Psychopathology Exam 2

Describe the differences and similarities between anxiety and fear.

Fear is a response to an immediate threat, while anxiety is a response to a vague sense of threat or danger. Both involve emotional and physiological reactions, but fear is typically more acute and tied to specific situations, whereas anxiety is more generalized.

List the main characteristics of Generalized Anxiety Disorder

Characterized by excessive anxiety under most circumstances and worry about practically anything

What is the psychodynamic explanation of generalized anxiety disorder (traditional and

contemporary psychodynamic theorists)?

Freud believed that all children experience anxiety

• Realistic anxiety when they face actual danger

• Neurotic anxiety when they are prevented from expressing id

impulses

• Moral anxiety when they are punished for expressing id impulses

Contemporary theorists still believe that childhood experiences do have an effect

What are the biological treatments for generalized anxiety?

Drug therapy, relaxation training, biofeedback

What is the cognitive behavioral perspective of GAD?

Proponents suggest that psychological problems are often caused by dysfunctional ways of thinking, and that GAD is caused by maladaptive assumptions.

What are the new-wave theories of cognitive explanation?

Metacognitive theory

• Developed by Wells; suggests that the most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry)

Intolerance of uncertainty theory

• Certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur

Avoidance theory

• Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal

Describe CBT treatment for GAD

focuses on changing maladaptive assumptions and understanding the role that worrying plays

What is a specific phobia, and what are its most common types?

Persistent fears of specific objects or situations

• When exposed to the object or situation, sufferers experience

immediate fear

• Most common: Phobias of specific animals or insects, heights,

thunderstorms, and blood

 How are phobias developed?

Phobias develop through conditioning (ex: classical conditioning) and modeling (observation and imitation)

Behavioral-evolutionary explanation: species-specific biological predisposition to develop certain fears

How are phobias treated? Explain each technique.

systematic desensitization - pair relaxation with feared objects

flooding - forced non-gradual exposure

modeling - therapist confronts the feared object while the fearful person

observes

What causes social anxiety disorder?

1. Unrealistic high social standards

2. View themselves as unattractive human beings

3. Socially unskilled and inadequate

4. They believe they are in danger of being

incompetent

5. Belief that inept behaviors in social situations

will lead to terrible consequences

6. Belief that they have no control over feelings of

anxiety that emerge during social situations

What components must be addressed in the treatment of social anxiety?

overwhelming social fear and lack of social skills

Explain the biological perspective of panic disorder.

norepinephrine is irregular in people with panic attacks or they inherit a predisposition to abnormalities in areas like the amygdala

How is panic disorder treated through CBT?

Tries to correct people’s misinterpretations of their bodily sensations

Differentiate between obsessions and compulsions.

Obsessions - recurrent & persistent thoughts, impulses, or images (THEME: DIRT & CONTAMINATION) that are experienced as intrusive & inappropriate, & cause significant anxiety

Compulsions - repetitive behaviors (hand washing, ordering, checking) or mental acts (praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession

What is the cognitive behavioral perspective of OCD? How is it treated?

They misinterpret thoughts, leading to anxiety, and the compulsive behaviors reinforce the cycle over time. Treatments include exposure and response prevention, and covert response prevention

What are the biological factors involved in OCD?

• OCD linked to overactivity of orbitofrontal cortex and caudate nuceli

• abnormal serotonin activity

Which ones are the obsessive-compulsive related disorders? Give a brief explanation of each.

Hoarding disorder

Hair-pulling disorder

Exoriation - picking at skin

Body dysmorphic disorder

Which disorders can be triggered by trauma?

acute stress disorder, PTSD, dissociative disorders

 Functions of the endocrine system.

releases hormones; controls metabolism, sleep, stress responses

Divisions and functions of the autonomic nervous system (sympathetic and parasympathetic).

parasympathetic: rest and digest

symapthetic: fight or flight

Functions of corticosteroids.

stress hormones

State and trait anxiety.

State anxiety refers to temporary feelings of anxiety that are elicited by a specific situation or stressor. It fluctuates with the circumstances and can change from moment to moment.

Trait anxiety is a characteristic of an individual that reflects a stable tendency to respond with anxiety across a variety of situations. It is more enduring and is often considered a part of an individual's personality.

Acute, generalized and posttraumatic stress disorders: Diagnostic characteristics of each, and similarities and differences between them.

