Abnormal Psych Essay 1 PDF

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The two predominant theoretical approaches for understanding and treating mental disorders are currently the biological and the cognitive-behavioural paradigms. “Biological theories have primarily implicated dysfunctions in or damage to the brain, problems of control of one or another peripheral nervous system, or malfunctioning of the endocrine system” (Dozios, 2015, p. 28). The biological theoretical approach treats patients pharmaceutically. Alternatively, cognitive-behavioural theorist believe that thoughts and behaviours are learned from our environments. Because these theorists believe that maladaptive thoughts and behaviours are learned, they also believe they can be unlearned. Both approaches have been used to treat General Anxiety Disorder (GAD), and Major Depressive Disorder (MDD). This essay will demonstrate that there are strengths and weaknesses to using either a cognitive-behavioural or biological theoretical approach for treating and understanding these two specific disorders, however, cognitive-behavioural therapy has had a greater long-term success rate. One of the beliefs that biological theorists hold is that disruptions in the neurotransmitter system may be linked to the onset of both GAD and MDD. According to the textbook Abnormal Psychology: Perspectives (2015) these disruptions can occur in several ways: (1) there may be too much or too little of the neurotransmitter produced or released into the synapse; (2) there may be too few or too many receptors on the dendrites; (3) there may be an excess or a deficit in the amount of the transmitter-deactivating substance in the synapse; or (4) the reuptake process may be too rapid or too slow. (p. 29) In line with the belief that there is a medical start to these two disorders, clinicians first line of defense in their treatment is the use of pharmaceutical drugs.

Some of the pharmaceuticals that are used to treat GAD and MDD include: Monoamine Oxidase Inhibitors (MAOIs), Tricyclics (TCAs), Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-norepinephrine Reuptake Inhibitors (SNRIs) and Benzodiazepines. There are several strengths associated with the biological approach to understanding and treating mental disorders: they have been proven to be effective in the treatment of MDD and GAD symptoms, and they work relatively quickly. Benzodiazepines are frequently used to treat GAD and effectively reduce symptoms by 65 to 70 percent in the short term (Dozios, 2015, p.123). When it comes to using anti-depressants to treat MDD, a review of controlled trials has shown that of the patients who successfully completed a trial of any antidepressant 50-70 percent of them responded to treatment (Dozios, 2015, p. 193). Patients who have been prescribed medication can expect to see symptom relief within 4-6 weeks. Currently, there is a new antidepressant available (venlafaxine hydrochloride) that has shown to be effective in treating GAD and with few side effects. Another advantage to this approach is to consider the stigma that is attached to the label mental illness. Individuals can find it reassuring to hear “it’s not your fault”, that in fact their behaviour has a biological/medical cause that can be helped by medical treatment. While there are strengths associated with this approach there are also weaknesses. Adverse side effects are one weakness that is associated with prescribing medication to treat GAD and MDD. An example of this can be seen in Carlos from Case Study #5 in our supplementary text. Side-effects from the drugs being prescribed to him left Carlos feeling defeated, and still feeling depressed. After being hospitalized for three weeks, doctors finally found a combination of drugs that were tolerable for him. Side effects of drugs used to treat GAD and MDD can vary from weight gain, dry mouth, and constipation to digestive and

cardiovascular issues. Another serious weakness associated with prescribing medication alone, to treat GAD or MDD, is that the relapse rate is high. “a recent survey of 119 psychiatrists in clinical practice treating depressed patients with SSRIs found that most (89 percent) observed the return of depressive symptoms after a favourable SSRI response, despite continued treatment” (Dozios, 2015, p. 193). Furthermore, when a patient is told the cause is biological they may lose a sense of control when it comes to the treatment and recovery of their disorder. Cognitive behavioural theorists, on the other hand, posit that thinking and behaviour are learned through our experiences and maintained in the same way that behaviour is. Therefore, therapy revolves around working with a client to change their maladaptive thinking. If this thinking can be monitored, and changed, the client should see the behavioural and emotional results they hope to see. The goal of cognitive-behavioural therapy “is to teach people to become aware of the meanings of and attributions to events in their lives, and to examine how these cognitions contribute to the emotional reactions that follow” (Dozios, 2015, p. 190). Some of the treatment strategies used in CBT are: activity scheduling, thought records, behavioural experiments, cognitive restructuring, exposure techniques, and problem solving. In contrast to the biological approach, the main strengths of the cognitive behavioural paradigm is that there are no side effects and the success rates of patients appear to be long term. For example: when researchers followed up, one or two years later, on patients who had responded successfully to CBT they had a significantly lower relapse rate compared to those who had responded to antidepressant medication. This was true in Carlos’ case as well. After 18 months of CBT, he was completely off his medications and feeling as if the dark cloud that had been hanging over his head had finally been lifted. CBT is now the choice treatment for GAD

and mild forms of MDD. When MDD is more aggressive and persistent, medication paired with CBT is encouraged. The downside to CBT is that there is a commitment to treatment, by clients, that needs to be made to reach the recovery stage. Unlike the biological approach, treatment time for CBT is typically 16-20 sessions. Another weakness, as mentioned previously, is the stigma attached to psychological treatment. If we refer again, back to Carlos, his psychiatrist initially suggested CBT but Carlos declined hoping to stick with medication alone. It is implied that the reason for his decline to psychotherapy was his fear of becoming like his sister who had schizophrenia. The stigma attached to therapy deterred him from seeking CBT. “The national mental health survey reported that only 32 percent of individuals with mental health problems had contact with a health care professional in the past year” (Dozios, 2015, p. 125). As stated before, there are strengths and weaknesses associated with using either a cognitive-behavioural or biological approach to understanding and treating mental disorders. Both paradigms are effective in relieving patients of their symptoms, however, based on results CBT success rates seem to be longer lasting. Neither one of these approaches should be discounted but it is important to remember that to accept a single-factor explanation for any disorder, for example: strictly biological, is discounting just how incredible human behaviour is. In all its complexity, it is unlikely that human behaviour is the product of a single defect or experience (Dozois, 2015, p. 25).

Reference: Dozois, D. J. (2015). Abnormal psychology: Perspectives (5th ed.). North York, Ontario: Pearson Canada. Gorenstein, E.E., and Comer, R. J. (2015). Abnormal Psychology Online Course Psyc 2490 (2nd ed.). New York, NY: Worth Publishers....