Unit 2

stressor definition

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)