Chapter 9 Book Notes
Chapter 9 Book Notes psy 240
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This 7 page Class Notes was uploaded by Alicia Rinaldi on Tuesday September 8, 2015. The Class Notes belongs to psy 240 at University of Miami taught by Dr. Parlade in Fall 2014. Since its upload, it has received 29 views. For similar materials see abnormal psychology in Psychlogy at University of Miami.
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Date Created: 09/08/15
Chapter 9 Treatments for Mood Disorders l Treatments for Unipolar Depression A Psychological Approaches 1 Psychodynamic Therapy a Belief that unipolar depression results from unconscious grief over realimagined loss and dependence on other people Free association dreams resistance amp transference review of past events and feeHngs Patients will learn to cope better and become more independent Long term psychodynamic therapy is only occasionally helpful i Depressed clients may not join fully into the discussions ii People may become discouraged and end treatment too early 2 Behavioral Therapy a Behavioral theories tie mood to the rewards in a person s life b Therapists f i Reintroduce depressed clients to pleasurable activities ii Appropriately reinforce their depressive and nondepressive behaviors iii Help improve their social skills Behavioral activation adding pleasurable events to one s life can lead to a better mood Negative behaviors keep others at a distanceess of a chance for rewarding expedences Contingency management systematically ignoring a client s depressive behaviors while praising or rewarding constructive statements amp behaviors Most effective when two or more behavioral techniques are combined 3 Cognitive Therapy a Cognitive triad people with maladaptive attitudes view themselves their world and their future in negative ways b Automatic thoughts illogically thinking negative thoughts that produce depression h Cognitive therapy a therapy developed by Aaron Beck that helps people identify and change the maladaptive assumptions and ways of thinking that help cause their psychological disorders Therapists combine behavioral techniques with cognitive therapy Similar to Ellis rationalemotive therapy 4 phases i phase 1 Increasing activities and elevating mood making a schedule of enjoyable activities ii phase 2 challenging automatic thoughts iii phase 3 identifying negative thinking and biases iv phase 4 changing primary attitudes cognitivebehavioral therapy has been shown to help newwave cognitivebehavioral therapists practice acceptance and commitment therapy guiding depressed clients to recognize amp accept their negative cognitions but not be bothered by them B Sociocultural Approaches 1 Multicultural treatments a b c Culturesensitive therapies seek to address unique issues faced by members of minority groups sometimes involves training therapist in that culture Used in combination with CBT Medication needs of many minority clients remain unmet 2 FamilySocial Treatments a Interpersonal Psychotherapy i IPT A treatment for unipolar depression that is based on the belief that clarifying and changing one s interpersonal problems will help lead to recovery ii Developed by Gerald Klerman and Myrna Weissman iii 4 problems that must be addressed interpersonal loss ip role dispute ip role transition ip de cits iv ip loss clients explore their relationship with lost person amp develop new ways of remembering them vi vii viii ip roe dispute examine why 2 people have different expectations of their relationship and resolving it ip roe transition helps people develop supports and skills the new role requires ip de cits ex extreme shyness or social awkwardness helping people recognizing their de cits amp teaching them social skills amp assertiveness this therapy has been shown to work well b Couple therapy The therapist works with 2 people who share a longterm relationship Behavioral marital therapy helps spouses change harmful barbital behavior by teaching them communication amp problem solving skills Shown to work well C Biological Approaches 1 Electroconvulsive Therapy a ECT a treatment for depression in which electrodes attached to a patient s head send an electrical current through the brain causing a convulsion b Controversial scary amp risky to some safe to others c The Treatment Procedure iv Electrodes are attached to head amp electricity is passed through brain producing a short seizure Bilateral ECT one electrode on each side current passed through both sides of brain Unilateral current passes through one side Depression subsides after 612 treatments over 24 weeks d The Origins of ECT Accidentally concluded that brain seizuresconvulsions prevent psychosis First drug metrazol was used then insulin coma therapy