Acute stress disorder - Symptoms begin within four weeks of event and last for less than one month

PTSD - Symptoms may begin either shortly after the event, or months or years afterward. Symptoms continue longer than one month

 Relationship between personality and stress disorders.

Some studies suggest that people with certain personalities, attitudes, and coping styles are particularly likely to develop stress disorders. Risk factors include: preexisting high anxiety, negative worldview

Neurotransmitters involved in trauma and stress related disorders.

norepinephrine and cortisol

Therapeutic approaches to trauma and stress related disorders.

drug therapy, behavioral exposure technique, insight therapy

What is psychological debriefing?

A form of crisis intervention that has victims of trauma talk extensively about their feelings and reactions within days of the critical incident

Four-stage approach:

 Normalize responses to the disaster

 Encourage expressions of anxiety, anger, and frustration

 Teach self-help skills

 Provide referrals

Characteristics of each type of dissociative amnesia.

Localized – most common type; loss of all memory of events occurring within a limited period

Selective – loss of memory for some, but not all, events occurring within a period

Generalized – loss of memory beginning with an event, but extending back in time; may lose sense of identity; may fail to recognize family and friends

Continuous – forgetting of both old and new information and events; quite rare in cases of dissociative amnesia

Psychodynamic view of DID

DID is thought to result from a lifetime of excessive repression, and dissociative amnesia and fugue are single episodes of mass repression

Behavioral view of DID

Behaviorists believe that dissociation is a response learned through operant conditioning: Momentary forgetting of trauma leads to a drop in anxiety, which increases the likelihood of future forgetting

Differences between depersonalization and derealization disorder.

Depersonalization: sense that one’s own mental functioning or body are unreal or detached

Derealization: sense that one’s surroundings are unreal or detached

Characteristics of DID, including diagnostics, switching and relationships between subpersonalities.

Mutually amnesic relationships – subpersonalities have no awareness of one another

Mutually cognizant patterns – each subpersonality is well aware of the rest

One-way amnesic relationships – most common pattern; some personalities are aware of others, but the awareness is not mutual

Diagnostic characteristics of depression and mania.

Cognitive symptoms

• Hold negative views of themselves

• Blame themselves for unfortunate events

• Pessimism

Behavioral symptoms

less active, less productive

Emotional symptoms

• Feeling “miserable,” “empty,” “humiliated”

• Experiencing little pleasure (anhedonia)

Motivational symptoms

Lacking drive, initiative, spontaneity

Neurotransmitters involved in depression

serotonin and norepinephrine

Brain areas involved in depression

Likely brain areas in the circuit include the prefrontal cortex, hippocampus, amygdala, and Brodmann’s Area 25

What are MAO inhibitors used for and how do they work?

The drug works biochemically by slowing down the body’s production of MAO

 MAO breaks down norepinephrine

 MAO inhibitors stop this breakdown from occurring

 This leads to a rise in norepinephrine activity and a reduction in depressive symptoms

What are SSRIs used for and how do they work?

Depression; These drugs act only on serotonin

What is learned helplessness

Theory holds that people become depressed when they think that:

 They no longer have control over the reinforcements (rewards and punishments) in their lives

 They themselves are responsible for this helpless state

Motivational symptoms of mania

need for constant excitement, involvement, companionship

Behavioral symptoms of mania

Very active – move quickly; talk loudly or rapidly

What is the difference between bipolar 1 and bipolar 2 disorders?

Bipolar 1: Full manic and major depressive episodes

 Most sufferers experience an alternation of episodes

 Some experience mixed episodes

Bipolar 2: Hypomanic episodes and major depressive episodes

 No history of manic episode

 Significant distress and sysfunction

What is rapid cycling bipolar disorder?

Rapid cycling bipolar disorder is a severe form of bipolar I or II defined by four or more mood episodes (mania, hypomania, or depression) within 12 months.

Conversion disorder

People with this disorder suffer actual changes in physical functioning, they are not purposefully faking symptoms

Somatic symptom disorder

People with these disorders have many long-lasting physical ailments that have little or no organic basis. Less dramatic than conversion

Differences between primary and secondary gains.

Primary gain: hysterical symptoms keep internal conflicts out of conscious awareness

Secondary gain: hysterical symptoms further enable people to avoid unpleasant activities or receive sympathy from others

What is the method of action for tricyclics?

Tricyclic antidepressants (TCAs) primarily act by inhibiting the reuptake of norepinephrine and serotonin (5-HT)