Psychopathology Exam 3

DSM criteria for Obsessive-Compulsive Disorder

- Obsessive-Compulsive Disorder is characterized by the presence of (1) obsessions and/or (2) compulsions.

- obsessions/ compulsions are time consuming (at least 1 hour per day)

the difference between obsessions and compulsions

obsessions- repetitive thoughts

compulsions- repetitive behaviors

the difference between autogenous and reactive obsessions

- Autogenous obsessions are intrusive thoughts, feelings, or urges that are not in response to external stimuli (unwanted).

- Reactive obsessions are thoughts, feelings, or urges that are provoked by something in the environment.

the primary motivation of compulsions

to alleviate fear or anxiety related to obsessions

treatments for OCD

- drug therapies

- psychotherapies: CBT and ERP

Exposure and Response Prevention (ERP)

Exposure

- Exposing the individual to the unwanted stimulus (e.g., germs, public places, etc.)

- The individual may create a hierarchy of fears or unwanted experiences

Response Prevention

- After being exposed, the individual refrains from engaging in safety behaviors, or acts that alleviate the uncomfortable experience (e.g., handwashing, checking).

DSM criteria for Body Dysmorphic Disorder

- a preoccupation with the perceived defects in one's physical appearance.

- The focus of the preoccupation is unobservable to others or appears slight.

the primary features of Body Dysmorphic Disorder

- the preoccupation is excessively distressing, time-consuming (e.g., 5 hours per day), and difficult to control.

- spend an excessive amount of time, money, or energy in behaviors intended to alleviate the associated distress.

The primary reason why people hoard in Hoarding Disorder

due to a perceived potential need for the item

DSM criteria for Trichotillomania

- characterized by the recurrent pulling out of one's own hair

- most commonly involves the scalp, the eyebrows, and the eyelashes.

DSM criteria for Excoriation

- involves the recurrent picking of one's skin and subsequent, repeated attempts to decrease or stop the skin-picking.

- most commonly occurs on the face, arms, and hands.

The features of, and differences between Excoriation and Trichotillomania

- Both involve repetitive body-focused behaviors performed despite attempts to stop and both cause distress or impairment.

- The key difference lies in the target of the behavior—skin vs. hair—and the physical consequences that result (lesions vs. hair loss).

- Excoriation is more associated with imperfections

DSM criteria for Selective Mutism

- Selective Mutism is a consistent failure to speak in situations that warrant speech

- In Selective Mutism, the individual speaks in some contexts but not in others (home vs school)

- often the result of high social anxiety

- typically begins before the age of 5 and most commonly subsides by early adulthood

in what circumstances mutism is likely to present in the case of Selective Mutism

They often are comfortable speaking with first-degree relatives but may fail to speak in the presence of close friends, school, or more distant relatives.

the age onset of Selective Mutism

5

DSM criteria for Specific Phobia

- anxiety or fear related to specific objects or situations.

- Exposure to the phobic object or situation almost always provokes an immediate fear response that is out of proportion to the actual threat of the object or situation

- anxiety or fear is persistent, typically lasting 6 months or more.

- Avoidance is a primary feature

what medication is used (but not very safe) for Specific Phobias

Benzodiazepines

DSM criteria for Panic Disorder

- recurrent brief, unexpected, and intense surges of fear or discomfort (panic attacks).

- can occur in the absence of an anxious state or in the presence of anxiety

- a period (1 month or more) of persistent concern or worry about having another panic attack OR changes in behavior related to the panic attacks

- Panic attacks often do not have a specific trigger and appear to "come out of the blue."

the specific requirements for Panic Disorder

a period (1 month or more) of persistent concern or worry about having another panic attack OR changes in behavior related to the panic attacks

Exposure Therapy

An approach to treatment that involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in the emotional response

types of exposure therapy

- Imaginal Exposure: Imaginal Exposure is often the first step in Exposure therapy and involves exposure to a mental representation of the feared stimulus (i.e., thinking about it)

- In Vivo Exposure: In Vivo Exposure is real-life exposure to the feared stimulus (e.g., going to a dog park).

- Virtual Reality Exposure: Virtual Reality exposure is useful when in vivo exposure is not practical (e.g., fear of flying on planes; fear of heights).

DSM criteria for Social Anxiety Disorder

- the individual fears that they will be negatively evaluated leading to embarrassment, rejection, or humiliation.

- Social situations are avoided or endured with extreme anxiety.

- The fear or anxiety is disproportionate to the actual threat.

- may present in specific social scenarios (e.g., public speaking, performance evaluations) or may be more generalized to a range of social interactions.

- often reinforced by fears of appearing anxious.

specific fears associated with Social Anxiety Disorder

being negatively evaluated leading to embarrassment, rejection, or humiliation.

Grounding

Grounding techniques are coping strategies used to help a person detach from emotional distress, anxiety, or flashbacks by refocusing attention on the present moment — the "here and now."

