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Exam 3 madness and medicine
Exam 3 madness and medicine
46
Psychology
Graduate
07/06/2011

Additional Psychology Flashcards

 


 

Cards

Term
Freedman & Watts book
Definition

Psychosurgery

-step-by-step of how to do lobotomies

 

-logo of black butterflies (depression for france) and trepanated skull

Term
Freeman & Watts Lobotomy
Definition

-drilled hole manually

-rongeur (curved needle nose priors) and snapped skull bone to largen hole

-metal rod through head

-push in tool lots of time to mess up tissue

-always took before/after pics

Term
# of lobotomies in US
Definition
20,000
Term
Site of Lobotomies
Definition

-mainly in state hospitals

-also in private hospitals, universities, VAs

-McClean hospital (private) outside of Boston did a lot

 

-mainly on backwards schizophrenics

Term
Factors leading to acceptance of lobotomies
Definition

-conditions in mental hospitals (overcrowding) 

-economics

-professional forces

Term
Freeman's adopted lobotomy
Definition

Trans-orbital lobotomy or ice pick lobotomy

-eye socket broke a lot in deep frontal cut

-Louptone- ice pick like tool 

-shock to head as preperation

 

Complications- brain infections (not sterile) and instrument getting stuck

Term
Tulane guy
Definition

-heath

-put electrodes into schizos heads

-thought central area of brain had dimished activity in schizophrenic patients

-1950s

Term
Reason for electrical brain stimulation
Definition

-Heath

-treat schizophrenia by stimulating the septal region of the brain

Term
Historical context of Heath
Definition

-mental hospitals in crisis

-movement to root psychiatry in bio medicine

-drastic somatic therapies were widely used and accepted

Term
Bioethics movement (6)
Definition
  1. 1st heart transplant led to ethical dilemnas (who gets next heart) 
  2. federal funding of research
  3. centralization of medicine (hospital facilities) 
  4. increased medical specialization
  5. civil rights and consumerism (awareness from Nazi Drs., untrusted strangers not providing treatment) 
  6. awareness of mistreatment of research subjects (Tuskeegee)
1960s after Heath
Term
Medical ethical movements (7)
Definition

-biomethics movement- 1960s

-patients rights by courts and federal regulations

-biomedical ethics- 1970s

 

  1. hippocratic oath "I will keep them from harm"
  2. declaration of Geneva (1948) : before Heath
  3. International code of medical ethics (1949) 
  4. AMA's Principles of medical ethics (etiquette between doctors)
  5. patient consent (needed even in 50s, Heath didn't get it) 
  6. Therapeutic privilege (catch of consent, not needed if consent will do patient harm)
  7. Research Ethics 

 

 

Term
Research Ethics
Definition

-Tx stops and R begins when the research is an unproven technique or the goal is to get info that will help others instead of only the individual 

 

-Nuremberg- case against 20 doctors resulted in voluntary consent and enlightened decision

 

Informed consent- technical legal doctrine needed for research to be ethical (1957-while Heath was doing studies) 

-Heath claimed he had informed consent but never went through process so he didn't

Term
Problems with Tulane Experiments
Definition

-dangerous

-ill conceived (not reason to think it would work)

-inhumane (neg stimulation to see bx) 

-unethical (by standards of the time) 

Term
Lobotomy
Definition

nerve tracts (white matter) of frontal lobes

-promoted by well trained respected physicians

 

Moniz (2nd nobel prize)

Term
Moniz
Definition

-lobotomies

-cerebral angiography (see blood in brain)

Term
Origins of lobotomies
Definition

-2nd international neurological congress (frontal lobes changed a lot w/out person changing, silent lobes)

 

-Fulton & Jacobson "Function of Frontal Lobes" (delayed response task)

Term
Delayed Response task
Definition

-monkeys find item after hidden then screen dropped

-monkeys wrong they got really upset (called experimental neurosis

-first animal model of neuroses

 

-Becky: monkey got really upset when wrong

-did lobotomy and no longer upset

-Moniz suggested with humans

Term
1st Lobotomy
Definition

-Almedia Lima- Surgeon

-pen into morgue brain for practice

 

-63 year old women w/ melancholia, alchol in frontal lobes

-cured after 2 months

Term
Target of early lobotomies
Definition
-old depressed women
Term
Lobotomy operation (original)
Definition

Lucotone- knife used

-insert through 2 holes in top of head

-deploy plunger to poke out wire loop

-turn loop to cut tissue which was left in

Term
1st 20 lobotomies
Definition

7 cured (all affective)

7 improved

6 unchanged

Term
Lobotomy complications
Definition

Acute

-vomitting

-urination/fecal incontinenence

-disorientation

 

Chronic

-apathy (dont care) 

