Behavior Disorders Exam 2

obsessions

intrusive and recurring thoughts, impulses, and images that are irrational and appear uncontrollable to the individual

compulsions

repetitive behaviors or mental acts that the person feels driven to perform in order to reduce the distress caused by obsessive thoughts

commonly reported compulsions

- decontamination

- checking

- repeating routine activities

- ordering/arranging

- mental rituals

hoarding

- previously a subtype of OCD

- thoughts are not intrusive or unwanted (can be neutral or positive)

- hard to conceptualize excessive saving as compulsive or ritualistic

- does not seem to result in an escape from (or neutralization of) obsessional anxiety

poor insight and overvalued ideation (OCD subtype)

- individuals who view their obsessional fears and compulsive behavior as reasonable

- more strongly associated with religious obsessions, fears of mistakes, and aggressive obsessional impulses

serotonin hypothesis (OCD)

- OCD arises from abnormalities in the serotonin neurotransmitter system

- medications that increase brain levels of serotonin are effective in reducing OCD symptoms

structural abnormalities (OCD)

- connects regions of the brain that play roles in information processing and behavioral responses

- examination of glucose utilization in OCD and non-OCD brains

two-factor theory (OCD)

- stimulus that poses no objective threat comes to evoke obsessional fear

- avoidance behaviors develop as a means of reducing anxiety

- superstitious conditioning

- operant conditioning plays a role in maintenance of behaviors

- little evidence that classical conditioning can account for onset of fear

- verbal transmission and modeling may account for development

cognitive-behavioral model (OCD)

- unpleasant mental intrusions are a normal and universal experience

- OCD individuals cannot tolerate or dismiss mental intrusions

- attempt to inhibit thoughts have paradoxical effects (e.g., white bear phenomenon)

- compulsive behaviors persist because they are immediately reinforced by reducing anxiety

psychodynamic model (OCD)

- OC behaviors represent unconscious conflicts between the id and the superego

- accounts for general themes in obsessive thoughts (e.g., contamination, sex, aggression)

- aligns with general organization of the brain

depression prevalence

- affects approximately 33 million Americans at some point in their life

- prevalence rate is increasing and the age of onset is decreasing

- women are twice as likely to develop depression (these differences occur after age 13)

HPA (hypothalamic-pituitary-adrenal) axis

it is hypothesized that women are more likely to have a dysregulated HPA response to stress because women are more likely o have exposure to events/situations that contribute to HPA dysregulation

comorbidity (depression)

- depression is a common comorbid problem with both physical ailments and behavior disorders

- evidence suggests that the presence of other problems augers later depression (e.g., anxiety, substance use)

- depression can also lead to other comorbid problems (e.g., substance use)

- materanal depression was significantly related to higher levels of psychopathology and negative affect in children

risk factors (depression)

- divorce

- single-parent status, stress, & social support

- lower socioeconomic status

- woman

symptoms of depression

- depressed mood and/or loss of interest or pleasure in daily activities for more than two weeks (anhedonia)

- mood represents a change from baseline functioning and is accompanied by impaired social, occupation, and/or educational functioning

- at least 5 of the other symptoms (weight change, change in sleep, fatigue, feelings of worthlessness, concentration difficulties, psychomotor agitation, suicidality)

conservation-withdrawal

strategy of preserving or regaining energy or resources

patch behavior

- as food in a patch becomes depleted, organisms give up on a patch if the rate of return is lower than the return in other patches

- if the overall return drops below the cost, foraging stops

- foraging may stop and deer will remain motionless even if starving

learned helplessness

- dogs exhibited a lack of escape behavior when unable to control intermittent shocks to their feet

- led to theory that depressed person expects that they are helpless to control aversive outcomes and behave in accordance with these expectations

depression as an adaption

- many examples where any behavioral response is unlikely to achieve some positive outcome