DSM criteria for Agoraphobia

- is afraid of being in a situation in which escape would be difficult if needed due to an embarrassing behavior

- The agoraphobic situation is avoided or endured with intense anxiety.

specific fears associated with Agoraphobia

- situations include being on a plane, subway, bus, auditorium, in a line, or open spaces such as a parking lot.

- fears include panic attack, incontinence, fear of falling in elderly people

DSM Criteria for Enuresis

- repeated voiding of urine that either occurs twice a week for 3 consecutive months OR causes significant distress or impairment in functioning.

- cannot be diagnosed until the individual reaches a developmental age of 5

DSM criteria for Encopresis

- defecating at inappropriate times and must occur at least once per month for 3 consecutive months.

- individual is at least 4 developmental years old.

DSM criteria for Pica

- the intake of nonfood substances over a period of at least 1 month that is not appropriate based on developmental level or cultural context.

- most commonly diagnosed in young children, pregnant women, or those with other mental health disorders

DSM criteria for Anorexia Nervosa

- Restriction of energy intake relative to requirements, leading to a significantly low body weight (less that that minimally expected)

- Intense fear of gaining weight or of becoming

fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

- Disturbance in the way in which one's body weight or shape is experienced

1. Restricting Type: Over the last 3 months, the individual has not engaged in binging or purging behavior and the primary cause of weight loss is of a restrictive nature (e.g., dieting, fasting, excessive exercise).

2. Binge-eating/Purging Type: During the last 3 months, the individual has engaged in recurrent episodes of binge-eating or purging behavior.

DSM criteria for Bulimia Nervosa

A) recurrent episodes of binge eating characterized by both:

1. eating in a discrete period of time, an amount of food that is larger than what most individuals would eat in similar situations and time.

2. sense of lack of control over eating

B) recurrent inappropriate compensatory behaviors to prevent weight gain

C) both behaviors of A and B occur at least once a week for 3 months

D) self-evaluation is unduly influenced by body shape and weight

general features of Pica

the intake of nonfood substances over a period of at least 1 month that is not appropriate based on developmental level or cultural context.

the difference between Anorexia Nervosa and Bulimia Nervosa

Anorexia Nervosa is characterized by a significantly low low body weight

time requirements for Bulimia Nervosa and Anorexia Nervosa (how many episodes of binging and for how long)

- anorexia nervosa: no set frequency or duration

- bulimia nervosa: greater than one binge and compensatory behavior per week, for at least 3 months

DSM Criteria for Reactive Attachment Disorder

- requires child neglect

- Children with Reactive Attachment Disorder rarely seek comfort when distressed or fail to respond to comfort when distressed.

- They exhibit minimal social or emotional responsiveness to others and have limited positive affect (they often appear irritable, sad, tearful, etc.).

- symptoms must have been evident before the chronological age of 5 with a developmental age of at least 9 months

DSM criteria for Posttraumatic Stress Disorder

- Exposure to actual or threatened death, serious injury, or sexual violence

-must display a variety of symptoms:

1.) Intrusive Symptoms

2.) Avoidance (maintains the other 3 sources)

3.) Cognitive/Mood Symptoms

4.) Arousal Symptoms

- Symptoms must be present for a minimum of 1 Month.

DSM criteria for Acute Stress Disorder

- Symptoms are the same as those of PTSD but 9 symptoms must be present from any of the four categories previous mentioned.

- The duration of these symptoms is 3 days to 1 month.

DSM criteria for Prolonged Grief Disorder

- The death, at least 12 months ago (6 months for children and adolescents)

- persistent grief response at least 1 month:

1.) Intense yearning/longing for the deceased individual.

2.) Preoccupation with thoughts or memories of the deceased person.

- Since the death, at least 3 of the following symptoms have been present most days:

1.) Identity disruption

2.) Marked sense of disbelief about the death

3.) Avoidance of reminders that the person is dead

4.) Intense emotional pain

5.) Difficulty reintegrating into one's relationships and activities after the death

6.) Emotional numbness

7.) Feeling that life is meaningless after the death

8.) Intense loneliness as a result of the death

the cause of Reactive Attachment Disorder

- results from severe social and emotional neglect in childhood.

- often involves lack of basic needs (e.g., comfort, stimulation, social interaction) or a lack of consistent caregivers limiting the ability to form healthy attachments.

- Many individuals are placed in foster-care or other unstable caring environments.

the 4 specific symptom categories of PTSD

1.) Intrusive Symptoms

2.) Avoidance

3.) Cognitive/Mood Symptoms

4.) Arousal Symptoms

the time requirements for PTSD vs. Acute Stress Disorder

ASD requires 3 days- 1 month

PTSD requires a minimum of 1 month

treatments for PTSD

Drug Therapies:

- SSRIs

- SNRIs

- Prazosin (blood-pressure medication used for nightmares)

Psychotherapies:

- Cognitive Processing Therapy

- Eye-movement Desensitization and Reprocessing (EMDR)

- Prolonged Exposure (PE)