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84 Cards in this Set
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15. How is terrorism different from other community traumas (hint: there are three primary factors)?
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• Faceless enemy with malevolent intent
• Ongoing threat • Political undertones and ramifications |
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16. List five different coping mechanisms people reported using after the 9/11 terrorist attacks.
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• 97% reported talking about their feelings
• 90% reported turning to religion • 75% checked on their families • 60% participated in a group activity • 39% reported avoiding activities which reminded them of the attacks • 36%donated blood, money or volunteered |
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17. As discussed in class, what were five primary predictors of PTS after 9/11? What were the six primary predictors of anniversary related 9/11 PTS?
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• Predictors: Prior Mental and Physical Disorders
- Denial - Self-Blame - Seeking social support - Disengaging from coping - 5th= not sure. Maybe if subjects were in NY or Miami (any big city) • Anniversary related PTS - Hispanic ethnicity - Income - Pre 9/11 Mental Health - # of recent traumas - Anniversary related TV and radio exposure |
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18. What did Mehl and Pennebaker find regarding social interactions after 9/11 (hint: this was the study where people had their daily life conversations recorded)? What is one interpretation of why this occurred?
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• Overall conversation time did not differ from pre to post-9/11…however, the type of conversation did
• Group and phone conversations decreased • Dyadic conversations increased • Increases in dyadic conversations less intrusive thoughts 2 weeks post-9/11 |
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19. Define primary prevention, secondary prevention, and early treatment intervention and give an example of each.
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• Primary prevention:
- Taking steps to reduce exposure to trauma - Law and public policy related • Secondary prevention: - Crisis intervention techniques delivered within days of the trauma - Psychological debriefing • Early treatment interventions - Delivered soon after symptoms have emerged |
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20. What is psychological debriefing? What is CISD? Is this found to be helpful in reducing
PTS after a trauma? Cite evidence in your response. |
• Psychological debriefing: a conversation with an individual who just experienced a traumatic event to inform them about their response and allowing them to talk about it.
- Delivered within several days of a traumatic event - Critical Incident Stress Debriefing (CISD) • Ventilating emotions about the trauma while discussing one’s thoughts, feelings, and reactions • Provides psycho education about traumatic stress responses and tries to normalize these responses - Pre-incident preparedness - One-one-one individual crisis support - Demobilization (providing food, rest, facts) - Defusing (small group intervention) - Family support - Referral • Most endorse it as helpful, Research has been mixed • Adult crime victims randomly assigned - 1 hour debriefing where they talked about their feelings and encouraged to express negative emotions such as guilt, shame and fear - No difference between groups • Newcastle earthquake in Australia - 80% of debriefed group found it helpful, but MORE symptomatic! |
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24. What are the five primary myths of coping? Describe each and provide a specific study that counteracts each myth in your response. What are problems with holding on these “myths’?
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1. Depression is inevitable following loss
2. Distress is necessary 3. Failure to experience loss is indicative of psychopathology 4. It is necessary to “work through” or process a loss |
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1. Depression is inevitable following loss
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b. 30 days after loosing spouse, a minority (35%) could be classified as definitely or probably depressed
c. Study of primarily Mormon elderly bereaved- 3 months post loss i. 14.6% of men and 19.6% of women reported “at least mild” depression d. Spinal cord injury patients i. 2.7% experienced a depressive disorder |
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2. Distress is necessary
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a. Several attributions
b. “Absent grief”= “pathologic” mourning? c. Emotionally week person d. Unable to become attached to others i. Narcissistic with little recognition of the person who was lost |
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3. Failure to experience loss is indicative of psychopathology
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a. Evidence?
b. Those who are more distressed shortly following a loss are MORE depressed 1-2 years later c. Cross- sectional study of 53 spinal- cord- injured patients i. Absence of depression was associated with higher self-concepts and with staff ratings of successful adjustment to the disability. d. Study of 124 parents who lost an infant to SIDS i. Those who showed low distress at 3 wks also showed low distress at 18 months later ii. Did not have significantly different attributions of pregnancy or of the baby as having been beautiful, intelligent and happy while alive |
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4. It is necessary to “work through” or process a loss
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a. Working through= active attempts to make sense of the loss/ trauma
i. Searching for answers, thinking of the way that the loss could be avoided, preoccupied with thoughts about the loss ii. In SID study, the more parents “worked though” the death at 3 wk interview, the more distress they were, and the less emotional resolution at 18 months b. High initial yearning after bereavement was predictive of WORSE mental and physical health outcomes at 13 months postloss i. Similar results were found at 2 and 4 year follow-up |
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15. How is terrorism different from other community traumas (hint: there are three primary factors)?
