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68 Cards in this Set

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Psychodynamic Theories on Therapy
- based on Freud
- Goal : help patients achieve insight, dig up buried conflicts
- Insight = conscious awareness of psychodynamics underlying problems
Methods of treatment in Psychodynamic Therapy
- Free Association (sit behind the client, verbal reports on feelings, etc)
- Dream interpretation
Psychodynamic responses to therapy
- Resistance ( a) defensive maneuvers that hinder process of therapy)
- Transferrence ( a) Client responds irrational to therapist like he/she was important figure from client's past - positive or negative)
- Counter-transference
Humanistic Psychotherapy - "Client Centred Therapy"
- focused on relationship between client and therapist
- designed by Carl Rogers
three important therapist attributes (as per "client centred therapy" by Rogers)
a) unconditional positive regard
a) empathy
a) genuineness
Gestalt Therapy
(Humanistic Psychotherapy)
-Goal: bring feelings, wishes and thoughts into immediate awareness

Methods:
a) Often carried out in groups

b) more active and dramatic approaches than client-centred approaches

c) role-play
Cognitive theories
- Aaron Beck and Albert Ellis
- role of irrational and self-defeating thought patterns
- help clients discover and change cognitions that underlie problems
Ellis' Rational Emotive Therapy (ABCD Model)
(cognitive theory)
Activating Event
Belief system
Consequences
Disputing maladaptive behaviours
Beck's Theory
(cognitive theory)
help clients identify and reprogram their “automated” thought patterns
- "Beck Depression inventory" major contribution to depression and self instructional training
Behaviour Therapies
Maladaptive behaviours are the problem, not the symptom

- maladaptive behaviours can be unlearned through classical and operant conditioning, modeling

- problem behaviours are learned
Exposure
(Classical conditioning therapies)
- Exposure : Treat phobias through exposure to feared CS in the absence of UCS

- flooding : expsed to real life stimuli

- Implosion: imagine scenes involving stimuli

- highly effective and extinguishing anxiety, but can also create anxiety
Systematic Desensitization
(Classical conditioning therapies)
Learning treatment for anxiety using counterconditioning

- train muscles to relax
- stimulus hieararchy
In-vivo Desensitization
(Classical conditioning therapies)
Controlled exposure to "real life" situations

- creates more anxiety than systematic, but has faster results
Aversion Therapy
(Classical conditioning therapies)
condition an aversion to CS (like alcohol)
Operant conditioning or "behaviour modification treatments"
(Classical conditioning therapies)
Attempt to increase or reduce behaviour

- positive and negative reinforcement
- extinction
- used on profoundly disturbed children


Punishment only used with parental consent on destructive children.
Token Economies
(Classical conditioning therapies)
enourage behaviour with positive reinforcement

- give tokens for desirable behaviour
- backed up by social reinforcers like pride
Modelling and social skills training
(Classical conditioning therapies)
learn new skills by observing and imitating a model

uses roleplay

Key: increased self efficacy. I can do that too!
Cultural Barriers to psychological treatment
- cultural norms
- language
- access to treatment (affordability and proximity)
- lack of culturally responsive treatments
Difficulties in evaluating therapy
- many variables aren`t controlled (self selection and selection bias)
- therapist-client interaction varies
- hard to measure effects
- who measures the outcomes
Somatoform disorders
physical complains / disabilities with no known biological cause

- hypochondria
- pain disorder (out of proportion to problem)
- conversion disorder (sudden and random neurological issues, i.e. glove anesthesia)
Psychogenic Amnesia
(Disscociative Disorder)
- extensive but selective memory loss following trauma
Psychogenic fugue
(Disscociative Disorder)
loss of personal identity
Dissociative Identity Disorder (DID)
(Disscociative Disorder)
two or more separate personalities

Trauma-dissociation Theory = DID generally results from severe traumatic experience during early childhood
Scizophrenia
`split mind``
delusions, disorganized speech, hallucinations, blunted emotion
Subtypes of Schizophrenia
- Paranoid (delusions of persecution or grandeur)
- Disorganized (confusion, incoherence)
- Catatonic
- Undifferentiated
Two main categories of Schizophrenia
Type I = positive symptoms, pathological extremes (delusions, hallucinations, etc)

Type II = negative symptoms, absence of normal reactions (lack of expression or motivation)
Biological Causal factors of Schizophrenia
- genetic, skips a generation
- Unusual MRI activity, hallucinations related to Thalamus (mainly type II)
- Neurodegenerative hypothesis
- Dopamine hypothesis
Neurodegenerative hypothesis
- Biological theory for Schizophrenia
- destruction of neural tissues in regions that affect congitive processing and emotion
- Thorazine calms people down
Dopamine hypothesis
Schizophrenia results from overactivity of dopamine

Defective Neuroreceptors
Psychological causal factors of Schizophrenia
Freud = extreme use of defence mechanism regression (ability to cope with stress)

-Cognitive - inability to filter out irrelevant information
APA Guidelines for randomized Clinical Trials
(research method)
- Procedures must be followed exactly
- sessions taped or observed
- some measures of improvement must be behavioural
- need for follow-up data
Meta-Analysis
(research method)
Allows researchers to combine the statistical results of many studies to reach an overall conclusion

