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stressor definition
external/internal events or situations that place physical or psychological demands on a person (things)
stress definition
internal psychological or physiological response to a stressor (feel)
Yerkes-Dodson law
how anxiety affects performance
optimal/moderate stress correlates to strong performance
low stress = weak performance
high stress = impaired performance due to strong anxiety
types of trauma and stressor-related disorders
adjustment
acute stress disorder (ASD)
post-traumatic stress disorder (PTSD)
adverse childhood experiences (ACEs) definition
stressful and potentially traumatic events experienced during childhood and infancy
what percentage of adults have reported at least 1 ACE
70%, majority
what percentage of adults have reported experiencing 4+ ACEs
20%
in the first 2 years, a baby’s brain grows up to ____% of adult size
80%
adjustment disorder definition
difficulty coping with or adjusting to a specific life stressor
DSM-5 criteria for adjustment disorder
exposure to a stressor of any type or severity
symptoms begin within 3 months of exposure to stressor
one or both of the following:
marked distress is out of proportion to severity or intensity of stressor
significant impairment in social, occupational, or other important areas of functioning
acute stress disorder (ASD) DSM-criteria
direct or indirect exposure to a traumatic stressor involving actual or threatened death, serious injury, or sexual violence
disturbance persists from 3 days - 1 month after exposure to trauma
post traumatic stress disorder (PTSD) DSM-criteria
direct or indirect exposure to a traumatic stressor involving actual or threatened death, serious injury, or sexual violence
symptoms are present for at least 1 month
requirements for diagnosis of ASD and PTSD
exposure to traumatic events
intrusion symptoms
avoidance
negative alterations in mood or cognition
arousal and changes in reactivity/hypervigilance
traumatic events associated with ASD and PTSD
combat
sexual assaults, sexual harassment
violent crime or domestic violence
natural disasters
car accidents or work-related accidents
outcomes after exposure to traumatic events w/resilience
__% of people have continuous dysfunction for up to 2 years after potentially traumatic event
5-15
outcomes after exposure to traumatic events w/resilience
__% of people experience recovery over time to more stable baseline and functioning
15-25
outcomes after exposure to traumatic events w/resilience
__% of people experience minimal-impact resilience following PTE
35-65, most common, small uptick in dysfunction following PTE and fairly quick baseline functioning
PTE
potentially traumatic event
________ abilities for resilience
innate
biological dimension of ASD/PTSD: stressor activates what nervous system to release stress hormones
sympathetic
biological dimension of ASD/PTSD: childhood stress can change stress-responsive neurobiological systems which increase the _________ to the disorder
vulnerability
anger is a ______ emotion
secondary
psychological risk factors for ASD/PTSD
anxiety, depression, hostility, anger
specific cognitive styles or dysfunctional thoughts (assume the worst)
social dimension of ASD/PTSD
social support can buffer PTSD symptoms (protective factor)
treatment for trauma-related disorders
antidepressants
prolonged exposure therapy
cognitive behavioral therapy
trauma-focused CBT
EMDR
what is EMDR
involves visualizing traumatic experience while following a therapist’s fingers moving side to side
other stressor-related disorders
asthma
high blood pressure
cardiovascular disease
headaches
cluster headaches
severe pain around one eye
sweating
swelling
tearing
runny nose
biofeedback training
learn to voluntarily control physiological processes in order to improve physical or mental health
somatic definition
prominent physical or bodily symptoms associated with significant impairment or distress
somatic related disorders: acute physical illnesses _____ or ____ _____ be present
may or may not
somatic symptom disorder (SSD) definition
pattern of reporting and reacting to pain or other distressing symptoms, involves persistent thoughts or high anxiety about the symptoms of a potential illness
somatic symptom disorder (SSD): pattern occurs for at least
6 months
somatic symptom disorder (SSD): signs/symptoms
repeatedly checks for signs of illness or abnormality and worry even after shown evidence that they do not have a serious medical condition
illness anxiety disorder definition
chronic pattern of preoccupation with having or contracting a serious illness
associate illness anxiety disorder with what?