- biologically-driven down-regulation of a prepotent (i.e., dominant) response

- there are benefits to regulating investment strategies as a function of changes in anticipated levels of payoffs

incentive-disengagement theory (adaptation)

the role of depression was to disengage motivation for an unreachable goal

control theory (adaptation)

low mood prompts the consideration of alternative strategies (e.g., low mood elicited by a mismatch between achievements and expectations)

behavioral model (depression)

- low rates of response contingent reinforcement (RCPR)

- responses aimed at reducing aversive stimuli are not negatively reinforced

- responses aimed at procuring rewards are not positively reinforced (may also be punished)

- ultimately, behavior that is not reinforced (or is punished) will extinguish

Lewinsohn's model (depression)

- decrease in rewards (or increase in costs) in the environment lead to lower response-contingent reinforcement, which increase depressive symptoms

- person does not engage in activities that provide reinforcement

- the environment does not provide opportunities for reinforcement

- inability to access available rewards (skills deficits)

- environmental changes (e.g., loss)

- depressed mood creates cognitive vulnerabilities ( e.g., pessimism) and behavioral consequences (e.g., social withdrawal)

- change toward more negative self-schema

avoidance behaviors

- response depression can create a self-perpetuating feedback loop

- behavioral repertoire becomes more inhibited/narrow to avoid further negative outcomes, which is maintained through negative reinforcement

- depressed behavior serves as an avoidance function aimed at alleviating negative affect (e.g., social withdrawal, excessive drinking and sleeping)

- although avoidance behaviors provide immediate belief, they exacerbate depression in the long-run

attributions

- ascribing causal influences for some event

- specific, unstable, and external for positive events

- global, stable, and internal for negative events

cognitive triad

- depressed patients have negative beliefs about themselves, their circumstances, and their future

- underlie the content of automatic thoughts; automatic, internal verbal statements about life experiences

schema confirmation

- individuals develop the expectation that desired outcomes are unlikely to occur or that aversive outcomes are likely to occur and that no behavioral response will alter this likelihood

- this view has consequences on behavior and information processing that exacerbate depression

gender differences in cognitions

women are more likely to focus inward when feeling distressed (e.g., rumination), whereas men are more likely to be action oriented

Coyne's Model (depression)

- similar to Lewinsohn's model but more focused on how the social environment responds to the depressed individual

- an initial event or situation elicits depressive symptoms and support/reassurance seeking

- an initially positive social response over time becomes hostile or resentful to the continued support/reassurance seeking

- individuals either find excuses to create social distance with the depressed person or provide only insincere support or reassurance

- the depressed person may interpret these as rejection or platitudes and feel socially isolated, furthering depression

suicide

- suicidal ideation (i.e., thoughts) are not uncommon in depression, but do not necessarily translate into an attempt

- most models recognize that suicide risk is a result of the interplay between predisposing and precipitating factors

- a critical factor is unbearable and inescapable psychological pain, combined with hopelessness

suicide paradox

- although men report depression at lower rates than women, they die by suicide at much higher rates

- possibly due to differences in coping styles and help-seeking behaviors

- traditional masculine norms discourage emotional expression, leading men to underreport

masked depression hypothesis

- depression in men may be "masked" by somatic complaints, workaholism,or antisocial behavior

- men may express psychological distress through externalizing behaviors (e.g., aggression, risk-taking) rather than through sadness

addictive behavior

any compulsive habit in which individual seeks a state of immediate gratification despite longer-term costs associated with the habit

biological models (of addiction)

- genetic risk; some people may be predisposed to find effects of psychoactive substances reinforcing

- individuals may be predisposed for behavioral control problems (i.e., impulsive personalities)

- inability to regulate some behavior despite consequent problems resulting from the behavior

temporal discounting

- individuals may elect the short-term gratification associated with substance use over the long-term benefits of sobriety

- used as a model of addictive behaviors

operant conditioning (addiction)

- rewarding effects following behavior will increase the chance that the behavior will occur again

