Abnormal Psychology

110 CHAPTER 4

A clinician might consider many different types of treatment for Leon’s

depression and anxiety, depending both on Leon’s specifi c symptoms and on the

type of treatment the clinician is trained to provide. Treatment for psychological

disorders is the use of a procedure or substance to reduce or eliminate psychological

problems or symptoms and/or improve quality of life.

Notice that the defi nition of treatment does not explicitly mention abnormal-

ity. In fact, many people who seek treatment do not have symptoms that warrant

a DSM-IV-TR diagnosis. They have problems in their relationships or work or are

struggling with a personal issue; they simply want to talk things through and receive

guidance and support. Because these sorts of problems are not “abnormal,” such

people, and their treatment, are not specifi cally discussed in this book.

As our defi nition implies, treatment has two possible goals: (1) to reduce or

eliminate specifi c symptoms, and/or (2) to improve the general quality of life. With

regard to the fi rst goal, successful treatment may reduce or eliminate some symp-

toms, but not necessarily all of them. A given treatment focuses on diminishing

particular symptoms, referred to as the target symptoms. For instance, in treating

Leon’s social anxiety, medications may target the physical symptoms of anxiety

(such as an increased heart rate when he thinks he must talk to others). Cognitive

techniques may target unrealistic and maladaptive thoughts about social interac-

tions (“I will be totally humiliated if I try to talk to someone at work”). Behavioral

techniques may target the physical symptoms as well as the avoidant behavior. Each

type of treatment targets specifi c symptoms, either by addressing the symptoms di-

rectly (for example, by using behavioral techniques) or by altering the factors that

give rise to the symptoms (for example, changing the levels of neurotransmitter sub-

stances). A given type of treatment may improve certain symptoms but not others.

What about the second goal of treatment? Treatment may also seek to improve

thequality of life—patients’ psychological, social, and material well-being (Gladis

et al., 1999). Researchers and clinicians recognize that health is not simply the

absence of disease, but is a state of having mental and social well- being (World

Health Organization, 1948). Research examining how treatment improves

patients’ quality of life asks whether their relationships with friends, relatives, and

coworkers have improved, whether the patients can take better care of themselves,

and whether they can function more fully in society (Abraham et al., 2006; Beasley

et al., 2006; Keyes, 2007).

Generally, clinicians who are trained to diagnose psychological disorders (see

Chapter 3) are also trained to treat such disorders. Mental health treatment may

take place in hospitals, psychiatric institutions, clinics, private offi ces, religious in-

stitutions, or, less frequently, in patients’ homes or workplaces. Who provides a par-

ticular patient’s treatment and where it is provided

depend on that patient’s health insurance coverage

and fi nances, the availability of appropriate treat-

ment within the patient’s community, and pos-

sibly the patient’s ability to travel in order to

obtain specialized treatment.

One way to categorize the treatments

themselves is according to the type of factor

they target: neurological, psychological, or

social (see Table 4.1). But ultimately, all treat-

ments have the same broad goal—to decrease

symptoms and/or improve quality of life. The

goal of treatment can be likened to an X on

a map—the place toward which the treatment

nudges the patient; each type of treatment pro-

vides a different path toward that destination.

Different treatments, when successful, bring the

patient to the same general place, but follow

different paths.

Treatment (for psychological disorders)
The use of a procedure or substance to
reduce or eliminate psychological problems
or symptoms of psychological disorders and/
or improve quality of life.

Biomedical treatments
Treatments that are designed to reduce target
symptoms and/or improve quality of life by
changing brain functioning, hormonal activity,
or another aspect of bodily functioning.

Psychopharmacology
The use of medication to reduce or eradicate
symptoms of psychological disorders; also
the study of such treatment.

Agonists
Medications that mimic the effects of a
neurotransmitter or neuromodulator and
activate a particular type of receptor.

Table 4.1 • Aspects of Neurological, Psychological, and Social Factors

That May Change as a Result of Successful Treatment e

sib

obt

the

the

soc

me

sym

goa

am

nud

vid

Dif

pat

diff

Neurological Factors Psychological Factors Social Factors

• Neuronal activity


• Levels of transmitter
  substances


• Level of stress hormones


• Amount of substance
  used (for those with
  substance abuse)


• Bodily symptoms of
  arousal (as in anxiety
  disorders or sexual
  disorders)


• Appetite


• Sleep
  
  
  • Mental processes
  
  
  • Mental contents
  
  
  • Specifi c behaviors, includ-
    ing those associated with
    caring for oneself
  
  
  • The experience and regu-
    lation of emotions
    
    
    • Relationships (social
      support, pattern of fam-
      ily and work interactions)
    
    
    • Social isolation
    
    
    • Socioeconomic status