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• Faceless enemy with malevolent intent
• Ongoing threat • Political undertones and ramifications |
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16. List five different coping mechanisms people reported using after the 9/11 terrorist attacks.
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• 97% reported talking about their feelings
• 90% reported turning to religion • 75% checked on their families • 60% participated in a group activity • 39% reported avoiding activities which reminded them of the attacks • 36%donated blood, money or volunteered |
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17. As discussed in class, what were five primary predictors of PTS after 9/11? What were the six primary predictors of anniversary related 9/11 PTS?
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• Predictors: Prior Mental and Physical Disorders
- Denial - Self-Blame - Seeking social support - Disengaging from coping - 5th= not sure. Maybe if subjects were in NY or Miami (any big city) • Anniversary related PTS - Hispanic ethnicity - Income - Pre 9/11 Mental Health - # of recent traumas - Anniversary related TV and radio exposure |
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18. What did Mehl and Pennebaker find regarding social interactions after 9/11 (hint: this was the study where people had their daily life conversations recorded)? What is one interpretation of why this occurred?
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• Overall conversation time did not differ from pre to post-9/11…however, the type of conversation did
• Group and phone conversations decreased • Dyadic conversations increased • Increases in dyadic conversations less intrusive thoughts 2 weeks post-9/11 |
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19. Define primary prevention, secondary prevention, and early treatment intervention and give an example of each.
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• Primary prevention:
- Taking steps to reduce exposure to trauma - Law and public policy related • Secondary prevention: - Crisis intervention techniques delivered within days of the trauma - Psychological debriefing • Early treatment interventions - Delivered soon after symptoms have emerged |
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20. What is psychological debriefing? What is CISD? Is this found to be helpful in reducing
PTS after a trauma? Cite evidence in your response. |
• Psychological debriefing: a conversation with an individual who just experienced a traumatic event to inform them about their response and allowing them to talk about it.
- Delivered within several days of a traumatic event - Critical Incident Stress Debriefing (CISD) • Ventilating emotions about the trauma while discussing one’s thoughts, feelings, and reactions • Provides psycho education about traumatic stress responses and tries to normalize these responses - Pre-incident preparedness - One-one-one individual crisis support - Demobilization (providing food, rest, facts) - Defusing (small group intervention) - Family support - Referral • Most endorse it as helpful, Research has been mixed • Adult crime victims randomly assigned - 1 hour debriefing where they talked about their feelings and encouraged to express negative emotions such as guilt, shame and fear - No difference between groups • Newcastle earthquake in Australia - 80% of debriefed group found it helpful, but MORE symptomatic! |
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24. What are the five primary myths of coping? Describe each and provide a specific study that counteracts each myth in your response. What are problems with holding on these “myths’?
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1. Depression is inevitable following loss
2. Distress is necessary 3. Failure to experience loss is indicative of psychopathology 4. It is necessary to “work through” or process a loss 5. Recovery and resolution are necessary following a loss |
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1. Depression is inevitable following loss
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b. 30 days after loosing spouse, a minority (35%) could be classified as definitely or probably depressed
c. Study of primarily Mormon elderly bereaved- 3 months post loss i. 14.6% of men and 19.6% of women reported “at least mild” depression d. Spinal cord injury patients i. 2.7% experienced a depressive disorder |
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2. Distress is necessary
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a. Several attributions
b. “Absent grief”= “pathologic” mourning? c. Emotionally week person d. Unable to become attached to others i. Narcissistic with little recognition of the person who was lost |
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3. Failure to experience loss is indicative of psychopathology
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a. Evidence?
b. Those who are more distressed shortly following a loss are MORE depressed 1-2 years later c. Cross- sectional study of 53 spinal- cord- injured patients i. Absence of depression was associated with higher self-concepts and with staff ratings of successful adjustment to the disability. d. Study of 124 parents who lost an infant to SIDS i. Those who showed low distress at 3 wks also showed low distress at 18 months later ii. Did not have significantly different attributions of pregnancy or of the baby as having been beautiful, intelligent and happy while alive |
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15. How is terrorism different from other community traumas (hint: there are three primary factors)?