- Effect size
Types of control groups in Randomized clinical trials
- no treatment
-placebo control
- other effective treatment

random assignment of clients to experimental or control groups i.random assignment of clients to experimental or control groups
Factors affecting outcome of treatment
-Client variables
-Openness
-Self-relatedness
-nature of the problem
-Therapist variables (quality of relationship, empathy, unconditional acceptance, genuineness, trust, caring)
- techniques
- Dose-response effect
- faith in therapist
- plausible explanation for problems
protective setting and supportive relationship
-opportunity to practice new behaviours
- increased optimism and self-efficacy
Psychopharmacology
Study of how drugs affect cognitions, emotions, behaviour
Tricyclics
anti-depressant drug class

a)increase activity of norepenephrine and seratonin
b)prevent reuptake of excitatory neurotransmitters
i.Monoamine oxidase (MAO) inhibitors
anti-depressant drug class

a)increase activity of norepenephrine and seratonin
b)Monamine oxidase breaks down neurotransmitters
Newer drugs
i.Buspirone (buspar)
ii.fewer side effects
iii.enhances inhibitory neurotransmitter GABA
iv.Sometimes using older antidepressants now
Anti-anxiety drugs
.designed to reduce anxiety without affecting alertness or concentration

ii.slow down excitatory synaptic activity

side effects:
a)drowsiness
b)lethargy
c)dependence
d)alcohol

iv.“Gaba” is the princible inhibitory neurotransmitter

v.Very effective
Selective seratonin reuptake inhibitors (SSRIs)
class of antidepressant drug

a)block reuptake of seratonin

b)milder side effects than other antidepressants

c)reduce depressive symptoms more rapidly
Antipsychotic drugs = major tranquilizers
- decrease action of dopamine
- Reduce positive symptoms of schizophrenia
- can produce tardive dyskinesia
a)severe movement disorder
Electroconvulsive therapy (ECT)
Began with observation that schizophrenia and epilepsy rarely occur together = therefore, seizure induction can help schizophrenia

hasn't been effective in treating schizophrenia

Useful in treating severe depression
i.particularily those in risk of suicide
ii.effects can be immediate
iii.60-70% improve
ECT procedure
A.Procedure
patient given sedative and muscle relaxant
placed on well-padded mattress
shock less than 1 second, causing seizure of CNS
Psychosurgery
.method of last resort

procedures that remove or destroy parts of brain

least used of biomedical procedures
Lobotomy
destroy nerve tracts to frontal lobes
Cingulotomy
Cut fibres that connect frontal lobes and limbic system

used in cases of severe depression and OCD
Deinstitutionalization
Transfer of treatment from mental institutions to community

requires availability of mental health care in community
Situation-focused prevention
(mental health prevention)
reduce or eliminate environmental causes of disorders

enhance situational factors that prevent disorders
Competency-focused prevention
designed to increase personal resources and coping skills
When to seek professional assistance
i.severe emotional discomfort
ii.unable to handle problem or life transition
iii.past problem is worsening or has resurfaced
iv.thinking about, dreaming about or responding to a traumatic event with negative emotions
v.Preoccupation with weight or body image
vi.severe and recurring conflicts with others
vii.hearing voices or feeling like everyone is out to get you
What is stress?
stimuli/events in environment that place demands on us = stressors

our RESPONSE

interaction between organism and environment
"Life events scale" for measuring stress
Quantify stress over a given period of time
Social Readjustment scale
Point values to measure stress

Points = "Life change units"
Four aspects of appraisal process (stress)
Primary appraisal (demands of situation)

Secondary (resources available to cope)

Judgements of consequences of situation

personal meaning
Chronic Stress and GAS
(General Adaption Syndrome)

two stages:
1. Alarm

2. Resistance
why do some people suffer psychological and/or psychological distress and others to not?
Commitment to work, family and other involvements

Control

Challenge
Cognitive protective factors
Coping self-efficacy

HARDINESS - control, challenge, commitment

Finding meaning

optimism
Physiological Reactivity to stress
i.relationship between two classes of hormones
catecholamines and corticosteroids

both involved in “fight or flight”


Cortisol
effects last longer; more damaging
Social Causation Hypothesis
higher levels of stress among low-income

people who are wealthy less likely to get depression, schizophrenia; even cardiovascular disease
Social Drift Hypothesis
as functioning deteriorates – drift down socio-economic ladder
Three clusters of personality disorders
A - anxiety and fearfullness
B - dramatic and impulsive disorders
C - Odd and eccentric
Brain damage from Alzheimer's
a)Caused by deterioration in frontal and temporal lobes of brain

b)plagues in brain (holes)

c)destruction of cells that product acetylene
Which neurotransmitter is the main cause of anxiety disorders?
GABA
Low levels may cause highly reactive nervous systems

inhibitory neurotransmitter

Drugs that affect GABA transmission treat anxiety; Valium, etc
Three Major Patterns after Depressive Episode
no recurrence
recovery with recurrence
no recovery
Neurotransmitters responsible for mood disorders
under activity of nor-epinephrine, dopamine and seratonin in depression

PRIMARY target is norepinehrine
Personality-based vulnerability
Trauma early in life creates vulnerability later

Psychodynamic causal factor of mood disorders
Depressive attributional pattern
mood disorder causal factor
success = factors outside self
negative outcomes = personal factor
Learned helplessness Theory
depression occurs when people expect that bad events will occur and they think that they can't cope with them