Psych 405 Module 2

disorders

fear

Central nervous systems's physiological and emotional response to a serious threat to one's well-being

anxiety

central nervous system’s physiological and emotional response to a vague sense of threat or danger

normal anxiety seen as a motivation

generalized anxiety disorder (GAD)

disorder marked by persistent and excessive feelings of anxiety and worry about many events

constant worry

paralyzed, overwhelmed and so anxious

free floating anxiety

GAD symptom, anxiety is always there 

women to men ratio GAD

2:1 ratio

GAD diagnosis checklist and symtoms

more than 6 months, uncontrollable ongoing anxiety

edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems

significant distress or impairment 

GAD sociocultural perspective

societal and multicultural factors

most likely to develop in people faced with dangerous ongoing social conditions or threatening environments

housing instability/poverty/pandemic/stigma

Separation Anxiety Disorder

extreme anxiety/panic when separated from key people

most common among children

GAD psychodynamic perspective (freud)

GAD occurs with high anxiety levels or inadequate defense mechanisms

ex: when kids get punished for ID impulses, they develop anxiety

GAD psychodynamic (today)

GAD can be traced back to early parent-child relationships

ex: toilet training (anal stage)

GAD psychodynamic therapies

free association

interpret transference, resistance, and dreams

short term therapy is more effective than long term

treatment for GAD (freudian, psychodynamic)

focus on control of ID

treatments for GAD (object-relations therapist, psychodynamic)

help identify and settle early relationship problems

GAD humanistic perspective

occurs when people stop looking at themselves honestly and acceptingly

set high standards

lack of unconditional positive regard-conditons of worth

GAD humanistic treatment

client-centered therapy

shows unconditional positive regard and support

not trying to change behaviors and thoughts, just acknowledging -doesn't really help

GAD cognitive- behavioral

problematic behaviors and dysfunctional thinking

GAD maladaptive assumptions (cognitive-behavioral, ellis)

guided by assumptions about safety, control, and react in bad ways

hold silent assumptions

particularly about dangers

metacognitive theory (cognitive-behavioral)

GAD

people hold positive and negative beliefs about worrying- ex: helps motivate, digs me in a hole

intolerance of uncertainty theory (cognitive behavioral)

GAD

people cant tolerate knowledge that negative events may occur, even if possibility is small

need an answer, often leads to spiraling

avoidance theory (borkovec, cognitive behavioral)

worrying helps reduce arousal by distracting from unpleasant feelings

rational emotive therapy (cognitive behavioral) 

 

helps change maladaptive assumptions

mindfullness-based cognitive behavioral therapy

sit in moment with thoughts

acceptance and commitment therapy (cognitive behavioral)

GAD

accept thoughts

ABC model of rational-emotive behavioral therapy (cognitive behvaioral)

Activating events

-tiggers emotional response

-external or internal events

Beliefs

-about your self

-rational or irrational

-spirals

Consequences

-outcomes resulting from beliefs

GAD biological perspective

caused mainly by biological factors

brain circuits-hyperactivity may lead to GAD

Benzos

provide anxiety relief

receptors recieve GABA

increase gaba

Gabapentinoids

anxiety reducing effect, increase GABA levels

Brain circuits

networks of brain structures working together

drug therapies for GAD

barbiturates (early)

benzos (early)-problems

Antidepressents (recent)increase seratonin and norepinephrine

antipsychotics (recent)

Phobia

intense and persistent fear of object, activity, or situation

desire to avoid

distress that interferes with functioning

Specific phobia

fear of object or situation

exposure produces fear

avoidance

distress or impairment

specific phobia women to men ratio

2:1

agoraphobia

fear of not feeling safe, being able to escape

worry about safety, embarrassment

lead to isolation

phobia (cognitive behavioral)

developed through classical conditoning (US, CS)

modeling

phobia (behavioral-evolutionary)

species-specific biological predisposition (snakes)

explains why some phobias are more common than others

specific phobias treatment

exposure therapy

desensitization

flooding

modeling

systematic-desensitization

common in phobia treatment

fear heiarchy-start small and work way

focus on grounding

VR

agoraphobia treatment

exposure therapy

telehealth or someone goes in house to help

fear heiarchy

social anxiety disorder

avoidance/fear of social interaction

fear of judgement. embarrassment

self fullfilling prophecy (social anxiety disorder)

go to party and sit in corner- no one approached me no one likes me

confirming your belief 

social anxiety disorder treatment

benzos

antidepressants

exposure therapy, systematic therapy

roleplaying

social skills training

panic disorder

linked with agoraphobia

short, out of random panic attacks, gradually pass

repeatedly

panic disorder women to men

2:1

panic disorder biological factors

hyperactive panic circuit

amygdala/hippocampus

panic disorder drug therapies

antidepressents-norepinephrine in panic brain circuit

benzos

panic disorder (cognitive behavioral)

bodily sensations are misinterpreted as medical problem and controlled by avoidance behavior

anxiety sensitivity

panic disorder (CBT)

correct misinterpretations of bodily sensations

educate about panic attacks

teach coping, grounding

OCD obsessions

persistent thoughts, ideas, impulses, images

intrusive

trying to ignore triggers anxiety

aware the thoughts are excessive 

OCD compulsions

repetitive and rigid behaviors or mental acts feel they must do to prevent anxiety

