3Defining Psychological Disorders Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions.When behavior is unjustifiable (not rational), maladaptive, atypical (violates the norm), and disturbing psychiatrists and psychologists label it as disordered.Remember: U-MADOBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.
4Medical PerspectivePhilippe Pinel ( ) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. He suggested humane treatment.“Lunatic Ball”
5Biopsychosocial Perspective Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders.
6Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders.The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to the 60 identified in the 1950s.OBJECTIVE 3| Describe the goals and content of the DSM-IV.
7Goals of DSMDescribe (400) disorders.Determine how prevalent the disorder is.Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar. Also, insurance companies usually require a firm diagnosis to cover health care costs.Others criticize DSM-IV for classifying almost anything as a disorder/syndrome.
8Anxiety DisordersFeelings of excessive apprehension and anxiety that cause distress or cause maladaptive behaviors to reduce the levels of stress.Generalized anxiety disorders (GAD)PhobiasPanic disordersObsessive-compulsive disorders (OCD)Post-Traumatic Stress Disorder (PTSD)OBJECTIVE 5| Define anxiety disorder, and explain how this condition differs from normal feelings of stress, tension, or uneasiness.
9Generalized Anxiety Disorder (G.A.D) Disorder characterized by persistent and uncontrollable tenseness and apprehension (worrying).2. Autonomic arousal.Inability to identify or avoid thecause of certain feelings.OBJECTIVE 6| Contrast the symptoms of generalized anxiety disorder and panic disorder.Must have at least three of the following:- Restlessness- Feeling on edge- Difficulty concentrating/mind going blank- Irritability- Muscle Tension- Sleep Disturbance
10Panic Attack DisorderMinute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations.Anxiety is a major component of panic attack disorder, making people avoid situations that cause it. Panic Attack disorder and agoraphobia (fear of open/public places) usually go together.
11PhobiasPhobias are marked by a persistent and irrational fear of an object or situation that disrupts behavior.Agoraphobia –fear of open places(only phobia listed in the DSM)OBJECTIVE 7| Explain how a phobia differs from fears we all experience.
12Obsessive-Compulsive Disorder (O.C. D.) Persistence of unwanted thoughts (obsessions) and urges/behaviors (compulsions) to engage in senseless rituals that cause distress.OBJECTIVE 8| Describe the symptoms of obsessive-compulsive disorder.
13Post-Traumatic Stress Disorder (P.T.S. D.) Often caused by severely threatening uncontrollable events. Four or more weeks of the following symptoms constitute Post-Traumatic Stress Disorder:Haunting memories (flashbacks)2. Nightmares3. Social withdrawal (uncommon anger orsubstance abuse)OBJECTIVE 9| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.4. Jumpy anxiety5. Sleep problems (insomnia)
15Explaining Anxiety Disorders Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.OBJECTIVE 10| Discuss the contributions of the learning and biological perspectives to our understanding of the development of anxiety disorders.
16The Learning Perspective Learning theorists suggest that (classical) conditioning leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced (operant).Investigators believe that fear responses can be passed along to others through observational learning (modeling).
17The Biological Perspective Natural Selection has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species. Perhaps it’s part of Jung’s collective unconscious?Twin studies suggest that our genes may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias.
18The Biological Perspective A PET scan of the brain of a person with Obsessive-Compulsive Disorder (OCD). High metabolic activity (red) in the frontal lobe areas are involved with directing attention.Too little of the neurotransmitter Serotonin can also contribute to anxiety disorders
19Dissociative Disorders Usually nurture-based where conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings..Depersonalization DisorderHaving a sense of being unreal.OBJECTIVE 11| Describe the symptoms of dissociative disorders, and explain why some critics are skeptical about dissociative identity disorder.2. Being separated from the body.3. Watching yourself as if in a movie.
20Other Dissociative Disorders Dissociative Amnesia – amnesia caused by some kind of trauma (not by injury). For example, soldiers in combat.Dissociative Fugue (flight) – Person totally forgets who they are and may develop a completely new identity, personality, etc. in a new place.Like “witnessprotection”from yourself!
21Dissociative Identity Disorder (D.I.D.) Formerly called Multiple Personality Disorder (MPD), it is a disorder in which a person exhibits two or more distinct and alternating personalities(each with its own name, voice, mannerisms, occupations, etc).Chris Sizemore, the basis for themovie The Three Faces of Eve
22Emotional extremes of mood disorders come in two principal forms. Major depressive disorderBipolar disordersOBJECTIVE 12| Define mood disorders, and contrast major depressive disorder and bipolar disorder.
23Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions.5 of the following:(at least one of which has to be depressed mood or loss of interest/pleasure)depressed moodloss of interest/pleasureweight lossinsomnia/hypersomniapsychomotor agitation/retardationloss of energy/fatiguefeelings of worthlessness/guiltdecreased concentrationsuicidal ideation/thoughts of death.
24Dysthymic DisorderDysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by mild daily depression lasting two years or more with two or more of the following symptoms:Major DepressiveDisorderBlueMoodDysthymicpoor appetite/overeatinginsomnia/hypersomniafatigue/low energylow self-esteemdecreased concentrationhopelessness
25Bipolar DisorderFormerly called Manic-Depressive Disorder, it is an alternation between depression and mania(highs & lows).Depressive SymptomsManic SymptomsGloomyElationWithdrawnEuphoriaInability to make decisionsDesire for actionTiredHyperactiveSlowness of thoughtMultiple ideas
26Bipolar DisorderMany great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase.WhitmanWolfeClemensHemingway
27Explaining Mood Disorders Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it.Lewinsohn notes that a theory of depression should explain the following:Behavioral and cognitive changesCommon causes of depressionGender differencesDepressive episodes usually self-terminate.Depression is increasing, especially in the teensOBJECTIVE 13| Discuss the facts that an acceptable theory of depression must explain.
28SuicideThe most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide.
30Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%).Linkage analysis and association studies link possible genes and dispositions for depression.OBJECTIVE 14| Summarize the contribution of the biological perspective to the study of depression, and discuss the link between suicide and depression.
31Biological Perspective Neurotransmitters: A reduction of norepinephrine and serotonin has been found in depression.Drugs that alleviate mania reduce norepinephrine.Pre-synapticNeuronSerotoninNorepinephrinePost-synapticNeuron
32Biological Perspective PET scans show that brain energy consumption rises and falls with manic and depressive episodes.
33Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.OBJECTIVE 15| Summarize the contribution of the social-cognitive perspective to the study of depression, and describe the events in the cycle of depression.
34Depression Cycle Negative stressful events. Pessimistic explanatory style.Hopeless depressed state.These hamper the way the individual thinks and acts, fueling personal rejection.
35Explanatory style plays a major role in becoming depressed.
36Psychotic Disorders Schizophrenia Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease.Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women.
37Symptoms of Schizophrenia The literal translation is “split mind” but is not the same as DID. Schizophrenia is a group of severe disorders characterized by the following:Disorganized (word salad) & delusional thinking.Disturbed perceptions (hallucinations).Inappropriate emotions & actions.OBJECTIVE 16| Describe the symptoms of schizophrenia, and differentiate delusion and hallucinations.John Nash
38Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”This monologue illustrates fragmented, bizarre thinking with distorted beliefs (usually of grandeur or persecution) called delusions (“I’m Mary Poppins”). It also demonstrates a principle called “word salad” (jumbling up ideas in sentences).Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”).
39Disturbed Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual or tactile.
40Inappropriate Emotions & Actions A schizophrenic person may laugh at the news of someone dying or show no emotion at all (apathy/flat affect).Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).
41Subtypes of Schizophrenia Schizophrenia is a cluster of disorders. These subtypes share some features, but there are other symptoms that differentiate these subtypes.OBJECTIVE 17| Distinguish the five subtypes of schizophrenia, and contrast chronic and reactive schizophrenia.
42Positive and Negative Symptoms Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (positive symptoms - inward).Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals (negative symptoms - outward).
43Chronic and Acute Schizophrenia When schizophrenia is slow to develop (chronic/process) recovery is doubtful.Such schizophrenics usually display negative (outward) symptoms.When schizophrenia rapidly develops (acute/reactive) recovery is better.Such schizophrenics usually show positive (inward) symptoms .
45Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.Brain AbnormalitiesDopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.OBJECTIVE 18| Outline some abnormal brain functions and structures associated with schizophrenia, and discuss the possible link between prenatal viral infections and schizophrenia.
46Abnormal Brain Activity, Etc. Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.
47Pre-natal/Neo-natal development Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.There is also evidence of people who suffered from oxygen deprivation at birth and/or poor fetal nutrition may also have higher rates of schizophrenia.Malnutrition, methamphetamine and cocaine abuse, and social conditions (urban life, racial discrimination, adversity and family dysfunction) have also been contributed to the development of the disorder.
