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)