Abnormal Psychology: Anxiety, Somatic, Mood, and Health Conditions (Chapters 4–7)

Comprehensive review flashcards covering diagnostic criteria, maintaining mechanisms, etiology, and evidence-based treatments for anxiety, somatic, dissociative, mood, and health-related disorders (Chapters 4 to 7).

How does anxiety differ from fear in terms of timing and threat focus?

Anxiety is a future-oriented apprehension and preparation for a possible threat (the threat need not be present), whereas fear is an alarm reaction to immediate danger marked by strong autonomic activation.

What is the clinical distinction between a panic attack and panic disorder?

A panic attack is a discrete event involving an abrupt surge of intense fear or discomfort with physical and cognitive symptoms; panic disorder requires recurrent unexpected panic attacks accompanied by persistent concern or behavioral changes.

How are expected, unexpected, and situationally predisposed panic attacks differentiated?

Expected panic occurs directly in response to a known cue; unexpected panic appears without an obvious cue; and situationally predisposed panic is more likely to occur in a specific situation without being inevitable.

What are the core features and maintaining processes of Generalized Anxiety Disorder (GAD)?

GAD involves excessive, difficult-to-control worry across multiple life domains accompanied by symptoms such as restlessness, fatigue, concentration issues, irritability, muscle tension, and sleep disturbance. Worry is maintained because it provides a short-term sense of preparation or prevents stronger emotional imagery.

What is anxiety sensitivity, and what is a common clinical example of it?

Anxiety sensitivity is the fear that bodily sensations will lead to catastrophic consequences; for example, misinterpreting a racing heart as an impending heart attack or complete loss of control.

How do interoceptive conditioning and interoceptive avoidance interact in panic disorder?

In interoceptive conditioning, internal sensations (such as breathlessness or dizziness from exercise or heat) become conditioned fear cues after pairing with panic. Interoceptive avoidance refers to actively avoiding activities that produce these sensations (e.g., stairs, caffeine, hot rooms).

What characterizes agoraphobic avoidance, and what factors shape it?

Agoraphobic avoidance involves avoiding places or situations where escape or access to help might be difficult during panic-like symptoms. It is shaped by perceptions of safety, distance from home, and the presence of trusted companions.

What unique physiological response distinguishes blood-injection-injury phobia, and how is it addressed?

It involves a distinctive vasovagal fainting pattern (a drop in heart rate and blood pressure), which can be counteracted using applied muscle tension techniques.

How is social anxiety disorder distinguished from ordinary shyness?

Social anxiety disorder involves an excessive fear of negative evaluation, embarrassment, rejection, or offending others that causes persistent functional impairment.

What are the culture-related anxiety concepts Taijin kyofusho and pa leng?

Taijin kyofusho is characterized by an intense fear of offending or embarrassing others, whereas pa leng involves a fear of the cold.

What diagnostic timeframe separates Acute Stress Disorder from Posttraumatic Stress Disorder (PTSD)?

Acute Stress Disorder occurs from 3 days through 1 month following trauma exposure, whereas PTSD persists beyond 1 month.

What is the distinction between an obsession and a compulsion?

An obsession is a recurrent, intrusive, and unwanted thought, urge, or image; a compulsion is a repetitive behavior or mental act performed to reduce distress or prevent a feared event.

What is thought-action fusion?

A cognitive bias in which an individual equates having a thought with increasing the likelihood of an event occurring, or views having the thought as morally equivalent to actually carrying out the act.

How does Exposure and Response Prevention (ERP) treat OCD?

ERP requires systematic contact with feared cues or obsessional triggers while deliberately resisting compulsive rituals, thereby testing catastrophic predictions and weakening the ritual cycle.

How do Body Dysmorphic Disorder, Trichotillomania, and Excoriation Disorder differ in their primary targets?

Body Dysmorphic Disorder focuses on preoccupation with slight or unobservable flaws in physical appearance; Trichotillomania involves recurrent pulling out of one's hair; and Excoriation Disorder centers on recurrent skin picking resulting in lesions.

How do Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) differ?

Both arise from severe neglect or insufficient care, but RAD manifests as emotionally withdrawn behavior with little comfort-seeking, whereas DSED presents as overly familiar behavior with unfamiliar adults and reduced checking back with caregivers.

How are Somatic Symptom Disorder and Illness Anxiety Disorder distinguished?

Somatic Symptom Disorder is characterized by distressing somatic symptoms accompanied by disproportionate thoughts, anxiety, and devotion of energy. Illness Anxiety Disorder centers on a preoccupation with having or acquiring a serious illness when somatic symptoms are absent or mild.