48Genetic FactorsThe likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease.IdenticalBoth parentsFraternalOne parentSiblingNephew or nieceUnrelatedOBJECTIVE 19| Discuss the evidence for a genetic contribution to the development of schizophrenia.
49Early warning signs of schizophrenia include: 1.A mother’s long lasting schizophrenia.2.Birth complications, oxygen deprivation and low-birth weight.3.Short attention span and poor muscle coordination.4.Disruptive and withdrawn behavior.5.Emotional unpredictability.6.Poor peer relations and solo play.
50Personality Disorders Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning.They are usually without anxiety, depression, or delusions.OBJECTIVE 21| Contrast the three clusters of personality disorders, and describe the behaviors and brain activity associated with antisocial personality disorders.
51Some Personality Disorders Some Personality DisordersAvoidant Personality Disorder – the person commonlywithdraws due to fear of rejectionNarcissistic Personality Disorder – the person is very self-absorbed and have delusions of grandeurBorderline Personality Disorder – the person has unstable emotions and relationships and ultimately an unstable identityAntisocial Personality Disorder – the person (usually male) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath.Dependent Personality Disorder – the person is abnormally dependent on other people
52Understanding Antisocial Personality Disorder Like mood disorders and schizophrenia, antisocial personality disorder has biological and psychological reasons. Youngsters, before committing a crime, respond with lower levels of stress hormones than others do at their age.
53Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat offenders had 11% less frontal lobe activity compared to non-murders.NormalMurderer
54Understanding Antisocial Personality Disorder The likelihood that one will commit a crime doubles when childhood poverty is compounded with obstetrical complications.
55Somatoform Disorders Disorders that usually involve abnormal bodily sensation or body image:Hypochondriasis – fear of or believingthat you have illnesses that you don’t really haveConversion Disorder – developing physical symptoms without an actual biological causeBody Dysmorphic Disorder – belief that oneor more of the features/parts of your bodyare abnormal/grotesque and need to be fixed
56Childhood Disorders Attention-Deficit Hyperactivity Disorder (ADHD) 3 key symptomsInattentionHyperactivityImpulsivityThe Big Questions:Is it over diagnosed?Is it a real syndrome at all?How can it be better diagnosed?What causes it?
57Childhood Disorders Autistic Disorders Asperger syndrome Key symptoms Impaired speech or developmentImpaired social interaction (such as decreased eye contact and inability to carry on a conversation)Impaired theory of mind (understanding of others’ point of view)Behaviorally inflexible – stick to routine; distress when it changesTends to occur more in males than in femalesAsperger syndrome“high functioning” form of autism with normal (or high) levels of intelligence and possible savant syndromeyet with decreased social functioningPossible Causes?Differences/damage in the brain’sneural connections?Genetic Factors?Mercury in Vaccines?
58Other DisordersTic Disorders – facial tics, blurted out words or soundsTourette’s SyndromeFactitious Disorders – disorders in which the person fakes symptoms or inflicts symptoms on self or others to gain attention/sympathy (malingering = sickness forpersonal or monetary gain)Munchausen Syndrome – person claims to have symptoms and undergoes many treatments/surgeries to receive attentionMunchausen Syndrome by Proxy – person induces illnesses in others (usually parents do this to kids) to receive indirect attentionCauses? Perhaps person was given great care by a doctor growing up and neglected by parents? Other, underlying personality disorders?
60History of Insane Treatment Maltreatment of the insane throughout the ages was the result of irrational views. Many patients were subjected to strange, debilitating, and downright dangerous treatments.
61History of Insane Treatment Philippe Pinel in France and Dorthea Dix in America founded humane movements to care for the mentally sick.Philippe Pinel ( )Dorthea Dix ( )
62TherapiesPsychotherapy involves an emotionally charged, confiding interaction between a trained therapist and a mental patient.Biomedical therapy uses drugs or other procedures that act on the patient’s nervous system, curing him or her of psychological disorders.OBJECTIVE 1| Contrast psychotherapy and the biomedical therapies, and explain how an eclectic approach or psychotherapy integration varies from either of these two main forms of therapy.An eclectic approach uses various forms of healing techniques depending upon the client’s unique problems.
63Psychological Therapies We will look at four major forms of psychotherapies based on different theories of human nature:Psychoanalytical theoryHumanistic theoryBehavioral theoryCognitive theoryOBJECTIVE 2| Define psychoanalysis, and discuss the aims of this form of therapy.
