Treatment of Clinical Disorders Flashcards

(67 cards)

1
Q

what are the different goals of treatments of disorders?

A

direct intervention, symptom support, or insight-based

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2
Q

what are the problems with determining if treatment is working?

A
  1. self reports are unreliable
  2. the worst symptoms often go away on their own
  3. placebo effects
  4. nocebo effects
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3
Q

what are nocebo effects?

A

incorrect expectations about illness progression or treatment outcomes make our symptoms worse

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4
Q

what is treatment efficacy vs effectiveness?

A

efficacy is how well the treatment works in ideal conditions; effectiveness is how well the treatment works in real-life conditions

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5
Q

what is the function of the active control group in an RCT?

A

by administering standard or mock treatment, the active control measures efficacy compared to the new intervention and measures placebo/nocebo effects

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6
Q

what is the function of the inactive control group in an RCT?

A

measures efficacy compared to doing nothing, natural improvement, and patient bias for assessing pre/post symptoms

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7
Q

what is natural improvement?

A

the tendency of symptoms to return to their mean or average level

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8
Q

what is reconstructive memory?

A

client’s motivation to get well causes errors in reconstructive memory for the original symptoms (“getting what you want by revising what you had”)

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9
Q

what is the function of serotonin?

A

feelings of well-being, appetite, and sleep

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10
Q

what is the function of dopamine?

A

increasing activity in various brain regions, especially those related to reward and pleasurable feelings

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11
Q

what is the function of GABA?

A

primarily related to inhibiting neuronal activity (more GABA = less activity)

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12
Q

what is the function of norepinephrine?

A

increasing arousal and sense of alertness, especially when stress response is occurring

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13
Q

what is the function of typical antipsychotics?

A

exclusively block dopamine receptors, reducing the effects of dopamine in the brain; good for positive symptoms

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14
Q

what is the function of atypical antipsychotics?

A

block activity of both serotonin and dopamine; fewer side-effects and helps with some negative symptoms

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15
Q

what conditions are treated with antipsychotics?

A

schizophrenia, bipolar, and treatment-resistant depression

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16
Q

what are the limitations of antipsychotics

A

significant side-effects, and not always as good for treating negative symptoms

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17
Q

what are anxiolytics used for?

A

anxiety (general and specific), sleep disorders, PTSD, OCD

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18
Q

what are the limitations of anxiolytics?

A

only alleviates symptoms and builds a strong drug tolerance

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19
Q

what are antidepressants used for?

A

anxiety, depression

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20
Q

what are the three main types of antidepressants?

A

SSRIs, SNRIs, Bupropion

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21
Q

what do SSRI’s do?

A

increase serotonin available in the brain

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22
Q

what do SNRI’s do?

A

increase both serotonin and norepinephrine

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23
Q

what does bupropion do?

A

increases norepinephrine and dopamine (also used to stop smoking)

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24
Q

what are some limitations of anti-depressants?