-akinesia (diminished movement)

-loss of initiative

-mutism

-abnormal hunger

-puerility (no social inhibition, childish)

Term
Lobotomies in US
Definition

Freeman - 1st US lobotomy

Worked with Watts (surgeon)

Term
Freeman's 1st Lobotomy
Definition

-63 female w/ severe agitated depression

-operation 6 cores per side

-successfull

Term
Freeman at conferences
Definition

Southern Medical Association

 

- 6 cases presented - success

-complications (perseveration of speech, increased reflexes, disturbances of vesical control)

-freeman was reasonable, said not good for everyone and ppl lose something

-Meyer & NEJM sanctioned lobotomies

 

Chicago neurological society

-20 lobotomies

-torrent of criticism from psychoanalysits 

 

 

 

 

 

Term
Imperfections of original lobotomies
Definition

-8 of 20 needed reoperation

-2 died of hemorraghe

-variable location of damage

-leucotone breaking off in brain

-dead tissue left in brain caused epilepsy

Term
New Alternatives
Definition

-pharmacotherapy

-defocalization

-insulin coma therapy

-metrazol convulsive therapy

-ECT

-psychosurgery

Term
Pharmacotherapies 1900-1950
Definition

-stimulants (amphetamine)

-antihistamines

-LSD
-Barbiturates 

Term
Antihistamines
Definition

-Thorizine

-most imp drug in psychiatry

-sedative and led to other drugs

Term
barbiturates
Definition

Barbital-1st one (Fisher & Mering)

-narcoanalysis, prolonged narcosis, depatterning

Term
prolonged narcosis
Definition

- Macleod used diff drugs (bromide) to ship patients

- Klaesi popularized using barbiturates w/ it

-Baily & Sargant had competition (Baily charged w/ murder)

-1st somatic theory of 20th century 

-book says 1st truly effective psychological treatment ever produced

Term
Depatterning
Definition

-fix patterns in the brain

-Cameron:prolonged narcosis, ECT, & prerecorded message

Term
Defocalization
Definition

Cotton

Focal Infection Theory/sergical antisepsis

 

-bacteria from infection is causing mental illness so cutting out the bacteria will cure the illness

Term
Acceptance of Defocalization
Definition

-okay for teeth not organs

-1st ever clinical control trial to show it was ineffective

-didn't spread widely like other treatments

-cotton said 80% effective

Term
Malaria Therapy
Definition

Jauregg

-fever therapy (led to aggressive medical treatments of mental illness) 

-discovered by patient w/ strep

-Started with tuberculin therapy (too toxic) 

Prob worked w/ GPI

 

Jauregg- 1st nobel prize in psychiatry

 

-Penicillin (antibiotic) made malaria therapy obsolete

Term
Insulin Coma therapy 
Definition

Sakel 

 

-insulin takes glucose into tissue, not enough for brain (hypoglycemia) 

-started w/ drug addiction

-widely accepted, hard needed lots of staff

88% success

-daily for weeks, glucose to wake up

side-effects (seizures & foaming)

Term
Metrazol convulsvie therapy
Definition

Meduna

 

-antagonism between epilepsy & schizophrenia

-metrazol produced seizures

-severity fo seizures too bad, never caught on, ECT made it obsolete 

 

 

Term
ECT
Definition

Cerletti

-studied epilepsy in animals

-dogs head to butt killed them

-pigs before slaughtering on the head

-1st trial w/ homeless schizophrenia and it produced seizures, he almost died from apnea

Term
Complications of ECT
Definition

-less deaths than insulin (brain damage) 

-less complications than metrazol (broken bones)

Term
ECT advancements
Definition

Curare- prevents muscle spasms

used w/ everyone (43% of hospitals) 

1950s tx for depression

Term
ECT today
Definition

Indications

-major depression

-acute mania

-psychosis

 

3x/week, 6-12 total sessions, maintanence at 1-3 wk intervals

 

complications

-cardiovascular (hypertension, arrhythmia)

-cognitive disorientation (acute) 

-memory impariment

-prolonged seizure & apnea

Term
alkaloid
Definition

natural occuring substance w/ nitrogen

 

-"alkaloid era" beginning of asylum psychopharmacology

 

(belladonna alkaloid) cocaine, morphine 

Term
Helabore
Definition
-ancients used this to clean out gastrointestinal tract (early form of psychopharmacology)
Term
Radial stab incisions
Definition
blunt tool that went into hole in side of head to mess up tissue in frontal lobes
Term
Hashish 
Definition

Hashish and mental illness (1st psychopharm book) 

-Maroe

-extract of marijuana

Term
Mikke Fynn
Definition

Chloral hydrate

-one of the first sedatives

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