- pharmacological, social, and environmental factors produce rewards following self-administration

classical conditioning (addiction)

drug-induced euphoria becomes associated with stimuli present during euphoric state (e.g., drug taking paraphernalia, locations, behaviors, people)

opponent-process theory (of addiction)

- any effects of substance on CNS are automatically opposed by CNS mechanisms that reduce intensity of effects

- function is to maintain or restore biological homeostasis

- two opposing processes

- process A: effects of the substance

- process B: opponent biological response

- experience = [A - B]

latency to response (opponent-process)

the time it takes for process initiation

augmentation time (opponent-process)

the increasing intensity of effects of process over time

decay function (opponent-process)

the decreasing intensity of effects of process over time

withdrawal effects (opponent-process)

- process B lasts longer than process A

- process B is aversive

- reinitiation of process A is effective in removing aversive effects of state B

tolerance (opponent-process)

- body's compensatory response (process B) is strengthened through use, weakened through disuse

- more of substance is required to produce desired effects of process A

- process A effects remain relatively stable over time

cravings (opponent-process)

- body learns cues related to substance intake (classical conditioning)

- process B initiated when cue is present

- process B produces withdrawal effects prior to substance intake (craving)

- user initiates process A to reduce craving (process B)

expectancy theory (addiction)

- the ultimate focus is on what motivates people to drink alcohol more so than others

- if people expect alcohol consumption to lead to positive outcomes, they will be more inclined to drink

- if people expect alcohol consumption to lead to negative outcomes, they will be less inclined to drink

tension-reduction theory (addiction)

- a model used to account for people's motivation to drink

- based on the intuitive notion that individuals drink alcohol to reduce tension, but has received only moderate empirical support

- more recent work has focused on the tension-reduction properties of alcohol at the biological level (e.g., genetic predisposition for the stress-alleviating effects of alcohol)

social learning theory (addiction)

- incorporates aspects of other explanatory models

- situational factors can function as "triggers" through associative learning

- emphasizes coping skills and abstinence self-efficacy (the patient's belief in their ability to refrain from drinking)

marijuana

- neural correlates strikingly similar to other drugs (e.g., activation of the dopaminergic neurons)

- tolerance from changes in brain structure and function

- withdrawal symptoms including irritability, nervousness, restlessness, sleep difficulties, decreased appetite, anger, uncooperativeness, and cravings

video game addiction

- brain imaging studies reveal similarities in neurobiological alterations between internet gaming disorder (IGD) and other addictions

- activation occurs in brain regions linked to reward

- reduced activity is observed in impulse control areas, leading to impaired decision-making

- structural changes include a reduction in gray-matter volume and white-matter density

dual system theory (video game addiction)

suggests that behavioral excess results from an imbalance between hyperactivity of the reward system and hypoactivity of the inhibition system

video game addiction predispositions

- certain personality traits appear associated with risk of acquiring or maintaining video game addiction (neuroticism, sensation seeking/impulsivity, trait anxiety, state anxiety, and aggression)

- men more likely to become addicted than women

social media addiction predispositions

- certain personality traits associated (impulsivity, self-esteem, anxiety, social anxiety, age, and negative attentional biases)

- insecure attachment styles

- women more likely to develop addiction

social media addiction

- can lead to mood disturbance, interpersonal problems, negative physical and emotional outcomes, poor mental health, lowered academic performance

- evidence suggesting problems mediated by self-esteem

hyper-personal model (social media addiction)

exposure to selective and glorified self-presentations online (i.e., upward comparisons) lead to beliefs that others are more successful and happier

psychobiology of social media

- leads to decrease responsively in several brain areas

- these brain changes are tied to increased depressive symptoms

- use becomes less rewarding and more compulsory over time, starting with initial difficulties inhibiting use and cue reactivity/cravings