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• Faceless enemy with malevolent intent
• Ongoing threat • Political undertones and ramifications |
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16. List five different coping mechanisms people reported using after the 9/11 terrorist attacks.
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• 97% reported talking about their feelings
• 90% reported turning to religion • 75% checked on their families • 60% participated in a group activity • 39% reported avoiding activities which reminded them of the attacks • 36%donated blood, money or volunteered |
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17. As discussed in class, what were five primary predictors of PTS after 9/11? What were the six primary predictors of anniversary related 9/11 PTS?
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• Predictors: Prior Mental and Physical Disorders
- Denial - Self-Blame - Seeking social support - Disengaging from coping - 5th= not sure. Maybe if subjects were in NY or Miami (any big city) • Anniversary related PTS - Hispanic ethnicity - Income - Pre 9/11 Mental Health - # of recent traumas - Anniversary related TV and radio exposure |
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18. What did Mehl and Pennebaker find regarding social interactions after 9/11 (hint: this was the study where people had their daily life conversations recorded)? What is one interpretation of why this occurred?
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• Overall conversation time did not differ from pre to post-9/11…however, the type of conversation did
• Group and phone conversations decreased • Dyadic conversations increased • Increases in dyadic conversations less intrusive thoughts 2 weeks post-9/11 |
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19. Define primary prevention, secondary prevention, and early treatment intervention and give an example of each.
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• Primary prevention:
- Taking steps to reduce exposure to trauma - Law and public policy related • Secondary prevention: - Crisis intervention techniques delivered within days of the trauma - Psychological debriefing • Early treatment interventions - Delivered soon after symptoms have emerged |
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20. What is psychological debriefing? What is CISD? Is this found to be helpful in reducing
PTS after a trauma? Cite evidence in your response. |
• Psychological debriefing: a conversation with an individual who just experienced a traumatic event to inform them about their response and allowing them to talk about it.
- Delivered within several days of a traumatic event - Critical Incident Stress Debriefing (CISD) • Ventilating emotions about the trauma while discussing one’s thoughts, feelings, and reactions • Provides psycho education about traumatic stress responses and tries to normalize these responses - Pre-incident preparedness - One-one-one individual crisis support - Demobilization (providing food, rest, facts) - Defusing (small group intervention) - Family support - Referral • Most endorse it as helpful, Research has been mixed • Adult crime victims randomly assigned - 1 hour debriefing where they talked about their feelings and encouraged to express negative emotions such as guilt, shame and fear - No difference between groups • Newcastle earthquake in Australia - 80% of debriefed group found it helpful, but MORE symptomatic! |
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24. What are the five primary myths of coping? Describe each and provide a specific study that counteracts each myth in your response. What are problems with holding on these “myths’?
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1. Depression is inevitable following loss
2. Distress is necessary 3. Failure to experience loss is indicative of psychopathology 4. It is necessary to “work through” or process a loss 5. Recovery and resolution are necessary following a loss |
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1. Depression is inevitable following loss
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b. 30 days after loosing spouse, a minority (35%) could be classified as definitely or probably depressed
c. Study of primarily Mormon elderly bereaved- 3 months post loss i. 14.6% of men and 19.6% of women reported “at least mild” depression d. Spinal cord injury patients i. 2.7% experienced a depressive disorder |
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2. Distress is necessary
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a. Several attributions
b. “Absent grief”= “pathologic” mourning? c. Emotionally week person d. Unable to become attached to others i. Narcissistic with little recognition of the person who was lost |
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3. Failure to experience loss is indicative of psychopathology
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a. Evidence?
