PSY202, Final Study Guide
PSY202, Final Study Guide PSY 202
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Chapter 12: Behaviors Are Consistent with Strong Attitudes • An attitude is more likely to predict behavior, to be consistent over time, and to be resistant to change: ◦ the stronger it is ◦ the more personally relevant it is ◦ the more speciﬁc it is ◦ if it is formed through direct experience • Attitude accessibility predicts behavior consistent with the attitudes • Explicit attitudes ◦ Those you are aware of and can report • Implicit attitudes ◦ Those you are not aware of ◦ May be associated with the brain areas involved with implicit memories ◦ Implicit Associations Test ◦ might not endorse but can still inﬂuence your behavior The Theory of Cognitive Dissonance • When we are confronted with information implying that we may have behaved in ways that are irrational, immoral, or stupid, we experience a good deal of discomfort. • This feeling of discomfort caused by performing an action that runs counter to one’s customary (typically positive) conception of oneself is referred to as cognitive dissonance. • Leon Festiner (1957) was the ﬁrst to investigate the precise workings of this powerful phenomenon. • Three basic ways we try to reduce cognitive dissonance: ◦ By changing our behavior to bring it in line with dissonant cognition ◦ By attempting to justify our behavior through changing one of the dissonant cognitions ◦ By attempting to justify our behavior by adding new cognitions Nonverbal behavior • What do we know about people when we ﬁrst meet them? • We know what we can see and head, and even though we know we should not judge a book by its cover, this kind of easily observable information is crucial to our ﬁrst impression. • With no words at all, we can communicate volumes. • Nonverbal communication: the way in which people communicate, intentionally or unintentionally, without words. ◦ nonverbal cues include: ▪ facial expressions ▪ tone of voice ▪ gestures ▪ body position/movement ▪ the use of touch ▪ gaze • Nonverbal cues serve many functions in communication ◦ You can express “I am angry” by narrowing your eyes, lowering your eyebrows, and setting your mouth in a thin straight line. ◦ You can convey the attitude “I like you” with smiles and extended eye contact. ◦ You can communicate your personality with traits, like being an extrovert, with broad gestures and frequent changes in voice pitch and inﬂection • Some nonverbal cues actually contradict the spoken words ◦ communicating sarcasm is the classic example of verbal-nonverbal contradiction We Make Attributions about Others: • Attributions are people’s casual explanations for events or actions, including other people’s behavior. • People are motivated to draw inferences in part by a basic need for order and predictability in their lives ◦ Just world hypothesis • Fundamental attribution error: ◦ We tend to overemphasize the important of personality traits and underestimate the importance of situation ◦ Actor-observer discrepancy ▪ Ampliﬁcation of the correspondence bias ▪ We tend to see other people’s behavior as disposition ally caused, while we are more likely to see our own behavior as situationally caused ▪ The eﬀect occurs because perceptual salience and information availability diﬀer for the actor and the observer ◦ Diﬀerences in Eastern vs. Western errors We Conform to Social Norms • Conforming to social norms or expectations is necessary in a civilized society ◦ Autokinetic eﬀect ◦ Solomon Asch’s objective line length test – subject was surrounded by people who were told to give the wrong answer. Most of the time, the subject would agree with everyone else on the wrong answer in fear of being ostracized. • When we conform for acceptance, this is Normative Social Inﬂuence The Chameleon Eﬀect • Conformity: adjusting one’s behavior or thinking to coincide with a group standard Stereotypes Are Based on Automatic Categorization • Attitudes and beliefs about groups are prejudice ◦ Emotional component: also prejudice ◦ Cognitive component: stereotypes ◦ Behavioral component: discrimination • Stereotyping is a cognitive process, not an emotional one. ◦ Cognitive schemas that help us organize information about people on the basis of their membership in certain groups • Stereotyping does not necessarily lead to intentional acts of abuse • Often stereotyping is merely a technique we use to simplify how we look at the world – and we all do it to some extent. Stereotype: a generalization about a group of people in which identical characteristics are assigned to virtually all members of the group, regardless of actual variation among the members. Your Name Matters • in 2006, researchers sent 1,100 identically worded email inquiries to Los Angeles-area landlords. • The