Tutorials

Question 1

T2

Does degree of belief in a memory predict the accuracy of a memory?

Answer 1

No.

Question 2

T2

Are traumatic memories easier to retrieve than non-traumatic?

Answer 2

No.

Question 3

T2

Does recall of true memories result in more of an emotional spike than recall of false memories?

Answer 3

No.

Question 4

T2

What may cause patients to believe in therapists’ suggestions? 3 things

Answer 4

1. Therapist is an authority figure.
2. Already vulnerable –more suggestible.
3. Reduces feelings of defectiveness/ externalises blame.

Question 5

T3

What are the treatments of choice for OCD? Why?

Answer 5

Exposure and response therapy or CBT. Only ERP shown to be efficacious and specific (it’s an EST).

Question 6

T3

What are the main symptom dimensions of OCD according to DSM-IV?

Answer 6

(a) contamination obsessions with cleaning/washing rituals;
(b) doubts about harm with checking/reassurance seeking rituals;
(c) obsessions relating to a need for symmetry, exactness or completeness and associated ordering, repeating or arranging rituals;
(d) unacceptable thoughts of a violent, sexual or religious content with covert mental rituals;
(e) hoarding –separate disorder

Question 7

T3

Has there been a treatment developed specifically for a subtype of OCD?

Answer 7

Danger Ideation Reduction Therapy [DIRT] for contamination (Menzies). A purely cognitive therapy (no exposure) that teaches about the nature of bacteria/contamination. Shown superior to ERP. Possibly efficacious – only one research group.

Question 8

T4

What evidence, based on treatment efficacy, suggests that depression is distinct from prolonged grief?

Answer 8

Treatments for depression are not effective for grief.

Question 9

T5

What lesson do Ryan et al. (2012) suggest should be drawn from the Waterlow case?

Answer 9

Enforced treatment should not be based on estimation of risk –this is too difficult for doctors to assess. Instead, it should be based on decision-making capacity. If individual incapable of making a decision himself, then others should be allowed to decide for him. May be based on patient’s ‘authentic self’.

Question 10

T6

What are 5 problems with the Swiss heroin trials (1997)?

Answer 10

1. No control group – all wanted heroin
2. 5 times more spent on social services than in normal methadone clinics
3. Most severe addicts were those who dropped out
4. Addicts motivated to stay in program – and fail – in order to access heroin.
5. Lower enrolment in abstinence programs while heroin trial was running.

Question 11

T7

What is the core psychopathology of eating disorders (except for binge eating)?

Answer 11

Overevaluation of eating, shape, weight and their control. Self-worth derived from these factors.

Question 12

T7

What percentage of patients make full recovery from BN after CBT?

Answer 12

About 50%.

Question 13

T7

What 3 factors does the current cognitive treatment for BN address?

Answer 13

1. dietary restraint, 2. response to adverse mood states, 3. over-evaluation of eating, shape, weight and control.

Question 14

T7

What 4 additional maintaining processes for BN are suggested by Fairburn et al. (2003)?

Answer 14

11. Clinical perfectionism – self-worth judged via striving and success in meeting demanding goals.
12. Core low self-esteem – more globally negative view of self, independent of performance. Leads to hopelessness, undermining treatment compliance.
13. Mood intolerance – inability to cope appropriately with certain emotional states. Sometimes intolerance of all intense mood states, including positive ones (e.g. excitement). Engage in ‘dysfunctional mood modulatory behaviour’- reduces awareness of mood. E.g. self-injury, alcohol, bing-eating, vomiting, intense exercising.
14. Interpersonal difficulties – range of factors. 1. Family tensions intensify resistance to eating –may be to do with need for control. 2. Need to be slim in family –e.g. parent with AN. 3. Interpersonal stress commonly precipitate binging (evidence patients with BN more sensitive to social interactions). 4. Long-term IP difficulties reduce self-esteem.

Question 15

T7

What are the advantages and disadvantages of treating eating disorders with a transdiagnostic approach?

Answer 15

Disadvantages:
- Overlooks differences between disorders

Advantages:

• Might treat patients who don’t respond well to normal CBT, which focuses on specific symptoms
• Patients often move between diagnoses, suggesting treatment has not adjusted core psychopathology

Question 16

T7

What are the advantages and disadvantages of behavioural programs for weight gain?

Answer 16

+ Gets weight up. Don’t die.

– Doesn’t attack underlying causes. Doesn’t treat disorder. Distressing.

Question 17

T7

What are the advantages and disadvantages of group treatment for AN?

Answer 17

+ Support from others

• Normalises negative behaviour.

Question 18

T7

What are 4 challenges of establishing a therapeutic alliance with patients with Anorexia Nervosa?

Answer 18

1. Have to enforce eating –exactly what they don’t want to do.
2. Hospital environment coercive, encourages subversion.
3. ANs like control –can perceive themselves as superior, more self-control.
4. They don’t think they’re ill. So hard to treat those who don’t believe diagnosis. Unmotivated. May need stages of change model and MI.

Question 19

T8

Why are those with CU traits often confused with those on Autism spectrum?

Answer 19

CU traits overlap with ASD traits. Both lack empathy and have impaired emotional processing and social functioning.

And both CU and ASD traits are often comomorbid with ADHD.

Question 20

T8

Is there any association between autism spectrum disorders and CU traits?

Answer 20

No. They occur independently.

Question 21

T8

What evidence is there that the CU specifier –now limited to conduct disorder –could be extended to other disorders?

Answer 21

The value of CU traits in predicting poor clinical outcomes for treatment for conduct disorder pertains across other clinical populations (ADHD, ASD, CD, ODD). It may be a transdiagnostic marker.

Question 22

What is an obsession?

Answer 22

Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive or unwanted.

Question 23

What is a compulsion?

Answer 23

Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. They are aimed at reducing distress or danger.