Abnormal Cp 5-8

psychological reactions in anxiety disorders include increased heart rate, blood pressure and muscle tension except in

blood injection injury phobia

generalized anxiety disorder is considered the basic anxiety disorder because

all the other anxiety disorders include intense generalized anxiety

the behavioral inhibition system (BIS)

leads an individual to be behaviorally inhibited, experience anxiety and apprehensively evaluate the situation when activated

the effective treatment for social phobia that was described in the text involves

both group therapy where the patients role play their socially phobic situations in front of the group and ratherintensive cognitiive therapy aimed at uncovering and changing the automatic or unconscious perceptions of danger

__ would be an example of an internal cue or coniditioned stimulus for a panic, whereas ___ would be an example of an external cue that might become a conditioned stinulus for future panics

exercise; being in a movie theater where panic first occured

anxiety is difficult to study because

humans may manifest it in many different ways

Monica was mugged 8 months ago and just began experiencing symptoms of PTSD last week. she would most likely be diagnosed with

delayed onset PTSD

__ rituals seem to be conducted for the purpose of restoring a sense of safety and control; whereas, ___ rituals seem to be conducted in order to prevent some future imagined disaster

washing; checking

The criterion that distinguishes a pathological worry process from the normal kind of worrying that all of us do from time to time is that, in the pathological worry process

the individual finds it very difficult to turn off or control the worry process

an individual with panic disorder with agoraphobia experiences a combination of

anxiety, panic and phobic avoidance

people demonstrate anxiety in which of the following ways

ALL :)

three basic types of panic attacks

situationally bound, unexpected, situationally predisposed.

the emotion of fear

is an emergency of defensive reaction often called the fight or flight response

psychological theorist D. Clark emphasizes which processes as the most important in panic disorder?

cognition

ardele has an excessive fear of flying. whenever he tries to fly he immediately becomes so anxious that he ends up taking a bus. which would he most like be diagnosed with?

specific phobia- situational type

tamara has been worrying that her hair is chronically dirty. she is distressed because she cannot stop thinking about the dirt in her hair and she realizes that these thoughts are inappropriate. she tries to surpress her thoughts but that does not work. w

because she does not recognize that the thoughts are a product of her own mind.

the primary psychological factor that makes us vulnerable to experiencing anxiety in later life when the right trigger occurs is

a general sense of uncontrollability

Francis was frightened by a clown at his b-day party. at the age of 8 he still becomes anxious at the sight of a clown. he displays phobic avoidance of anywhere where there might be a clown present. diagnosis?

specific phobia- other type

non psychological treatments for OCD such as medication and psychosurgery

have been shown to offer relief from OCD in some patients

compulsions can either be ___ or ____

behavioral; mental

... investigators have found prevalence rates of approx ____ among impatients populations and __ among non clinical samples

3-6%; 0.5-1%

which is not an example of population that has been found to experience dissociative experiences

body dysmorphic disorder patients

recent research supports that the diathesis stress model as applied to our conceptualization of dissociative identity disorder. this suggests that

both normal dissociative reactions are qualitatively different from pathological dissociative experiences and some people will not develop dissociative identity disorder despite severe trauma

a defining feature of dissociative identity disorder is that

certain aspects of the person's identity becomes detached or dissociated

Greta occasionally has sensations of detachments from her surroundings, as if she were in a dream. this feeling usually occurs when she is overtired. she experiences?

a dissociative experience

generalized amnesia refers to

total loss of memory, including one's own identity

an apparent cause of almost all cases of dissociative identity disorder is

severe physical or sexual abuse

a fundamental goal in the treatment of dissociative identity disorder is to

relieve the early trauma to help the individual gain a sense of control over it

julian went to great lengths to avoid running into others and hardly went to class. he thought his acne was so bad that people would be repulsed by him. he is suffering from?

body dysmorphic disorder

true about dissociative identity disorder

it was previously known as multiple personality disorder

ideas of reference

involve the belief by the individual that all personal interactions and other events in his or her world are somehow involved with his or her physical defect

cases in which the person is convinced that he has been taken over by the devil

trance and possession disorder

an alter is

any one of the different identities in a person with dissociative identity disorder

frenzy withcraft refers to

refers to a form of dissociative fugue that occurs among the members of the Navajo tribe

the average number of alters in a person is

15

a type of dissociative disorder

depersonalization disorder

false memory syndrome occurs when a person

strongly holds that a false memory is true

transition from one identity to another in dissociative identity

is called the switch

the term "neurosis" was elmininated in 1980 because

all :)

ECT

offers a safe and resonably effective treatment for severe depression

feelings of depression

are universal and experienced by everyone occasionally

the greater prevalence of mood disorders in women can be accounted for by the greater prevalence of

major depression disorder and dyshymia in woman

common experience of depression

major depressive episode

anhedonia is

the inability to experience pleasure

highest suicide rates?

elderly males

depression in children

can occur in infants as young as three months old

__ may be more effective for depression with atypical features

MAO inhibitors

tricyclis help approx __ of patients who began treatment compared to 25-30% of patients taking placebo pills

50%

many of our elderly citizens who kill themselves after losing touch with their friends or family would fit into with category

egoistic suicide

what is anxiety?

a mood state characterized by marked negative affects and somatic symptoms of tension in which a person apprehensively anticipated future danger or misfortune

how is fear different from anxiety?