inquiries were signed randomly, with an equal number signed ◦ Patrick McDougall ▪ received positive or encouraging replies from 89% of landlords ◦ Tyrell Jackson ▪ only 56% responded positively ◦ Said Al-Rahman ▪ encouraged by 66% of landlords. Stereotypes Can Lead to Prejudice: • Negative stereotypes of groups lead to: ◦ prejudice ▪ aﬀective or attitudinal responses associated with stereotypes, usually involving negative judgments about people on the basis of their group membership. ◦ discrimination ▪ unjustiﬁed and inappropriate treatment of people as a result of prejudice • In-group/out-group bias: ◦ Some people are more likely to develop associations between aversive events and members of an out-group ▪ those people appear to be more likely to be racially biased ◦ The formation of in-group and out-group distinctions appear to occur early in life. • Outgrip homogeneity eﬀect • In-group favoritism ◦ Women are quicker than men to form in-group bias, perhaps as a result of evolution • The killing of Amadou Diallo by New York City police oﬃcers is used as an example of how implicit biases may impact behavior and how extensive training can reduce this implicit bias. • Inhibiting stereotypes ◦ research suggests that negative stereotypes can be countered through learning and self-regulation When Do We Harm or Help Others? • Aggression can be adaptive • Many factors may inﬂuence helping behavior ◦ Prosocial behaviors provide beneﬁts to those around us and promote positive interpersonal relationships ◦ Such behaviors may ensure the survival of the human species as such behaviors improve group functioning and strong groups are more likely to function in an eﬀective manner • Some situations lead to bystander apathy ◦ people fear social blunders ◦ diﬀusion of social responsibility ◦ people are less likely to help when they are anonymous and can remain so ◦ a cost-beneﬁt trade-oﬀ involves how much harm people risk by helping, or what beneﬁts they would have to forgo if they stopped to help Attraction The Person Next Door: The Propinquity Eﬀect • One of the simplest determinants of interpersonal attraction is proximity (sometimes called propinquity) • Propinquity eﬀect: the ﬁnding that the more we see and interact with people, the more likely they are to become our friends. Chapter 13: Psychodynamic Theories Emphasize Unconscious and Dynamic Processes • Sigmund Freud developed one of the most inﬂuential theories of personality development by observing patients he treated • His underlying assumption was that unconscious forces, such as wishes and motives, inﬂuence behavior • There are three major components of Freud’s theory: ◦ Topographical model ▪ conscious, unconscious, preconscious ◦ Development of sexual instincts ▪ oral, anal, phallic, latency, genital psychosexual stages • Structural model ◦ id, ego, superego ◦ defense mechanisms were described as strategies used by the ego to cope with the anxiety caused by conﬂicts between the id and the superego Type and Trait Approaches Describe Behavioral Dispositions • Typologies: ◦ discrete categories in which we place people • Traits: ◦ Behavioral dispositions that endure over time and across situations • Implicit personality theory: ◦ personality characteristics go together, allowing for predictions about people on the basis of minimal evidence • Estimates of the number of traits have ranged from almost 18,000 to the 16 Cattle identiﬁed through factor analysis to the Big Five. • Eysenck’s hierarchical model: ◦ The speciﬁc response level ▪ observed behaviors ◦ the habitual response level ▪ behaviors observed on several occasions ◦ traits • Eysenck proposed three superordinate traits: ◦ introversion-extraversion, emotional stability, and psychoticism (or constraint) • The Big Five or Five Factor Model: ◦ Five basic personality traits: ▪ openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism (OCEAN) ◦ Signiﬁcant evidence supports the ﬁve factor model ▪ including some predictive studies and cross-cultural studies People Are Sometimes Inconsistent • Situationism ◦ Mischel proposed that behaviors are determined as much by situations as by personality traits • This aﬀected the ﬁeld for more than a decade and caused considerable rifts between: ◦ social psychologists, who tended to emphasize situational forces ◦ personality psychologists, who focused on individual dispositions • The basic argument made by personality researchers in the person- situation debate is the extents to which traits predict behavior depends on: ▪ The centrality of the trait ▪ The aggregation of behaviors over time ▪ The type of trait being evaluated Personality Is Rooted in Genetics • Nearly all personality traits have a genetic component ◦ Genetic inﬂuence accounts for approximately half of the variance (40-60%) between