Biomedical Therapy

10 Key excerpts on "Biomedical Therapy"

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  Visualizing Psychology

  • Siri Carpenter, Karen Huffman(Authors)
  • 2012(Publication Date)
  • Wiley

    (Publisher)

  3. Describe the risks associated with biomedical therapies. RETRIEVAL PRACTICE While reading the upcoming sections, respond to each Learning Objective in your own words. Then compare your responses with those in Appendix B. ome problem behaviors seem to be caused, at least in part, by chemical imbalances or disturbed nervous system functioning, and so can be treat-ed with biomedical therapies . Psychiatrists, Biomedical Therapy Using physiological interventions (drugs, electroconvulsive therapy, and psychosurgery) to reduce or alleviate symptoms of psychological disorders. or other medical personnel, are generally the only ones who use biomedical therapies. However, in some states licensed psychologists can prescribe certain medications, and they often work with patients receiving biomedical therapies. In this section, we will discuss three aspects of biomedical therapies: psychopharmacology, electroconvulsive therapy (ECT) , and psychosurgery . S Digital Vision/Getty Images 388 CHAPTER 14 Therapy Psychopharmacology Since the 1950s, drug companies have developed an amaz-ing variety of chemicals to treat abnormal behaviors. In some cases, discoveries from psychopharmacology have helped correct chemical imbalances. In these instances, using a drug is similar to admin-istering insulin to people with diabetes, whose own bodies fail to manufacture enough. In other psycho-pharmacology The study of drug effects on the mind and behavior. cases, drugs have been used to relieve or suppress the symptoms of psychological disturbances even when the underlying cause was not thought to be biological. As shown in Table 14.1 , psychiatric drugs are classified into four major categories: antianxiety , antipsychotic , mood stabilizer , and antidepressant .

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  Psychology

  • Ronald Comer, Elizabeth Gould, Adrian Furnham(Authors)
  • 2014(Publication Date)
  • Wiley

    (Publisher)

  BIOLOGICAL TREATMENTS 583 Biological Treatments LEARNING OBJECTIVE 2 Describe the major biological treatments for psychological disorders. Biological therapies use biochemical and physical methods to help people overcome their psychological problems. The practitioners who apply such approaches are usually psychia- trists, therapists whose training includes medical school. The three principal kinds of brain interventions are drug therapy, electroconvulsive therapy and psychosurgery. Drug therapy is by far the most common of these approaches. Drug Therapy Since the 1950s, researchers have discovered several kinds of effective psychotropic drugs , which can significantly reduce the symptoms of psychological disorders (Julien et al., 2011). Some of these medications have been introduced in previous chap- ters and are used widely, either as the first-line treatment for a disorder or in conjunction with psychotherapy or other interventions. As you can see in Table 20.2, four major psychotropic drug groups are used in therapy: antianxiety, antidepressant, antibipolar and antipsychotic drugs. Antianxiety drugs , also called minor tranquilizers or anxiolytics, help reduce tension and anxiety. Antidepressant drugs help improve the mood of people who are depressed (see the following ‘When a Depressed Person Takes an Antidepressant’ box). Antibipolar drugs , also called mood stabilizers, help steady antianxiety drugs psychotropic drugs that reduce ten- sion and anxiety. antidepressant drugs psychotropic drugs that lift the mood of depressed people. antibipolar drugs psychotropic drugs that help sta- bilize the moods of people suffering from bipolar disorder. WHAT HAPPENS IN THE B R A I N ? the moods of those with a bipolar disorder, the condition marked by mood swings from mania to depression. And antipsychotic drugs help reduce the confusion, hallucinations and delusions of psychotic disorders, the disorders (such as schizophrenia) marked by a loss of contact with reality.

