Treatment of Psychological Disorders

Counseling and Therapy

Pre-industrialized societies – the "mad" were either ostracized or viewed as special (medicine man, touched by God)

Asylums – middle ages

Mental hospitals

Community mental health (drugs)

Biological Therapies

Drug therapy – most common

Antianxiety – (GAD) Buspar, Imipramine

Xanax right before Panic Attack helps – but can be addictive so shouldn’t be taken regularly

Antipsychotic – Haldol, clozapine, risperidol

Block dopamine

Antidepressants – Elavil, Prozac, Zoloft,

Lithium (bipolar)

Elevate levels of serotonin

Meta-analysis showed no difference between meds and placebo

b/c of unwanted side effects, 2/3 Pts stop taking

Promotion by HMOs, drug companies, lobbying state/federal legislatures

Hope and problems with Herbal remedies

Same brain changes found in OCD pts who took Prozac and those who engaged in Cognitive-Behavioral therapy

ECT – used for depression that does not respond to drugs or counseling

Psychosurgery – lobotomy, cingulotomy

Efficacy – not more effective than psychotherapy in most cases – as a last resort, it is effective

Psychodynamic

Analysis

Catharthis

Free association

Dream analysis – manifest, latent

Resistance

Transference / countertransference

Modern approaches

Behavior Therapy

Focus on modifying behaviors

Flooding

Systematic desensitization

Aversive conditioning

Operant conditioning – successive approximations

Biofeedback

Most effective for Phobias, PTSD, Conduct problems (children)

Cognitive Therapy

Reduce/eliminate irrational thoughts

Aaron Beck – very active – client needs to change her thoughts

Clients selectively perceive

Clients overgeneralize from few examples

Clients magnify importance of few events

Engage in absolutist thinking – world is black and white

Most effective for Depression, Anger management

Humanistic-Existential

Client-centered therapy – Carl Rogers – self-actualization; no "power" over client

Unconditional positive regard

Empathic understanding

Genuineness

Gestalt – wholistic – bring all aspects of personality together – become aware of all parts of oneself

Rational Emotive Therapy

Albert Ellis

* Irrational beliefs

> We must be loved

> We must prove we are competent

Family Therapy

Systems perspective

Dysfunction involves whole family

We all affect each other

Genograms

Group Therapy

Therapist as guide, director

Clients see others with problems

Clients may confront "peers"

Learn empathy

Works against egocentric thinking

Less expensive

Effectiveness of Therapy

Difficult to do experiments to PROVE effectiveness – ethics

Must match therapy with disorder

Look for degree of improvement, comparing treatment modalities

Psychodynamic = 70% improvement

Client-centered = 75%

Cognitive vs drugs for depression

Human Sexuality

431-445

Types/Stages

Robert Sternberg – Triangular Theory – passion – Intimacy - Committment

 

Attachment

Bonding

Secure, Insecure

"Generally" predictive of adult relationships

 

Motives – Biology

"A human is just a gene’s way of making more genes."

Males evolved to spread their seed far and wide, females to be much more selective due to consequences of pregnancy

Testosterone more strongly related to male arousal than female hormones are to female arousal

Kinsey research established that sexual arousal and orientation exist on continuums, rather than having a "bipolar" nature (just one or the other)

Masters and Johnson research opened the door to an understanding of female sexuality

Cross-cultural research shows males consistently prefer youth and beauty, females prefer wealth, status, and commitment

Sexual Orientation

No evidence that experience creates S.O.

Some evidence of genetic influence

Some evidence of prenatal hormones influencing brain development (hypothalamus)

Is Homophobia Associated With Homosexual Arousal?   1996, Journal of Abnormal Psych.

Ø  90% of homosexuals are targets of verbal abuse and threats

Ø  > 1/3 are victims of violence due to being gay

Ø

ØHomophobia different from homonegativity

ØPhobias produce anxiety

University of Georgia study - all participants were "straight" males.

ØHomophobia – measured – the “dread” a person experiences when placed in close quarters with a homosexual. “I would feel nervous being in a group of homosexuals.”

ØHomonegativity – believe it’s “not right”

ØCurrent study – exclusively heterosexual men

ØPenile Plethysmograph – reliable discrimination between homosexual and heterosexual men

ØAggression questionnaire – no difference between homophobic and nonhomophobic

Arousal to Male-Female video

 

Arousal to Female-Female video

 

Arousal to Male-Male video

ØResults demonstrate that homophobic males show significant sexual arousal to male homosexual erotic stimuli

ØLatent homosexuality

ØBut one study doesn’t PROVE anything