Lecture Notes: Chapter 17 and Course Overview

Introduction

• Last lecture before the final exam.
• Wrap up Chapter 17, review game, Q&A session.

Therapy and Treatment Insights

Efficacy of Different Therapies

• Prior meta-analysis: Little difference between therapy types.
• New meta-analysis: CBT vs. generic counseling
  • Sample size: 30,000 people.
  • CBT: 60% recovery rate; Generic counseling: 40% recovery rate.
  • Significant advantage noted after 18 sessions.

Variables Influencing Therapy Success

• Common Factors in Therapy
  • Faith in therapist, plausible explanation for problems, alternative perspectives, protective setting, practice new behaviors, increase optimism/self-efficacy.
• Client Factors
  • Openness to therapy, self-relatedness, dose-response effect (benefit per therapy session).

Eclectic Therapeutic Approach

• Most therapists integrate multiple techniques (eclectic approach).

Specific Study Mentioned

• Behavioral activation vs. cognitive therapy vs. drug therapy.
• Note on attrition rates: 44% in drug condition.

Biological Approaches to Treatment

Drug Therapies

• Anti-Anxiety Drugs

  • Benzodiazepines (e.g., Xanax, Valium) increase GABA transmission.
  • Effective short-term; highly addictive.

• Antidepressants

  • MAO inhibitors: Prevent breakdown of neurotransmitters.
  • SSRIs: Inhibit serotonin reuptake; increase serotonin transmission.
  • Efficacy: Modest improvement over placebos, especially for severe depression.
  • Concerns: Side effects including sexual dysfunction.

• Antipsychotics

  • Used for schizophrenia; reduce dopamine transmission.
  • Side effect: Tardive dyskinesia (motor issues).

Electroconvulsive Therapy (ECT)

• Used for treatment-resistant depression.
• Involves induced seizures; effective but risks amnesia.

Psychosurgery

• Rarely used; includes procedures like prefrontal lobotomy.
• Historical context mentioned (e.g., JFK's sister).

Prevention and Future Directions

• Deinstitutionalization: Challenges of reintegrating patients.
• Prevention
  • Situation-focused: Environmental causes (e.g., poverty).
  • Competency-focused: Teaching coping mechanisms.

Final Exam Information

• Final exam format: 70 multiple-choice questions.
  • 30 questions from initial chapters and 40 from Chapters 16 and 17.
  • Focus on big ideas from early chapters.

Concluding Remarks

• Psychology as a work in progress; skepticism encouraged.
• Reminder of the fallibility of human endeavors.

Q&A Highlights

• Bipolar Disorder: Difference between Type 1 and 2.
• Schizophrenia: Type 1 vs. Type 2 symptoms.
• Exposure Therapy: Systematic desensitization vs. exposure response.
• Biomarkers for Alzheimer's: Amyloid plaques and neurofibrillary tangles.
• Gestalt Therapy: Focus on integration of experiences.
• Exam Preparation: Focus on key terms and concepts from all chapters.