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  Real World Psychology

  • Catherine A. Sanderson, Karen R. Huffman(Authors)
  • 2019(Publication Date)
  • Wiley

    (Publisher)

  Today, most improve enough to return to their homes and lead successful lives—if they con- tinue to take their medications to prevent relapse. Electroconvulsive therapy (ECT) A Biomedical Therapy based on passing electrical current through the brain; it is used almost exclu- sively to treat serious depression when drugs and psychotherapy have failed. Psychosurgery A form of Biomedical Therapy that involves alteration of the brain to bring about desirable behavioral, cognitive, or emotional changes; generally used when clients have not responded to other forms of treatment. Lobotomy An outmoded neu- rosurgical procedure for mental disorders, which involved cutting nerve pathways between the fron- tal lobes and the thalamus and hypothalamus. FIGURE 14.15 Electroconvulsive therapy (ECT) Modern ECT treatments are conducted with considerable safety precau- tions, including muscle-relaxant drugs that dramatically reduce muscle contractions, and medication to help clients sleep through the procedure. Note, however, that ECT is rarely used today, and generally only when other treatments have failed. Will McIntyre/Science Source New York Times Co./Archive Photos/Getty Images 480 CHAPTER 14 Therapy On the other hand, drug therapy has been criticized on several grounds. First, although psychotherapeutic drugs may relieve symptoms for some people, they seldom provide cures, and some individuals become physically dependent. Furthermore, psychiatric medications can result in a variety of side effects, ranging from mild fatigue to severe impairments in memory and movement, along with the risk of unexpected deaths (Lawrence et al., 2017; Mentzel et al., 2017; Ray et al., 2019). On a more positive note, drug therapy is often very effective when combined with talk therapy. For example, researchers have tested whether children and teenagers experiencing clinical depression would benefit from receiving cognitive-behavioral therapy (CBT) along with medication.

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  Discovering Psychology

  The Science of Mind

  • John Cacioppo, Laura Freberg(Authors)
  • 2015(Publication Date)
  • Cengage Learning EMEA

    (Publisher)

  All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Chapter 15 | HEALING THE TROUBLED MIND 596 What Are Biological Therapies? The major types of biological treatments for psychological disorders include medication, elec-troconvulsive therapy (ECT), psychosurgery, deep brain stimulation, and neurofeedback. Medication Medication is the most commonly used of the medical therapies. Particularly in the last 60 years, the discovery of medications that effectively treated psychological disorder has dramati-cally shaped the outcomes of millions of patients. A comprehensive review of psychoactive medications is clearly beyond the scope of this text, but we will discuss the use of medication for some specific disorders later in this chapter. Electroconvulsive Therapy Electroconvulsive therapy (ECT) is used in some severe cases of depression that do not respond to other treatments. In ECT, the patient is anesthetized and given a muscle relaxant before the induc-tion of general seizures, which are produced by electricity applied through electrodes on the head. Between 6 and 12 treatments, at a rate of 3 treatments per week, are typically given. Ladislas Meduna (1896–1964) recommended ECT for patients with schizophrenia after observing that people who had epilepsy had unusually high numbers of glia and people with schizophrenia had low numbers of glia (Kalinowsky, 1986). ECT was first used with patients with schizophrenia in the 1930s, with poor results. However, observations of improved mood in these patients follow-ing ECT led to further use with patients diagnosed with major de-pressive or bipolar disorder.

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  Introduction to Psychological Science

  Integrating Behavioral, Neuroscience and Evolutionary Perspectives

  • William J. Ray(Author)
  • 2021(Publication Date)
  • Routledge

    (Publisher)

  psychotropic medications. Psychotropic medications are those that are used to treat mental disorders. The study of these drugs is the domain of psychopharmacology (Evans, 2019).

  As you will see, introduction of medications directed at mental illness allowed individuals to live in more independent settings. In the middle part of the 20th century, this led to the closing of mental hospitals throughout the US. The closing of hospitals is described in the box: The World Is Your Laboratory: Closing Mental Hospitals in America. Today, medication plays an important role in the treatment of mental illness. In addition to medication, there are other treatment approaches that seek to directly change physiological processes. Today, treatments range from the widespread prescribing of drugs to deal with psychological disorders to the less-often used but significant measures involving shock or electrical stimulation of the brain to the rarer use of neurosurgery.

