Psych 202 1st edition Lecture 25 Current Lecture Psychopathology 3 Aron Beck s cognitive triad sees 3 fundamental distortions in rational processing o Negative view of self o Negative view of world o Negative view of future o Automatic thoughts of people currently depressed With respect to events they are experiencing examples I m no good I m so weak I m a failure My future is black I don t think I can go on My life is a mess Albert Ellis developed the ABC model approach advocated by Seligman in Ch 12 of learned optimism o Ellis says a musterbatory cognitive style underlies human neurotic suffering In order to be happy I must o We make ourselves miserable with our thinking We disturb ourselves with internal sentences involving many musts shoulds oughts demands commands The 3 main musts I must do well or I m no good You you louse must treat me well or you re worthless and deserve to roast in hell The world must give me exactly what I want precisely what I want or it is horrible awful place Summary of cognitive approaches o For Seligman Beck and Ellis emotional disorders depression in particular result from irrational distortions in the cognitive processing of events o Events don t cause depression or anxiety or emotional distress in general thinking about events does ABC o Given the cause cognitive distortions the treatment targets cognitive distortions through disputation reappraisal ABCDE D disputation talking to oneself o Treatment changing the irrational thinking o A doesn t cause C o B causes C It is how we react to the thoughts we have from the things we are experiencing These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute Biological and psychological treatments for depression o Medications work in 60 of cases 3 types Selective serotonergic reuptake inhibitors SSRI s Between 3 weeks and 3 months meds usually assist them in returning to level of emotional experience to roughly what they were feeling before Tricyclics inhibit reuptake of Norephinephrine MAO inhibitors inhibit enzymatic deactivation of NE and 5 HT pg 60 Styron Nardil had no signs of hypomania so he met criteria for major depression very severe almost succeeded in killing himself none of his meds worked until this one A pharmacologic treatment of last resort Did it work for him yes He claimed he got better because of the safety of being in hospital and was able to grieve death of his mother when he was a child o Psychotherapy focused on depressive thinking and behavior cognitive behavioral therapies Also shows 60 efficacy in reducing acute symptoms in short run But shows far greater efficacy in reducing relapse than medications alone Cognitive psychotherapy has about same level of success as medication Less likely to relapse if had cognitive psychotherapy than just medication alone Pills don t give you skills They change biochemical environment They will get you over crisis but won t necessarily be life long success o Electroconvulsive therapy ECT Creates short term memory problems A treatment that reduces level of depression from severe to normal in 80 of cases The most effective treatment that exists for short term reduction of symptoms You only do this if other things didn t work Their depression usually returns Saves a lot of lives Treatment for bipolar disorder o Medication lithium carbonate has unique anti manic properties with 80 positive response in actively manic patients also reduces depression Once people start taking this medication they usually stay on it for a lifetime o Adjunctive psychotherapy for Medication management Family and social relationships Education Problem solving and reality testing o Quotes from Kay Jamison on meds psychotherapy and the interconnectedness of the biology and psychology of mood emotion and mental health Pg 5 6 Pg 88 89 Bipolar disorder is a biological illness that has psychological manifestations Biology and psychology are all of one integrated framework about what causes what All begins with genes Expressed emotion is a variable that refers to criticism and hostility directed at patient by their family Relapse within nine months Yes Medication alone 61 Medication plus therapy 10 No Medication alone 39 Medication plus therapy 90 Personality disorders o Group of disorders o All involve an enduring pattern of inner experience and behavior that has 5 characteristics Deviates markedly from the expectations of the individual s culture Is pervasive and inflexible Has an onset in adolescence or early adulthood Is stable over time And leads to either significant personal distress or impairment in socialoccupational role functioning o Distinguishing schizophrenia from the odd eccentric personality disorders Bottom line there are no psychotic symptoms delusions hallucinations or profound disturbances of speech and thinking in personality disorders o DSM diagnostic criteria for schizotypal personality disorder Compare the following video to Ms Wilcox below and pay special attention to the distinction between Ideas of reference vs delusions of reference The person in this case isn t names so we ll just use her words I ve been feeling very spacy lately AND strangers cross streets to avoid me So not delusional Idea of reference thinks people cross the street to avoid her Not delusions in this case She thinks she can read peoples minds But has doubts There is no other symptoms Her magical thinking and clairvoyance the ocean reference She has schizotypal symptoms