1. fear is an alarm response
2. fear is not future oriented
3. fear has immediate and identified threat
4. anxiety has ambiguous threat

integrated model of anxiety

biological: tendency to be high strung
psychological: grew up learning the world is unsafe
social: current life stress

panic attack

an abrupt experience of intense fear or discomfort accompanied by a number of physical symptoms

3 types of panic

1. cued or situationally bound
2. unexpected
3. in between cued and uncued
TO MEET THE DISORDER THE ATTACK MUST BE UNCUED

panic disorder

1. uncued
2. concern over future attacks or implications of the attack

agorophobia

fear of places from which escape might be difficult
- usually comes with panic
- 75% female
could this be conditioned in females??

treatment for panic disorder

- Xanax (but high relapse rate)
- CBT: exposure, hierarchy, panic control, relaxation and breathing

generalized anxiety disorder

excessive worry and anxiety, restlessness, fatigue, difficulty concentration, irritability, muscle tension, sleep problems

types of phobias

animal
natural environment (heights)
blood injection- injury (needles)
situational (planes)
other (chocking, clowns)

causes of phobia

prepared learning, early trauma, information transmission

treatment

Drugs: beta blockers, paxil
Exposure + relaxation
drug + therapy = decrease
drug = decrease
placebo = increase
placebo + therapy = INCREASE

PTSD

exposure to traumatic event, fear, helplessness, avoiding thoughts and reminders, panic attacks, lasts atleast a month

acute stress disorder

reaction within 1 month after trauma, emoitional numbing, derealization

OCD

obsession: urges that the individual tries to resist
compulsion: thoughts or actions designed to suppress or provide relief

treatment for OCD

prozac or clomipramine (increases seratonin)
psychosurgery
exposure and response prevention

dissociation disorder

disruption in the usually integrated functions of consciousness, memory, identity or perception of the environment

2 types of features in dissociation

1. depersonalization: lose sense of your own reality
2. derealization: lose sense to the realness of your external world

types of dissociation disorders

1. depersonalization
2. dissociation amnesia
3.. dissociation trance
4. dissociation fugue
5. dissociation identity disorder (MPD)

dissociation fugue

sudden, unexpected travel away from home or work, inability to recall one's past, confusion about personal identity and/or takes up a new identity

DID (multiple personality disorder)

presence of 2+ distinct identities or personality states that take over the individuals behavior, inability to recall important personal information, having alter changes

treatments for dissociation disorders

fugue and amnesia: they recover on their own, friends and family help them remember
DID: the goal is to integrate the personalities to have only one person in control

symptoms of major depressive episode

Sleep
Iinterest
Guilt
Mood
Energy
Concentration
Appetite
Psychomotor activity
Suicidal thoughts

types of depression

-atypical (eat more, sleep more)
-psychotic (hallucinations/delusions)
-melancholic
-reactive
-catatonic
-postpartum

seasonal affective disorder

must be seasonally related, phototherapy treatment

dysthymia

mild depression that lasts for atleast 2 years without a relapse for more than 2 months at a time, 2 or more symptoms,
double depression: dysthymia + major depressiive episode

bipolar disorder

tendency for manic episodes to alternate with major depressive episodes in a roller coaster fashion

Mania

inflated self esteem, less sleep needed, more talkative, racing thoughts and ideas, distractibility, excessive involvement in pleasurable activities with high potential for pain

types for biopolar disorder

- biopolar I: manic episodes, meets criteria for MDD
-biopolar ll: meets criteria for MDD, less than full manic episodes

rapid cycling

biopolar l and ll

cyclothymia

chronic for 2+ years, less severe manic and depression

treatment for bipolar

-lithium [a salt]: improvement in atleast 60% of the cases
-antiseizure meds

anxiety vs depression

anxiety: apprehension, tension, edginess, trembling, nightmares
depression: helplessness, depressed mood, loss of interest, lack of pleasure, suicidal thoughts,
both: anticipating the worst, worrying, poor concentration, irritability, lack of sleepm cryin

Depression

Major depressive disorder (MDD) (also known as recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder)

learned helplessness theory

depressive attribution styles
1. internal: i am the cause
2. stable: its not going to do away
3. global: im a failure in everything

treatment for depression

-trycyclics: work on norepinephrines, lethal if overdosed, blurred vision, dry mouth, constipation, weight gain, sleepy, sexual dysfunction
-MAO inhibitors: works on nerepinephrine and seroronin, must avoid foods that contain tyramine (cheese, red wine, b

treatment for depression

-SSRI: blocks reuptake of seroronin,
prozac = serafem
paxil = seroxat, zoloft, luvox, celexa