OCD women to men

1:1

OCD (psychodynamic cause and treatment)

battle with ID and Ego defenses

anal stage, over controlled toileting

free association and interpretation 

OCD (cognitive behavioral and therapy)

unwanted, intrusive thoughts

try to reduce thoughts with actions

exposure and response prevention exercises

OCD (biological cause and therapy)

genetics, hyperactive cortico-straito-thalamo-cortical brain circuit

antidepressents (seratonin)

OCD related disorders

hoarding

trichotillomania

excoriation(skin)

body dysmorphic disorder

stressor

event or pattern that causes arousal and fear

stress response

persons reaction to event (demands)

autonomic nervous system

2 parts

network of nerve fibers that connect central nervous system to other organs

endocrine system

network of glands throughout the body that release hormones

acute stress disorder

fear begins within four weeks of event last for less than a month

arousal, avoidance, don’t feel real, reexperiencing

PTSD

fear may begin shortly after event of months and years after, last longer than a month

traumatic event, death, SA, injury

dissociative

dreams

distress

sleep issues

arousal/alert

biological factors (PTSD and Acute)

hyperactive stress circuit

inherited

adverse childhood experiences (ACEs)

• neglect

• abuse

• parent conflict

• catastrophe

• family w psych issues

• poverty

prolonged grief disorder

severe, continuous symptoms of grief almost every day that occur for a year or more after death

preexisting memory impairments

way you view yourself and the world

ex: self blame, “i cant”

intolerance of uncertainty

worry about potential negative outcomes, need to feel control “was i right to…?”

multifinality

same type- different outcomes

equifinality

different type-same outcome

PTSD treatment

antidepressant

cognitive processing therapy (CPT)

midfullness-based techniques

exposure therapy (written, prolonged)

eye movement desensitization and reprocessing (EMDR)

cognitive processing therapy (CPT)

try to get patient to identify “stuck point” and the view of the trauma, and how to move on

written exposure therapy (WET)

for PTSD

unique therapy where you have the patient write down their traumatic situation and what they remember and listen to it over and over against until anxiety is no longer there

eye movement desensitization and reprocessing (EMDR)

It involves a series of steps that combine eye movements, cognitive processing, and relaxation techniques to try and help the brain process the memory (also uses lights)

Dissociative disorders

major changes in memory like one part of memory or identity becomes separated from others, triggered by traumatic events

identity

involves sense of who we are and where we fit in our environment

memory

helps shape our identity

dissociative amnesia

inability to recall important info usually stressful or upsetting info

often triggered by an upsetting event

protective measure

dissociative identity disorder (DID)

at least 2 different sub-personalities with unique set of memories, behaviors, thoughts, emotions

sometimes biological or adaptive (diff BPs, diff talents/languages)

localized dissociative amnesia

most common, lose all memory within a period of time

selective amnesia

lose memory for somethings but not all

continuous amnesia

forgetting continues into the future, rare in cases of dissociative amnesia

dissociative fugue

extreme dissociative amnesia, forget identity and past and flee to a new location

mainly last a week, sometimes up to a year

most people regain all memories and never have a reoccurrence

DID women to men ratio

3:1

switching (DID)

sudden movement from one personality to another, normally triggered by stress

Mutually amnesic realtionships

none of the personalities are aware of eachother

mutually cognizant patterns (relationship)

personalities are aware of each other and communicate

one-way amnesic relationship

some are aware and some are not (conscious personality vs. unconscious)

DID (cognitive view)

state-dependent learning

• link between state and recall, can also be associated with moods

ex: scared- 1 personality

happy-another personality

• conditioning

DID (psychodynamic view)

caused by repression

self-hypnosis

people may hypnotize themselves to forget trauma

DID and dissociative amnesia treatment

search unconscious

hypnotic therapy

drug therapy

depersonalization- derealization disorder

dissociative disorder, persistent, reoccurring episodes of depersonalization and/or derealization

aware of what is happening

triggered by fatigue, pain, stress, substance recovery

depersonalization

feeling separate from body

watching self from above

dreamlike, dizzy

aware that perceptions are distorted

derealization

seeing the external world is unreal and strange

changing object shape or size 

may see others as robots

aaron beck’s cognitive triad

negative view of oneself, ones expereinces, and ones future

Cortico-Striato-Thalamo-Cortical (CSTC) circuit

linked to OCD

panic/fear circuit

PTSD, anxiety, acute stress disorder,