Showing posts with label Science. Show all posts
Showing posts with label Science. Show all posts

Tuesday, April 28, 2009

Treating OCD...what works and wat doesn't

The anxiety disorder known as obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, neurotic behaviors that one is compelled to perform without reason. OCD causes the brain to focus on a particular thought or urge, such as hand washing, or checking the front door lock at night exactly 13 times.
The most effective treatment for obsessive-compulsive disorder would most narrowly be two-pronged; a combination of behavioral and cognitive therapy.
On the behavioral side, exposure and response prevention would involve the repeated exposure to the source of obsession, (the front door lock at night). Then, the afflicted would be asked to refrain from the compulsive behavior that would usually be performed. For example, as the patient sits next to their front door, anxiety-ridden, the urge to check the lock should theoretically go down. This shows the patient that they have control over their anxiety and can turn it off and on. Traditionally, behavioral therapy attempts to eliminate unwanted behaviors through classical conditioning, systematic desensitization, progressive relaxation, exposure therapy, flooding, aversive conditioning and/or operant conditioning.
The other prong of the therapy for OCD would come in the form of cognitive therapy. This therapy would attempt to eliminate irrational thoughts and create an awareness of negative thinking and words. It would assume that OCD focuses on scary thoughts of exaggerated situations, (for example, the idea that if the front door lock is not checked 13 times, a rapist/murderer will break into my home and slowly kill everyone that I love). A larger part of this therapy, however, focuses on teaching healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior. This comes about primarily from gentle questioning, which helps patients discover their irrational and maladaptive thoughts and change their views.
These two forms of therapy are clearly a superior combination, over their three counterparts of psychoanalytic therapy, humanistic therapy or family/group therapy.
Psychoanalytic therapy would not work because it states that the unconscious holds the key to everything and that childhood memories hold the key to everything. It uses free association, dream analysis and transference. However, none of these offer real solutions to fix the problem, nor are they scientifically-backed.
Humanistic therapy uses introspection and active listening to promote personal growth, genuineness, acceptance and empathy. However, that is not what an OCD patient needs¾ they are not having problems with their inner being, they just have something wrong with their brain. They are like a CD stuck on repeat, not a tortured soul that needs to be tamed.
Finally, family/group therapy would presumably be ineffective for people with OCD as well. This form of therapy aims demonstrate that patients are not alone in their problems and to share helpful hints with one another. However, this is still not what an OCD patient needs. Rather than hearing that ‘no person is an island,’ OCD patients need to be conditioned to not obsess on one minute thing.
Thus, the cocktail of the behavioral and cognitive therapies would be the most effective, because it tackles the issue of contorted thoughts and maladaptive behaviors.

Treating depression...what works and what doesn't

Although major depressive disorder is sometimes seen as a hopeless cause by the afflicted, proper treatment and therapy can really lead to decreased symptoms and lifted spirits.
Of the five major therapeutic categories, cognitive treatment is undoubtedly the most effective.

The cognitive behavioral theory of depression states that the patient’s excessive self-criticism and rejection is the root of the disorder. Cognitive therapy attempts to correct the negative thoughts and dysfunctional attitudes, therefore eliminating the patient’s pessimism and hopelessness.
The methods of cognitive therapy include gentle questioning, which helps them discover their irrational and maladaptive thoughts. In addition, homework assignments are given to break through the vicious cycle of depression (increased negative thinking leads to increased social isolation which in turn leads back to increased negative thinking).
It should be noted, though, that there are certainly cognitive critics. These people argue that the depressed patient’s pessimistic, negative thoughts are a result of their major depression, but not the cause. However, cognitive therapy triumphs over the other four major forms of therapy.
Psychoanalytic therapy does not work for major depressive disorder because it does not have any real roots in childhood, and even if it did, this form of therapy does not provide any real suggested treatments.
Humanistic therapy could also be effective in treating major depressive disorder. This form of therapy attempts to promote personal growth and acceptance through active listening and reflection. And while this type of introspection is important for the depressed patient, the therapy doesn’t offer any real solutions and takes too long to find a root cause; all the while the patient slumps into a deeper depression.
Because major depressive disorder is not generally a learned behavior, behavioral therapy is usually ineffective. Happiness cannot be classically conditioned through systematic desensitization, progressive relaxation, exposure therapy, flooding or aversive conditioning. Furthermore, operant conditioning does not work either, because the token economy technique does not work with something as abstract as joy.
Finally, the family/group therapy is not usually viewed as an effective therapy for major depressive disorder. Family therapy examines the role of the depressed member in the overall psychological well-being of the whole family and examines the role of the entire family in the maintenance of the depression. However, if someone in my family is diagnosed with depression, the chances that I am not already doing all that I can to help them is pretty slim; thus family therapy isn’t going to tell me anything I don’t already know and will provide few real solutions.
Therefore, the cognitive therapy clearly triumphs; it’s use of small steps to gradually (but still relatively rapidly) change thinking is clearly the way to go to see the most effective results.

Thursday, February 5, 2009

Eating disorders aren't only socially-rooted

If eating was just something that we did for fun, then yeah, eating disorders would be a choice. They would be something that people do just to be popular, 'lets just stop eating' and 'I don't need to eat today' would be common themes of high school conversation. But here's the thing, eating disorders are not just a fad or anything that people do for fun; they're real and they're a problem.
There are two main forms of eating disorders; anorexia and bulimia. Microsoft Student 2006 defines anorexia as:
Mental illness in which a person has an intense fear of gaining weight and a distorted perception of their weight and body shape. People with this illness believe themselves to be fat even when their weight is so low that their health is in danger. A person with anorexia nervosa severely restricts food intake and usually becomes extremely thin.

Similarly, Microsoft Student 2006 defined bulimia as:

An eating disorder in which persistent over concern with body weight and shape leads to repeated episodes of binging (consuming large amounts of food in a short time) associated with induced vomiting, use of laxatives, fasting, and/or excessive exercise to control weight.
Anyway, I got on this topic because in AP Psychology the other day, we were talking about eating disorders. Although our book came to no clear conclusion, my teacher did, and this was what made me mad. He decided that the root of all eating disorders was the need to belong and the desire to be popular. This made me so mad, however, I didn't express my ideas because I rarely speak up in that class.
He didn't even make mention of problems that are obviously going on psychologically. (And by the way, the Microsoft Student definition of anorexia, which calls it a 'mental illness' is out of date because the term was recently dropped.) I know for a fact that, while there are some people that have strange social motivations, not everyone conforms to our preconceived stereotype. It is ridiculous to believe that there is a social root to every problem, because removing them from the social atmosphere and placing them in one that everyone was obese would not solve the problem.
And the National Eating Disorders Association agrees; on their website they posted:
The National Eating Disorders Association (NEDA) is a non-profit organization dedicated to supporting individuals and families affected by eating disorders. We campaign for prevention, improved access to quality treatment, and increased research funding to better understand and treat eating disorders. We work with partners and volunteers to develop programs and tools to help everyone who seeks assistance.In 1999, NEDA established a toll-free helpline and has assisted more than 50,000 people find appropriate treatment. Tallying more than 50 million web hits each year, NEDA is proud to serve as a clearinghouse of information on eating disorders.

Questions PSA from NEDA on Vimeo.
Most just have issues within themselves that they need to work out, and they don't need people preaching to them about how being popular isn't everything while they are trying to get better. Thus, we need to change our mindsets before we expect the problem of eating disorders to resolve themselves.