until Cerletti used an electric current Tried for other problems but works best for severe depression e Changes in ECT procedures Seizures could cause broken bones dislocations memory loss confusion and brain damage Today patients are given muscle relaxers and anesthetics to put patients to sleep Could produce long or short term amnesia f Effectiveness of ECT Effective for unipolar depression amp delusions Use has declined because of memory loss and the rise of antidepressants 2 Antidepressant Drugs a MAO lnhibitors Monoamine oxidase inhibitors an antidepressant drug that prevents the action of the enzyme monoamine oxidase Originally used as tuberculosis treatment MAO inhibitors block MAO from degrading norepinephrine which reduces depressive symptoms iv Shown to help but certain combos with food are unsafe b Tricyclics i An antid with a 3 ring molecular structure ii was supposed to help schizophrenia but was better for depression iii keep taking them after symptoms subside for less chance of a relapse iv reduce depression by reuptake mechanisms v when rst taking these drugs activity of neurons that use norepinephrine and serotonin is slowed down so it won t work for 10 days vi usually given over MAO inhibitors but MAO inhibitors did work better for some c SecondGeneration Antidepressants Selective Serotonin Reuptake Inhibitors SSRls 2nCI generation antid drugs that increase serotonin activity without affecting other neurotransmitters Works about the same as tricyclics but it s harder to overdose and they don t have dietary restrictions or some side effects that other meds have iii Some antid s fail to help people so their prescription often changes until something works 3 Brain Stimulation a Vagus Nerve Stimulation i One vagus nerve on each side ii Primary form of communication btw brain amp organs iii Vagus nerve stimulation a treatment procedure for depression in which an implanted pulse generator sends regular electrical signals to a person s vagus nerve the nerve in turn stimulates the brain iv Deemed successful allowed after 4 other treatments don t work b Transcranial Magnetic Stimulation i A treatment process for depression in which an electromagnetic coil which is placed on or above a person s head sends a current into the individual s brain ii Usually works after 24 weeks safe amp helps c Deep Brain Stimulation i DBS a treatment procedure for depression in which a pacemaker powers electrodes that have been implanted in Brodmann Area 25 thus stimulating that brain area ii So far studies have shown this works but they need to do more studies D How Do The Treatments for Unipolar Depression Compare 1 2 mm Unipolar depression seems to be one of the most treatable conditions Cognitive cogbehavioral interpersonal biological therapies are all highly effective shown in research People who improve with these therapies are bound to relapse Classes offered after treatment ends to prevent relapses Couple therapy helps with marriages Placebobehavioracognitive cogbehavioral interpersonal biological 8 9 Psychodynamic therapies are less effective than others Combination of cognitive amp drug therapy may help teens more than either alone could ECT seems to be effective for those who don t respond to drug treatment ll Treatments for Bipolar Disorders A Preface 1 Lithium a metallic element that occurs in nature as a mineral salt and is an effective treatment for bipolar disorder Mood stabilizingantibipolar drugs psychotropic drugs that help stabilize the moods of people suffering from bipolar mood disorder B Lithium and Other Mood Stabilizers 1 2 3 Discovery of lithium s calming effects was made by accident lt s crucial to nd the correct amount to give a patient Effectiveness of Lithium and Other Mood Stabilizers a Studies show it is effective in treating manic symptoms b Continued usage after episodes subside prevents relapse c Mood stabilizers work for depression but not as well d Usually a combo of mood stabilizers and anti d s is prescribed Mode of Operation of Mood Stabilizers a Researchers suspect drugs change synaptic activity in neurons affecting their second messengers b Second messengers chemical changes within a neuron just after the neuron receives a neurotransmitter message and just before it responds neurotransmitter itself is rst messenger c Mood stabilizing drugs increase production of neuroprotective proteins proteins in certain neurons that prevent cell death d Mood stabilizers also may correct bipolar functioning by changing sodium and potassium ion activity in neurons C Adjunctive Psychotherapy 1 Psychotherapy or drugs alone don t help some people 2 Individual group or family therapy is used as an adjunct to mood stabilizing drugs
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