A

take time to start working, require increasing dosage or change over time

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25
what are the two main types of mood stabilizers?
mineral salts/lithium; anticonvulsants
26
what do mineral salts/lithium medications do?
decrease epinephrine and increase serotonin, helps with mania and depression
27
what do anticonvulsant medications do?
increase GABA and norepinephrine and can especially help during manic episodes
28
what are psychostimulants?
drugs used to treat attentional disorders, selectively release norepinephrine, serotonin, and dopamine; boosts attention, wakefulness, and persistence
29
what are psychostimulants used for?
ADHD, depression, eating disorders
30
what are the limitations of psychostimulants?
tolerance build-up, addictive, especially with recreational use
31
what are the two families of psychotherapy treatments?
insight-focused and intervention-focused
32
what is eclectic psychotherapy?
a form of psychotherapy that involves drawing on techniques from different forms of therapy, depending on the client and the problem
33
what is psychodynamic therapy/psychoanalysis?
explores childhood events and encourages people to use the understanding gained from the exploration to develop insights into their psychological problems
34
what are the unique features of psychodynamic therapy?
interpretation (therapist must reveal cause of problems) transference (the client projects their unconscious desires and defense mechanisms onto therapist, who analyzes) removing interference (client must be distraction free) long course of treatment (~2 years, with multiple sessions per week)
35
what is the focus of psychodynamic therapy?
finding things the client doesn't want to talk about ECEs Dreams/hopes/fears reading between the lines, and building a narrative
36
what are the techniques of psychodynamic therapy?
unstructured talk, free association (generate ideas as they come to mind), dream analysis, resistance
37
what is interpersonal psychotherapy?
a form of psychotherapy focusing on helping clients improve current relationships
38
what is the mechanism of interpersonal psychotherapy?
talk about interpersonal behaviours/feelings rather than free association; pays attention to client's grief, role disputes, or deficits; and focuses and functioning with the assumption that as relationships improve, symptoms will subside
39
what is person centered therapy?
a humanistic therapy in which the therapist acts as a mirror through which the client reaches their own insight and becomes their “authentic self”
40
what are the assumptions of person-centered therapy?
that all people have a tendency towards growth, and that this growth can be facilitated by acceptance and genuine reactions from the therapist; and that people can determine own goals for therapy
41
what is the mechanism of person-centered therapy?
focus on empathy and radical self-acceptance, client accept themselves and find their own ways of dealing with their problems
42
what are the unique features of person-centered therapy?
insight comes from patient (not therapist) therapist provides compassion and judgement-free zone therapist is genuinely themself, self-reports own experiences, and acts as a model for the client emphasis is an open communication, empathy, total acceptance
43
what is unconditional positive regard?
a technique of PCT where the therapist accepts, cares for, and seeks to understand the client no matter what they say or do
44
what is active listening/mirroring?
a technique of PCT where the therapist echoes, restates, and clarifies what the patient said, but does not add their own interpretation
45
what is motivational interviewing?
a technique of PCT where the therapist restates noticed discrepancies in what the client is saying, doing, or believing, and asks them for clarification, but does not ask them to change
46
what is Gestalt therapy?
therapy with the goal of helping the client become aware of their thoughts, behaviours, experiences, and feelings; and to “own” or take responsibility for them
47
what is a main technique of Gestalt therapy?
technique of ‘focusing’ → asking client to attune to current feelings as they describe an event, or put their feelings into an imagined circumstance
48
what is the main assumption of behavioural therapy?
assumes disordered behaviour is learned and that symptom relief is achieved through changing overt, maladaptive behaviours into more constructive behaviours
49
what is cognitive behavioural therapy?
a blend of cognitive and behavioural therapeutic strategies wherein the therapist teaches skills to change client’s maladaptive automatic behaviours and cognitive distortions, and replaces them with more positive ones
50
what are the unique features of CBT?
research-based, psychoeducation, teaching skills rather than finding a narrative or origin, homework, focused/short-term
51
what is classical conditioning?
a CBT technique to associate a stimulus with a physical reaction by pairing them in time repeatedly (ex: antabuse)
52
what is operant conditioning?
a CBT technique that associates a stimulus with an outcome through reward and punishment (ex: token economy, monetary punishment)
53
what is exposure?
a CBT technique involving confrontation of an emotion-arousing stimulus repeatedly, leading to a decrease in physiological response (this depends on habituation and response extinction)
54
what is response prevention?
a CBT technique where a maladaptive coping strategy is prevented to show the participant that nothing bad will happen if they resist the behaviour
55
what is cognitive restructuring?
a broad range of CBT techniques used to challenge, clarify, and remove automatic negative thoughts and beliefs
56
what is dialectical behavioural therapy? (DBT)
teaching emotional regulation skills, accepting one’s thoughts and not identifying with them, building self-compassion through mindfulness meditation
57
what are the unique features of DBT?
- frequent meetings (2x/week, up to 12 months) - group/class settings - in-vivo coaching (therapist often available by phone or online to give live in-the-moment coaching as emergencies arise
58
what are the techniques of DBT?
mindfulness meditation, distress tolerance, interpersonal effectiveness (how/when to ask for help while maintaining good relationships), emotional regulation
59
what is DBT effective for?
BPD and reducing non-suicidal self-harm behaviours
60
what are the advantages of group therapy?
showing clients that they are not alone, model appropriate behaviours for each other, and it is often just as effective as individual therapy
61
what are the disadvantages of group therapy?
difficult to unite people with similar needs (especially in cases of CBT, which focuses on specific problems), group members can undermine the treatment of other group members (i.e. by dominating discussion, threatening other members or making them uncomfortable), and there is just less attention on the individual
62
what is electroconvulsive therapy (ECT)?
a treatment that involved inducing a brief seizure by delivering an electrical shock to the brain (sometimes called shock therapy)
63
what is ECT used for?
used primarily for treatment-resistant depression
64
what is TMS?
- treatment that involves placing a powerful pulsed magnet over a person’s scalp to alter neuronal activity in the brain - when used for depression, magnet is placed above an eyebrow to stimulate the left or right prefrontal cortex
65
what is psychosurgery?
the surgical destruction of specific brain areas; may be used to treat severe and unresponsive psych disorders (specific surgeries target the corpus callosum and the little ridge above it (cingulate gyrus))
66
what is deep brain stimulation (DBS)?
combines use of psychosurgery with electrical currents such as ECT and TMS
67