Exploring clinical applications of classical conditioning
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Exploring clinical applications of classical conditioning
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[post_date] => 2024-12-25 13:44:27
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[post_content] => Practice Passage (Question 1-5)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
Pavlov’s dogs are perhaps the most famous case of classical conditioning. In his experiments Pavlov paired the ringing of a bell with presenting his dogs with food, and then he measured the amount of saliva produced by ringing the bell alone. By taking these measurements before and after the pairing, it was shown how a stimulus that normally has no response could be paired with a stimulus that does.
The principles of classical conditioning extend far beyond canines and saliva; they can even be used to condition our immune system as a means of treating autoimmune diseases. Lupus is one such autoimmune disease, and treatment requires the suppression of a person’s immune system to protect their tissues and organs from being targeted by their own white blood cells. Cyclophosphamide is a chemotherapeutic drug taken orally or intravenously that is considered to be the standard treatment for lupus; however, like many chemotherapies, the side-effects of the drug can be quite severe.
In 1992 a team of researchers showed that the human immune system can be classically conditioned, such that an 11 year old girl suffering from lupus was able to have significant reduction of her symptoms without any need of immunosuppressant drugs. This provided an opportunity to treat their patient’s disease while avoiding the deleterious side effects of cyclophosphamide.
For their experiment, the researchers utilized a “Compound CS” which was a liquid that tasted of cod liver oil and had the smell of a rose. They paired Compound CS with the cyclophosphamide treatments on 6 occasions for a year. Every other month of treatment, the researchers did not administer the cyclophosphamide, and simply gave their patient compound CS instead. Despite administering the immunosuppressant drug at half the normal dose, the 11 year old patient still evidenced immunosuppression and continued to do well after a 5 year followup.
*Citation: Giang DW, Goodman AD, Schiffer RB, Mattson DH, Petrie M, Cohen N, Ader R. J Conditioning of cyclophosphamide-induced leukopenia in humans. *
Neuropsychiatry Clin Neurosci. 1996 Spring;8(2):194-201. Cohen N, Ader R. Immunomodulation by classical conditioning. Adv Biochem Psychopharmacol. 1988;44:199-202.
[post_title] => Exploring clinical applications of classical conditioning
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[question] => If cyclophosphamide is a standard drug treatment for lupus, why should a physician consider using Compound CS and classically conditioning his or her patients?
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[description] => Reason for the Correct Answer:
The conditioning relies on the fact that the drug is efficacious, if it did not produce immunosuppression then a patient could not be conditioned with it to treat lupus.
The research specifically only replaced half of the dosage of cyclophosphamide with Compound CS, taking cyclophosphamide is still an integral part of treatment.
If a patient is noncompliant treatment, one would have to identify why a patient isn’t taking their medication before attempting a different means of treatment.
Compound CS functions as an alternative treatment for when cyclophosphamide’s side effects are too severe.
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[each_answer] => A. Classical conditioning could be used in cases where the drug is ineffective in treating lupus
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[each_answer] => B. Compound CS could be helpful when a drug’s side-effects are not tolerable
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[each_answer] => C. Compound CS could be helpful in ending the use of cyclophosphamide to treat lupus
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[each_answer] => D. Classical conditioning could be used when a patient is not compliant with treatment
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[question] => In Pavlov’s experiment and in the 1992 experiment involving autoimmunity, the bell and Compound CS both represent which of the following aspects of Classical Conditioning?
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A conditioned response is the resultant behavior after a stimulus is presented.
A stimulus is the event which prompts some behavior in the subject.
The conditioned stimulus would be the initially neutral stimulus that is introduced by the researchers in both experiments.
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[each_answer] => A. Conditioned stimulus (CS)
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[each_answer] => B. Unconditioned response (UR)
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[each_answer] => C. Conditioned response (CR)
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[each_answer] => D. Unconditioned stimulus (US)
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[quiz_unique_key] => 83407773
[question] => Why did the researchers choose Compound CS to be used as the conditioned stimulus?
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[answer] => 4
[description] => Reason for the Correct Answer:
Compound CS would be taken in liquid form, while cyclophosphamide is administered either as a pill or through IV therapy.
The experiment was set up such that Compound CS is taken to replace cyclophosphamide, rather than being taken concomitantly.
Though it may help in overcoming a patient’s aversion to treatment, his or her enjoyment of Compound CS wouldn’t be necessary for the purposes of the experiment.
Compound CS wouldn’t be useful as a placebo if it normally interfered with a patient’s immune system.
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[each_answer] => A. Compound CS could be used to help the patient have a positive treatment experience
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[each_answer] => B. Compound CS could lessen side-effects when taken in conjunction with cyclophosphamide
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[each_answer] => C. Cod liver oil and rose perfume as a placebo would mimic the same methods of treatment as cyclophosphamide
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[each_answer] => D. Cod liver oil and rose perfume would not normally interfere with the immune system
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[question] => The use of Compound CS carries many ethical considerations because its use involves the replacement of a standard drug treatment with what is essentially a placebo. Which of the following would NOT support the use of Compound CS for a patient study?
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[answer] => 2
[description] => Reason for the Correct Answer:
The severity of side effects is the main reason classical conditioning is being considered to treat the disease.
Patients must always have informed consent, especially in experimental research.
If a patient is unable to tolerate a drug, then finding a safe alternative is ideal.
In the case of Compound CS, it is being used differently than most placebos. In most studies, placebos are being used with the intent of comparing treatment (the drug) versus no treatment (the placebo), in the case of Compound CS, researchers were specifically trying to use a placebo as the treatment itself.
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[each_answer] => A. Enrolling a patient in the study would be better justified if they were unable to tolerate the side effects of cyclophosphamide
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[each_answer] => B. Administering Compound CS would be no different from administering placebos in other experimental studies
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[each_answer] => C. Giving Compound CS to a patient would not cause additional harm and therefore there would be no risk in replacing cyclophosphamide
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[each_answer] => D. Obtaining consent from a patient before undergoing treatment with Compound CS would better justify their participation in the study
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[quiz_unique_key] => 574431310
[question] => If a dog was classically conditioned to salivate upon hearing a bell ring, which of the following terms would describe the salivation?
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[answer] => 2
[description] => Reason for the Correct Answer:
A stimulus in the case of Pavlov’s dogs would be either the bell ringing or the food.
Whether or not salivating occurs alongside a stimulus determines whether it is an unconditioned or conditioned response.
The conditioned response would be the result of a paired stimulus causing a response that it normally would not, i.e. the dog salivating because of a bell ringing.
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[each_answer] => A. Unconditioned stimulus (US)
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[each_answer] => B. Conditioned response (CR)
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[each_answer] => D. Conditioned stimulus (CS)
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