1. how are psychological disorders treated?

to help them unlearn learned behaviors that

psychotherapy, psychotropic medications, negatively affect their functioning
alternative treatments - operant conditioning: 좋은 행동 reinforced, 나쁜행
동 punished
(1) psychotherapy is based on psychological - token economies
principles - social skills training: to elicit desired behavior
- psychotherapy: treatment for psychological - modeling: the first step. therapist acts out an
disorders where a therapist workds with clents appropriate behavior -> 환자는 이를 따라하고 연
to help them understand their problems and 습하고 적용한다.
work toward solutions § cognitive therapy: help to change distorted
- aclectic approach: use a variety of techniques thought patterns that produce maladaptive
that seem appropriate for a given client behaviors and emotions
- cognitive restructuring: helpt to recognize
☃ psychodynamic therapy maladaptive thought patterns and replace them
- Sigmund Freud with ways of viewing the world
§ psychoanalysis - rational-emotive therapy: explain the client’s
§ identify unconscious conflicts errors in thinking and demonstrating
§ techniques: free association + dream analysis more-adaptive ways to think and behave
- free association: client say whatever come to § cognitive-behavioral therapy (CBT):
mind incorporates techniques from cognitive therapy
- dream analysis: interpret the hidden meaning of and behavior therapy to correct faulty thinking
the client’s dreams and maladaptive behaviors
§ goal: increase the client’s awareness of his own - one of the most effective therapies, especially
unconscious psychological processes for anxiety disorders and mood disorders
§ psychodynamic therapy: therapist works with
clients to help them become aware of how ☃ group therapy
their unconscious processes may be causing - treat people in groups
conflict and impairing daily functioning - vary widely in the types of clients enrolled in
§ talking therapy the group, the duration of treatment,....
- social support that group members can provide
☃ humanistic therapy -> most helpful aspects
- humanistic therapy: therapist works with clients - used in combination with individual
to help them develop their full potential for psychotherapy
personal growth through greater
self-understanding ☃ family therapy
- approach to personality emphasizes personal - systems approach: individual is part of a larger
experience context, any change of his behavior will affect
- client-centered therapy: encourages people to the whole system
fulfill their potential for personal growth - each person in a family plays a particular role
- create a safe and comforting setting for clients and interacts with the other members in specific
- active listening ways
- unconditional positive regard - 가족 구성원의 변화 -> 전체적 변화

