierarchy of aversive stimuli (fearful stimuli)
2. Taught deep relaxation techniques (PMR)
3. Learns to associate relaxation technique with fearful situation
4. Encouraged to gradually go higher in the hierarchy

Question 6

Evaluate covert sensitisation and imaginal desensitisation in terms of its strengths

Answer 6

• Usefulness: taught and instructed to self administer the treatment - learn to manage behaviour independently, gaining a sense of control
• Situational: Assumes that behaviour is triggered by situation → reduce risks of self blame, but may not be addressed if behaviour can be triggered by a different situation
• Evidence for long term effectiveness
  CS: 19 months (Glover - Kleptomania)
  ID: 5 years (Pathological gambling)

Question 7

Evaluate covert sensitisation and imaginal desensitisation in terms of its limitations

Answer 7

• Reductionism: focuses on current behaviours and may ignore underlying factors influencing behaviour (experiences, maladaptive thoughts + behaviours)

- Research methods: case study and self report
Case study: unique and not applicable to everyone, reduces population validity and generalisability to people with tendencies of ICDs and NSAs
Self report (Y-BOCS): risk of social desirability bias and researcher bias (subjective) --> reduces internal validity

• Covert sensitisation:exposed to fearful stimuli —> can be counterproductive to healing

Question 8

What is ICT and how does it work?

Answer 8

EMDR (Eye Movement Desensitising and Reprocessing) + FS

- stimulate REM sleep with eye movement + identifying FS (sensation + emotion + cognition linked with the behaviour)

Question 9

Evaluate ICT in terms of its strengths

Answer 9

• Usefulness: does not require client to fully stop the behaviour - can motivate client, total withdrawal can be distressing
• Holistic: targets source of behaviour - feeling states, etc

Question 10

Evaluate ICT in terms of its limitations

Answer 10

• Research method: case study –> unique: not generalisable to population with the disorder - reduces population validity
• Usefulness: reliant on the presence of the therapist → may have risks of relapse if treatment is not accompanied by other skills