Psychology Anxiety, OCD, Trauma, Mood & Bipolar Disorders

What is the primary difference between anxiety and fear?

Anxiety is a future-oriented mood state, while fear is a present-oriented mood state marked by negative affect.

What are the two primary responses of the body when confronted with danger?

One signal goes to the cerebral cortex (slow but accurate), and another goes to the limbic system/amygdala (quick but not always accurate).

How can anxiety be adaptive?

Anxiety helps us plan for future threats, prepare, avoid potentially dangerous situations, and problem-solve.

What is a key benefit of fear?

Fear prepares us to respond to immediate threats and can save lives.

What happens in maladaptive anxiety disorders?

The fear system misfires, causing individuals to experience fear even when no danger is present, leading to significant distress and impairment.

What evidence supports the impact of early life stress on anxiety?

Animal studies show that rat pups separated from their mothers have larger startle reactions, and human studies indicate that childhood abuse or early parental death increases anxiety disorders.

What personality traits are associated with increased risk of anxiety disorders?

Neuroticism and behavioral inhibition are risk factors; neuroticism is linked to frequent negative emotions, and behavioral inhibition relates to caution in novel situations.

How does social support influence anxiety symptoms?

Social support can buffer symptoms by reducing the intensity and persistence of emotional reactions to stressors, while lack of support can intensify symptoms.

What distinguishes normal worry from Generalized Anxiety Disorder (GAD)?

Normal worry does not disrupt daily activities and is controllable, while GAD involves uncontrollable worry that significantly disrupts life.

What is a defining feature of Generalized Anxiety Disorder (GAD)?

Uncontrollable worry about a wide range of different things.

What is the Contrast Avoidance Model in relation to GAD?

Individuals with GAD find rapid emotional shifts aversive and remain in a high state of worry to avoid these shifts.

What does Worry Control Treatment for GAD involve?

It includes identifying cognitive errors, replacing them with accurate thoughts, and preventing safety behaviors.

How effective is Cognitive Behavioral Therapy (CBT) for GAD compared to other treatments?

CBT is a short-term treatment that has shown large effect sizes, with 57% classified as recovered at 12 months.

What types of medications are commonly used to treat GAD?

Minor tranquilizers like benzodiazepines (e.g., Valium, Xanax) and antidepressants (e.g., Paxil) are used, though benzodiazepines can cause withdrawal symptoms.

What is the effect size of medication compared to placebo for GAD treatment?

Medication is more effective than placebo, with a small effect size (hedges g = .38) and limited long-term follow-up data.

What is the response of a person who perceives a garden hose as a snake indicative of?

This fear response is primarily due to information relayed quickly via the sensory thalamus (low road).

What do heritability studies suggest about anxiety disorders?

They suggest that the underlying cause of most anxiety disorders is likely genetic.

What is the relationship between neuroticism and anxiety disorders?

Individuals with high neuroticism are twice as likely to develop an anxiety disorder.

How does behavioral inhibition in infants relate to social anxiety disorder?

Infants with high behavioral inhibition are three times more likely to develop social anxiety disorder as adolescents.

What role does social support play in anxiety management?

Social support can reduce the intensity and persistence of anxiety symptoms, acting as a buffer against stress.

What are common cognitive errors in GAD that treatment aims to address?

Treatment aims to replace inaccurate thoughts with more accurate ones to help manage worry.

What is a panic attack?

An intense feeling of terror with symptoms like heart pounding, chest pain, dizziness, and feelings of unreality.

How long do panic attacks typically last?

Usually no more than 30 minutes.

What is panic disorder?

A condition characterized by unexpected panic attacks, persistent anxiety about having more attacks, and potential agoraphobia.

What percentage of the U.S. population is affected by panic disorder?

About 3.5%.

What is agoraphobia?

Fear or avoidance of situations/events due to anxiety about having a panic attack.

What is the typical onset age for panic disorder?

Between ages 25-29.

What role does the locus coeruleus play in panic disorder?

It is a major source of norepinephrine that, when activated by stress, can lead to increased heart rate and panic symptoms.

What is a common misinterpretation that can lead to panic attacks?