individuals in personality traits ◦ Environment also plays a large part • Parenting style has an eﬀect ◦ Children who are raised with inadequate parenting are not socialized properly ◦ More likely to become delinquent or display antisocial behavior • In general, genetics inﬂuence personality based on multiple genes • However, single genes have been identiﬁed in: ◦ Novelty seeking ▪ dopamine ◦ Neuroticism and agreeableness ▪ serotonin Temperaments Are Evident in Infancy • From birth, infants show temperamental diﬀerences that can be grouped into three categories: ◦ Activity level ◦ Emotionality ◦ Sociability • Long term implications of temperaments: ◦ Research has demonstrated that early temperament is predictive of later personality and behaviors • Gender and temperaments ◦ Girls have stronger ability to control their attention and to resist impulses ◦ Boys are physical active and experience more high-intensity pleasure ▪ rough and tumble play • Shyness and inhibition ◦ Shyness has been linked to early temperament with about 15-20% of newborns classiﬁed as inhibited ◦ Biological evidence indicates the amygdala shows created responsively in shy individuals ◦ About 25% of inhibited children do not become shy ▪ Illustrating the importance of parental creation of calm and safe environments Personality Traits Are Stable Over Time • Over many years the relative rankings of individuals on each of the Big Five personality traits remind stable • Stability is lowest during early childhood and highest over age 50 • Age-related change ◦ in general, people become less neurotic, less extraverted, and less open to new experiences as they get older ◦ People tend to become more agreeable and much more conscientious with age • The brain develops well into early adulthood ◦ May explain the greater evidence of personality change before age 30 ◦ Environments tend to be relatively stable, especially after early adulthood Our Self-Concepts Consist of Self-Knowledge • Self-awareness: ◦ The objectiﬁed self ▪ Researchers have diﬀerentiated between the self as the knower (“I”) and the self as the object that is known (“me”) – called the objectiﬁed self ◦ The theory of objective self-awareness ▪ Self-awareness leads people to act in accordance with their personal values and beliefs ◦ Self-discrepancy theory ▪ Awareness of diﬀerences between personal standards and goals leads to strong emotions ◦ Self-awareness is highly dependent on the normal development of the frontal lobes ▪ As evidenced by the diﬃculties experienced by those with damage to this region ◦ Self-schema ▪ Network of interconnected knowledge about the self ▪ Memories, beliefs, generalizations about the self-help ﬁlter information ▪ Activation of the middle of the frontal lobes occurs when people process information about themselves • Working self-concept ◦ The immediate experience of the self ◦ Limited to the amount of personal information that can be processed cognitively at any given time Chapter 14: Psychological Disorders • People are fascinated by the exceptional, the unusual, and the abnormal. This fascination may be caused by two reasons: ◦ During various moments, we feel, think, and act like an abnormal individual. ◦ Psychological disorders may bring unexplained physical symptoms, irrational fears, and suicidal thoughts. • There are 450 million people suﬀering from psychological disorders • Depression and schizophrenia exist in all cultures in the world The Medical Model • Philippe Pinel (1745-1826) from France insisted that madness was not due to demonic possession, but an ailment of the mind. • When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders ◦ Etiology: cause and development of the disorder ◦ Diagnosis: identifying (symptoms) and distinguishing one disease from another ◦ Treatment: treating a disorder in a psychiatric hospital. ◦ Prognosis: forecast about the disorder. lassifying Psychological Disorders • The American Psychiatric Association rendered a Diagnostic and Statical Manual of Mental Disorders (DSM) to describe psychological disorders. • The most recent edition, DSM-V (2013), describes 400 psychological disorders compared to 60 in the 1950’s Mental Disorders Are Classiﬁed into Categories • There are clear advantages to categorizing disorders such as being able to investigate etiology and treatment Goals of DSM 1. Describe disorders 2. Determine how prevalent the disorder is Mental Disorders Must Be Assessed • Assessment refers to the process of examining a person’s mental functions and psychological health ◦ Allows for a diagnosis to be made ◦ Ongoing assessment can assist in understanding the eﬀectiveness of treatment, situations that might trigger relapse, and improved understanding of the disorder. • Structured vs. unstructured interviews: ◦ The