PSCI 102C Quiz 2

What are the similarities and differences between panic disorder and agoraphobia?

Panic Disorder: experience of recurrent unexpected panic attacks (i.e., a false alarm), develop anxiety or worry or fear about another attack, and many develop agoraphobia
Agoraphobia: fear of being in places (pubic transport, open spaces, enclosed places, standing in line/a crowd, leaving home) in which it would be difficult to escape or get help in the event of unpleasant physical symptoms, may avoid these situations

Often occur together

Generalized Anxiety Disorder

Excessive uncontrollable anxious apprehension and worry about multiple areas of life (e.g., work, relationships, health) that persists for six months or more and sensitive to threats
Causes: generalized biological vulnerability, less responsiveness on physiological measures, low cardiac vagal tone, autonomic restrictors
Onset: median age is 30, more females, peaks in middle age
Symptoms: muscle tension, restlessness, fatigue, irritability, concentration difficulties, sleep disturbances
Treatment: psychological interventions (CBT) - evoke worry and confront images and thoughts head-on (more effective in the long term), pharmacotherapy - benzodiazepines (negative side effects) and antidepressants, meditation therapy - accepting of anxiety and not giving it weight, combined treatments - acute vs long-term outcomes

Social Anxiety Disorder (Social Phobia)

Extreme fear or discomfort in social or performance situations that markedly interferes with functioning and leads to avoidance of social situations or endured with great distress
Causes: biological and evolutionary vulnerability (adaptive to fear rejection), similar learning pathways as specific phobias
Onset: adolescence, peaks around 13, females
Symptoms: avoidance of social situations because of fear or anxiety of being exposed to possible scrutiny
Treatment: cognitive-behavioral treatment (highly effective), cognitive-behavioral group treatment, SSRIs, beta blockers, benzodiazepines (relapse rates are high following medication discontinuation)

Specific Phobia

Extreme irrational fear of a specific object or situation where the person will go to great lengths to avoid phobic objects. While most recognize the fear and avoidance and unreasonable, it still interferes with their ability to function
Causes: direct experience, biological and evolutionary vulnerability, traumatic conditioning, preparedness
Onset: females, run a chronic course
Symptoms: fear, anxiety, distress, impairment
Treatment: cognitive-behavior therapy (highly effective with exposure)

Obsessive-Compulsive Disorder (OCD)

A vicious cycle of obsessions and compulsions
Causes: parallels the other anxiety disorders, early life experiences, learning that some thoughts are dangerous/unacceptable, thought-action fusion (the thought is similar to the action; thinking something will make it more likely to happen)
Onset: early adolescence, young adulthood, equal gender distribution
Symptoms: the obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in important areas of functioning
Treatment: biological treatment - clomipramine and others SSRIs (benefit up to 60% of patients), relapse is common with medication discontinuation, psychosurgery (cingulotomy) is used in extreme cases, psychological treatment - CBT is most effective and involves exposure to anxious cues and prevention of ritualized response, combining CBT with medication is no better than CBT alone

Posttraumatic-Stress Disorder (PTSD)

Trauma exposure and response that markedly interferes with functioning

Causes: intensity of trauma and one’s reaction to it, learn alarms (direct conditioning and observational learning), biological vulnerability, uncontrollability and unpredictability, exposure to actual or threatened death, serious injury, or sexual exploitation
Symptoms: recurrent and intrusive memories, dreams, flashbacks, avoidant of stimuli, restriction or numbing of emotional responsiveness
Treatment: social support post-trauma reduces risk, psychological treatments - CBT (highly effective) that can include graduated or massed (flooding) imaginal exposure, develop narrative of traumatic event to process understanding, challenge maladaptive beliefs about the world, medication - generally use medications effective against anxiety and panic, SSRIs

Define and explain the differences among specific, situational, animal, and natural environment phobias

Specific Phobia: Unreasonable fear of a specific object or situation that markedly interferes with daily life functioning
Situational Phobia: Anxiety involving enclosed places (like claustrophobia) or public transportation (like fear of flying)
Animal Phobia: Unreasonable, enduring fear of animals or insects that usually develops early in life
Natural Environment Phobia: Fear of situations or events in nature, especially heights, storms, and water

What are the impacts of biology, gender, and culture on phobias?

Biology:
Gender:
Culture:

Fear

Emotion of an immediate alarm reaction to present danger or life-threatening emergencies. A present-oriented mood state. Immediate fight or flight response to danger or threat. Involves abrupt activation of the sympathetic nervous system. Strong avoidance/escapist tendencies. Marked negative affect

Anxiety

Mood state characterized by marked negative affect and bodily symptoms of tensions in which a person apprehensively anticipates future danger or misfortune. May involve feelings, behaviors, and physiological responses. A future-oriented mood state. Apprehension about future danger or misfortune. Physical symptoms of tension. May lead to avoidance of situations likely to provoke fear

Acute Stress Disorder

Occurs within the first month after trauma (PTSD can’t be diagnosed until after a month). Severe reaction immediately following a terrifying event, often including amnesia about the event, emotional numbing, and derealization. Many victims later develop posttraumatic stress disorder.