What is Functional Neurological Symptom Disorder (Conversion Disorder), and what does its diagnosis require?

It involves motor or sensory symptoms that are incompatible with recognized neurological disease. Diagnosis requires positive clinical evidence of internal inconsistency or incompatibility, not merely a normal lab or imaging test.

How does Factitious Disorder differ from Malingering and Conversion Disorder?

Factitious disorder involves the intentional falsification of symptoms to assume the sick role without obvious external rewards; malingering involves intentional falsification for external incentives (e.g., financial gain); conversion disorder involves non-intentional, involuntary neurological symptoms.

What is the difference between depersonalization and derealization?

Depersonalization is an experience of detachment or feeling like an outside observer of one's own self, body, thoughts, or sensations; derealization is an experience of unreality or detachment concerning one's external surroundings (e.g., the world feels dreamlike or artificial).

What is dissociative fugue, and how is it currently classified in diagnosis?

Dissociative fugue involves purposeful travel or bewildered wandering associated with autobiographical amnesia or identity confusion; it is currently specified within dissociative amnesia.

What are the clinical definitions of the host, alter, and switch in Dissociative Identity Disorder (DID)?

The host is the personality state most frequently in control of behavior; an alter is an alternative identity or personality state; and a switch is the transition between states. These are descriptive clinical terms, not separate people.

How do the trauma model and sociocognitive model explain Dissociative Identity Disorder (DID)?

The trauma model proposes that DID develops as a severe defense mechanism to repeated severe childhood trauma in individuals with high dissociative capacity. The sociocognitive model suggests identity presentations may be shaped by therapist suggestions, media portrayals, and cultural expectations.

What minimum symptom durations are required for a major depressive episode, manic episode, and hypomanic episode?

A major depressive episode requires symptoms for at least 2 weeks; a manic episode requires at least 1 week (or any duration if hospitalization is necessary); and a hypomanic episode requires at least 4 consecutive days.

What severity and functional criteria distinguish a manic episode from a hypomanic episode?

A manic episode causes marked impairment in functioning, requires hospitalization, or includes psychotic features; a hypomanic episode involves an observable change in mood and functioning but does NOT cause marked impairment, hospitalization, or psychosis.

What diagnostic requirement separates Bipolar I Disorder from Bipolar II Disorder?

Bipolar I requires at least one manic episode (depression is common but not required); Bipolar II requires at least one hypomanic episode AND at least one major depressive episode, with no history of a manic episode.

What is the defining requirement for Persistent Depressive Disorder (dysthymia)?

A chronic depressed mood and associated depressive symptoms persisting for at least 2 years in adults or at least 1 year in children and adolescents.

What characterizes Disruptive Mood Dysregulation Disorder (DMDD)?

Severe recurrent temper outbursts and persistent irritability in children, diagnosed in part to avoid inappropriate overdiagnosis of bipolar disorder where distinct manic episodes are absent.

What are the three components of Aaron Beck's cognitive triad in depression?

Negative, biased automatic thoughts and schemas regarding the self, the world, and the future.

How does hopelessness theory explain vulnerability to depression?

It proposes that attributing negative life events to stable (permanent) and global (broad/permeating) causes creates a state of hopelessness that increases depression risk.

What are the primary clinical targets of Interpersonal Psychotherapy (IPT) for depression?

IPT focuses on interpersonal issues that impact mood, specifically targeting grief, role disputes, role transitions, and interpersonal deficits.

What is the sequential hormone pathway of the Hypothalamic-Pituitary-Adrenocortical (HPA) axis under stress?

The hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates the anterior pituitary to release adrenocorticotropic hormone (ACTH), which prompts the adrenal cortex to release cortisol.

What are the three sequential stages of Hans Selye's General Adaptation Syndrome (GAS)?

Alarm reaction, resistance, and exhaustion.

What does the concept of allostatic load describe?

The cumulative biological wear and tear on the body resulting from chronic, repeated physiological adaptation to stress across cardiovascular, metabolic, immune, and neural systems.

Which specific component of the Type A behavior pattern is most strongly linked to coronary heart disease?

Hostility (rather than high competition or time urgency alone).

How does gate control theory explain pain modulation?

It proposes that dorsal horn spinal mechanisms act as a gate that can open or close to modulate incoming nociceptive signals, influenced by descending neural pathways from the brain (such as emotions, cognitions, and attention) and endogenous opioids (endorphins and enkephalins).

What is biofeedback, and how is it used in behavioral medicine?

A technique that makes physiological processes (such as heart rate, muscle tension, or blood pressure) visible or audible in real time so patients can learn voluntary control to support stress and symptom management.