PSY 341 - Exam 2

Anxiety

Notes: Negative mood state characterized by bodily symptoms of physical tension, and apprehension about the future (APA, 1994).

Book: The central nervous system's physiological and emotional response to a vague sense of threat or danger

What is the Yerkes-Dodson Law?

At low or high levels, arousal causes poor behavioral performance, whereas at intermediate levels it causes better, or optimal performance.

Fear

Notes: Immediate alarm reaction to danger.

Book: The central nervous system's physiological and emotional response to a serious threat to one's well-being.

What is the difference between anxiety and fear?

Fear is the response to a threat of our well-being, anxiety is the response to the "unknown" such as the future. Anxiety is also the response to a vague sense of threat or danger.

obsessive-compulsive disorder (OCD)

DSM-5: Presence of recurrent obsessions, compulsions, or both

Book: A disorder in which a person has recurrent and unwanted thoughts and/or a need to preform repetitive and rigid actions.

What are the two components of Obsessive Compulsive Disorder?

Obsessions and Compulsions.

obsession

Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress.

compulsion

A repetitive and rigid behavior (e.g. hand washing, checking, ordering) or mental acts (e.g. praying, counting, repeating words silently) that a person feels driven to preform in order to prevent or reduce anxiety.

What is the purpose of a compulsion?

The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address, or they are clearly excessive.

What is the behavioral treatment for OCD?

exposure with response prevention.

What is Specific Phobia?

A severe and persistent fear of a specific object or situation that is excessive or unreasonable, lasting at least 6 months.

What are the major behavioral approaches to treatment for Specific Phobia?

Exposure Treatment: Systematic desensitization, Flooding, and Modeling.

Social Phobia/Social Anxiety

DSM-5: Marked, disproportionate, and persistent fear or anxiety about one or more social situations in which an individual is exposed to possible scrutiny by others.

Book: A sever and persistent fear of social or performance situations in which embarrassment may occur.

What is the focus of treatment for Specific Phobia in psychodynamic treatment?

Content of phobia is the focus; the phobia object or situation is the symbol of unconscious fear.

What is the cognitive-behavioral treatment for Social Phobia?

Develop hierarchy of feared situations.

Identify automatic thoughts.

Challenge/restructure Ats (automatic thoughts).

Construct rational responses.

Exposure!!

What is a cognitive distortion/maladaptive assumption?

guided by irrational beliefs that lead them to act and react in inappropriate ways.

Assumptions/interpretations (cognitions), behaviors, physiological anxiety response

What are the three parts of the cognitive behavioral model?**

Cognition, Physio, Behavior

What are some types of cognitive distortions?

All or nothing thinking: Sees things in black and white categories.

Jumping to conclusions: Negative interpretations without evidence.

Jumping to conclusions includes: Mind reading: Conclude someone is reacting negatively to you and don't bother to check it out.

Fortune-teller error: anticipate things will turn out badly, and feel your prediction is an established fact.

Generalized Anxiety Disorder (GAD)

DSM-5: Excessive or ongoing anxiety and worry about two or more activities or events, for at least 3 months.

What is the psychodynamic explanation for GAD?

Neuroses: repeated failure of the ego defense mechanism to reduce the intense anxiety aroused by id impulses.

Panic Disorder

An anxiety disorder marked by recurrent and unpredictable panic attacks.

What are some forms of Panic Disorder?

Comorbidity and Nocturnal panic

What is the difference between a panic attack and "normal" anxiety?

Panic attacks occur suddenly and unexpectedly. They often reach their peak within minutes, and gradually pass. With anxiety attacks, you can usually pin point the cause of the attack and can last any where from minutes to days or weeks.

What is the most effective treatment for panic disorder?

Cognitive behavioral therapy (CBT)

What structure in the brain is overactive in potentially threatening situations?

Amygdala

What is a stressor?

an event that creates a sense of threat by confronting a person with a demand or opportunity for change of some kind.

What is a chronic stressor?

continuous and long term stress

What is the behavioral explanation for the maintenance of Social Phobia?

A very intense anxiety, anticipatory anxiety, physiological anxiety response.

Stress Response

A person's particular reactions to stress.

sympathetic nervous system

The nerve fibers of the autonomic nervous system that quicken the heartbeat and produce other changes experienced as arousal and fear.

What does the sympathetic nervous system do?

Dilates pupils, relaxes bronchi in lungs, accelerates/strengthens heartbeat, inhibits stomach/pancreatic activity, stimulates glucose production by liver, stimulates secretion of adrenaline/noradrenaline

How does the brain react to stress?

Amygdala activates hypothalamus.
Hypothalamus activates sympathetic nervous system.
Pituitary releases adrenaline

What is the fight or flight response?

Also known as the freeze response, is the psychological reaction to a stressful situation. (Stress Response)

What is your core affective state (what are the two dimensions that make up your current physiological state)?