clinical interview is the most common assessment tool ▪ Allowing interviews to express empathy, build a rapport, and discover the nature of the client’s problem. • Types of testing: ◦ Behavioral assessment includes observations of individuals in a variety of settings and psychological testings: ▪ Beck Depression Inventory ▪ Minnesota Multiphase Personality Inventory ◦ Neuropsychological assessment allows for a determination of possible brain abnormalities. • Evidence-based assessment: ◦ Uses research to guide how mental disorders are evaluated including: ▪ Selecting appropriate psychological tests ▪ Using appropriate neuropsychological methods ▪ Using critical thinking in making a diagnosis ental Disorders Have Many Causes • Diathesis-stress model ◦ Disorders are caused by an underlying vulnerability or predisposition (diathesis) to a mental disorder that is triggered by stress ▪ The diathesis can be biological, such as a genetic predisposition to a speciﬁc disorder, or environmental, such as childhood trauma. • Biological factors ◦ Genetics • Toxins ◦ Some mental disorders may arise from prenatal problems such as maternal illness, malnutrition, and exposure to toxins ◦ Environmental toxins and malnutrition during childhood and adolescence can increase risk for mental disorders • Diﬀerences in Brain ◦ structural imaging, PET, and fMRI have revealed diﬀerences in brain anatomy between those with mental disorders and those without ▪ may be due to genetics ◦ the role of neurotransmitters • Psychological factors ◦ Freud believed that mental disorders were mostly due to unconscious conﬂicts ◦ Thoughts and emotions are shaped by the environment and can profoundly inﬂuence behavior ▪ Family systems model ▪ Sociocultural model • Cognitive-behavioral factors: ◦ Thoughts can become distorted and produce maladaptive behaviors and emotions ◦ One way of categorizing mental disorders is to divide them into two major groups ▪ Internalizing disorders ▪ Externalizing disorders • Sex diﬀerences in mental disorders ◦ Disorders associated with internalizing are more prevalent in females, externalized disorders are prevalent more in men. • Culture and mental disorders ◦ Most mental disorders show both universal and culture-speciﬁc symptoms ▪ They may be very similar around the world, but at the same time, they reﬂect cultural diﬀerences Disorders • Anxiety Disorders: feeling of excessive apprehension and anxiety. ◦ Generalized Anxiety Disorder (GAD) ◦ Panic Disorder ◦ Phobias ◦ Obsessive-Compulsive Disorder (OCD) ◦ Post-Traumatic Stress Disorder (PTSD) There Are Diﬀerent Types of Anxiety Disorders • More than 25% of people will experience an anxiety disorder at some point in their lives • Diﬀerent anxiety disorders share some emotional, cognitive, somatic, and motor symptoms. ◦ Despite similar symptoms, the behavioral manifestations of these disorders are quite diﬀerent. • Phobic Disorder: ◦ speciﬁc phobias involve particular objects or situations ◦ social phobia involves fear of being humiliated in a social situation • Generalized Anxiety Disorder ◦ persistent and uncontrollable tenseness and apprehension ◦ autonomic arousal ◦ inability to identify or avoid the cause of certain feelings • Obsessive Compulsive Disorder ◦ a person experiences repeated intrusive thoughts or images (obsessions) ◦ the person feels compelled to engage in ritualistic behavior (compulsions) • Post Traumatic Stress Disorder ◦ Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD): ▪ Haunting memories ▪ Nightmares ▪ Social withdrawal ▪ Jumpy anxiety ▪ Sleep problems ◦ Resilience to PTSD ▪ Only about 10% of women and 20% of men react to traumatic situations and develop PTSD ▪ Holocaust survivors show remarkable resilience against traumatic situations ▪ All major religions of the world suggest that surviving a trauma leads to the growth of an individual Anxiety Disorders Have Cognitive, Situational, and Biological Components • Situational factors such as observation of anxiety in others or biological factors such as an inhibited temperament also work together to develop anxiety disorders. • OCD ◦ People are aware that their obsessions and compulsions are irrational and yet they are unable to stop them ▪ One explanation is that the disorder results from conditioning ◦ Biological components ▪ Most likely involving a genetic factor ◦ Streptococcal infection can cause a sever form of OCD in some young children, possibly due to damage in the caudate nucleus Mood Disorders • Emotion extremes of mood disorders come in two principal forms ◦ Major Depressive Disorder ▪ Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide. ▪ Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. ▪ Signs include: ▪ lethargy and fatigue ▪ feelings of worthlessness ▪ loss of interest in family and friends ▪ loss of interest in activities ◦ Bipolar disorder ▪ formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder ▪ Depressive symptoms: ▪ gloomy withdrawn ▪ inability to make decisions ▪ tired ▪ slowness of thought ▪ Manic symptoms: ▪ elation ▪ euphoria ▪ desire for action ▪ hyperactive ▪ multiple ideas ▪ Many great writers, poets, and composers suﬀered from bipolar disorder. During their manic phase, creativity surged, but not during their depressed phase. Theory of Depression • Depressive episode self-terminate • Stressful events often precede depression • Depression is increasing, especially in the teens. Biological Perspective • Genetic inﬂuences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (25%). • Linkage analysis and association studies link possible genes and dispositions for depression. Social-Cognitive Perspective • The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles. • Depressed Mood ◦ Social-cultural inﬂuences: ▪ traumatic/negative events ▪ cultural expectations ▪ depression-evoked responses ◦ Psychological inﬂuences: ▪ negative explanatory style ▪ learned helplessness ◦ Biological inﬂuences Schizophrenia • The literal translation is “split mind” which refers to a split from reality. A group of severe disorders characterized by the following: ◦ Disorganized and delusional thinking ◦ Disturbed perceptions ◦ Inappropriate emotions and actions • Symptoms ◦ Positive: presence of inappropriate behaviors and thoughts ▪ Hallucinations ▪ Delusions ▪ Disorganized thinking ▪ Disorganized speech ◦ Negative: absence of appropriate behaviors and thoughts ▪ Losing interest in activities ▪ Feeling out of touch ▪ Lack of emotion (apathy) ▪ Lack of expression ▪ Rigid body Onset and Development of Schizophrenia • Nearly 1 in 100 people suﬀer from schizophrenia, and throughout the world over 24 million people suﬀer from this disease (WHO, 2002) • Schizophrenia strikes young people s they mature into adults. It aﬀects men and women equally, but men suﬀer from it more severely than women. Chronic and Acute Schizophrenia • When schizophrenia is slow to develop (chronic/process), recovery is doubtful. Such schizophrenics usually display negative symptoms • When schizophrenia rapidly develops (acute/reactive), recovery is better. Such schizophrenics usually show positive symptoms. Understanding Schizophrenia • Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. • Brain Abnormalities ◦ Dopamine Overactivity: researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. ◦ Schizophrenia patients may exhibit morphological changes in the brain like enlargement of ﬂuid-ﬁlled ventricles • Viral Infection ◦ Schizophrenia has also been observed in individuals who contracted a viral infection (ﬂu) during the middle of their fetal development • Genetic Factors ◦ The likelihood of an individual suﬀering from schizophrenia is 50% if their identical twin has the disease ◦ Both parents with schizophrenia 45% ◦ Fraternal twin 15% ◦ Sibling 10% Schizophrenia Is Primarily a Brain Disorder • Five factors that have been found to predict the onset of psychotic disorders: ◦ Family history of schizophrenia ◦ Greater social impairment ◦ Higher levels of suspicion and paranoia ◦ History of substance abuse ◦ Higher levels of unusual thoughts Personality Disorders • Personality disorders are characterized by inﬂexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. • Personality disorders tend to be controversial • Borderline Personality Disorder: ◦ characterized by disturbances in identity, in aﬀect, and impulse control ◦ characterized by problems with identity, aﬀective disturbances, impulsivity, sleep abnormalities ◦ 1-2% of adults meet the criteria for borderline personality disorder; twice as common in women than men ◦ possible causes: low serotonin, trauma, or abuse Chapter 15: Psychotherapy Is Based on Psychological Principles • With over 400 psychological therapies available, the precise techniques used by individual therapists may vary widely • One factor known to aﬀect the outcome of therapy is the relationship between the therapist and the client • Psychodynamic therapy focuses on insight: ◦ Along with Josef Bruer, Sigmund Freud pioneered the mentor of psychoanalysis ◦ Treatment involved uncovering unconscious feelings and drives that, Freud believed, gave rise to maladaptive thoughts and behaviors ▪ Techniques included free association and dream analysis • The general goal of psychoanalysis is to increase clients’ awareness of these unconscious processes and how they aﬀect daily functioning • Over the past few decades, psychodynamic therapy has become controversial due to: ◦ It’s expensive, the length of time required for treatment, and the lack of evidence of eﬀectiveness for most disorders • Humanistic therapies focus on the whole