64Psychoanalytic Therapy The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud.Sigmund Freud's famous couch
65PsychoanalysisSince psychological problems originate from childhood repressed impulses and conflicts, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them.When energy devoted to id-ego-superego conflicts is released, the patient’s anxiety lessens.
66PsychoanalysisFreud developed the method of free association to unravel the unconscious mind and its conflicts. The patient lies on a couch and speaks about whatever comes to his or her mind.OBJECTIVE 3| Describe some of the methods used in psychoanalysis, and list some criticisms of this form of therapy.
67Psychoanalysis Criticism During free association, the patient edits histhoughts, resisting his or her feelings toexpress emotions. Such resistance becomesimportant in the analysis of conflict-drivenanxiety. Eventually the patient opens up andreveals his or her innermost privatethoughts, developing positive or negativefeelings (transference) towards the therapist.Psychoanalysis is hard to refute because it cannot be proven or disproven.Psychoanalysis takes a long time and is very expensive.
68Humanistic TherapyHumanistic therapists aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.Unlike psychodynamic therapies,humanistic therapies focus onThe present and future, not past conflictsConscious issues not unconscious conflictsTaking responsibility for one’s feelings and behaviors,not finding what is hiddenPromoting individual growth, not curing illnesses- Person in therapy called client (not patient)OBJECTIVE 5| Identify the basic characteristics of the humanistic therapies, and describe the specific goals and techniques of Carl Rogers’ client-centered therapy.
69Humanistic TherapyDeveloped by Carl Rogers, person-centered therapy is a form of humanistic therapy.The therapist listens to the needs of the patient in an accepting and non-judgmental way (unconditional positive regard) , addressing problems in a productive way and building his or her self-esteem. Therapist also demonstrates empathy and genuineness.
70Humanistic TherapyThe therapist engages in active listening and echoes, restates, and clarifies the patient’s thinking, acknowledging expressed feelings.
71Behavior TherapyTherapy that applies learning principles to the elimination of unwanted behaviors.To treat phobias or sexual disorders, behavior therapists do not delve deeply below the surface looking for inner causes.OBJECTIVE 6| Explain how the basic assumption of behavior therapy differs from those of traditional psychoanalytic and humanistic therapies.
72Behavior TherapyExposure therapy involves exposing people to fear-driving objects in real or virtual environments.
73Behavior TherapySystematic Desensitization (Counter-conditioning) is a type of exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli (commonly used to treat phobias).
74Behavior TherapyOperant conditioning procedures enable therapists to use behavior modification, in which desired behaviors are rewarded and undesired behaviors are either unrewarded or punished.A number of withdrawn, uncommunicative year-old autistic children have been successfully trained by giving and withdrawing reinforcements for desired and undesired behaviors.OBJECTIVE 8| State the main premise of therapy based on operant conditioning principles, and describe the views of proponents and critics of behavior modification.
75Aversion TherapyAversive Conditioning is a type of counterconditioning that associates an unpleasant state with an unwanted behavior. With this technique, temporary conditioned aversion to alcohol has been reported (but doesn’t seem to work long-term).
76Behavior TherapyTherapists may create a token economy in which patients exchange a token of some sort(usually a secondary reinforcer), earned for exhibiting the desired behavior, for various privileges or treats(perhaps a primary reinforcer). It’s often used by parents and teachers.
77Behavior Therapy Criticisms Will the desired behaviors continue and/or undesirable behaviors come back when the training/reinforcement stops?Is it really ethical for one human being to “train” another?
78Cognitive TherapyTeaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions.
79Cognitive TherapyRational-Emotive Therapy - Albert Ellis developed a theory that irrational thoughts led to self-defeating emotions.Ellis developed the ABCD model to explain this:A = Activating event that triggers the emotion (e.g. failing a test)B = Belief System: how person appraises the event (e.g. “I’m stupid and no good at this subject”)C = emotional/behavioral Consequences of the appraisal in step B (e.g. feeling worthless and dumb)D = Disputing their erroneous beliefs in step B (e.g. “I’m not dumb. I just did not study hard enough and go in for the extra help that I needed”) This is what Ellis wanted to train his clients to be able to do through Rational Emotive Therapy.Therapists present common irrational beliefs to clients and help to train them to cognitively restructure/reappraise their thinking.
80Cognitive TherapyCognitive therapists often combine the reversal of self-defeated thinking with efforts to modify behavior.Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy).AP Psych Rocks!