  Biological approaches play an important role in the treatment of mental disorders. Treatment effectiveness is not an either/or question of psychological and biological approaches but an attempt to combine treatments that work together in an effective way. For example, research from 2015 shows that psychotherapy along with lower levels of psychotropic medication are very effective for treating schizophrenia (Insel, 2016, Kane et al., 2016).

  Psychotropic Medications

  During the US Civil War, a textbook by Union Army Surgeon General William Hammond suggested that lithium bromide be used to treat manic patients (see Perlis & Ostacher, 2016, for an overview). However, it was not until 1949 that the Australian John Cade reported that lithium had a calming effect on animals and humans with mania. As you will see, lithium is still used to treat mania, which we refer to as bipolar disorder today. Drugs that came to be called antidepressants for the treatment of depression such as monoamine oxidase inhibitors (MAOIs) and the tricyclic antidepressants (TCAs) were discovered by serendipity in the 1950s (Fava & Papakostas, 2016). Some common MAOIs are Nardil and Parnate. Common tricyclics are Elavil and Tofranil. SSRIs (selective serotonin re-uptake inhibitors) such as Prozac and Paxil were developed later. These are typically used for the treatment of mood disorders. Benzodiazepines such as Valium have been used for the treatment of anxiety for at least 50 years.

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  Psychology

  • Douglas Bernstein, , , (Authors)
  • 2015(Publication Date)
  • Cengage Learning EMEA

    (Publisher)

  Still, some methods appear effective enough in the treatment of particular disorders to have been listed as empiri-cally supported therapies ( ESTs ) that can guide evidence-based practice . The outcome of treatment is also affected by the char-acteristics of the client and the therapist and the relationship that develops between them. Several factors, including personal pref-erences, must be considered when choosing a form of treatment and a therapist. The effects of cultural differences in the values and goals of therapist and client have also attracted increasing attention. In all forms of treatment and under all but the most exceptional circumstances, the client’s rights include the right to confidentiality. Biological Treatments Is electric shock still used to treat psychological disorders? Biological treatment methods seek to relieve psychological disor-ders by physical or pharmaceutical means. Psychosurgery proce-dures once involved mainly prefrontal lobotomy; when used today, usually as a last resort, they focus on more limited areas of the brain. Electroconvulsive shock therapy ( ECT ) involves passing an electric current through the patient’s brain, usually in an effort to relieve severe depression. Today, the most prominent form of bi-ological treatment involves psychoactive medications, including those with antipsychotic , antidepressant , or tranquilizing ( anx-iolytic ) effects. Psychoactive medications appear effective in many cases, but critics point out that a number of undesirable side effects are associated with these medications. Medications may be no more effective than some forms of psychotherapy for many people. Combining medication and psychotherapy may help in some cases and in the treatment of certain disorders, but their joint effect may be no greater than the effect of either one alone.

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  Psychology

  • Graham C. Davey(Author)
  • 2018(Publication Date)
  • Wiley

    (Publisher)

  Electroconvulsive therapy is a controversial therapy in many countries. Discuss the benefits and drawbacks of this therapy and give your opinions on its use.

  SECTION SUMMARY

  • Biological approaches to treating mental health problems include both drug treatments and other methods such as electroconvulsive therapy (ECT).
  • Drug treatments are commonly used to treat the symptoms of a range of mental health problems including depression, anxiety, and psychosis.
  • These drug treatments may be offered alone or in combination with psychological therapies.
  • While several drug treatments may be helpful in treating mental health problems or reducing the distress associated with their symptoms, adverse side effects are also common.
  • ECT is recommended by NICE as a treatment choice only for those with severe, life-threatening depression.

  EVALUATING TREATMENTS FOR MENTAL HEALTH PROBLEMS

  LEARNING OBJECTIVE 16.6

  Evaluate the various therapies implemented in the treatment of mental health problems.