b. Those who are more distressed shortly following a loss are MORE depressed 1-2 years later c. Cross- sectional study of 53 spinal- cord- injured patients i. Absence of depression was associated with higher self-concepts and with staff ratings of successful adjustment to the disability. d. Study of 124 parents who lost an infant to SIDS i. Those who showed low distress at 3 wks also showed low distress at 18 months later ii. Did not have significantly different attributions of pregnancy or of the baby as having been beautiful, intelligent and happy while alive |
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5. Recovery and resolution are necessary following a loss
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a. Study of kibbutz children whose fathers had been killed in war
i. Almost 50% of children showed emotional disturbance at 6,18, and 43 mo postloss ii. 2/3 of children had psychological problems and impairment in diverse areas of functioning b. Study of long- term effects of loss of spouse or child to a motor accident i. 4-7 years later, higher depression, psychiatric symptoms mortality, divorce 1. Lower social functioning and psychological well being |
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25. Define the two stage model of coping with loss described by Stroebe and Schut.
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1. Loss-oriented coping: attempt to process or resolve some aspects of the loss itself
2. Restoration-oriented coping: attempting to adapt to or master the challenges of daily life due to the loss |
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26. What is “survivors syndrome”? What are some explanations for why holocaust survivors who lived on a Kibbutz in Israel fared better than those who lived in a city?
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• Survivors syndrome: Changes in survivor’s quality of emotional life, interpersonal relations, and functioning as spouses or parents
• Kibbutz residents adjusted better o Instrumental support (economic security) o Psychological support (strong sense of togetherness) o Superordinate goals (building a country and society) |
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27. What are the mechanisms by which religion may be linked with lower distress after a traumatic event?
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• Religious participation
o Higher social support and greater meaning • Importance of religion o Cognitive processing and finding meaning |
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28. Define vulnerability, risk factors, resilience and protective factors.
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• Vulnerability= individuals’ susceptibility to a disease
• Risk factors= biological or psychosocial hazards that increase likelihood of a negative outcome • Resilience= personality factor/ individual difference • Protective factors= modify, ameliorate or buffer reactions to a situation that normally leads to adverse outcomes |
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29. What were the primary findings associated with the Kauai Longitudinal Study?
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• Kauai longitudinal study
o Followed 505 children o 42 girls and 30 boys encountered 4 or more risk factors but did not result in negative developmental outcomes • Risk factors include poverty, prenatal stress, troubled homes • Temperamental characteristics o Very active, affectionate, good natures as infants o Better reading and reasoning skills o After high school, more positive self-concept and higher locus of control • Established a close bond with caregiver • Found emotional support outside of their own family • Participation in extracurricular activities • As adults, found meaningful careers o Women= cooperative o Men= competitive |
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30. Define ex juvantibus reasoning. How does this relate to what we know about depression? What are two problems with viewing depression as a chemical imbalance?
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• Ex Juvantibus reasoning: translates to “from that which helps.” Refers to a process inference about disease causation from an observed response of the disease of treatment
- Ex. Patient whose headache has been alleviated by taking aspirin, an ex juvantibus line of reasoning would state that the headaches were caused by low levels of aspirin in the brain. Obviously, the fact that aspirin cures headaches does not prove that headaches are caused by the absence of aspirin. In "The 21-Century Brain" (2006), Steven Rose applies the term to the use of psychoactive drugs to "cure" depression, implying that the underlying cause of depression is not simply low levels of certain chemicals in the brain (such as serotonin) that these drugs treat. (Wikipedia) |
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31. What is learned helplessness and how does it relate to depression?
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• Learned helplessness = If stressed uncontrollably we become pessimistic about the effects of our own skilled actions.
• Seligman – study of rats exposed to an “uncontrollable stressor” - Coping response and reward - little effect on helpless rats - Control and mastery not available to the rats • Beck – cognitive distortions and overgeneralizations- “I’m not good at studying vs. I’m not good at anything” |
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32. What is an “inverted U-shape” in regards to the association between negative life events and distress?
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• Inverted U shape between negative life events and well being/distress. People who had some negative life events had a lower effect distress level then people who had no negative life events. People who had the highest number of negative life had the most distress.
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33. What are the two necessary symptoms to meet diagnostic criteria for Major Depressive Disorder?