Interpreting unexplained physiological symptoms as a sign of something wrong, leading to increased anxiety.

What is the focus of cognitive-behavioral therapy (CBT) for panic disorder?

Exposure to bodily sensations associated with panic attacks and cognitive restructuring of inaccurate thoughts.

What are interoceptive exposures in the treatment of panic disorder?

Techniques that provoke panic-like symptoms in a safe environment to help patients cope.

What are specific phobias?

Intense and persistent fears of objects or situations that do not pose a real threat.

What are the two main components of specific phobias?

Fear and avoidance of the feared stimulus, along with anxiety about encountering it.

What is the median age of onset for specific phobias?

8 years old.

What are common types of specific phobias?

Animal phobias, natural environment phobias, situational phobias, and blood-injection-injury phobias.

What factors contribute to the development of specific phobias?

Genetic factors, sociocultural influences, and traumatic experiences.

What is the effectiveness of exposure treatment for specific phobias?

Exposure treatment is more effective than no treatment or placebo, with large effect sizes.

What is the importance of graduated exposure in treating specific phobias?

It helps patients activate their fear and learn that they are not in danger, allowing anxiety to peak and then subside.

What is the difference between in vivo and imaginal exposure?

In vivo exposure involves direct contact with the feared stimulus, while imaginal exposure involves visualizing the feared situation.

What is the relationship between specific phobias and other disorders?

The onset of specific phobias often precedes the onset of other disorders, indicating a potential vulnerability to psychopathology.

What is a common treatment approach for specific phobias?

Structured and consistent exposure to feared stimuli, often through multiple sessions.

What is the effect size for exposure treatment compared to no treatment?

Large effect size (g = 1.00).

What is the role of safety behaviors in panic disorder?

CBT aims to reduce and remove safety behaviors that reinforce anxiety.

What is the significance of the downward spiral in panic disorder?

It describes how misinterpreting physiological symptoms can lead to escalating anxiety and panic attacks.

What is obsessive compulsive disorder (OCD)?

A condition where a person has uncontrollable, recurring thoughts and/or behaviors that they feel the urge to repeat.

What are obsessions in the context of OCD?

Recurrent intrusive thoughts that cause anxiety.

What are compulsions in OCD?

Repetitive behaviors that a person feels the urge to perform in response to obsessive thoughts, usually to reduce anxiety.

What are the characteristics of a person with OCD?

They cannot control their thoughts or behaviors, spend at least 1 hour per day on them, do not derive pleasure from rituals, and experience problems in daily life.

What is exposure with response prevention (ERP)?

A treatment method where a person is exposed to items that trigger their obsessions while being prevented from engaging in compulsions.

What is body dysmorphic disorder (BDD)?

A preoccupation with an imagined defect in appearance or excessive concern over a slight defect, causing significant impairment or distress.

What are common behaviors associated with body dysmorphic disorder?

Compulsive checking, significant efforts to hide perceived defects, and avoidance of normal activities.

What is the prevalence of body dysmorphic disorder in the general population?

Approximately 1% of the general population.

What is the typical onset age for body dysmorphic disorder?

Usually in adolescence.

What treatment is often ineffective for body dysmorphic disorder?

Plastic surgery.

What does cognitive behavioral therapy (CBT) for BDD involve?

Psychoeducation, cognitive restructuring, exposure and ritual prevention, and modifying self-defeating assumptions about appearance.

What is posttraumatic stress disorder (PTSD)?

A disorder that develops after experiencing a traumatic event, characterized by symptoms such as intrusion, avoidance, negative cognition, and arousal.

What types of events can lead to PTSD?

Traumatic events such as natural disasters, accidents, physical assault, molestation, rape, and combat.

What is the likelihood of women developing PTSD compared to men?

Women are 1.5-2 times more likely to develop PTSD.

What is the average recovery time for PTSD symptoms?

Complete recovery within 3 months occurs in 50% of individuals.

What is prolonged exposure therapy for PTSD?

A treatment involving 9-12 weekly sessions that includes psychoeducation and repeated exposure to trauma memories.

What is acute stress disorder?

A condition occurring 3 days to 1 month after trauma, involving symptoms like recurrent memories, distressing dreams, and hypervigilance.

