L5-6 Causes of Mental Disorders

Question 1

Three historical treatments of mental disorders

Answer 1

Trepanning
Lobotomy
Mosquito therapy

Question 2

What is trepanning

Answer 2

o Historical treatment used for seizures and psychotic disorders
o Drilling a whole in the head
o Often fatal
o Stone age

Question 3

What is a lobotomy

Answer 3

o Popular in 1920s
o Scalpel in eye and moving it back and forth to cut connections between front of brain and back of brain
o Caused catastrophic brain damage
o People were often much calmer after procedure, but this was because they had lost a lot of what makes them a human – such as motivation, inhibition, executive function

Question 4

What is mosquito therapy

Answer 4

o Historically used for treatment of psychotic disorders
o Placed people who were psychotic in a room and had mosquitos infected with malaria bite them
o Everyone got horrible sick

Question 5

Biological therapies target ………..

Answer 5

brain abnormalities directly

Question 6

The most common form of biological therapies are

Answer 6

pharmacological therapies

Question 7

Pharmacological treatments primarily act on _______

Answer 7

neurotransmitters

Question 8

Antidepressant SSRI’s primarily act on neurotransmitter

Answer 8

serotonin

Question 9

Anxiolytics (benzos) primarily act on _____

Answer 9

GABA

Question 10

Antipsychotics i.e., Olanzapine primarily act on

Answer 10

dopamine

Question 11

What are two other biological therapies which are not drugs

Answer 11

Electroconvulsive therapy (ECT)
Deep brain stimulation

Question 12

What is Electro Convulsive Therapy? What is it used for? What are its side effects?

Answer 12

o Effective for the treatment of severe, treatment-refractory depression
o Involves passing a current through the brain of an anaesthetized patient
o Notable side-effect: amnesia. People lose memories especially around the time of the therapy

Question 13

What is deep brain stimulation? What is it used for? Does it work?

Answer 13

o Used for various things, particularly treatment-refractory OCD
o Electrodes placed in ventral striatum, connected to battery pack
o Evidence it improves obsessions and compulsions

Question 14

Psychological therapies target brain abnormalities _______ by ………

Answer 14

indirectly

by changing peoples thoughts and behaviours

Question 15

Psychological therapies target maladaptive behaviour (_______ therapies) and maladaptive thoughts (_______ therapies).

Answer 15

behavioural

cognitive

Question 16

Psychological therapies reflect underlying assumptions about causation of mental illness. Explain these assumptions for three different psychological models of mental illness

Answer 16

o	Psychoanalysis (unconscious conflict)
o	Behavioural (maladaptive learned responses)
o	Cognitive (maladaptive cognitions)

Question 17

What is the aim of psychoanalysis

Answer 17

• Aim of psychoanalysis: identify hidden unconscious conflicts and allow them into conscious
• Key idea: making the patient aware (i.e. conscious) of their unconscious conflicts takes pressure off the ego (which is always in battle with id and superego), which is therapeutic

Question 18

What are some criticisms of psychoanalysis?

Answer 18

• How reliable is the psychoanalysts interpretation?
• How many different psychoanalysts would interpret dreams etc. in the same way?
• Takes a long time
• Clients often in therapy for more than 5 years
• Limited evidence as to its effectiveness

Question 19

What is the aim of behavioural therapy

Answer 19

• Focuses on trying to change client’s behaviour so that they can function more effectively
• Key idea: changing the client’s behaviour will end up changing their cognitions

Question 20

What are the two things behavioural therapy focuses on

Answer 20

o Preventing reinforcement of maladaptive behaviours

o Reinforcing adaptive behaviours

Question 21

What is one of the key techniques of behavioural therapy which has to do with preventing maladaptive responses

Answer 21

exposure techniques (for anxiety and phobias)

Question 22

True of false. Exposure techniques are the most common and effective treatment for anxiety disorders – typically more effective than drugs

Answer 22

true

Question 23

What are the two categories of exposure techniques

Answer 23

• Graded exposure
o Jackie has a phobia of birds and feathers. Feather on other side of the room, getting closer, eventually touching the feather.
• Flooding
o Jackie walks in to the room and a bucket of feathers is tipped on her head straight away.

Question 24

What do exposure techniques involve and what is the key idea.

Answer 24

• Involve exposing people to their fears, preventing them from escaping, and enabling extinction to occur
• Key idea: avoidance of the feared stimulus maintains anxiety.

Question 25

Explain operant conditioning and rewarding adaptive behaviour through the example of the Baltimore cocaine study

Answer 25

Uses drug tested 3x a week, and given no reward, small financial reward, or large financial reward for clean urine tests.

Almost 75% samples in large reward group came back cocaine negative by rewarding adaptive behaviours with larger financial reward

Question 26

What is behavioural activation in simplest terms, which form of therapy is it associated with

Answer 26

Behavioural therapy
Encourages adaptive behaviours that are inherently rewarding.

i.e., encouraging client to engage in activity that makes them feel even a little bit good (to break cycle of low energy/motivation/inactivity)

Question 27

What is relationship between MDD and energy/inactivity. How do behavioural therapists treat this

Answer 27

People with MDD have low energy and motivation, tend to isolate themselves > become inactive > this tends to make you feel worse > vicious cycle

Behaviourists implement behavioural activation - encouraging adaptive behaviours that make someone feel a little bit good.

• pleasure based activities (going to a movie)
• mastery based activities (doing the washing)

Question 28

In the study on behavioural activation, cognitive therapy, and drug therapy, which approach was most effective at reducing remission rates of MDD post treatment

Answer 28

behavioural activation

Question 29

Cognitive therapists focus on identifying and challenging…..

Answer 29

unrealistic and unhelpful beliefs

• A (Activating Event) > B (Belief) > C (Emotional Consequence)
• Change in B leads to a change in C

Question 30

Cognitive therapy aims to

Answer 30

Cognitive therapy aims to identify and modify cognitive distortions, maladaptive cognitive styles and irrational thoughts through cognitive restructuring and thought challenging

Question 31

What is the cognitive therapeutic approach. Explain in relation to panic disorder patient worries about having a heart attack.

Answer 31

• Belief: “When my heart beats fast it’s a sign that I have heart disease and I’m going to have a heart attack and die”
• Alternative (more realistic) belief: “an increase in heart rate may be the result of lots of benign things - stress, exercise, caffeine, over-breathing etc.” … “hearts are strong muscles and can handle beating fast”

Question 32

Explain a cognitive behavioural experiment used for someone who has social anxiety which causes them to shower 3 times per day and constantly change clothes to stay clean.

Answer 32

• Behavioural Experiment: Jane wore the same outfit for 2 days straight. She even dabbed tomato sauce on her blouse. Carefully observed if anyone made any comments, showed disgust, moved away, etc.
• What happened? No-one commented, or even seemed to notice. When Jane commented “Oh, I’ve spilt sauce on myself”, her colleague didn’t seem concerned (or even particularly interested).
• Reflection: “Maybe people aren’t taking as much notice of my appearance as I thought… It actually takes a lot to get so dishevelled that others notice”

Question 33

What is the best form of therapy?

Answer 33

Depends on the disorder!
• CBT probably has the most supporting evidence for anxiety and mood disorders
• Pharmacotherapy still the most effective treatment against schizophrenia and bipolar I
• Evidence that psychotherapy plus pharmacotherapy is more effective than either in isolation