Trauma- & Stressor-Related Disorders

PTSD, acute stress disorder, adjustment disorders (clinically significant emotional and behavioral symptoms in response to one or more specific stressors), and attachment disorder (developmentally inappropriate behaviors in which a child is unable or unwilling to form normal attachment relationships with caregiving adults). They all share a common etiology - stressful experiences.

Obsessive-Compulsive & Related Disorders

OCD, hoarding disorder, body dysmorphic disorder, trichotillomania (people’s urge to pull out their own hair from anywhere on the body including scalp, eyebrows, and arm), excoriation (recurrent, difficult-to-control picking of one’s skin leading to significant impairment or distress)

Body Dysmorphic Disorder

A preoccupation with some imagined defect in appearance by someone who looks reasonably normal. Persistent and intrusive thoughts about appearance accompanied with compulsive behaviors. Two effective treatments - drugs that block the re-uptake of serotonin and exposure and response prevention, CBT

Blood-Injection-Injury Phobia

Unreasonable fear and avoidance of exposure to blood, injury, or the possibility of an injection. Victims experience fainting and a drop in blood pressure

Obsessions

Recurrent intrusive thought or impulse the client seeks to suppress or neutralized while recognizing it is not imposed by outside forces

Panic Attack

An abrupt experience of intense fear. Physical symptoms include heart palpitations, chest pain, dizziness, sweating, chills, or heat sensations. Cognitive symptoms include fear of losing control, dying, or going crazy

Compulsions

Repetitive, ritualistic, time-consuming behavior or mental act a person feels driven to perform

Dissociative Identity Disorder (DID)

The adoption of several new identities (from 15-100), where the identities display unique behaviors, voice, and postures
Causes: history of severe, chronic trauma, often abuse in childhood, closely related to PTSD, mechanism to escape from the impact of trauma, biological vulnerability possible
Onset: almost always in childhood or adolescence
Symptoms: two or more distinct personality states, disruption of marked discontinuity in sense of self and agency, alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning
Treatment: focus on reintegration of identities, identify and neutralize cues/triggers that provoke memories of trauma/dissociation, patient may have to relive and confront the early trauma (hypnosis)
Controversy: widespread reports of child abuse preceding DID came only after a movie, relatively few clinicians diagnose a large number of cases, requires therapist to reify distinct personalities

Illness Anxiety Disorder

Physical complaints without a clear cause. Severe anxiety about the possibility of having a serious disease where medical reassurance doesn’t help
Causes: cognitive perceptual distortions and familial history of illness
Onset: any age, sex ratio equal
Symptoms: very mild or absent, main problem is worry about having serious illness, a high level of anxiety about health
Treatment: challenge illness-related misinterpretations, provide more substantial and sensitive reassurance and education, stress management and coping strategies, CBT, antidepressants

Somatic Symptom Disorder

Presence of one or more medically unexplained symptoms. Substantial impairment in social or occupational functioning. Disorder involving extreme and long-lasting focus on multiple physical symptoms for which no medical cause is evident
Causes: little is known, may include familial history of illness, stressful life events, sensitivity to physical sensations, experience suggesting that there are benefits to illness (attention)
Onset: adolescence, most likely to affect unmarried, low SES women
Symptoms: disproportionate and persistent thoughts about the seriousness of one’s symptoms, high level of health-related anxiety, excessive time and energy devoted to these symptoms or health concerns
Treatment: CBT, reduce the tendency to visit numerous medical specialists (“doctor shopping”), assign “gatekeeper” physician, reduce supportive consequences of talk about physical symptoms

Can dissociative identity disorder be faked? Why or why not?

Can DID be faked

What are alters, and how are they related to dissociate identity disorder?

Shorthand term for alter ego, one of the different personalities or identities in DID

Define and explain the differences between conversion disorder, malingering, and factitious disorder

Conversion Disorder: physical malfunctioning of sensory or motor functioning (like blindness or difficulty speaking) without any physical or organic pathology
Malingering: deliberate faking of a physical or psychological disorder motivated by gain
Factitious Disorder: non-existent physical or psychological disorder deliberately faked for no apparent gain except, possibly, sympathy and attention

What is the difference between depersonalization and derealization?

Depersonalization: temporarily losing the sense of your own reality, as if you were in a dream or were watching yourself
Derealization: situation in which the individual loses a sense of the reality of the external world (e.g., things seem like they’re changing shape)

Dissociative Disorder

Disorder in which individuals feel detached from themselves or their surroundings and feel reality, experience, and identity may disintegrate

Localized or Selective Amnesia

Memory loss limited to specific times and events, particularly traumatic events

Dissociative Amnesia

Dissociative disorder featuring the inability to recall personal information; usually of a stressful or traumatic nature

Generalized Amnesia

Loss of memory of all personal information, including identity

Dissociative Fugue

Dissociative disorder featuring sudden, unexpected travel away from home, along with an inability to recall the past, sometimes with assumption of a new identity