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Samenvatting Capita Selecta
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- Rijksuniversiteit Groningen (RuG)
Dit is een in het Engels geschreven samenvatting van het boek Capita Selecta voor het tweedejaarsvak Klinische Psychologie.
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Voorbeeld van de inhoud
Capita Selecta in Clinical PsychologyChapter 1: Psychopharmacology
Chapter Objectiee
There are some good reasons to provide at least an overview of peychopharmacology in this
book. We want to alert the reader to these advantages of having basic knowledge in
psychopharmacology:
- Efectve professional interacton between psychologists and prescribing physicians
treatng the same patent.
- The possibility of being proactve in collaboratng with a physician to compose an
ideal treatment package for patents that may consist of drug treatment and parallel
psychological supports.
- Better understanding of the patent’s full medical status in order to complete
meaningful assessments.
- Better understanding of potental somatc and psychological symptoms that can arise
from medicaton efects and medicaton side efects.
The Language of Pharmacology: Important Concepte
When it comes to prescripton drugs there is considerable opportunity for confusion because
each drug company creates trade namee for its drugs. The science of pharmacology uses a
terminology of its own that associates one specifc name with one specifc drug type; we
refer to these terms as generic names.
To retain transparency and assure patent safety, the medical-pharmaceutcal world
has created a reference book, referred to as the Compendium of Pharmaceutcals and
Specialtes (CPS). This provides a listng of trade names that can then be matched with
generic names and also allows the reverse. For each drug listed in the CPS, there is also
informaton about the chemical itself, typical dosages, the intended efect, and known side
efects.
Frequently Used Terms and Abbreviatons
Concepte and
definitone
Toxicity Refers to the fact that prescripton drugs ofen are powerful in order to
have their intended impact but that taking too much of a drug becomes
harmful.
Side efecte Prescripton and illicit drugs may also produce uncomfortable and
undesirable symptoms that are not intended but are ofen unavoidable.
Adieree efecte With some drugs, the unintended efects can become truly dangerous and
lead to dangerous conditons.
Tolerance Describes the fact that with many medicatons patents will need higher
dosages to attain the same efect if the medicaton is taken over an
extended period of tme.
Half-life It is useful to know what the length of the likely efect is by describing at
what point the medicaton has roughly reached the midpoint of the tme
interval for which it is efectve.
Withdrawal Stopping of medicatons or illicit drugs ofen leads to unpleasant
symptoms because the patent’s body has adjusted to the medicaton.
Potentaton and Many patents take more than one kind of medicaton, and some
eynergiem individuals even mix prescripton drugs and illicit chemicals without being
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, aware that these chemicals may interact with each other.
Dependence Medicatons and illicit drugs taken over a long period of tme lead to
adjustments of the patent’s physiological functons such that he will
become used to, and even rely on, the presence of such chemicals in his
body.
Abbreiiatone
Rx Prescripton
qd Every day
b.i.d. 2x/day
t.i.d. 3x/day
q.i.d. 4x/day
p.r.n. As needed
p.o. Per mouth
etat Immediately
Typee of Peychopharmacological Medicaton and Areae of Applicaton
An approach to classifying psychoactve street drugs is to block them into (a) uppers (drugs
that increase arousal and alertness) and (b) downers (drugs that decrease excessive arousal
and produce calm). Prescripton drugs, however, have more complex mechanisms. In terms
of drug actons, there is some overlap between street drugs and prescripton drugs. What
does apply to all drugs is that increasing dosage also increases toxicity and ultmately the
probability of death.
The relevant main areas of psychological, psychiatric, and general medical practce
applicatons and the corresponding use of drugs that can be broadly called
psychopharmacological agents are:
- Pain (analgesics)
- Anxiety (anxiolytcs)
- Depression (antdepressant)
- Bipolar disorder (lithium derivatves)
- Schizophrenia (major tranquilizers of antpsychotcs)
- Post-traumatc stress disorder (various afect-modulatng drugs)
- Smoking cessaton (afect-modulatng drugs like Bupropion)
- Weight loss (stmulants like amphetamines)
The nature of possible relatonships between pharmacological medicaton and psychological
interventons can be seen as ftng into one of these four categories:
1. Pharmacological medicaton is recognized as a highly efectve and necessary frst-line
treatment. However, despite the fact that medicaton is needed and efectve for
some conditons, there also is consistent evidence that the additon of psychological
support and behavioral training can further enhance the benefts of many frst-line
drug treatments.
2. Both psychological and drug treatments are recognized as efectve, and either one
can be an appropriate frst-line treatment. Typically, it is true that the medicaton
takes efect more quickly than psychological treatment, whereas the psychological
treatment is ofen associated with lower relapse rates and better follow-up
outcomes.
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, 3. There is evidence that psychological treatment is a superior choice to medicaton and
should be considered as a frst opton, even though this may not necessarily rule out
that medicaton can also produce some beneft or be added later.
4. A fourth possible opton is to plan from the outset to integrate medicaton and
psychological therapy.
