Psychosurgery

Question 1

Aim of psychosurgery

Answer 1

Surgical procedure for treating psychological disorders. Aim to eradicate undesirable behaviour by removing/destroying part of the brain.

Medical model - believe psychological disorders have a physiological cause so need physical treatment.

Question 2

Describe pre-frontal leucotomy

Answer 2

• Moniz 1930s
• Drill 2 holes into skull at temples
• Push leucotome (wire loop) in
• Move to sever nerves between frontal lobe and rest of brain
• ‘Apple-corer’ method

Question 3

Describe transorbital lobotomy

Answer 3

• Freeman 1940s
• Orbitoclast inserted through eye-socket
• Twisted in frontal lobe to destroy connections
• Took 10 mins
• ‘Ice-pick’ method

Question 4

Effectiveness of early lobotomies

Answer 4

• Complications downplayed
• Range of undesirable side effects - permanent (unnatural tranquility)
• Comer (2002) early lobotomy fatality rate 6% and side effects including seizures, lack of emotional responsiveness, personality changes

Question 5

Rosemary Kennedy for transorbital lobotomy

Answer 5

• 23 years old
• Nov. 1941 lobotomy left her with the mental capacity of a 2 year old.
• Couldn’t walk or speak intelligibly.
• Spent the rest of her life institutionalised.

Question 6

Describe bilateral cingulotomy

Answer 6

• Incision made in nerves of brain using MRI to guide surgical instruments
• Sever nerve bundles from limbic system
• Use gamma knife to burn tissue and break links

Question 7

Effectiveness of bilateral cingulotomy

Answer 7

• Cosgrove and Rauch (2001) effective in 56% of OCD patients

Question 8

Mary Lou Zimmerman for bilateral cingulotomy

Answer 8

• Received for OCD
• 4 lesions from heated electrodes
• Major loss of normal function, abscess in brain dementia and emotionally disabled. Family won $7.5 million

Question 9

Describe deep brain stimulation

Answer 9

• Implant electrodes in brain
• Pace-maker like device in upper chest
• Connected by insulated wires
• Send high frequency electrical impulses to interrupt brain circuitry
• Temporary and can be turned off if ineffective

Question 10

Effectiveness of DSB

Answer 10

• Mayberg ethical al (2005) 4 in 6 patients with depression showed significant improvements

Question 11

General ethical issues of psychosurgery

Answer 11

• Effects can’t be reversed
• Can someone with severe mental illness make informed consent? Can family consent?
• Last resort - BUT how do you know if patients adhered to previous treatments?
• Offered to as young as 18 - brain doesn’t fully develop until mid 20s

Question 12

Link to biological assumptions

Answer 12

• Localisation of brain function - can only remove certain part of brain causing undesirable behaviour