Clinical Psych Exam 2

Panic Attack

A sudden episode of extreme anxiety involving four or more panic symptoms

Panic Symptoms

Dizziness, Shortness of breath, Racing heart, Trembling

Panic Disorder

Recurring and unexpected panic attacks followed by at least one month of worrying about additional attacks or their consequences (heart attack)

Specific Phobia

A strong fear of a specific object or situation that causes anxiety and avoidance

Social Anxiety Disorder

A strong and persistant fear of social or performance situations where a person can be negatively evaluated by others

Etiology

The causes or factors that contribute to a disorder

Brain Structure

Differences or dysfunction in brain areas involved in detecting and responding to threats may increase panic

Neurotransmitters

Chemical messangers that allow neurons to communicate

Abnormalities in Neurotransmitters

May contribute to anxiety and panic

Brain acidosis

An increased acidity in brain tissue which can activate suffocation alarm mechanisms and trigger panic attacks

People who have panic disorders are more affected when - Brain Activity

They are submitted to procedures with increased brain activity; sensitivity

Cognitive Model

Panic develops or worsens when people interpet normal bodily sensations catastrophically

Anxiety Sensitivity

Believing that bodily sensations associated with anxiety are harmful or dangerous

Interoceptive Awareness

Heightened awareness of bodily sensations

Interoceptive Conditioning

Bodily sensations associated with previous panic attacks become conditioned signals that another attack is coming

Behavioral Model

Panic can be learned and maintained from conditioning and avoiding

Behavioral Model In Panic Example

Avoiding feared situations prevents a person from learning that they are actually safe

Cognitive Behavioral model

Bodily change is noticed → interpreted as dangerous → anxiety increases → Bodily change increases → those symptoms seem even more dangerous which creates a long cycle of panic

Panic Control Treatment

A cognitive-behavioral treatment that teaches people how to understand panic, reinterpret bodily sensations and develop coping tools

Psychoeducation

Teaching a person what panic is, how symptoms occur, and why the sensations themselves are not necessarily dangerous

Interoceptive Exposure

Purposefully producing feared bodily sensations so the person can learn how to tolerate them

SSRI’S

Selective Serotonin reuptake inhibitors

SNRI’S

Seratonin Norepinephrine reuptake inhibitors

Direct Learning Phobia

Developing a fear after personally experiencing something negative associated with feared subject

Observational Learning Phobia

Developing a fear after observing someone displaying fear from the subject

Informational Learning Phobia

Developing a fear by hearing or reading that something is dangerous

Classical Conditioning - Phobia

A previously neutral object or situation becomes associated with fear

Disgust

Defensive emotion that creates avoidance and rejection usually due to fear of contamination or disease

Systematic Desensitization

Treatment involving relaxation, a fear hierarchy and gradual exposure to feared stimuli

Fear Hierarchy

List of fears, least to most frightening

Flooding

Treatment with intense exposure to feared stimuli

Cognitive Elements (SAD)

People with social anxiety disorder have high standards and focus on negative elements

Emotional Reasoning (SAD)

Assuming that because you feel something it must reflect reality

Negative Beliefs (SAD)

Strong beliefs about being socially incompetent

Behavioral Elements (SAD)

Avoidance and safety behaviors maintain social anxiety

Safety Behaviors (SAD)

Avoiding eye contact, rehearsing sentences, staying beside a “safe” person, speaking as little as possible

Behavioral Experiments

Dropping safety behaviors to test predictions

EX: If I stop for five seconds everyone will think i’m incompetent, stopping and observing what happens

OCD

A disorder causing obsessions, compulsions or both; extreme distress

Obsession

Recurrent or persistant intrusive thoughts, urges and images

Compulsions

Repetitive behaviors or mental acts a person needs to do to reduce distress and feared outcomes

Epidemiology

The study of how common a disorder is and how it is distributed across populations

Epidemiology in OCD

1-2% Yearly Prevalence; 2-3% lifetime prevalence

Scrupolsity

OCD involving religious or moral fears

Neurocircutory

The brain circuits associated with a behavior or disorder

CSTC Loop

Hyperactive circuts related to habits and compulsive behavior

Behavioral Perspective of OCD

Compulsions are maintained becasue they temporarily reduce anxiety; reinforce

Cognitive perspective of OCD

The person interprets intrusive thoughts as extremely meaningful and important; increases anxiety

Exposure and Response Prevention (ERP)

Confront something that triggers OCD → Do not perform compulsion; Helps 65-75%

Habituation

Becoming accustomed to a stimulus so response decreases with exposure

Inhibitory Learning

Developing a new association that competes with an existing fear association

EX: Dirt= Disease NO “Dirt does not always carry disease”

Serotonin Based Anti Depressants

Helps up to 60% of OCD patients

PTSD

A trauma and stress disorder related to death, threat of death, injury, Smeguall assault

Criterion A: Stressor

Stressors can occur from first hand experience, hearing others talk about trauma

Four PTSD Symptom Cluster

Intrusion, Avoidance, Negative alterations in cognition and mood, Alterations to arousal and reactivity

Intrusion

Trauma involuntarily comes back into awarness; nightmares, flashbacks

Avoidance

Avoiding trauma related people, feelings, places

Negative alterations in cognition and mood

Persistant negative changes in emotions; guilt, shame, self doubt

Alterations in arousal and reactivity

Increased psychological reactivity; irritation, concentration and sleep problems

Depersonalization

Feeling detached from yourself as you are an outside figure looking in

Derealization

Feeling like your surroundings are distant and unusual

Delayed Expression

The full diagnostic criteria is not met until at least 6 months after trauma

Complex PTSD

Prolonged or difficult trauma that is hard to escape from

Extra symptoms of complex PTSD

negative self concept, relationship difficulties

PTSD Vulnerability

Factors that influence why one person may develop PTSD while another does not

Event Severity

More severe trauma can impact PTSD vulnerability

Duration

Longer lasting trauma can impact vulnerability

Proximity

How closely someone experiences traumatic event can affect vulnerability

Human Generator Stressor

Human made trauma (instead of natural causes) can affect vulnerability in PTSD

Social Support

The presense or absense of social support can affect PTSD vulnerability

Cognitive Traps

Problematic patterns of thinking when addressing trauma can maintain that distress: distorted blame, weird thoughts on the world

Behavioral Explanation of PTSD

Avoidance plays a major role in maintaining PTSD symptoms

Trauma Focused Psychotherapy

Engages trauma focused conversation so new learning can begin

Prolonged Exposure (PE)

Treatment involving repetitive engagements of truama memories and situations

Cognitive Process Therapy

Therapy that identifies and challenges traumatic related beliefs called stuck points

Stuck Points

Unhelpful or inaccurate beliefs about the traumas cause or consequences

EX: “It was my fault” “I cant trust anyone”

EDMR

Using eye movements to retrace traumatic memories

Written Exposure Therapy

Writing about the trauma

MDMA Assisted Psychotherapy

MDMA administered while doing psychotherapy