- social media use activates the same brain regions as does heroine and cocaine

filtering (social media)

social media algorithms selectively present content to users, which can create "echo chambers"

hyper nudging (social media)

use of algorithms to subtly influence users' behavior (e.g., liking) or decision-making (e.g., purchasing) through targeted recommendations or prompts

microtargeting (social media)

use of detailed user information to delivered highly personalized content or ads

obsessions vs repetitive thoughts

- unwanted or uncontrollable, and intrude into consciousness (often triggered by something in the environment)

- the content of obsessions is also incongruent with the individual's belief system and is not the type of thought that person would expect of himself or herself

subtypes of OCD

- contamination

- responsibility for harm and mistakes

- incompleteness

- unacceptable taboo thoughts with mental rituals

symptom accommodation

occurs when a friend for relative participates in the loved one's rituals, facilitates avoidance strategies, assumes daily responsibilities for the sufferer, or helps to resolve problems that have resulted from the patient's obsessional fears and compulsive urges

ego-syntonic symptoms

behaviors, values, feelings that are in harmony with the needs and the goals of the ego or one's ideal self-image (the individual considers their behavior to be rational and appropriate

ego-dystonic symptoms

the obsessive thoughts are unwanted, upsetting, and personally repugnant (incongruent with the belief system of the individual)

two-factor theory (OCD)

- first stage (classical conditioning): neutral stimulus is paired with aversive stimulus, so the conditioned stimulus comes to elicit a conditioned fear response

- situations, objects, thoughts, images, etc. that pose no threat come to evoke obsessional fear

- second stage (operant conditioning): avoidance behaviors develop as a means of reducing anxiety; avoidance is negatively reinforced by the immediate reduction in distress it engenders

cognitive deficit model (OCD)

proposes that OCD symptoms arise from abnormally functioning cognitive processes, such as memory, problems with reality monitoring (the ability to discriminate between memories of actual versus imagined events), and inhibitory deficits (the inability to dismiss extraneous mental stimuli)

chronic MDD

the depression occurs continuously and without remission for at least 2 years

atypical MDD

marked by mood reactivity (i.e., mood brightens in response to positive events or potential positive events), hypersonic, extended fatigue, heightened sensitivity to criticism, and a significant increase in appetite and weight gain

peripartum MDD

major depressive episode occurs during pregnancy or within the 4 weeks following delivery

persistent depressive disorder

- must meet two of six symptoms accompanied by the occurrence of a depressed mood for most of the day, for more days than not, for at least 2 years

- poor appetite or overeating

- insomnia or hypersomnia

- low energy or fatigue

- low self-esteem

- poor concentration or difficulty making decisions

- feelings of hopelessness

pure dysthymic syndrome

the individual meets the criteria for persistent depressive disorder (dysthymia) and has not had a major depressive episode in the previous 2 years

persistent depressive episode

indicates full criteria for major depressive episode have been met at some point in the preceding 2 year period

chronic depression

- greater comorbidity with anxiety, substance use, and personality disorders than persons with nonchronic MDD

- associated with more extreme normal-range personality traits, such as higher neuroticism and lower extraversion, lower self-esteem, higher levels of depressive cognitive biases, higher levels of experiential avoidance, & greater suicidality

- greater early adversity, maladaptive parenting, childhood emotional abuse, and family history of depression

Skinner (depression)

proposed that depression is related to a reduction in behaviors that elicit positive reinforcement from the environment

Fester (depression)

postulated that three proximal causes were likely to contribute to a depressive shift in affect:

- infrequent positive reinforcement

- behaviors are further inhibited by the presence of anxiety

- unexpected changes in environmental stimuli (including interpersonal relationships) decrease the frequency of behaviors

Lewinsohn (depression)

agreed with his behavioral predecessors that depression develops when individuals experience a low rate of positive reinforcement for their behavior, and extended previous conceptualizations by positing that the rate of positive reinforcement is contingent upon three elements:

- the number of reinforcing activities in which an individual engages

- the amount of positive reinforcement that the environment is able to provide

- the skillfulness of the individual in eliciting reinforcement from the environment

vicious web (depression)