☃ behavior and cognitive therapies (2) biological therapies are effective for certain
§ behavior therapy: therapist works with clients disorders
- biological therapy: based on medical approaches
to illness and to disease 2. What are effective treatments for common
disorders?
☃ psychotropic medications
- psychotropic medications: drugs that affect (1) Anxiety and obsessive-compulsive disorders
mental processes and that can be used to treat are best treated with cognitive-behavioral therapy
psychological disorders - combination of cognitive and behavior therapies
-> change brain neurochemistry - anti-anxiety drugs
- categories of drugs: anti-anxiety drugs, -> side effects: short term, do little, addictive
antidepressants, mood stabilizers, antipsychotics, - cognitive-behavioral therapy (CBT)
stimulants
- comorbidity: 한 약으로 여러 분야?의 정신질환 치료 ☃ specific phobias
가능 - behavior techniques
- exposure: involves repeatedly exposing a client
☃ alternative treatments for extreme cases to an anxiety-producing stimulus or situation
- extreme treatment-resistant cases -> alternative and has the goal of reducing the client’s fear
biological treatment - systematic desensitization: exposing a client to
§ electroconvulsive therapy (ECT): involves increasingly anxiety-producing stimuli or
administering a strong electrical current to the situations while having the client relax at the
client’s brain to produce a seizure same time
- generally occurs under anesthesia -> make fear hierarchy
- effective for severe depression -> alternatives: 컴퓨터 시뮬레이션
§ transcranial magnetic stimulation (TMS): uses a - anti-anxiety drugs
magnetic field to interrupt function in specific -> 효과 끝나면 다시 공포 생성
regions of the brain - antidepressants
- interrupting the activity of neurons in that -> 부작용 있음
region - CBT is equally effective in treating social phobia
- successful in cases of depression
§ deep brain stimulation (DBS): involves passing ☃ panic disorder
electricity through electrodes planted in the - CBT -> 제일 좋음
client’s brain to stimulate the brain at a - cognitive restructuring: address ways of reacting
certain frequency and intensity to the symptoms of a panic attack 예를 들면 테
- severe obsessive-compulsive disorder (OCD) and 러가 일어날 것 같다는 불안감이 들 때 실제로 테러가
depression 일어날 확률은 얼마인지 알아보는 것
- break the connection between the trigger
(3) Scientific evidence indicates which treatments symptom and the resulting panic
are safe and effective
- randomized clinical trials -> hallmark of good ☃ obsessive-compulsive disorder
research - exposure and response prevention: teaches
clients to relax as they are gradually exposed to
(4) various providers assist in treatent for increasingly feared stimuli or situations,
psychological disorders - goal: break the conditioned link between a
- psychiatrists, clinical psychologists, counseling particular stimulus and a compulsive behavior
psychologists, psychiatric social workers, - cognitive therapy: cognitive restructuring
psychiatric nurses, paraprofessionals - exposure and response >>>> drug
- CBT : good - medications for schizophrenia also works for
- lobotomy bipolar disorder: quetiapine(drug: antipsychotic)
- lithium has side effects
(2) Many effective treatments are available for - CBT
depressive disorders
(4) antipsychotic medications are superior
☃ psychotropic drug treatment treatments for schizophrenia
- use drugs!! (antidepressants) (serotonin low -> ☃ psychotropic drug treatments
high) - early: conventional antipsychotics – 너무 부작용
- SSRI: fewest serious side effects, first line 이 많다. 파킨슨병 걸린 것같이 동작 제어 못함
medication (Tardive dyskinesia)
- tricyclics - now: atypical antipsychotics – 전의 부작용은 없는
☃ cognitive-behavioral treatment 데 seizures, heart rate problems, substantal
§ anti-depressant medications weight gain, fatal reduction in white blood cells
§ CBT: 생각하는 방향이 부정적일 때.. 그 생각하는 방 와 같은 부작용이 있음
식이 얼마나 잘못되었는지 깨닫게 하고 생각하는 다 ☃ behavior therapy
른 방식을 알려줌 -> 좋음: 오래 가고 부작용도 없다 - client have long-standing social problems
- social skill training: 감정 컨트롤, social cue알아차
☃ alternative treatments 리기, 행동의 결과 예상하기
§ Seasonal affective disorder - 인지과정을 바꾸거나 환청을 고치는 데에는 behavior
- phototherapy: client is exposed to high-intensity therapy 효과 없음
light each day
- regular aerobic exercise -> endorphins released ☃ prognosis in schizophrenia
- electroconvulsive therapy (ECT): severly - 빨리 질환 발견해서 적극적으로 치료하는 것이 중요하
depressed, works quickly 다. 그러나 나이가 들면 증상이 나아지긴 한다
-> 부작용: high relapse rate and memory - prognosis: a prediction of the likely course of a
impairments psychological disorder
-> 언어 담당하는 뇌 쪽으로 안사용하면 기억장애는 - prognosis of schizophrenia: depends on age,
거의 오지 않는다. gender and culture
- transcranial magnetic stimulation (TMS): left - 늦게 증상 발현된 사람, 여성, 가족간 유대관계가 더
frontal brain -> reduce depression 공고한 개발도상국 사람들이 더 나은 prognosis 받는
-> does not involve anesthesia, no side effects 다

☃ deep brain stimulation 3. can personality disorders be treated?

