However there is evidence to show the effectiveness of BZs,Kahn et al (1986( found that BZs were more effective than a placebo treatment in reducing anxiety, and Hidalgo et al (2001) found that BZs were more effective than antidepressants.
A limitation of using BZs is that they can cause lots of side effects for example aggressive and memory loss. Another 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).
Beta Blockers reduces the activity of adrenaline. It binds the receptors on the cell of the heart and other parts of the body that are stimulated by arousal. By blocking them it makes it harder to stimulate cells in these parts of the body, so the heart beats slower with less force and blood vessels contract easier. This results a fall in blood pressure, this means there is less stress on the heart and this makes the person feel more calm and less anxious.
There is research to support the effectiveness of beta blockers. Liebowitz et al (1985) found that beta-blockers can also provide an effective means of anxiety control. 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.
A strength of BB is that they have few side effects compare to antidepressants.
Antidepressants: - SSRIs are the preferred drug. It increases amounts of serotonin which regulates mood and anxiety.
Research to support the effectiveness of antidepressants comes from Aouizerate et al he concluded that SSRIs provide relief for social phobias in 50-80% of cases, a level similar to BZs.
Even though SSRIs are portrayed as relatively safe, this is not the case adverse effects include anxiety, sexual dysfunction, nausea, insomnia and aggressive and even suicidal thoughts. However SSRIs are often considered preferable because they have fewer side effects.
MAOI is the enzyme responsible for breaking down monoamine transmitters such as serotonin, dopamine and nor adrenaline. The inhibitor prevents this from happening leading to higher uses of monoamines.
A strength of the use of MAOIs come from research by Liebowitz et al (1992) he found that MAOIs are more effective than placebos and more effective in the reduction of anxiety than BBs.
In conclusion drugs are easy to prescribe and require little motivation on the part of the user unlike other therapies such as psychoanalysis and CBT.Moreover drugs are fast acting and can be effective in relieving symptoms in hours or days rather than the weeks or years of other approaches. Finally they may be used with client groups for whom complex involved therapies may be e.g those with learning difficulties.
However one ethical issue surrounding drug therapies is that it is argued that they treat symptoms and not cause and are therefore superficial and short –term.
Another biological therapy is psychosurgery it is aimed to treat behaviour for which no pathology cause can be established. It is believed that an area of the brain is malfunctioning, and of the connection to this part of the brain is severed then the psychological symptoms may be relieved.
They are three types of psychosurgery:
1. Capsultonomy - Organ is removed with connection severed.
2. Deep brain stimulation (DBS) – involves placing wires in the brain, the wires are connected to a battery in the patient’s chest. When the current is on, this interrupts the target circuits in the brain. There is no disruption.
3. Transcranial Magnetic Stimulation (TMS) – is another technique which is like deep brain stimulation and it avoids destruction of brain tissue.
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. However Szasz (1978) criticised psychosurgery generally because the psyche is not something physical and therefore it is illogical to suggest that it can be operated on.
A study into the effectiveness of psychosurgery was done by Ruck et al his study give some indication of success of psychosurgery for a range of anxiety disorders including social phobias. However any benefits clearly have to be weighed against the potential for negative effects.
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shanygnejackson1 (student)