Pleasant and unpleasant

parasympathetic nervous system

The nerve fiber of the automatic nervous system that help return bodily processes to normal

What does the parasympathetic nervous system do?

Helps return the bodily processes to normal.

Contracts pupils, constricts bronchi in lungs, slows heartbeat, stimulates stomach/pancreatic activity, stimulates secretion of adrenaline/noradrenaline

What is adrenaline and noradrenaline

Another name for epinephrine and norepinephrine respectively.

What is the hypothalamic-pituitary-adrenal pathway (aka HPA axis)?

One route by which the brain and body produce arousal and fear.

What are corticosteroids?

A group of hormones, including cortisol, released by the adrenal glands at times of stress.

What can a person actively do to reduce the stress response in the moment?

Relaxation techniques and diaphragmatic breathing

What are some lifestyle changes that can keep the body's physiological state more relaxed?

Exercise, healthy diet, social support, and sleep

Acute Stress Disorder (ASD)

A disorder in which a person experiences fear and related symptoms soon after a traumatic event but for less than a month.

post-traumatic stress disorder (PTSD)

A disorder in which a person continues to experience fear and related symptoms long after a traumatic event.

1. What is the difference between Acute Stress Disorder and Posttraumatic Stress Disorder?

With acute stress disorder, the symptoms begin within four weeks of the event and last less than a month, as for PTSD symptoms can begin at ant time following the event, but must last longer than a month.

T or F? Posttraumatic Stress disorder can develop from acute stress disorder?

True

What is a potentially traumatic event (PTE)?

- an experience that can cause physical, emotional, or psychological distress or harm

- Perceived and experienced as a threat to one's safety or the stability of one's world

What is an example of potentially traumatic event (PTE)?

Abuse, Military combat, Violent personal assault (sexual assaults, physical attack, robbery, mugging), War, Being kidnapped, Terrorist attack, Torture, Natural or manmade disasters, Severe automobile accidents, Being diagnosed with life-threatening illness

How does the DSM-IV define a traumatic event (criterion A event)?

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence as follows:

· Direct exposure

· Witnessing, in person

· Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental. (This is rare.)

· Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts, professionals repeatedly exposed to details of child abuse.) This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. (It's okay to seek help as a professional, because these things can be traumatic)

Which forms of abuse do not count as DSM-IV traumatic events?

Emotional abuse

What are the four domains in which people can have responses to PTEs?

Cognitive, emotional, physical, and interpersonal

What are the three patterns of responses to traumatic events?

Normal reaction to an abnormal situation, trigger response, and delayed response

What are the four symptom categories in PTSD (criteria B,C,D, and E)?

Intrusions, effortful avoidance, negative alterations in cognitions or mood, trauma-related alterations in arousal or reactivity.

Which PTSD criterion is most chronic (i.e., consistently present in someone with PTSD)?**

Intrusive symptoms: distressing memories, dreams, flashbacks, physical reactions such as hyperalertness.

What is a trigger?

An event, object, or sensory experience that is reminiscent of some aspect of the traumatic event AND that lead to the PTSD symptoms onset.

What are the risk factors for developing PTSD?

trauma type (magnitude/duration, single v. multiple/chronicity), individual (prior trauma, childhood trauma, physical and emotional health), and environmental (concurrent stressors, limited availability of professional care & treatment).

What are the disorders that most commonly occur with PTSD (are comorbid with PTSD)?

Substance abuse, major depressive disorder, and anxiety disorders.

What is EMDR?

eye movement desensitization and reprocessing - An exposure treatment in which clients move their eyes in a rhythmic manner form side to side while flooding their minds with images of objects an situations they ordinarily avoid.

How does EMDR work?

The method involves the patient following a finger/hand/light while they processes the traumatic memories/emotions.

What is critical incident stress debriefing?

also called Psychological debriefing is a for of crisis interventions in which members meet to talk about their feelings and reactions to traumatic incident stress.

How are Critical incident stress debriefings often conducted?

They are often in group format

What is currently the most effective treatment for PTSD?

"Talk" therapy/Cognitive behavioral therapy

What are the psychophysiological disorders?

disorders in which biological, psychological, and sociocultural factors interact to cause or worsen a physical illness

What is psychoneuroimmunology?

The study of the connections among stress, the body's immune system, and illness.

What is the difference between Type A and Type B personality?

Type A is characterized by hostility, cynicism, drivenness, impatience, competitiveness, and ambition.

Type B, the person is more relaxed, less aggressive, and less concerned about time.

What are dissociative disorders?

Disorders marked by major changes in memory that do not have clear physical causes.

What is dissociative fugue?

A form of dissociative amnesia in which a person travels to a new location and may assume a new identity, simultaneously forgetting his or her past.

What is dissociative amnesia?

DSM-5: Inability to recall important autobiographical information, usually of a traumatic or stressful nature, that inconsistent with ordinary forgetting.

Book: A dissociative disorder marked by an inability to recall important personal events and information.

What are the types of dissociative amnesia?