ECT

shock therapy, high relapse rate (60%), short term memory loss, confusion, maybe long term memory problems

therapy for depression

changes errors in thinking, self control therapy, better protection against relapse than drugs

IPT

internal role dispute, adjusting to a loss of someone, acquiring new relationships, correcting social skill deficits
improves long term social functioning

sucicide

high among whites and native americans
low among hispanics an african americans

eating disorders

anorexia nervosa, bulimia nervisa, binge eating disorder, pica

anorexia nervosa

refusal to maintain body weight at or above the normal level, weight less than 85% of expected, intense fear of gaining weight, disturbance in perception of body weight, amenorrhea

types of anorexia nervosa

- restricting type
- blinge eating/purging type

medical consequences

dry skin, nails and hair, sensitivity to cold, lanugo on face and arms, electrolyte imbalance can lead to cardiac arrest

bulimia nervosa

binge eating and then compensatory behavior (vomiting, laxatives, fasting, excessive exercise), must occur at least 2 times a week for 3 months

types of bulimics

- purging type
-nonpurging type (becoming obese)

medical concequences

salivary gland enlargement, dental enamel erosion, electroyte imbalance

...

lateral hypothalamus produces hunger
ventromedial hypothalamus depresses hunger

drug treatment for eating disorders

tricyclics reduce bingeing and purging
prozac

therapy for bulimia

psychotherapy: ineffectiveness of purging, scheduling several small meals, coping strategies to resist binge eating

treatment for anorexia

psychotherapy: more difficult, meals more structured, include family, must change body attitude

pica

eating non food items

bulimia nervosa

uncontrolled excessive eating followed by removing the food via vomiting etc

binge

repeated episodes of uncontrolled eating

anorexia nervosa

refusal to eat food leading to a dangerous body weight

purging techniques

self induced vomiting or using laxatives

night eating syndrome

consuming most of your food in the night or evening time (high calorie midnight snacks) however in the morning they are not hungry. these individuals do not binge during the night and hardly ever purge

bariatric surgery

surgical approach to extreme obesity. stapling the stomach to create small pouches or gastric bypass surgery

REM

stage of sleep where rapid eye movement occurs, dreaming and the body is inactive

dyssomnias

problems of falling asleep or getting enough of sleep

parasomnias

abnormal behaviors such as nightmares or sleepwalking

PSG

assessment for sleep disorders where patients sleep in a lab and heart rate, brain waves etc are measured

actigraph

electronic device that is worn on the wrist and records body movement. can be used to record sleep/wake cycles

sleep efficiency

percentage of time spent sleeping over the total time in bed

microsleep

short seconds of of sleep that occur in people who have been sleep deprived

primary insomnia

difficulty in initiating, maintaining or gaining sleep.

rebound insomnia

in a person with insomnia, the worsened condition that can occur when drugs are used to treat the insomnia and then withdrawn

hypersomnia

excessive sleep

sleep apnea

brief periods where breathing ceases during sleep

narcolepsy

disorder which involves sudden and irresistible sleep attacks

breathing related sleep disorder

sleep disruption leading to hypersomnia or insomnia caused by breathing problems

circadian rhythm sleep

insomnia or hypersomnia caused by the bodies inability to synchronize its sleep patterns with the current pattern of night and day

nightmares

frightened or anxiety provoked dreams that occur during REM sleep

sleep terror

apparent wakening from sleep accompanied with panic. they occur during non REM sleep so nightmares are not involved

anxiety

negative affects and bodily symptoms of tension in which a person anticipates future dangers or misfortunes

fear

alarm reaction to to present danger

panic

sudden overwhelming fright or terror

panic attack

abrupt of intense fear accompanied by a number of physical symptoms

behavioral inhibition system

brain circut in the limbaic system that responds to threat signals by causing anxiety

panic disorder with agoraphobia

fear and avoiding situations where the person believes a panic attack might occur

agoraphobia

being in a place where escape might be difficult

panic control treatment

CBT for panic attacks (desentaziation)

specific phobia

fear of specific objects that intefere with daily functioning

blood injury injection phobia

fear of exposure to anything blood related. experience anxiety, fainting and dropped blood pressure

situation phobia

feared of closed spaces or public transportation

natural environment phobia

fear of events in nature

animal phobia

fear of animals ...

seperation anxiety disorder

mostly fear in children where they think harm will come to them if seperate from their parents

PTSD

distressing emotional disorder that follows exposure to a severe helplessness or threat. victim rexperiences the trauma, avoids any association with it and develops a numbing response

acute stress disorder

severe reaction immidetally following an event. includes amnesia, emotional numbing, derealization. many victims later develop PTSD

OCD

anxiety disorder involving unwanted, persistent, thoughts and impulses, as well as repeated actions to try to supress the thoughts

obsessions

recurrent thoughts the client seeks to supress while knowning that they are not imposed by outside forces

compulsions

repetitive actions a person feels driven to perform (checking)