81Group & Family TherapyGroup therapy normally consists of 6-9 people attending a 90-minute session that can help more people and costs less. Clients benefit from knowing others have similar problems.Family therapy treats the family as a system. Therapy guides family members toward positive relationships and improved communication. Marriage counseling is a form of this.OBJECTIVE 10| Discuss the rationale and benefits of group therapy, including family therapy.
82Effectiveness of Different Therapies Which psychotherapy would be most effective for treating a particular problem?DisorderTherapyDepressionBehavioral, Cognitive, InterpersonalAnxietyCognitive, Exposure, Stress InoculationBulimiaCognitive-behavioralPhobiaBehavioralBad HabitsBehavior ModificationOBJECTIVE 14| Summarize the findings on which psychotherapies are most effective for specific disorders.
83Alternative Therapies Seasonal Affective Disorder (SAD), a form of depression, has been effectively treated by light exposure therapy.
84Clinical psychologists: Therapists & TrainingClinical psychologists:They have PhDs mostly. They are experts in research, assessment, and therapy, all of which is verified through a supervised internship.Clinical or Psychiatric Social Worker:They have a Masters of Social Work. Postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems.
85Therapists & Training Counselors: Pastoral counselors or abuse counselors work with problems arising from family relations, spouse and child abusers and their victims, and substance abusers.Psychiatrists:They are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have extensive training in psychotherapy, but as MDs they can prescribe medications.
86The Biomedical Therapies These include physical, medicinal, and other forms of biological therapies.Drug TreatmentsSurgeryElectric-shock therapy
87Psychopharmacology is the study of drug effects on mind and behavior. Drug TherapiesPsychopharmacology is the study of drug effects on mind and behavior.With the advent of drugs, hospitalization in mental institutions has rapidly declined.OBJECTIVE 18| Define psychopharmacology, and explain how double-blind studies help researchers evaluate a drug’s effectiveness.However, many patients are left homeless on the streets due to their ill-preparedness to cope independently outside in society.
88Classical antipsychotics: Antipsychotic DrugsClassical antipsychotics:(Thorazine)Remove a number of positive symptoms (inward) associated with schizophrenia such as agitation, delusions, and hallucinations.Atypical antipsychotics:(Clozapine & Risperdal)Remove negative symptoms (outward)associated with schizophrenia such as apathy, jumbled thoughts, concentration difficulties, and difficulties in interacting with others.OBJECTIVE 19| Describe the characteristics of antipsychotic drugs, and discuss their use in treating specific disorders.
89Atypical Antipsychotic Clozapine (Clozaril) blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia.Antianxiety DrugsAntianxiety drugs (Xanax and Ativan) depress the central nervous system and reduce anxiety and tension by elevating the levels of the Gamma-aminobutyric acid (GABA) neurotransmitter.
90Mood-Stabilizing Medications Antidepressant DrugsAntidepressant drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake.Mood-Stabilizing MedicationsOBJECTIVE 20| Describe the characteristics of antianxiety drugs, and discuss their use in treating specific disorders.Lithium Carbonate, a common salt, has been used to stabilize manic episodes in bipolar disorders. It moderates the levels of norepinephrine and glutamate neurotransmitters.
91Electroconvulsive Therapy (ECT) Brain StimulationElectroconvulsive Therapy (ECT)ECT is used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression.OBJECTIVE 23| Describe the use of electroconvulsive therapy (ECT) in treating severe depression, and describe some possible alternatives to ECT.
92PsychosurgeryPsychosurgery was popular even in Neolithic times. Although used sparingly today, about200 such operations do take place in the US alone. Psychosurgery (trephination/lobotomy) is used as a last resort in alleviating psychological disturbances. Removal of brain tissue changes the mind and psychosurgery is irreversibleOBJECTIVE 24| Summarize the history of the psychosurgical procedure known as lobotomy, and discuss the use of psychosurgery today.
93Rosemary Kennedy’s Lobotomy We went through the top of the head, I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch." The instrument Dr. Watts used looked like a butter knife. He swung it up and down to cut brain tissue. "We put an instrument inside," he said. As Dr. Watts cut, Dr. Freeman put questions to Rosemary. For example, he asked her to recite the Lord's Prayer or sing "God Bless America" or count backwards. ... "We made an estimate on how far to cut based on how she responded." ... When she began to become incoherent, they stopped. —James W. Watts