Abnormal Exam 2

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fight or flight response

set of physical and psycholoical responses that help us high a threat or flee from it

fight or flight results from

the activation of two systems controlled by hypothalamus

autonomic nervous system
adrenal cortical system controlled by

hypothalamus

autonomic nervous system

the part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.

adrenal cortical system

the hormonal system situated in the adrenal cortex and activated by the hypothalamus, that responds to stress to determine fight-or-flight reactions

cortisol

stress hormone released by the adrenal glands

responses to threat:
somatic

tense muscles
increase heart rate
changes in respiration
dilated pupils
increased perspiration
adrenaline secretion
inhibited stomach acid
decreased salivation
Bladder relaxation

responses to threat:
emotional

sense of dread
terror
restlessness
irritability

Responses to threat:
Behavioral

escape
avoidance
aggression
freezing

Responses to threat:
cognitive

antipation of harm
exaggeration of danger
problems in concentration
hypervigilance
worried, ruminative thinking
fear of losing control
fear of dying
sense of unreality

Panic disorder

recurrent unexpected panic attacks

panic attacks

Short but intense periods during which people experience many symptoms of anxiety

biological theories of panic disorder

hyperventilate, inhale, a small amount of carbon dioxide
breathe into a paper bag
ingest caffeine or take infusions of sodium lactate

Panic disorders heriability

43-48%

(panic disorder)
People show \______ symptoms in the \______

dysregulation of norepinephrin,
locus ceruleus

people prone to panic attacks tend to

Pay very close attention to their bodily sensations and misinterpret them in a negative way, engage in catastrophic thinking, exaggerating symptoms and their consequences

anxiety sensitivity

unfounded belief that bodily symptoms have harmful consequences

interoceptive awareness

Heightened awareness of bodily cues that signal a coming panic attack

conditioned avoidance response

People associate certain situations or cues with symptoms of a panic attack such that future exposure to those situations or cues triggers symptoms
Sufferers then prevent having symptoms by avoiding those situations or cues. The reduction in anxiety reinforces the avoidance behavior

biological treatments for panic disorders

medications affecting serotonin and norepinephrine systems
SSRI, SNRI, tricyclic antidepressants

in biological treatments of panic disorders, most people experience a relapse of symptoms when

drug therapies are discontinued

Cognitive behavior therapy for panic disorder

relaxation and breathing exercises alone and while experiencing an attack
challenging catastrophizing thoughts
systemati desensitzation therapy

separation anxiety disorder

Developmentally inappropriate levels of concern over being away from a primary caregiver along with excessive distress when thinking about separation

fear of separation leads to

avoidance of school or leaving home

separation anxiety is not diagnosed until

symptoms persist for AT LEAST 4 weeks
significantly impair the child's functioning

Biological theories of separation anxiety

anxiety is heritable

Biological inhibition for seperation anxiety:
temperament makes children....

shy, fearful, irritability as toddlers
cautious, quiet, and introverted as school-aged children

psychological and sociocultural factors for separation anxiety

normla response to controllin and intrusive parents
elearned behavior from parents who are anxiety or depressed themselves

Cognitive behavioral therapies for separation anxiety

for coping and for challenging cognitions that feed anxiety
to learn relaxation exercises to practice when separated
challenge fears about separation and use SELF-TALK to calm themselves

drugs used for separation anxiety

antidepressants, antianxiety drugs, stimulants and antistamines

generalized anxiety disorder (DSM-5)

persistent, excessive anxiety and worry including over minor events

symptoms of generalized anxiety disorder

restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance

emotional and cognitive theories about generalized anxiety disorder

tendency to experience intense NEGATIVE emotions
show HEIGHTENED reactivity to emotional stimuli in the AMYGDALA
continuously scan the environment for possible threats (often unconscious)

biological theories about generalized anxiety

people with GAD have a dificiency in gamma-amino
leads to excesive firing of neurons in many areas of the brain
results in chronic, diffuse symptoms of anxiety
GAD has a modest heritability

Treatment Of GAD - Cognitive-Behavioral Therapy

-confront most common worries
-challenge catastrophizing thoughts
-develop coping strategies

Treatment of GAD: Biological

benezodiazepine drugs
tricyclic antidepressant impramine and the selective serotonin reuptake inhibitor paroxetine