- combination of anhedonia, amotivation, and avoidance

- individuals lose interest in activities that previously brought them pleasure (anhedonia) and subsequently lose the desire to attempt those activities (motivation)

- individuals stop engaging in activities or spending time with other people because they don't have energy or motivation to do so

avoidance (depression)

- minimizes distress, thereby becoming a negative reinforcer

- passive, short-term strategy that results in long-term difficulties

- reduces the opportunity to encounter positive reinforcement

automatic thoughts (depression)

the words that go through one's mind frequently in response to an event - they are considered automatic because one does not have to work to generate these thoughts; rather, they arise spontaneously without effort

cognitive distortion (depression)

the thinking of a depressed individual is not only negatively biased and automatic, but also fraught with cognitive errors, which are activated by continuous negative self-statements or derived from the individual's self-schema/core beliefs

diathesis-stress model (depression)

- depressogenic schemas begin to develop early in life (diathesis) and in most cases are latent until they are activate by life events (usually negative and stressful) and after that serve as a filter for incoming information

- hence, depressogenic schemas predispose individuals to depression because they increase the likelihood of cognitive errors and negative self-statements or automatic thoughts and result in negative emotional states

internal-external

"not at all my fault" vs "completely my fault"

global-specific

"I am always terrible at everything" vs "I am a terrible driver"

stable-unstable

"I will be alone for the rest of my life" vs "this is hard, but I learned a lot that will help me in the next relationship"

hopelessness depression

a subtype of depression wherein hopelessness is "an expectation that highly desired outcomes will not occur or that highly aversive outcomes will occur coupled with an expectation that no response in one's repertoire will change the likelihood of occurrence"

processing and memory (depression)

- information presented in therapy may be distorted by impaired attentional and memory processes

- the therapist will likely need to inquire directly about positive experiences that may have occurred

- shifts in the proportion of positive to negative events that are reported in therapy should be carefully tracked, as they may be indicative of clinical progress

rumination (depression)

- involves self-focused attention accompanied by a repetitive focus on negative emotional causes, symptoms, and consequences

- both automatic and ruminative thoughts are often depressogenic; however, rumination is a repetitive pattern of thinking that is characterized by a failure to disengage attention from thought content - they are often accurate reflections of reality

DSM changes (alcohol use)

- DSM-5 provides a distinct diagnosis for alcohol withdrawal syndrome, at least two of the symptoms must be met and those symptoms must cause clinically significant distress or impairment in functioning and must not be due to a general medical condition or be better accounted for by another mental disorder

- DSM-5 moved to a single diagnosis of substance use disorder, rather than having a distinction between substance abuse and substance dependence

early remission

none of the criteria for alcohol use disorder have been met for at least 3 months but for less than 12 months (with the exception of the craving criterion)

sustained remission

none of the criteria for alcohol use have been met at any time during a period of 12 months or longer (with the exception of the craving criterion)

immigration paradox (alcohol use)

individuals who are born outside the United States and then immigrate to the United States seem to have a lower risk for alcohol use disorders than their U.S.-born counterparts, despite the fact that the former seemingly encounter more risk factors than the latter

college campuses (alcohol use)

approximately 20% of college students met the criteria for alcohol use disorder

personality theory (addiction)

- the notion that personality played a causal role in alcoholism

- an examination of personality motives found that a high degree of neuroticism, along with a high degree of impulsivity or extraversion, predicted an increase on alcohol use as a coping method (more current research has shown that personality characteristics are not necessarily a core component of the disorder and there is clearly not a specific personality dimension that can reliably predict alcoholism)

- impulsivity/disinhibition appears to be the most relevant personality factor

Marlat & Horon (alcohol use)

the model of relapse conceptualizes lapses as resulting from the patient's lack of skills for coping with high-risk situations, which leads to low levels of self-efficacy beliefs about his or her ability to cope with stressful situations and expectancies that alcohol use will help him or her cope effectively with situations in the future