1. Localized (circumscribed) - loss of all memory of events occurring within a limited period of time.
2. Selective - loss of memory for some, but not all, events occurring within a period of time.
3. Generalized - begins with an event, but also extends back in time.
4. Continuous - forgetting of both old and new information and events.

What type of memory is affected by dissociative amnesia; what type of memory is NOT affected?

Episodic memory (i.e., autobiographical memory or personal material) is impaired.

Semantic memory (i.e., memory for abstract or encyclopedic information) usually remains intact

What is dissociative identity disorder?

DSM-5: Disruption of identity characterized by 2 or more distinct personality state.

Book: A disorder in which a person develops two or more distinct personalities. (use to be called multiple personality disorder).

How do subpersonalities differ in DID?

Vital statistics, Abilities and preferences, and Physiological response

How id DID described in some cultures?

As an experience of possession.

In DID, what does the disruption in identity involve?

It involves: marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensorimotor functioning.

What is the psychodynamic explanation for dissociative disorders?

- Psychodynamic theorists believe that dissociative disorders are caused by repression

- dissociative amnesia and fugue \= single episodes of massive repression

- did results from a lifetime of excessive repression, motivated by very traumatic childhood events

What is the behavioral explanation for dissociative disorders?

- Dissociation develops from normal memory processes and is a response learned through operant condition

- Escaping into an alternate personality decreases anxiety (and reinforces alternate personality)

What is state-dependent learning?

learning that becomes associated with the conditions under which it occurred, so that it is best remembered under the same conditions.

What are the steps of treatment for DID?

1. Recognizing the disorder.
2. Recovering the gaps in their memory.
3. Integrate their subpersonalities.

How is depersonalization disorder different from the other dissociative disorders?

Depersonalization/derealization disorder is not characterized by the memory difficulties found in the other dissociative disorders. Its central symptoms are persistent and recurrent episodes of depersonalization. People with depersonalization experience unreality, detachment, or being an outside observer with respect to one's thoughts, feelings, sensations, body, or actions.

What is Major Depressive Disorder?

A severe pattern of depression that is disabling and is not caused by such factors as drugs or a general medical condition.

What is a major depressive episode?

A period of two or more weeks marked by at least five symptoms of depression.

What are the symptoms of depression?

- Emotional symptoms: dejection, decreased enjoyment of pleasurable activities, low self-esteem

- Cognitive symptoms: pessimism and hopelessness

- Motivational symptoms: lack of drive, initiative, and spontaneity.

- Physical symptoms: loss of appetite, difficulty sleeping, loss of energy

What are the DSM-IV requirements for a diagnosis of MDD?

1. Presence of major depressive episode.
2. No pattern of mania or hypomania.

What is the DSM-IV criterion for MDD that is not mentioned in most antidepressant commercials? \***

either it causes increased thoughts of suicide or there are higher rates of relapse and recurrence when the drug is stopped

What is Unipolar Depression?

depression without a history of mania

What are the additional categorizations of MDD?

- With seasonal pattern: if symptoms vary with seasons.
- With catatonia: Marked by immobility or excessive activity
- With peri-partum onset: if onset during pregnancy or within 4 weeks of giving birth (also known as post-partum).
- With melancholic features: person almost completely unaffected by pleasurable events
- With atypical features: mood-congruent or incongruent psychotic symptoms
- With anxious distress: with anxiety (e.g., tense, keyed up)
- With mixed features: with some manic features

What is Bipolar Depression?

a disorder marked by alternating or intermixed periods of mania and depression.

What is Mania?

A state or episode of euphoria or frenzied activity in which people may may have an exaggerated belief that the world is theirs for the taking.

What is a manic episode?

A period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week, nearly every day.

Bipolar 1 disorder

a type of bipolar disorder marked by full manic and major depressive episodes

Bipolar 2 disorder

a type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes

What is the difference between Bipolar I and Bipolar II?

In bipolar I, the person is in full manic or has a history of manic episodes. Where as a person with bipolar II, has no history of manic episodes.

What is Cyclothymic Disorder?

a disorder marked by numerous periods of hypomanic symptoms and mild depressive symptoms

What is hypomania?

a less severe form of mania

What is Dysthymic Disorder?

Now called Persistent depressive disorder. A chronic form of unipolar depression marked by ongoing and repeated symptoms of either major or mild depression.

What is premenstrual dysphoric disorder?

a disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation.

What is the etiology of MDD?

Biological, Cognitive, Behavioral, Psychodynamic, Sociocultural

What is the etiology of Bipolar Disorder?

Genetic, Biochemical,Life events (environmental), psychodynamic view.

What pattern of attributions is most likely to be seen in depression?

Internal/external
Global/specific
Stable/unstable

How does learned helplessness contribute to depressed mood?

Motivational deficits
Cognitive deficits
Emotional deficits

What are the biological treatments for depression?

Antidepressants, ECT, brain stimulation, and psychosurgery.