  So far we have explored a number of different kinds of treatment for mental health problems, but how do we know if a treatment is effective? This may not be as simple as it sounds at first – different people have different ideas about what it means for a treatment to be effective, and measuring these outcomes and drawing confident conclusions about the causal effects of the interventions on measured outcomes is not always straightforward.

  Different schools of thought can have quite different assumptions about what ‘successful treatment’ is. Psychodynamic and humanistic therapies consider insight and personal development to be optimal therapy outcomes, whereas cognitive and behavioural therapists are more likely to be looking for symptom reduction and personal goal achievement. Recovery-oriented practice promotes the idea that building a meaningful and satisfying life should be the primary treatment goal (Shepherd, Boardman, & Slade, 2008) (see Focus Point 16.8).

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  Essentials of Clinical Psychology

  An Indian Perspective

  • S. K. Mangal, Shubhra Mangal(Authors)
  • 2023(Publication Date)
  • Routledge

    (Publisher)

  The majority of cases of mental disorders or illnesses may be adjudged as products of severe maladjustment caused by psychological factors. Physical or medical treatment in such cases does not prove very useful. Such patients need psychological treatment for solving their psychological difficulties and achieving better personality adjustment. This form of psychological treatment is known as psychotherapy.

  Psychotherapy: A method of treatment of a psychological problem or disorder used by a therapist through a behavioral approach in the form of establishing a psychological relationship with the patient with the purpose of solving his emotional difficulties for achieving adequate adjustment and mental health.

  Psychotherapy is a difficult term to define. However, it may be understood as a method of treatment of a psychological problem or disorder of an individual by a therapist through a behavioral approach in the form of establishing a psychological relationship with the patient for the purpose of solving the patient’s emotional difficulties and promoting adequate personality growth and adjustment.

  The main objective in psychotherapy is to bring about changes in the patient’s perception of himself and of his environment, thus resulting in positive, enduring changes in his behavior for achieving adequate adjustment and regaining better mental health. For the realization of this objective, a number of systematic approaches to psychotherapy, differing in goals and procedures, have been evolved. In this chapter, we focus our discussion on the use of various psychotherapies on the part of clinical psychologists and practitioners worldwide.

  Psychoanalytical or Psychodynamic Therapy

  The founder of psychoanalytical or psychodynamic therapy was Sigmund Freud, who developed the theory and technique of psychoanalysis for the treatment of abnormality and mental disorders. Freud believed that early conflicts, desires, painful or anxiety-arousing experiences, though repressed and unconscious, are responsible for the present abnormal behavior or mental disorder of an individual. With the use of psychoanalysis technique, he tried to help clients become aware of their thoughts, feelings, and other mental activities. Once they become aware of the underlying unconscious processes, they can make efforts to control them deliberately, rather than being controlled by them. In this way, the psychoanalytic or psychodynamic method invented by him for the treatment of mentally ill was primarily aimed at making one’s unconscious conscious (Cabaniss et al., 2011 ; Karon and Widener, 1995

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  Cognitive Behavioral Psychopharmacology

  The Clinical Practice of Evidence-Based Biopsychosocial Integration

  • Mark Muse(Author)
  • 2017(Publication Date)
  • Wiley-Blackwell

    (Publisher)

  1 Evidence-Based Biopsychosocial Treatment through the Integration of Pharmacotherapy and Psychosocial Therapy

  Mark D. Muse

  The integration of psychotropics into a broader psychosocial therapeutic plan would seem more than justified by previous reviews of the benefits associated with such a multimodal approach to coordinated behavioral health treatment (Reis de Olivera, Schwartz, & Stahl, 2014). It is no longer enough to think along traditional lines of which is the best medication for a particular diagnosis, nor is it sufficient to adhere to one school of psychotherapy and apply it without much regard to diagnosis. Thus, CBT (cognitive-behavioral therapy) for CBT's sake, just as pharmacotherapy as a standalone, would appear to be paradigms with diminished futures. Evidence-based therapeutic strategies argue that treatments, or a combination of treatments, might best be selected according to their relative impact on a certain constellation of symptoms, together with accompanying psychosocial variables, not the least among these being subject variables. Such an approach advocates integrating different biopsychosocial approaches to optimize therapeutic result. In some instances it is a question of selecting one treatment over another, while in the majority of cases it is more a question of combining treatments, and often this means coordinating multimodal therapeutic interventions (Lazarus, 1981).

