EXAM 2 psychopathology

L5- Stress

1. What are the symptoms of posttraumatic stress disorder? 

• Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.

• Avoidance of or efforts to avoid external reminders (peo- ple, places, conversations, activities, objects, situations)

• Psychological reactions( sweating, heart palpitations)

2. What is acute stress disorder?

Stress related disorder- a diagnostic category that can be used when symptoms develop shortly after experiencing a traumatic event and last for at least 2 days

 3. What happens to our body when we experience fear? 

Flight or flight gets activated by sympathetic Nervous system

4. What are helpful treatments for Post-traumatic stress disorder 

• Prolonged exposure therapy 

• Cognitive Processing Therapy (CPT

• eye Movement Desensitization and Reprocessing

• Medications – SSRIs for mood and anxiety

5. What treatment, despite its popularity, has the least empirical support for its efficacy for Post-Traumatic stress disorder

• Critical incident stress Debriefing 

6. What does exposure therapy for Post-Traumatic Stress Disorder involve?

repeatedly exposing themselves to trauma-related stimuli in a safe environment, individuals can learn to tolerate their fears and reduce their distress.

• VR 

L5- anxiety disorders

1. What is the Yerkes-Dodson curve? 

a graph that illustrates the relationship between arousal and performance

• performance increases with mental arousal (stress) but only up to a point. When an individuals' level of stress is too low or too high, their performance deteriorates

2. What is fear?

An unpleasant feeling triggered by the perception of danger, real or imagined.

 3. How is fear different from anxiety? 

Fear can be induced by non cognitive processing vs anxiety involves cognitive processing 

•  Fear-  Primitive, basic emotion with behavioral act of fight or flight-an instantaneous response necessary for survival  

• Response to imminent threat

• Anxiety- future orientated. Threat that has not happened yet

• A sense of uncontrollability regarding future events

4. What is a panic attack? 

intense fear response without any reason to be afraid

-often “unexpected” or “uncued”

Have episodes 

5. What is a phobia? 

Intense fear response to an object or situation

6. What are frequently occurring phobias?

Agoraphobia, claustrophobia, arachnophobia 

 7. What are behavioral treatments for anxiety disorders

Prolonged Exposure, cognitive behavioral therapy, mindfulness

8. What disorders are in the Obsessive- Compulsive and related disorders category in the DSM 5?

• Body dysmorphic Disorder

• Hoarding 

• Trichotillomania- hair pulling 

 9. Which Anxiety and Obsessive- Compulsive and related disorders occur more frequently in women?

Agoraphobia, panic disorders 

10. How prevalent are anxiety disorders and which are the most prevalent? 

4.7%= panic without agoraphobia more common 

11. What are obsessions and compulsions?

Obsessions- 

•  Recurrent, persistent thoughts, urges, or images that are experienced as aversive and cause marked anxiety. 

• attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).

• Contamination fears • Fears of harming oneself or others • Lack of symmetry • Pathological doubt

Compulsive- 

• Repetitive behaviors (e.g., hand washing, checking) or mental acts (e.g., praying, counting) that the individual feels driven to perform in response to an obsession or according to rule

• Cleaning • Checking • Repeating • Ordering/arranging • Counting

12. How is OCD treated? 

Exposure and response prevention-hierarchy of stimuli

Medications that affect neurotransmitter serotonin  

•  Prozac, Anafranil. 

• Improvement in 40-60%  

13. What is GAD? 

Generalized Anxiety Disorder- excessive anxiety and worry about events or activities for at least 6 months 

14. What situations do individuals with social anxiety fear? 

Going out in big crowds, socializing 

15. What situations do individuals with agoraphobia fear? 

Going outside at all, big crowds, normal outside stuff

16. How is Panic Disorder treated? 

Medications

• Serotonergic (SSRI)(prozac) - 60% panic free

• Noradrenergic 

• GABA (Benzos)- effective short term- 90% relapse 

Behavioral 

• Cognitive Behavior Therapy 

• E.g. Panic Control Treatment

• Exposure to interoceptive cues

• Relaxation/breathing (exercise)

• As good as meds/ less intrusive /less side effects 

17. Why are some phobias more common than others?

• Environmental factors

• Learned behavior

• Genetic 

• Traumatic experiences 

L6- mood disorders

1. What is a major depressive episode? 

a patient either has lost interest or pleasure in almost all activities or does not react to usually pleasurable stimuli or desired events.

