Cognitive Therapies

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Cognitive Therapies

• Cognition is thinking Cognitive therapies are
  designed to change the patients thoughts.
• (REBT) Rational-emotive behavioral therapy
  (Albert Ellis)
• Irrational thoughts lead to negative emotions
• I must perform well to be approved of by others
  who are perceived significant
• You must treat me fairly-if not, then it is
  horrible and I cannot bear it
• Conditions must be my way and if not I cannot
  stand to live in such a terrible and awful world

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• (CBT) Cognitive-behavior therapy (Aaron Beck)
• Believed that depression and other mood disorders
  result primarily from negative self-talk and
  distorted perceptions of reality
• Blame their setbacks on personal inadequacies
• Focus only on negative events
• Makes pessimistic projections about the future
• Draw negative conclusions about their self-worth
  from insignificant events

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Biomedical Therapies

• Psychosurgery
• The lobotomy was devised to control the
  symptoms of schizophrenia by disconnection the
  frontal lobes from the rest of the brain.
• The surgery was often used abusively to control
  patients whether or not it was medically
  necessary
• At least 50,000 people
• Psychosurgery is now used more cautiously and
  often with much more success
• Cingulotomy consists of burning dime size holes
  in the frontal cortex of patients
• Epilepsy (Corpus Collosum)

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Drug Class Typical Brand Names Neurotransmitter/ Brain Structures Acted On Symptoms Controlled Side Effects
Antianxiety Valium, Xanax Librium Buspar GABA reduced, Sympathetic Nervous System Activity Reduced Decreases Nervousness, Promotes Sleepiness Dependence, Sleep Disturbances Nausea, Confusion
Antipsychotic Haldol, Mellaril, Thorazine, Resperidal Dopamine Reduced Serotonin Increased Decrease of Symptoms (delusions, hallucinations, lack of emotion) Sleepiness, Anxiety, Appetite Changes, Dry Mouth Motor Problems (Tardive Dyskinesia)
Antidepressant (SSRI) Prozac, Zoloft, Paxil, (Tricylics and MAO inhibitors) Elavil, Nardil Serotonin Increased Epinephrine/norepinephrine increased Increases Energy, Improves Sleep and Mood Appetite problems, weight gain/loss, dry mouth and nausea
Mood stabilizers Lithium, Valproate Glutamate Reduced Increases gray matter in cerebral cortex Reduces or eliminates episodes of mania Lithium is a toxic metal, blood levels must be monitored to prevent damage to internal organs (Kidney and Thyroid)
Stimulant Ritalin Increases Dopamine Levels Increases Attention and Ability to Focus Appetite Suppression, Sleep Disturbances, Slows Growth in Children
Anticonvulsant Phenobarbitol Reduces firing of cortical neurons Reduces Seizures Constipation, Nausea Mild Dizziness
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Critics to Drug Therapies

• Superficial Short lived
• Relapse when drugs are discontinued
• Damaging Side Effects
• Tardive Dyskinesia
• Addiction

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Electrical Therapies

• (ECT) Electroconvulsive therapy
• It remains in limited use and only with consent
  of the patient
• It is used for the treatment of serious
  depression
• (TMS) Transmagnetic cranial stimulation
• Magnets are used to disrupt briefly the firing of
  cortical neurons.
• It is painless and induces no serious side effect
• It appears to be as effective as ECT in causing
  remission of depressive symptoms