Psychosurgery (Biological)

Question 2

What is psychosurgery?

Answer 2

It is a surgical procedure for treating mentally disordered behavior. By removing or destroying part of the brain, the aim is to eradicate the undesirable behaviour. Psychosurgery is used to describe the process of removing or destroying functioning parts of the brain in a way to bring about a change in behaviour.

Question 3

what is the medical model of mental illness assumption?

Answer 3

mental illnesses are like physical ones - can be treated in a physical way. Have a physical cause characterised by a syndrome. Treated through direct manipulation of physical bodily processes (psychosurgery)

Question 4

What does localisation of brain function mean (psychosurgery)?

Answer 4

Certain areas have different “jobs”. Destroying/removing certain areas of the brain that are thought to contribute to psychological problems

Question 5

What does the role of neurotransmitters mean (psychosurgery)?

Answer 5

Involves stimulating the brain which has an affect on neurotransmitters in the long run. For example, low levels of serotonin are linked with depression. If the brain is stimulated with higher serotonin levels, the patient will experience improved mental health

Question 6

What is the aim of psychosurgery?

Answer 6

The aim of psycho surgery is to relieve stress, anxiety and depression in patients who did not respond to any other treatment. It works by destroying parts of the brain. It was known for being misused and to control behavior

Question 7

What disorders does psychosurgery help with?

Answer 7

OCD, Bipolar, Depression, Schizophrenia

Question 8

Who is Egas Moniz?

Answer 8

In 1935, Egas Moniz came to the conclusion that the removal of the frontal lobes would result in a reduction of aggression and distress in patients. He called this a Prefrontal Leucotomy and was awarded a Nobel Peace Prize for his work. Moniz hoped that cutting nerve pass waus the carried thoughts from one part of the brain to the other would relieve patients of their distressing thoughts behaviours

Question 9

What is a prefrontal leuctonomy?

Answer 9

A prefrontal leuctomy was performed by drilling a hole into each side of the skull and inserting an ‘ice-pick’ instrument to destroy nerve fibers. Was later refineded as a leucotone, an instrument with a reractable wire lopp taht could cut into the brain and sever nerve fibers

Question 10

Who is Walter Freeman?

Answer 10

Walter Freeman popularised the transorbital lobotomy during the 1940s and the 1950s. He was expected to have carried out 2500 lobotomies in the US

Question 11

What is a transorbital lobotomy?

Answer 11

A transorbital lobotmoy is selective destruction of nerve fibers in the frontal lobe (impulse control and mood regulation). The transorbital lobotomy was thought to allievate some of the severe symptoms of mental illnesses. Performed by instereting a sharp instrument into the brain via the eye socket.

Question 12

What is stereostatic surgery?

Answer 12

A more modern, precise way of surgically treating mental disorders.

Question 13

What is a bilateral cingulotomy?

Answer 13

A bilateral cingulotomy is where surgeons can either burn away tissue by heating the tip of an electrode or use a gamma knife to focus beams of radiation at the target site

Question 14

What is a capsulotomy?

Answer 14

A capsulotomy is where surgeons insert probes through the top of the skull and down into the capsule (hypthamlamus)

Question 15

What is Deep Brain Stimulation?

Answer 15

In deep brain stimulation, surgeons thread wires through the skull into the brain which are connected to a battery pack in the patients chest. The batteries produce a high frequency current that interupts tge brain activity involved. It can be turned off

Question 16

Was there high success rates for early psychosurgery?

Answer 16

Both MOniz and Freeman claimed high success rates for their operations.
Inital evidence supported this, Pipperd (1955) reported worthwhile or good results with 50% of these mood disorders.
Other sources reported severe side effects.

Question 17

What was the fatality rate of early psychology?

Answer 17

In 2002, Comer found that the fatality rate was 6%.

Question 18

What were side effects of Early psychology?

Answer 18

> Change in personality
Lethargy
Apathy
Becoming irresponsible
Socially withdrawn

Question 19

Is modern psychosurgery effective?

Answer 19

Cosgrove and Rauch (2001) found that cingulotomies were effective in 56% of OCD patients and capsulotomies in 67%.
For major effective disorder success rates for cingulotomies was 65% and 55% for capsulotomies,
Only 25 patients a year are treated with psychosurgery so we don’t know how effective they actually are
Psychosurgery cannot be trialled with a placebo so we cannot measure the effectiveness

Question 20

Why is psychosurgery often a last resort?

Answer 20

> Causes lifechanging results
Invasive procedure
Dangerous
High risk

Question 21

What are the ethical issues with psychosurgery?

Answer 21

> Not always 100% valid consent
Causes irreversible damage
Once the brain has been severed, it will not grow back
Some side effects may be worse than the illness

Question 22

What are the ethical issues with Early Psychosurgery?

Answer 22

Many patients were lobotmised against their will, making violent patients easier to control.
Were more about a method of control than a treatment

Question 23

What are the ethical issues with modern Psychosurgery?

Answer 23

Done as a last resort with express consent, done with express consent. Some argue that psychosurgery is better than nothing at all, some patients may be sucidal (lesser of two evils)