Social anxiety disorder

people become anxious in social situations and are afraif of being rejected, judged, or humilated in public

social anxiety leads to the

avoidance of social and or performance situations

social anxiety is more common in

women

social anxiety develops

in preschool years, adolescence

Theories of social anxiety disorders (cognitive perspective)

people with social anxiety have ecessiveky high standards for their social performance and focus on negative aspects of social interactions and evaluate their own behavior harshly

Treatments for social anxiety

SSRI, SNRI
CBT - identifyin negatige cognitions people have and learning how to dispute these cognitions mindulness-based interventions and to accept anxiety and obsrve it rather than judging onself and avoiding people or situations

specific phobias

irrational fears of specific objects or situations

phobias lead to

avoidance with intense fear and anxiety when confronted with the object or situation

DSM-5 phobias

animal type
natural environment type
situational type
blood injecting injury type

Agoraphobia

people fear places where they might have troble escaping or getting help or getting help when anxious
That they will embarrass themselves if others notice their symptoms or efforts to escape

agoraphobia sometimes prevents people

from leaving their houses alone

behavioral theories of phobias

negative reinforcement, prepared classical conditioning

biological theories of phobias

genetic basis- runs in families

Behavioral treatments of phobias

exposure: desensitization, flooding, modeling

applied tension technique

Increases blood pressure and heart rate keeping people from fainting when confronted with the feared object

biological treatments of phobias

Benzodiazepines

obsessions in OCD

Persistent, unwanted, fearful thoughts
-Fear of germs, fear of being hurt, troubling religious or
sexual thoughts
intrusive
causes significant anxiety or distress

compulsions in OCd

repetitive tasks that relieve tension but cause significant impairment to a person's life
often aimed at reducing anxiety caused by obsessions
tends to be chronic if left untreated

common types of obsessions

Thoughts and images associated with aggression, sexuality, and/or religion
Something bad will happen
Need to make things 'just right'
Fear of contamination

hoarding

Difficulty getting rid of items that leads to accumulation of things that clutter and congest active living areas

disorders related to OCD

Hair pulling Disorder (trichotillomania)
Skin-Picking Disorder
Body Dysmorphic Disorder

Biological theories of OCD

- focus on circuit in the brain involved in motor behavior, cognition, and emotion
- response to drugs is good
- genetic component

Cognitive theories of OCD

Depression or general anxiety makes even minor events likely to invoke thoughts.
Rigid, moralistic thinking & feelings of responsibility.
Believe they should be able to control their thoughts.
negatively reinforcing bc reduce anxiety
have trouble accepting that other people have these thoughts occasionally

Treatment for OCD and related disorders (BIOLOGICAL)

antidepressants that enhance serotonin

treatment for OCD and related disorders (cognitive behavioral treatments_

exposure and response prevention
expose client to obsesison or fear and prevent compulsive behavior
allows client to see that thoughs themslves are not harmful
challenge indivudlas moralistic thoughts excessive sense of respnsibility and maladaotve cognitions

post-traumatic stress disorder

consequences of exposure to traumatic eventd

PTSD DSM-5

directly experiences or witnesses the event
learn that a violent/traumatic event happened to someone close
experience repeated or extreme exposure to the details of a traumatic event

PTSD symptoms

- Flashback episodes, where the event seems to be happening again and again.
- Repeated upsetting memories of the event; repeated nightmares of the event.
- Emotional "numbing"; feeling detached; inability to remember important aspects of the trauma.
- Having a lack of interest in normal activities.
- Avoiding places, people, or thoughts that remind you of the event.
- Difficulty concentrating.
- Agitation or excitability; insomnia.

dissociation (PTSD)

different facets of sense of self or consciousness become disconnected from one another

acute stress disorder

Occurs in response to traumas similar to those involved in PTSD
Diagnosed when symptoms arise within 1 month of exposure to the stressor and last no longer than 4 weeks