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• Depressed mood most of the day, nearly every day: SADNESS
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly everyday: Anhedonia |
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34. How does the anterior cingulated cortex (ACC) function in a depressed person?
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• The ACC is activated by negative experiences and consistently shows higher levels of activity in depressed people
• Take the ACC “offline” in a depressed brain by cutting its connection to the rest of the brain and depressive symptoms seem to abate. • ACC is linked to negative emotions if you electrically stimulate the ACC in people they feel a shapeless sense of fear and foreboding. The more left out a person feels, the more intensely the ACC activates. • The resting level of activity in the ACC tends to be elevated in people with depression-this is the fear and pain and foreboding churning away at those neurons. |
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35. How does stress interact with the biology of depression? What does the glucocorticoid profile of a depressed person look like?
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• People who are undergoing a lot of life stressors are more likely than average to succumb to a major depression. Have lots of glucocorticoids in the bloodstream and the risk of a depression increases.
• Atypical depression is characterized with abnormally low levels of glucocorticoids • Far more common feature of depression is an over active stress response, overly activated SNS, and elevated levels of glucocorticoids. - Excessive secretion of glucocorticoids is due to feedback resistance, where the brain is less effective at shutting down gluco secretion. |
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37. How is resilience different from recovery?
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• Resilience (SLIDE)
- Vulnerability= individuals susceptibility to a disease - Risk Factors= biological or psycho social hazards that increase likely hook of a negative outcome - Resilience=personality factor/individual difference that is an inherent factor in the person - Protective factors= modify, ameliorate or buffer reactions to a situation that normally leads to adverse outcomes. • Resilience and Recovery (from article) - Recovery = normal functioning temporarily gives way to threshold or sub threshold psychopathology (ex. Symptoms of depression or PTSD), usually for a period of at least several months, and then gradually returns to pre-event levels. o May be relatively rapid or last up to 2 years - Resilience = ability to maintain equilibrium. Protective factors foster the development of positive outcomes and healthy personality characteristics among children (ex. Posed to unfavorable or aversive life circumstances. = Resilience to loss and trauma pertains to the ability of adults in otherwise normal circumstances who are exposed to an isolated and potentially highly disruptive event, such as the death of a close relation or a violent or life-threatening situation, to maintain relatively stable, healthy levels of psychological and physical functioning. o May experience transient perturbations in normal functioning (ex. Several weeks of sporadic preoccupation or restless sleep) but generally exhibit a stable trajectory of healthy functioning across time, as well as the capacity for generative experiences and positive emotions. |
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38. Define self-enhancement and repressive coping. Provide an example for each.
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• Self-Enhancement
- Hardiness and Self-Enhancement operate on cognitive processes - Linked to resilience. Associated with benefits, such as high self-esteem but also with costs: narcissistic, evoke negative emotions in others. IN highly aversive events positives out weigh negatives bc of unrealistic or overly positive biases in favor of the self can be adaptive and promote well-being, particularly for bereaved indiv’s suffering from more severe losses. - Salivary Cortisol levels exhibited a profile suggestive of minimal stress responding. • Repressive coping - Operates on emotion focused mechanisms, such as emotional dissociation (maladaptive and associated with long term health costs, yet foster adaptation to extreme adversity) - Typically report relatively little distress in stressful situations but exhibit elevated distress on indirect measures such as autonomic arousal. - Linked to resilience. Repressors tend to avoid unpleasant thoughts, emotions, and memories. Shows better adjustment. o Positive emotion and laughter = one of the ways repressors and others showing resilience appear to cope well with adversity. Positive emotions can help reduce levels of distress following aversive events both by quieting or undoing negative emotion. |
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39. Define social support. What were the origins? Who was Durkheim? What was his major contribution? Describe what Cooley meant buy the “looking glass self”. How does this relate to social support?
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Social support is a process through which help is provided to or exchanged with others in an attempt to facilitate one or more goals”
• Specific types of social ties (e.g., social integration) • Availability or provision of social resources • Feelings of community and belonging • Helping transactions Durkheim: • Durkheim (1951), sociologist • Social isolation was associated with reduced psychological well-being Cooley • Charles Horton Cooley (1902) • Concept that a person’s self is a reflection of what they imagine other’s perceive them to be 1. We imagine how we appear to others 2. We imagine their judgments 3. We develop our self through the judgments of others |
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40. How could social support influence health? What are meant by main effects vs. buffering effects? Define each and provide an example.