person: ◦ Emphasizes personal experience, belief systems, and the phenomenology of individuals ◦ The goal of humanistic therapy is to treat the person as a whole • Key ingredients of client-centered therapy include: ◦ Creating a safe and comforting setting, empathy, reﬂective listening, and unconditional positive regard • Many techniques advocated by Rogers are used currently to establish a good therapeutic relationship between practitioner and client • Cognitive-behavioral therapy targets thoughts and behaviors: ◦ Many of the most successful therapies involve trying to change people’s behavior and cognition directly ◦ Beck pioneered cognitive reconstructing ◦ Ellis promoted rational-emotive therapy • Examples of these treatments include: behavior modiﬁcation, modeling, social skills training, cognitive therapy and cognitive behavior therapy (CBT) ◦ Interpersonal therapy integrates insight therapy with cognitive therapy ◦ CBT is one of the most eﬀective treatments available for anxiety and mood disorders ◦ Exposure is an eﬀective treatment for phobia and relies on classical conditioning processes • Group therapy builds social support: ◦ Group and family therapy have become more widespread ◦ Group therapy is less expensive than individual therapy ◦ Oﬀers the opportunity for practice of social skills and peer learning • Family therapy focuses on the family context: ◦ Family therapy reﬂects an understanding of systems approaches – an individual is part of larger groups that can maintain or exacerbate behavior ▪ Negative expresses emotion within families, for example, has been linked to higher relapse rates among those diagnosed with schizophrenia • Confession is good for the spirit: ◦ Irrespective of type of therapy, evidence suggests that simply talking about (or writing about) one’s problems can have a positive eﬀect Medication Is Eﬀective for Certain Disorders: • Drugs that aﬀect mental process are called psychotropic medications • The success of medication in the treatment of mental disorders is largely responsible for the era of deinstitutionalization ◦ Scores of patients were discharges from mental hospitals and treated with drugs as outpatients • Most psychotropic medications fall into three categories: ◦ Anti-anxiety ▪ Reduce anxiety and promote relaxation, but they also induce drowsiness and are highly addictive ▪ They should be used sparingly ◦ Antidepressants ▪ There are several classes including MAO inhibitors, tricyclic antidepressants, and SSRIs ◦ Antipsychotics (neuroleptics) ▪ Block the eﬀects of dopamine ▪ Antipsychotics are not always eﬀective ▪ They have signiﬁcant side eﬀects that can be irreversible ▪ Tardive dyskinesia ▪ These drugs are not useful for treating the native symptoms of schizophrenia ▪ Such as apathy and social withdrawal Alternative Biological Treatments Are Used in Extreme Cases • Alternative biological methods often used as last resorts because they are more likely to have serious side eﬀects than will either psychotherapy or medication • Lobotomies: ◦ one of the earliest formal procedures used on patients with severe mental illness was psychosurgery ▪ Areas of the frontal cortex were selectively damaged ◦ These prefrontal lobotomies were used to treat severe mental disorders, including: ▪ Schizophrenia, major depression, and anxiety disorders ◦ Patients who received lobotomies were often listless and had ﬂat eﬀect ◦ The procedure often impaired many important mental functions, such as abstract thought, planning, motivation, and social interaction ◦ With the development of eﬀective pharmacological treatments in the 1950s, the use of lobotomy was discontinued • Electroconvulsive therapy (ECT): ◦ Common in the 1950s and 1960s to treat mental disorders including schizophrenia and depression ◦ ECT now generally occurs under anesthesia with powerful muscle relaxants ◦ ECT is particularly eﬀective for some cases of severe depression, although there are some risks to its use • Transcranial magnetic stimulation and deep brain stimulation are newer techniques that may be promising ◦ Can be used for depression or bipolar disorder. ◦ Send shocks through the brain inducing small seizures. ◦ Are used when patients are suicidal and medication would take too long to help them. Behavioral and Cognitive Treatments Are Superior for Anxiety Disorders • Panic attacks: ◦ Imipramine prevents panic attacks • CBT: ◦ helps break the learned association between the physical symptoms and the mind • In the short term: ◦ CBT alone and imipramine alone were eﬀective for treating panic disorder but they did not diﬀer in results • Six months after treatment ended: ◦ Those who received psychotherpy were less likely to relapse than those who had taken medication • OCD: ◦ SSRIs and CBT are eﬀective treatments ◦ Researchers imaged