What is the recommended approach for psychological first aid after trauma?

Focus on addressing initial needs and concerns by providing support and resources.

What is the dropout rate for prolonged exposure therapy?

Approximately 20%.

What is the responder rate for prolonged exposure therapy?

About 85% of patients respond positively to treatment.

What is the effectiveness of prolonged exposure therapy?

Patients treated with PE fare better than 86% of those in control conditions.

What is a common misconception about trauma and PTSD?

Most people who experience trauma will develop PTSD (this is false).

What does not help in treating acute stress disorder?

Psychological debriefing is generally not recommended as it can lead to worse outcomes.

What is the role of avoidance in PTSD treatment?

Prolonged exposure therapy does not involve learning to avoid reminders of the trauma.

What are depressive disorders classified as in the DSM-5?

Mood disorders

Name the three types of depressive disorders in the DSM-5.

Major depressive disorder, persistent depressive disorder (dysthymia), disruptive mood dysregulation disorder

What characterizes disruptive mood dysregulation disorder?

Severe temper outbursts inconsistent with developmental level, occurring 3 times a week, with irritability in between, present for at least 12 months, and onset before age 10.

What are the key symptoms of major depressive disorder?

Depressed mood, anhedonia, significant weight change, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, feelings of worthlessness, inability to concentrate, and thoughts of death.

What is the lifetime prevalence of major depressive disorder in the U.S.?

16.1%

What is the gender ratio for major depressive disorder?

2:1 female to male

What is the average duration of major depressive disorder?

4 to 9 months

What percentage of individuals with major depressive disorder recover within 5 years?

90%

What is the mean age of onset for major depressive disorder?

25 years

What role does life stress play in major depressive disorder?

Life stress is important for understanding MDD, with 40-67% of individuals reporting a serious life event prior to onset.

What is rumination in the context of major depressive disorder?

The tendency to repetitively think about one's shortcomings or failures, which enhances the risk for depression.

What is the causal direction between life stress and major depressive disorder?

2/3 of the association is life stress leading to MDD, while 1/3 is MDD leading to stress.

What are common psychological treatments for major depressive disorder?

Interpersonal therapy, psychodynamic therapy, cognitive behavioral therapy (CBT), and behavioral therapy.

What is a key feature of cognitive behavioral therapy (CBT)?

Homework is an essential feature, focusing on examining thought processes as hypotheses.

What is behavioral activation (BA) in treating depression?

Increasing behavioral activity to counteract anhedonia through activity scheduling and task assignments.

What is electroconvulsive therapy (ECT)?

A treatment where a small current is passed through the brain to produce a seizure, effective for severe depression.

What is the response rate for electroconvulsive therapy?

Approximately 80% of patients respond to ECT.

What is the typical relapse rate after ECT?

50% relapse within 2 years.

What is the efficacy of antidepressant medications?

Approximately 50% response rate and 33% remission rate.

What is the primary action of most antidepressant medications?

They block the reuptake of serotonin and/or norepinephrine.

What are the characteristics of psilocybin-assisted therapy?

Involves preparatory meetings, psilocybin administration sessions, and focuses on processing experiences.

What is the mechanism of action for ketamine-like medications in treating depression?

They impact glutamate neurotransmission and act rapidly.

What is the significance of the subgenual cortex in depression treatment?

It is implicated in processing sadness and regulating sleep, appetite, and emotional responses.

What is the dropout rate for psychological treatments of depression?

Approximately 25%.

What is the remission rate for psychotherapy in treating depression?

Approximately 40%.

What is the primary side effect of SSRIs?

Low sexual desire.

What is the role of music and environment in psilocybin-assisted therapy?

Music is played, and participants wear eye-shades and headphones to enhance the therapeutic experience.

Is Major Depressive Disorder (MDD) limited to western cultures?

False

What is the average duration of a depressive episode in MDD?

4-9 months

Which age cohort is more likely to experience MDD?

Younger cohorts are more likely than older cohorts.

Does life stress always precede the onset of MDD?

False

Which treatment is more effective in the short-term for depression?

Cognitive-behavioral treatment is approximately equally effective compared to other treatments.