  “Evidence-based” is a lure that does not always provide us with clear-cut distinctions among multiple intervention strategies because, quite often, the evidence is not there. The evidence that is available, and it is substantial, is limited by its designs, which are driven by the interests of the investigators. Medications are largely tested against placebo, while CBT has rarely been pitted head-to-head against other psychosocial therapies, and where this has been done by resurrecting past studies in meta-analyses, the results are confoundingly ambiguous (Tolin, 2010), which is not a state to be cherished in science. Meta-analyses incorporate all of the shortcomings of the original randomized controlled trials (RCTs) that they attempt to digest (Kennedy-Martin, Curtis, Faries, Robinson, & Johnston, 2005; Walker, Hernandez, & Kattan, 2008). Oftentimes, meta-analyses find no difference between medication and psychotherapy, and no discernable advantage among various medications or among different psychotherapies. And, just as obfuscating is the fact that many studies are kept from public knowledge through selective publication, leading to a skewing of data toward a spurious impression of greater effectiveness than might otherwise be the case if all data were reported (Turner, Matthews, Linardatos, Tell, & Rosenthal, 2008). Still, one often finds that CBT is presented as having accumulated substantial data to support it as an efficacious therapy for the majority of psychiatric disorders (Butler, Chapman, Forman, & Beck, 2006), and this is certainly true because the number of studies completed with CBT as the independent variable far outweigh studies conducted on other psychotherapies. However, it is a stretch to say, based on the present data, that CBT is more

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  Foundations of Clinical Psychiatry Third Edition

  • Sidney Bloch, Bruce S. Singh(Authors)
  • 2013(Publication Date)
  • Melbourne University Press Digital

    (Publisher)

  28  

  Biological Therapies

  David Copolov and Philip Mitchell

  M OST PATIENTS with mild psychological conditions can be treated without recourse to biological therapies. However, for many with moderately severe disorders and for all of marked severity, such therapies are necessary components of management.

  Biological therapies, primarily drugs, but also including electroconvulsive therapy and psychosurgery, control symptoms by readjusting neurochemical processes assumed to be disturbed in psychiatric disorders, even though their specific neurochemical pathogeneses remains unknown. Most knowledge about neurotransmitter dysfunction, for example, in depression and schizophrenia, derives from establishing that particular drugs are effective and then working out their effect on neurotransmitter systems. We know that all anti-schizophrenic drugs block dopamine neurotransmission and that most antidepressants augment noradrenergic or serotonergic neurotransmission or both. Working back from these facts, researchers postulate that schizophrenia is associated with increased dopaminergic neurotransmission, and that depression is associated with impaired noradrenergic and serotonergic neurotransmission.

  Although evidence from measurement of neurotransmitters and their metabolites support these theories, post hoc reasoning arising from an understanding of the biological effects of psychopharmacological agents preceded these findings and remains persuasive. It provides a basis for research targeting the neurochemical systems affected by classical drugs with a view to developing novel drugs with similar, if not superior, therapeutic effects to the older drugs, but lacking their side-effects.

  Prior to the convulsive therapies and the psychotropics introduced in the late 1940s and early 1950s, treatments provided no or minimal relief and were non-specific in action. Patients might die from exhaustion during chronically excited states, or from infections through immobility associated with catatonia or retarded depression, or from suicide. In contrast, exhaustion and infections are no longer causes of premature mortality among psychiatric patients; the major current cause is suicide.

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