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stress-preventive: social support surrounds individuals with emotional and instrumental assistance that promotes well-being
stress-buffering: social support reduces the toll of stressful events by contributing to effective coping Main Effects: • Promotes positive psychological states health-promoting behavior, positive physiological responses • ex: friends tell you, “lets go to yoga” “lets go get drinks” Buffering Effects: • Eliminates/reduces effects of stressful experiences by altering appraisals and/or coping • ex: you have finals coming up, you live at home, and your family helps you out to lower your stress by cooking for you, cleaning up, |
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41. Define social integration. What are social networks? How do social networks influence mortality? We discussed several physical health benefits in class. List three. How is social integration related to the HPA axis? What happens to the key hormones involved in the stress response? Are there gender differences? If so, what are they?
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Social Integration:
• Active participation in social networks Social Networks • ex: marriage, neighbors, clubs, teams, religious groups, friends • sense of community identification with social roles 3 Health Benefits . lower rates of depression i. lower risk of alcohol consumption ii. lower risk of smoking iii. more involved in physical activity HPA Axis Relation iv. Regulation in the homeostatic regulatory processes of the body Stress Response Hormones (social support) v. lower levels of cortisol, epinephrine, norephinephrine vi. lower choleresterol vii. stronger vaccination response viii. better lymphocyte prliferation Stress Response (no support) ix. lower natural killer responses x. poorer lymphocyte xi. poorer control over latent virus Gender Differences: Emotional Support: Men: get more help benefits than women because they do not always expect to have emotional support, don’t express feelings very often so when they do they gain benefits Women: not as much because we always expect the emotional support Instrumental Support: Men: don’t need help from others because they are more egotistical and prefer to do everything themselves, can do it all on their own (ex: moving their own stuff) Women: gain more benefit, ex: have men help them move out, we ask for help more |
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42. What were Sheldon Cohen’s the main findings regarding social relationships and the “cold hotel”?
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xii. send people to a hotel
xiii. 2 weeks xiv. put in a cold virus xv. see how fast people got sick depending on how many social ties they had Findings: xvi. 1-3 ties= 4x more likely to get sick xvii. 4-6 ties= not as likely to get sick xviii. lowest social ties= cold risk higher xix. BUT, if conflict ridden (bad relationship with groups) ties were not beneficial |
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43. How does social integration relate to mental health?
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• Social integration= lower rates of depression
i. But, a loss of social ties= increase depressive symptomology ii. ex: moving away to college and in the beginning you feel sad and depressed |
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44. Describe how social relationships get “under the skin”.
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• Cognitive-emotional interpretations of stimuli then influence neuroendocrine activity via the neocortical and limbic centers
i. Information regarding the external social (and nonsocial) environment is processed first by the sensory systems of the neocortex |
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1. What constitutes a trauma according to the APA? What does NOT constitute a trauma?
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• DEF: “outside the range of usual human experience and that would be markedly distressing to almost anyone”
• Threat to life or the life/physical integrity of another • Destruction of home • Witnessing a violent event • Hearing of a traumatic event Not: • Divorce, illness What are some problems with a definition of trauma that is too stringent? Too lenient? What are three criticisms of DSM-IV criterion A? • Pathologizes normal responses to stressful events • Can be viewed as both too narrow and too broad in it’s definition of trauma • Fails to help differentiate symptoms unique to PTSD from those of other anxiety disorders • Fails to capture the range of peritruamatic dissociation |
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2. How are children’s reactions to a traumatic event different than those of an adult? What are two predictors discussed in class that predict worse outcomes in children?
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Children show less emotional numbing
• Trouble reporting avoidance reactions . PREDICTORS: • Influenced by family • Mother’s mental health • Parental unavailability to discuss the trauma |
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3. What is the history of PTSD? What political events led to it’s inception and ultimate inclusion in the DSM-III? What is the difference between acute and chronic PTSD?