Adjustment disorder

Emotional and behavioral symptoms occur in response to a stressor of any severity
Person does not meet criteria for acute stress disorder or PTSD

traumas leading to PTSD

Natural disasters
Human-made disasters
Traumatic events
Sexual assault

environmental and social factors theories of PTSD

severity and duration, idiiduals proximity to trauma and amount of social support avaliable

psychological theories of PTSF

preexisting cinditions increase risk
coping strats influence vulnerability to PTSD

gender and cross cultural theories in PTSD

women are more prone
african amercans have higher rates of PTSD
cultural influneces the manifestation of anxiety

neuroimagining findings in PTSD

brains of people with ptsd are more rective to emotional stimuli

biochemical findings in PTSD

Physiological responses to stress are exaggerated in PTSD sufferers
Exposure to extreme or chronic stress during childhood increases vulnerability

genetics in PTSD

vulnerability to PTSD can be inherited

treatments for PTSD

-Exposing clients to what they fear in order to extinguish that fear
-Challenging distorted cognitions that contribute to symptoms
-Helping clients reduce stress in their lives

stress inoculation therapy

Therapists teach clients skills for overcoming problems that:
Increase stress
Result from PTSD

biological therapies for PTSD

SSRIs and benzodiazepines

Anxiety disorders in older adults

•One of most common problems among older adults
•Few older adults seek treatment for anxiety disorders
•CBT has shown to be effective treatment
•Benzodiazepine frequently prescribed
•However, side effects and tolerance issues in population
•SSRIs becoming more common
•Interactions with other medications an issue for population

Somatic symptom disorders

Experiencing significant physical symptoms for which there is no apparent organic cause
As a result of psychological factors
Hard to detect or diagnose a psychological disorder for Individuals with a real physical disorder

Somatic system disorder

experiencing one or more somatic symptoms that cause signicant dirtress and/or impairment
excessive wrry about the symptoms or excessive time and energy devoted to the health concerns symptoms may vary but sytate of having sysmptoms is persistent
for some people sumtoms may include pain

illness anxiety disorder (hypochondriasis)

worry about having or developing a serious illness
somatic may or may not be present , when present, typically mild
avoidance of doctors and hospitals

theorie of somatic symptom disorder and illness anxiety - cognitive

dysfunctional belifs about illnesses
pay too much attention to physical vchanges and catastropizes symptoms
PTSD places people at risk of develping one of these disorders

Treatments of Somatic Symptom Disorder and Illness Anxiety Disorder
psychodynamic

provide insight into the connection between emotional and physical symptoms

Treatments of Somatic Symptom Disorder and Illness Anxiety Disorder
behavioral

reward healthy behaviors and remove rewards related to symtoms

treatmeants of somatic symptom disorder and illness anxiety disorder
cognitive

challenge catastrophizing and learn to inerpret physical symptoms appropiately

Treatments of Somatic Symptom Disorder and Illness Anxiety Disorder
belief systems

address cultural, religious, and other belief systems that may affect symptoms

conversion disorder

loss of neurologic function in sensory or motor area of the body without physical cause

common symptoms of conversion disorder

paralysis, blindness, movement and gait disorders, numbness, paresthesias, loss of vision or hearing, or episodes resembling epilepsy

glove anethesia

loss of all feeling in hand, as if one was wearing a glove that wiped out physical sensation

Freudian theories of conversion disorder

psychic energy from repressed emotions is transferred to a part of the body

Freudian primary or secondary gains

primary - physical symptoms allows person to avoid anxiety
secondary - attention from others, relieved of obligations

behavioral theories of conversion disorder

Alleviates stress by removing individual from the environment
La belle indifference

psychodynamic treatment of conversion disorder

helps express painful emotions or memories tht are linked to symptoms

cognitive treatment of comversion disorder

relieving the persons anxiety centered on the initial trauma that caused the conversion symptoms
reducing any benefits the person is recieiving from the conversion symptoms

Factitious disorder (munchhausen's syndrome)

deliberate faking of an illness to gain medical attention

Factitious disorder imposed on another (munchhausen's syndrome by proxy)

falsifying illness in another person
done to gety attention as in a mother faking a symptom in a child to get attention for herself
Gypsy Rose Blanchard (ex)

Dissociative Disorders

process where components of mental experiences are split from conscousness by remain accessible by dreams and hypnosis

hidden observer phenomenon

two modes of consciousness explain how dissociation occurs
-active mode and passive receptive mode

passive recpetive mode

registers and stores information in memory withou being aware that the informaton has been processed

active mode (dissociation)

conscious plans and desires and voluntary actions