hypochondriac
illness anxiety disorder: pattern must be present for at least
6 months
illness anxiety disorder involves _____ or ___ ________ symptoms
minimal/no somatic
conversion disorder is also known as what
functional neurological disorder
T or F: conversion disorder has actual symptoms present
true
conversion disorder definition
motor, sensory, or seizure like symptoms that cause motor weakness and abnormal movements
conversion disorder symptoms are ________ with any recognized medical disorder
inconsistent
conversion disorder: individuals are _____ _________ faking symptoms
not consciously
what disorder manifests in seizure-like movements that may be the body’s response to underlying stress
conversion disorder/functional neurological disorder
factitious disorder is also known was what
munchausen syndrome
factitious disorder definition
symptoms of physical and mental illness are DELIBERATELY induced or simulated with no apparent incentive
malingering
faking a disorder to achieve some goal/ “faking bad”
T or F: factitious disorder is different than malingering
true
what are the two types of factitious disorder
factitious disorder imposed on self or imposed on another
factitious disorder imposed on self definition
presentation of oneself to others as ill or impaired
factitious disorder imposed on another
pattern of falsification of physical and psychological symptoms in another individual
usually a mother who appears loving and attentive
biological dimension of somatic symptom and related disorders
lower pain threshold/higher sensitivity to pain
hypervigilance of bodily sensations
psychoanalytic/psychodynamic perspective of somatic symptom and related disorders
symptoms seen as DEFENSE against awareness of unconscious emotional issues
cognitive behavioral perspective of somatic symptom and related disorders
catastrophizing, jumping to conclusions
social dimension of somatic symptom and related disorders
rejection/abuse from family
feeling unloved
sexual abuse
previous physical illness
parental attentiveness
sociocultural dimension of somatic symptom and related disorders
women’s psychological distress historically viewed as hysterical
discrimination directly impacts health
dissociative identity disorder (DID) definition
disruption of identity, 2 or more distinct personality states, alterations in behaviors, attitudes, and emotions
dissociative identity disorder (DID) is formerly called
multiple personality disorder
dissociative identity disorder (DID) etiology
alternate personality states develop to help heal with difficult situations faced by primary personality
dissociative identity disorder (DID) controversy
some believe clinician bias, faulty assessment, or therapeutic techniques influence the increase in case number
condition unintentionally brought about by a therapist
what is an iatrogenic disorder
condition unintentionally brought about by therapist
characteristics of mood symptoms
affect person’s well being, school, work, or social functioning
continues for days, weeks, months, years
often occurs for no apparent reason
involves extreme reactions not always explained by individual’s circumstances
bipolar disorders involve episodes of what
hypomania and mania
which is easier to identify in the beginning of bipolar disorders: hypomania or mania
mania
what is the usual onset of bipolar disorders
teens and early 20s
T or F: bipolar disorders occur much LESS frequently than depressive disorders
True
T or F: bipolar disorders received much LESS medical attention than depressive disorders
false: more due to their level of disruption
symptoms of hypomania (8/10)
increased levels of activity or energy
impulsivity and risk taking
person may talk excessively (uncharacteristic of normal)
symptoms of mania (12/10)
even more pronounced mood changes than hypomania
variety of behaviors from euphoria to extreme irritability
cause marked impairment in social or occupational functioning
may involve loss of contact with reality/psychosis
on such a high, no care for consequences, don’t feel like they can stop themselves
diagnosis criteria for Bipolar I
at least 1 manic episode
major depressive symptoms common, but not required
symptoms present most of day, nearly every day for at least 1 week
diagnosis criteria for Bipolar II
at least one major depressive episode (>2 week)
at least one hypomanic episode (>4 days)
physiological symptoms of hypomania/mania
decreased need for sleep
high levels of physiological arousal
increased libido
weight loss due to high energy expenditure
_____ depressive and hypomanic symptoms can occur in individuals without a mood disorder
brief
_______ occurs both in depressive and bipolar disorders
depression
evaluating mood symptoms
need to consider severity of symptoms
variability of symptoms
for depressive disorders, it is important to ensure the individual has never experienced ____________?
episode of hypomania/mania
emotional symptoms of depression
depressed mood
sadness, emptiness, hopelessness, worthlessness, low self-esteem
limited enthusiasm for things that previously brought joy and pleasure/anhedonia
irritable, anxious, worried
anhedonia
lack of feeling pleasure in life
major depressive disorder DSM-5 criteria
impairment in functioning for most of the day, nearly every day, for two weeks or more
at least one of the following:
depressed mood, sadness, or emptiness
loss of pleasure in previously enjoyed activities
four or more of the following:
weight alteration
atypical sleep patterns
restlessness
low energy
feelings of worthlessness
difficulty concentrating
preoccupation with death or suicide
what was major depressive disorder with a seasonal pattern called previously
seasonal affective disorder
symptoms of MDD with a seasonal pattern
low energy
increased sleep
social withdrawal
carbohydrate craving
persistent depressive disorder was previously called what
dysthymia
for persistent depressive disorder how long do symptoms have to be present most of the day for more days than not to be diagnosed
2 years
diagnosis for persistent depressive disorder requires ____ or more of what symptoms?
two or more necessary
feelings of hopelessness
low self-esteem
poor appetite/overeating
low energy or fatigue
difficulty concentrating/ making decisions
sleeping too much or too little
premenstrual dysphoric disorder definition
serious symptoms of depression, irritability, and tension appearing the week before menstruation and remit soon after the onset of menses
what is the concern surrounding premenstrual dysphoric disorder
concern about designating symptoms of normal biological function as a psychiatric disorder
how can premenstrual dysphoric disorder be treated
changes in diet, exercise, stress management, vitamin supplements, SSRI, birth control
what percent of women/AFAB have premenstrual dysphoric disorder
10%
normal grief reactions
may last for several years
frequency and intensity diminishes
prolonged grief disorder
persistent and debilitating grief response
important to distinguish prolonged grief disorder from MDD
what percent of bereaved people experience prolonged grief disorder
10-15%
Aaron Beck is associated with what type of thinking? what type of approach is this?
faulty thinking, cognitive/CBT approach
what are the 3 types of faulty thinking
magnification/exaggeration, polarized thinking, overgeneralization
magnification/exaggeration
overestimating the significance of negative events
polarized thinking
an “all or nothing”, “good or bad”, and “either/or” approach to viewing the world
overgeneralization
holding extreme beliefs on the basis of a single incident and applying these inaccurate beliefs to other situations
albert ellis rational thinking perspective
belief system is a greater part of why we feel and behave the way we do, we disturb ourselves
change way of thinking will change your behaviors and emotions
depression is ___-___% related to genes/genetics
40-50
traits of negative self-schema
pessimism, negative view of self, feelings of helplessness
corumination
constantly talking about problems or negative experiences with others, increases depressive risk (especially young women)