2. What is a manic episode?

• A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary

• inflated self-esteem or grandiosity 

• Decreased need for sleep (e.g. feels rested after only 3 hours) 

• More talkative than usual or pressure to keep talking 

• Flight of ideas or racing thoughts • Distractibility 

•  Increase in goal directed activity (either socially, at work, school, or sexually) or psychomotor agitation

 3. What is a hypomanic episode?

Milder version of mania

• which a person experiences abnormally elevated, expansive, or irritable mood for at least 4 days.

4. What is a mixed episode?

characterized by symptoms of both full-blown manic and major depressive episodes for at least 1 week 

5. What is Major Depressive Disorder? 

a person exhibits more symptoms than are required for dysthymia and that the symptoms be more persistent-a persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms.

• Depressed mood most of the day, nearly every day (in children/adolescents can be irritable mood) 

•  Significant weight loss or gain or decrease or increase in appetite 

• Insomnia or hypersomnia every day 

• Diminished ability to think or concentrate, or indecisiveness, nearly every day

• Recurrent thoughts of death, recurrent suicidal ideation, suicide attempt 

6. What is Cyclothymic Disorder? 

• Milder, chronic version of bipolar disorder

• Mild depressive symptoms alternating with hypomanic symptoms over 2 years-

• Hypomanic and depressive periods present for half the time and not absent for more than 2 months at a time.

7. What is Persistent Depressive Disorder?

• Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.

• Criteria for a major depressive disorder may be continuously present for 2 years.

• Presence, while depressed, of two (or more) of the following: 

       - Poor appetite or overeating. • Insomnia or hypersomnia. • Low energy or fatigue. • Low self-esteem. • Poor concentration or difficulty making decisions. • Feelings of hopelessness.

 8. What is double depression? 

•  Major depressive episodes and dysthymic disorder 

• Dysthymic disorder usually develops first 

•  Facts and statistics • Associated with severe psychopathology 

• Associated with a problematic future cours

9. What is Bipolar 1? 

• Full blown mania (with or without depression)

10. What is Bipolar 2? 

• Milder version of mania (hypomania)

11. What events may lead to depression? 

• Stressful life events

• Medications

• Health issues

• Breavement 

12. What is the reciprocal gene environment model? 

Depressed individuals create or seek out stressful situations -Stress triggers depression

• theory that explains how genes and environment interact to shape behavior and development.

 13. What is Beck’s theory of depression? 

Beck hypothesized that the cognitive symptoms of depression often precede and cause the affective or mood symptoms rather than vice versa

• certain kinds of early experiences can lead to the formation of dysfunctional assumptions that leave a person vulnerable to depression later in life if certain critical incidents (stressors) activate those assumptions

• Negative coping styles • Depressed persons engage in cognitive errors 

• Tendency to interpret life events negatively 

• Types of cognitive errors • Arbitrary inference – overemphasize the negative  

14. What medications are used for major depression and bipolar disorder? 

Major depression

Selective Serotonin Reuptake Inhibitors - E.g. Prozac, Paxil

Tricyclics (Tofranil, Elavil) - Was frequently used for severe depression

MAO-I • Block monoamine oxidase • Result – more serotonin/norepinephrine

Bipolar disorder

Lithium- primary treatment

Anticonvulsants (carbamazepine, divalproex, and valproate)

15. What are side effects of transcranial magnetic stimulation? 

• Headaches 

• Fewer side effects

16. What psychotherapies work with depression?

Cognitive therapy- 10-20 weekly sessions

Behavioral Activation • Increased positive events • Exercise- 

 17. What psychosocial treatment works with bipolar disorder? 

 Interpersonal and Social Rhythm Therapy 

• Helping patients regulate circadian rhythms by teaching to regulate sleep cycles and everyday routines. 

• Family-focused treatment 

•  Treat family communication styles, improve coping skills • Early evidence of efficacy

 18. What is Hopelessness theory? 

Depressogenic cognitive style is the tendency to make negative inferences regarding stressful life events

• Self implications- seeing self as flawed or unworthy

• Negative interferences 

• Cause- stable and global attributions 

19. What disorder is most associated with suicide?

 Major depression- up to 15%

4 fold increase in death rates in depressed individuals after age 55

20. What is electroconvulsive therapy? Transcranial magnetic stimulation?

electroconvulsive therapy

Brief electrical current – less than 1 second. • Temporary seizures • 6 to 12 treatments • High efficacy • Severe depression, possibly mania

 Transcranial magnetic stimulation

Localized electromagnetic pulse • Fewer side effects (headaches most common) • Efficacy is likely good • More studies needed