Chapter Three ___________________________________ Treatment of - PDF document

Slide 1 ___________________________________ ___________________________________ Chapter Three ___________________________________ Treatment of Abnormal Behavior ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 2 ___________________________________ Classification and Assessment  DSM-IV-TR ___________________________________  Purpose: Classification system that allows clinician to match their client’s problems the form of treatment that is mot likely to be ___________________________________ effective. The system classifies disorders according to a specific set of symptoms which helps in diagnosis and stimulates research for treatment and possible prevention of the ___________________________________ disorder. ___________________________________ ___________________________________ ___________________________________ Slide 3 ___________________________________ Diagnositc Manual  United States-DSM!V-TR ___________________________________  Five axis descriptive classification system with each axis concerned with a different domain of information.  Axis one and two: clinical symptoms and Personality  Axis 3, 4 & 5: Medical and environmental factors ___________________________________ including overall level of function.  International Classification of Disease-ICD- developed by the World Health organization. ___________________________________ ___________________________________ ___________________________________ ___________________________________

Slide 4 ___________________________________ Major Domains of Information of DSM IV-TR (text pg 109)  Axis One -clinical disorders and other conditions- ___________________________________ includes all mental disorders except personality disorders.  Axis Two – Personality disorders and presence of mental retardation.  Axis Three- General Medical Condition ___________________________________  Axis Four- Psychosocial and environmental problems that could have an impact on diagnosis or treatment (e.g. divorce, unemployment)  Axis Five- Usually a number from 1-100 that asseses the ___________________________________ person’s level of psychological, social and occupational function. ___________________________________ ___________________________________ ___________________________________ Slide 5 ___________________________________ Biological  Goal of Treatment: Alter biology to relieve ___________________________________ psychological distress.  Primary Methods: Diagnosis and medication ___________________________________  Psychopharmacology - - study of the use of medications to treat psychological disturbances. • Psychotropic medications: chemical substances that ___________________________________ affect the psychological state. ___________________________________ ___________________________________ ___________________________________ Slide 6 ___________________________________ Treatment with Pharmacology  Neurotransmitter systems involved in ___________________________________ Pharmacological Treatment  Serotonin-Depression, Anxiety  Norepinephrine-Depression, Anxiety, OCD ___________________________________  Dopamine-Depression, Schizophrenia, ADD ___________________________________ ___________________________________ ___________________________________ ___________________________________

Slide 7 ___________________________________ Synthesis of Serotonin ___________________________________ Tryptophan Tryptophan hydroxylase 5HTP ___________________________________ MAO-inhibitors will stop 5 HTP Decarboxylase the breakdown of serotonin and therefore Serotonin make serotonin available at the synapse longer ___________________________________ Inactivated by MAO-A ___________________________________ ___________________________________ ___________________________________ Slide 8 ___________________________________ Synthesis of NE ___________________________________ Dopamine Beta-hydroxylase (enzyme) Norepinephrine ___________________________________ Phenethanolamine N-methyltransferase Epinephrine ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 9 ___________________________________ Synthesis of Dopamine Tyrosine ___________________________________ Drugs that act upon any of these metabolites or Tryosine enzymes can affect the hydroxylase amount of NT available (enzyme) L-dopa Aromatic amino acid ___________________________________ decarboxylase Dopamine Methylated by COMT ___________________________________ 3MT Converted by MAO-B HVA is a catabolite which HVA are cleared from the brain primarily by the CSF, also found in urine and blood ___________________________________ ___________________________________ ___________________________________

Slide 10 ___________________________________ Biological  Primary Methods (cont) ___________________________________  Psychopharmacology • Onset of effectiveness ___________________________________ • Effects in people with mental disorders vs. people who are functioning normally. • Psychotropics alleviate symptoms but are not a cure ___________________________________ for the underlying problem. ___________________________________ ___________________________________ ___________________________________ Slide 11 ___________________________________ Biological Primary Treatment Methods (cont) ___________________________________ Electroconvulsive Therapy - deliberate induction of a seizure by passing electricity through the brain. ___________________________________ • Unilateral vs. bilateral • Course of treatment • Side effects Psychosurgery- controversial treatment that ___________________________________ involves the surgical removal of specific regions of the brain. ___________________________________ ___________________________________ ___________________________________ Slide 12 ___________________________________ Biological  Role of Therapist: Active, directive ___________________________________ diagnostician-psychiatrist  Length of visit: Brief with occasional ___________________________________ follow-up visits. ___________________________________ ___________________________________ ___________________________________ ___________________________________

Slide 13 ___________________________________ Psychodynamic Therapies  Goal of Treatment - Gain insight into ___________________________________ defenses and unconscious motives.  Primary Methods - Interpretation of defense mechanisms. ___________________________________  Freudian Psychoanalysis  Psychodynamic Psychoanalysis  Role of Therapist- Passive, non-directive interpreter. ___________________________________  Length of Treatment- Usually long term, some new short-term treatments. ___________________________________ ___________________________________ ___________________________________ Slide 14 ___________________________________ Cognitive-Behavior Therapy  F ocuses on emotional, cognitive, and ___________________________________ behavior changes in the present and not insight about the past.  Goal of Treatment - Learn more adaptive ___________________________________ behaviors and cognitions.  Primary Methods - Instruction, Guided Learning, Homework ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 15 ___________________________________ Cognitive-Behavior Therapy Exposure therapies- based on Pavlov’s theory of classical conditioning. ___________________________________  Systematic Desensitization - if fears could be learned they could be unlearned through learning relaxation techniques and systematic exposure. ___________________________________  Flooding-exposure to the feared stimulus all at once without any attempt to calm anxiety. ___________________________________  Aversion Therapy-create an unpleasant response to behaviors such as addiction via drugs or shock. ___________________________________ ___________________________________ ___________________________________