How the Arriial of the Internet Hae Changee Clinical Practce
With the advent of the Internet, patents themselves have developed a great deal of savvy
about medical conditons, diagnoses, and possible interventons. Given that patents have
grown more cognizant of treatment optons, they ofen try to reduce their medicaton intake
because they:
- Dislike medicaton dependence and don’t accept the implicit role of “chronic
patent”.
- Notce unpleasant side efects.
- Are aware that long-term drug use can negatvely afect their liver or lead to
dependency.
- Learn from reports of scientfc advances in the popular press that partcular drugs
are not as efectve as initally believed.
Should Peychologiete Haie Drug Preecripton Priiilegee?
The profession is split over this issue, with one group arguing that a combinaton treatment
of medicaton and psychological support is ofen best ad that patents are not well served by
having two diferent practtoners providing these two forms of treatment in parallel. The
other side takes a more philosophical stance and posits that the very values and beliefs that
characterize the practce of clinical psychology are the emphasis on emoton, thought, and
behavior and an attempt to gradually empower patents to look afer themselves.
Conclueion
Some (Sobering) Additonal Consideratons
Chapter 2: Clinical Forensic Psychology
Oieriiew
Anonymoue mieeiiee are usually unwanted letters repeatedly sent by an individual, who
withholds their identty, to a partcular recipient.
Clinical Foreneic Peychology
The hybrid area of clinical forensic psychology has become increasingly important. Much of
the work for these hybrid professionals may be focused on the abnormal ofender, a hybrid
ofender who provides many challenges for health and justce systems which assume clients
that are singly disordered or ofenders.
The Abnormal Ofender
Within clinical forensic psychology and criminology, there is a strong connecton between
criminal deviance and mental abnormality, sometmes referred to as the mad-bad debate.
There is an area of overlap between these two forms of deviance and the interpretaton of
behavior into one or another category can vary.
If a proporton of crime can be attributed to mental abnormality, then an
examinaton of mentally disordered populatons should reveal a higher rate of crime.
In one-eided euicide pacte, the suferer sees only a bleak future in a threatening
world for those close to them, their way out being to kill their loved ones then themselves.
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, Mental illness has a defnite but inconsistent relatonship with crime, which is
specifcally evident but may be masked if generalized across both crimes and disorders.
Theoretcal links between crime and abnormality are also pertnent to the mad-bad
debate. Here the interface between clinical forensic psychology and law is vitally important,
as ratonal views of culpability in the mentally ill populaton must incorporate the fact that,
in most cases, mentally ill individuals can distnguish right from wrong.
Clinical Correlatee of Crime: Conettutonal and Peychological factore
There are assumptons regarding the individual causes of crime built into the legal system.
The Children and Young Pereone’ act assumes that young criminals are victms rather than
inherently ‘bad’ and that delinquency is a cry for help.
Biological Causes of Crime: The Enigma of the Consttutonal Criminal
Most species have a means of ritually defending the integrity of their species against
individuals who deviate from accepted norms, by excluding them physically or genetcally, or
even killing the deviant individual. Humans also carry this out, in the form of
insttutonalizaton. This approach to identfying crime as emanatng from the deviant
individual has popular and economic appeal, as it is easier to label an individual as ‘bad’ than
consider complex and expensive changes to society. This approach is termed biological
poeitiiem.
Older Biological Approaches to Crime
Cesare Lombroso was one of the frst to apply anything approaching a scientfc method to
the study of criminality in a move away from religious and philosophical argument. He was
infuenced by Paul Broca and incorporated some of Darwin’s evolutonary theory into his
explanaton of the causes of criminality. He studied and categorized racial types, bringing
him uncomfortably close to the racial anthropology movement with its social policy
infuences. This associaton also muddied the positvist aim of impartal scientfc objectvity.
Drawing on a pre-existng view of criminals as degenerates, Lombroso compared the heads
of prisoners with non-prisoners and found his criminal populaton to have more atavistc of
evolutonarily primitve features than his controls.
Kretschmere introduced the concept of body build indicatng personality types.
Sheldon applied this approach to crime by considering the basic three somatypes in terms of
temperament, then extrapolatng this to criminality.
- The ectomorph was thin and frail, and being a quiet introvert was thus not
predisposed to crime.
- The endomorph shape implied a sof, rotund body and a relaxed, sociable
personality, who would be less likely to turn criminal.
- The meeomorph refers to an athletc and muscular body build and was considered by
Sheldon the most likely of the somatypes to be criminal.
Early biological positvist approaches tended to pioneer the scientfc method in crime
research but were remarkably weak in establishing cause and efect relatons with the
factors on which they focused.
Chromosomal abnormalites are usually non-inherited abnormalites in the structures
containing the DNA sequences that form genes. One viable abnormality is the XYY male
resultng from non-disjuncton. The main established characteristcs associated with the XYY
abnormality were tallness, mental retardaton or immaturity and mild acne.
Eysenck: Personality and Crime
One of the major fgures in the area of biological positvism was Hans Eysenck. Eysenck’s
approach to crime causaton places his work in at least three camps: that of biological
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