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UW-Madison PSYCH 202 - Psychopathology 3

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Psych 202 1st edition Lecture 25 Current LecturePsychopathology 3-Aron Beck's "cognitive triad" sees 3 fundamental distortions in rational processing:oNegative view of selfoNegative view of worldoNegative view of futureoAutomatic 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 optimismoEllis says a "musterbatory" cognitive style underlies human neurotic suffering-"In order to be happy I must…"oWe 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 approachesoFor Seligman, Beck, and Ellis, emotional disorders (depression in particular) result from irrational distortions in the cognitive processing of eventsoEvents don’t cause depression (or anxiety, or emotional distress in general), thinking about events does: ABCoGiven the cause (cognitive distortions), the treatment targets cognitive distortions through disputation/reappraisal: ABCDE-D = disputation: talking to oneselfoTreatment: changing the irrational thinkingoA doesn’t cause CoB causes C-It is how we react to the thoughts we have from the things we are experiencingThese 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:oMedications 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 childoPsychotherapy 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 successoElectroconvulsive 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 disorderoMedication: 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 lifetimeoAdjunctive psychotherapy for:-Medication management-Family and social relationships-Education-Problem solving and "reality testing"oQuotes 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 disordersoGroup of disordersoAll 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 social-occupational role functioningoDistinguishing 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 disordersoDSM 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 streetsto 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


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