Biological therapies phobic disorders

Published: 2021-07-08 00:00:05
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One biological therapy for phobic disorders is chemotherapy. Drug therapies include Anti-Anxiety drugs, Beta blockers and Antidepressants. They aim to alter abnormal behaviour by intervening directly in bodily processes (helps with the symptoms). Those that experience psychological problems or show disturbed behaviour patterns go to their family doctors. The first line of treatment is medical. Drug therapies are most common for treatment for phobias. An example is anti-anxiety drugs which treat phobias by reducing anxiety levels.
Benzodiazeopines (BZs) slow down the activity of the central nervous system by enhancing the activity of GABA, a neurotransmitter that has a general quieting effect on many of the neurons in the brain. It does this by locking into GABA receptors on the outside receiving neurons, which opens a channel to increase the flow of chloride ions into the neuron. Chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, thus slowing down its activity and making the person feel more relaxed. BZs have been shown effective.
For example Kahn et al (1986) found that BZs were better than just using a placebo treatment, which suggests they have some pharmacological value, and Hildago et al (2001) found that BZs had better results than SSRIs. A second example is beta blockers (BBs) which are used to reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary response to stress. Beta Blockers bind to receptors on the cells of the heart and other parts of the body that are usually stimulated during arousal.
By blocking these receptors, it is harder to stimulate cells in these parts of the body, so the heart beats slower and with less force, and the blood vessels do not contrast as easily. This results in a fall in blood pressure, and so less stress on the heart. The person taking the medication will feel calmer and less anxious. Research has also shown that BBs can be effective treatment for phobias. For example, Liebowitz et al (1985) demonstrated that BBs provide an effective means of anxiety control. Kindt et al (2009) found that BBs also suppress memory and suggest in particular that they may interfere with the emotional content of memories.
Therefore, an additional advantage is that BBs lead to forgetting of fearful memories that would reduce subsequent anxiety in the same situation. However some studies have shown that the benefits may be largely explained in terms of placebo effect. For example Turner et al found no difference between a BB and placebo group in terms of reduced heart rate, feeling of nervousness etc. In terms of appropriateness, a limitation is that addiction can be a problem for BZs, even when low doses are given, they should only be given for a maximum of four weeks (Ashton ,1997). Drugs can’t provide a complete treatment as they focus on symptoms not causes.
This may lead to symptoms substitution because the real cause isn’t dealt with and a new set on symptoms may appear. A second issue is side effects. BZs in particular are linked to problems such as increased aggressiveness and long term impairment of memory. BZs have also been linked to addiction. Finally there is an issue of informed consent because patients are not always informed about the fact that drugs may not actually be much better than placebos. Therefore, they are not giving truly informed consent. When considering appropriateness it is also relevant to think of the strengths of drug therapies.
They offer an easy solution for patients, requiring little effort. And some drug treatments (such as BBs) have fewer problems with, for example, side effects and addiction. So not all drug treatments have the same limitations. Another biological therapy for phobic disorders is psychosurgery. Psychosurgery is a surgical intervention that aims to treat a behaviour for which no pathological cause can be established. In the case of psychosurgery it is believed that an area of the brain is malfunctioning, and if the connection to this part of the brain is severed, then psychological symptoms may be relieved.
An example of psychosurgery is capsulotomy and cigulotomy which are two operations performed to treat anxiety disorders. They functionally remove the capsule and the cigulum which are both part of the limbic system which is the area of the brain associated with emotion. Such operations are irreversible and are only performed as a last resort. A second example is deep brain stimulation (DBS) which involves placing wires in target areas of the brain. It involves no destruction of tissue although the wires are permanent.
They wires are attached to a battery and when this is switched on it interferes with the brain circuits in the region of the capsule and cigulum, resulting in a reduction of symptoms. Research support for the effectiveness of psychosurgery comes from Ruck et al (2003). Ruck studies 26 patients who had been suffering from non-obsessive anxiety disorders for over 5 years and has experienced considerable reduction in their psychological functioning and had tried numerous treatment options. After a capsulotomy was performed, assessments were conducted and followed up again a year later.
The mean pre-operative anxiety score started at 22. 0 but dropped to 4. 6 indicating a successful outcome showing that psychosurgery, (capsulotomy in particular) is effective. However, the negative symptoms were greater than expected. For example, seven patients attempted to commit suicide after the surgery and there were two recorded cases of epileptic seizures. The researchers concluded that while capsulotomy may be effective, it is expensive and has the potential for extremely adverse effects. Therefore any benefits clearly have to be weighed against the potential for negatives.
Further to this, psychosurgery is rarely suitable for phobias and then only for extreme cases that have proved otherwise untreatable, and that interfere with normal day to day functioning. Szasz (1978) criticised psychosurgery generally because a person’s psychological self is not something physical and therefore it is illogical to suggest that it can be operated on. This shows that because everyone is individual and unique, their mind is intangle and not interactive, so it is not always appropriate to use psychosurgery. Lastly, the use of psychosurgery can be applied to the real world.
Research has suggested that it may be possible to erase fearful memories, which could be a useful method of treating phobias. For example, Stehberg et al. (2009) have blocked memory consolidation in rats using a form of deep brain stimulation, and suggest this could lead to a novel treatment of a traumatic memory that underlie anxiety disorders. Further to this, Kindt et al. (2009) found that giving beta blockers to patients during an experiment resulted in a reduced fear response while placebos did not give the same reaction. This shows that that the use of biological therapies is effective in treating phobias.

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