- Obsessive-compulsive disorder: DBS is good (뇌 - Cluster B: borderline personality disorder,
에다가 전극 박는거) antisocial personality disorder
-> 단기간에 엄청난 효과
-> 장기간 효력 지속됨 (1) Dialectical behavior therapy is most successful
for borderline personality disorder
(3) psychotropic medications are most effective for - 고치기 힘들다
bipolar disorders - Marsha Linehan
- bipolar disorders -> 정확한 치료법이 있다! - “radical acceptance”: 자기 자신을 있는 그대로 수용
- psychotropic medications -> mood stabilizer - dialectical behavior therapy (DBT): form of
lithium therapy used to treat borderline personality
- SSRI antidepressant for biopolar Ⅱ disorder disorder
§ DBT의 3단계 -> SSRI + CBT: 제일 효과 좋음
- therapist targets the client’s most extreme and
dysfunctional behaviors -> client learns problem ☃ further thoughts on treatment approaches
solving techniques -> then, client can control - SSRI: benefit > risk
attention -> replace the behavior with less - suicide rate decreased after using SSRI
destructive ones - SSRI 과다복용 -> 자살 부추김 => “start low, go
- explore past traumatic experiences = root of slow”
his/her problem - 왠만하면 CBT 받을 수 있게 하자
- develop self-respect and independent problem
solvinig -> 매우 중요 + 환자들은 주위 사람들의 지 (2) children with ADHD can benefit from various
지를 매우 필요로 한다 approaches
- DBT 이후 환자의 prognosis가 나아질 수 있다 ● neuro-developmental disorder -> ADHD ->
- SSRI가 같이 사용되기도 한다, psychotropic medication(stimulants),
behavior(operant procedures)
(2) Antisocial personality disorder is extremely
difficult to treat ☃ psychotropic medication treatment of ADHD
- 정말 힘들다. 환자가 치료사를 가지고 놀려고 한다. § central nervous system stimulant:
- APD 환자: have diminished cortical arousal methylphenidate (Ritalin) or Adderall
-> 따라서 약이 아아주~ 약간 효과가 있긴 함, 장기적 - decrease overactivity and distractibility
으로는 아님 - attention and concentration
- operant procedures: use reinforcers to increase - small increase in positive behaviors, large
desirable behaviors (hospitalization 필요) decrease in negative behaviors
- prognosis of APD client is poor - drawback: sleep problems, reduced appetite,
- APD: 40세 이후로 좀 나아짐.. 반사회적 행위만.. 그 body twitches, temporary slowing of growth, 단기간
외 특징은 안바뀜(자기중심적, ....) 만 효과지속
- 사이코패스들은 40세 이후에도 잘 안바뀜 - drug abuse: 정말 조심해야 한다.
- medication + psychological therapies (behavior
4. How can disorders be treated in children and modification) -> 가장 이상적인 치료조합
adolescents?
- 일찍 치료 시작해야 함 ☃ behavior therapy for ADHD
- psychotropic medication, cognitive and behavior - operant procedures
therapy approaches 효과적임 - 처음에는 약물복용과 병행하다가 시간이 지날수록 약
은 줄이고 행동치료 중심으로 치료한다.
(1) Using medication to treat depression in
adolescents is controversial (3) Children with autism spectrum disorder benefit
● major depressive disorder -> psychotropic from structured behavior therapy
medications (antidepressants), ● behavior therapies (applied behavioral analysis)
cognitive-behavioral (changing negatie thoughts - generalization of skills, structured therapy -> 필
associated with depression) 요

☃ risks of antidepressants for adolescents ☃ behavior therapy for autism

- SSRI: 애들한테 안전할까? 자살충동을 부추기지는 않 - applied behavioral analysis: based on operant
을까? conditioning
-> effective in treating adolescent depression, 자 -> 권장되는 행동에 칭찬과 같은 보상이 따라옴
살충동도 줄임 - 일찍 치료할수록 효과가 좋다
- 일주일에 40시간 이상은 치료를 받아야 한다.
- 언어능력이 있는 아이들에게 더 큰 효과
- 단점: 시간 너무 많이 써야 함 -> 부모 부담 큼

☃ biological treatment for autism spectrum

disorder
- 뇌의 문제로 자폐증이 생긴 것이니.. 약물을 써보려 했
지만.. 아직까지는 알아낸 것이 별로 없다.

☃ prognosis
- long-term prognosis is poor
- 그래도 치료하면 많이 나아진다

☃ a case study of childhood autism spectrum

disorder
- James O’Neil
- 어렸을 때 많은 손해? 부담? 감안하고 치료 시작해서
일반 학교에서 수업을 듣고 친구를 사귈 수 있을 정도
로 많이 나아졌다