the brains of patients with OCF who were being treated with with Prozac or CBT ▪ Patients in both treatment groups showed the same changes in neural activity ▪ CBT may be a more eﬀective way of treating OCF than medication, especially over the long term Many Eﬀective Treatments Are Available For Depression • Cognitive-behavioral treatment of depression: ◦ Just as eﬀective as biological therapies in treating depression ◦ The goal of CBT is to help the client think more adaptively ◦ Although CBT can be eﬀective on it’s own, combining it with antidepressant medication is signiﬁcantly more eﬀective than either one of these approaches alone. • Alternative treatments: ◦ ECT has been eﬀective for some people with major depression ▪ ECT frequently results in amelioration of depressed mood, the mechanism by which this occurs is unknown ▪ ECT does have serious limitation, including high relapse rate and memory impairments ◦ “Happy lights” for seasonal aﬀective disorder (SAD) ◦ Transcranial magnetic stimulation can reduce depressive symptoms ▪ A series of studies demonstrated that TMS over the left frontal regions results in a signiﬁcant reduction in depression ▪ Used in patients who are not helped by traditional therapies • Pharmacological Treatment ◦ MAO inhibitors are aﬀective but are generally reserved for patients who do not respond to other antidepressants ◦ Tricyclics are extremely eﬀective antidepressants but there are a number of unpleasant side eﬀects ◦ SSRIs are prescribed most frequently because they have fewer seriously side eﬀects than MAO inhibitors and tricyclics ◦ Physicians often must resort to trial-and-error when ﬁnding a drug that works best for a patient Lithium For Bipolar Disorder • Only about 20% of patients maintained on lithium will experience relapses • Lithium seems to modulate neurotransmitter levels • It is eﬀective in stabilizing mood, but it has unpleasant side eﬀects including thirst, hand tremors, excessive urination, and memory problems. Pharmacological Treatments Are Superior For Schizophrenia • Historically, psychotic patients were often institutionalized in large mental hospitals • Brain surgery, such as prefrontal lobotomy, was considered a viable option for patients with severe mental disorders, but was ineﬀective in treating people with schizophrenia • The introduction of psychotropic medications in the 1950s eliminated the use of lobotomy • Chlorpromazine and haloperidol revolutionized the treatment of schizophrenia and became the most frequently used treatments for this disorder ◦ Chlorpromazine: acts as a major tranquilizer, reduces anxiety, sedates without inducing sleep, decreased the severity and frequency of the positive symptoms ◦ Haloperidol: is chemically diﬀerent and has less of a sedating eﬀect • Second-generation antipsychotics such as Clozapine, Risperdol, and Zyprexa are more eﬀective at reducing negative symptoms as well as the positive • Psychical treatments: ◦ Medication does not substantially aﬀect patients’ social functioning ◦ Social skills training is an eﬀective way to address some deﬁcits in schizophrenics ◦ Initial studies using CBT indicate that it is more eﬀective than other psychological treatments in reducing symptoms (psychological treatments aren’t as helpful, but CBT is the most helpful of them) • Prognosis in schizophrenia: ◦ One long term study followed participants for 32 years: ▪ between half and two-thirds were recovered or had considerable improvement in functioning on the follow-up ◦ The prognosis of schizophrenia patients depends on factors including age of onset, gender, and culture. ADHD in Children • Pharmacological treatment of ADHD ◦ The most common treatment is a central-nervous-system stimulant, Ritalin. ▪ Children on Ritalin experience an increase in positive behaviors and a decrease in negative behaviors ▪ Side eﬀects include sleep problems, reduced appetite, growth suppression ◦ Evidence indicates that although stimulants are beneﬁcial in the short term, their beneﬁts may not be maintained over the long term ◦ In addition there is a very real risk of abuse ▪ Numerous cases of children and adolescents buying and selling these stimulants ADHD in Children • Pharmacological treatment of ADHD ◦ The most common treatment is a central-nervous-system stimulant, Ritalin. ▪ Children on Ritalin experience an increase in positive behaviors and a decrease in negative behaviors ▪ Side eﬀects include sleep problems, reduced appetite, growth suppression ◦ Evidence indicates that although stimulants are beneﬁcial in the short term, their beneﬁts may not be maintained over the long term ◦ In addition there is a very real risk of abuse ▪ Numerous cases of children and adolescents buying and selling these stimulants
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