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HISTORY:
First and Second world war • Shell shock, battle fatigue • Interest in studying these things diminished shortly after the wars ended Vietnam War • Duration and unpopularity of the war • Post-combat observations – lasting set of symptoms not captured by existing diagnosis • “post-Vietnam syndrome” DSM III •DSM-III task force •Case studies of combat veterans and survivors of disasters •Variety of horrific events were linked to a distinct cluster of symptoms • Combat, rape, internment in concentration camps ACUTE VS. CHRONIC • Acute – duration of symptoms is less than 3 months • Chronic – duration of symptoms is 3 months or more |
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4. What is Acute Stress Disorder?
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• Exposure to a traumatic event
• Many of the same symptoms as PTSD; e.g., numbing, re-experiencing the event, avoidance, symptoms of anxiety • Lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the event |
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5. Can we define a mental disorder? Are there any problems with this definition? What are two examples of how diagnosis/categorizations might be considered subjective?
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• Extreme
o Is it atypical? (sadness vs. depression) • Socially undesirable o Does it fall outside norms of culture-subculture? Is it socially deviant? • Distress o Is the person distressed? Disturbing to others? • Disability o Is this working for the person? Or is it maladaptive? 2 EXAMPLES OF SUBJECTIVE • –Homosexuality until 1973 • –Body Dysmorphic Disorder (not accepted by HMO) • –Posttraumatic Stress Disorder (PTSD) – recently included, post-Vietnam War |
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6. In addition to exposure to a trauma, what are the three primary symptom clusters of PTSD? Give an example of each.
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• Reexperiencing (at least 1)
o Reliving the event, nightmares • Avoidance and numbing (at least 3) o Feeling detached, avoiding stimuli that remind you of the event, inability to remember • Hyperarousal (at least 2) o Insomnia, difficulty concentrating, irritable, angry |
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7. What are two methods of assessments for defining PTSD?
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• Clinical interviews
o in depth interviews conducted by clinicians or other highly trained indiviudals • Checklist o can be read aloud to children or adults o self- assesments o web or paper based |
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8.. What is a peritraumatic response? What component of this response predicts subsequent PTSD?
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• Peritraumatic risk factors – traumatic responses that occur during or shortly after the trauma itself
• Self-reported peritraumatic dissociation (feeling unreal or experiencing time slowing down during the trauma) predicts subsequent PTSD |
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9. Describe the Stroop interference task. How does this relate to potential cognitive impairments in people with PTSD?
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• Demonstration of reaction time
• Name of a color (blue, green, red) is printed in a different color (word red is printed in blue ink for example) Cognitive Aspects of PTSD •Re-experiencing symptoms -Intrusive recollections, nightmares, flashbacks • Automatic (involuntary) processes at work? – Emotional stroop paradigm – Interference for trauma-related words – Related to severity of PTSD rather than the severity of the trauma itself – Shows that the experience of having PTSD impacts cognitive functioning |
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10. What are the biological aspects of PTSD? What happens to the HPA-axis in people with PTSD?
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Biological Aspects of PTSD
• Higher resting heart rate • Exaggerated startle response • Nonadrenergic dysregulation -Greater release of norepinephrine • Sleep problems HPA-Axis dysregulatioon • Characterized by LOWER cortisol levels o Measured by 24 hour blood draws • What does this mean? o Hyper-responsive to environmental cues o Primed to respond maximally to stressors |
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11. Do subjects with PTSD report higher or lower ability to remember traumatic words when compared to other stimulus?
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• Forgetting paradigm
• Three groups - Abused women with PTSD - Abused women without PTSD - Controls • Subjects viewed trauma words (incest), positive words (celebrate), and neutral words (banister) • PTSD subjects exhibited memory deficits for positive and neutral words |
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12. Describe the findings related to the study of the nuclear accident at Three Mile Island.
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• TMI residents experienced
- increased symptoms, distress, depression & anxiety - Higher epinephrine, norepinephrine and cortisol - The more intrusive thoughts and out of control (subjective) the subject felt the worse the symptoms |
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13. What were the physiological differences between Katrina survivors who were displaced when compared to those who were not displace
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• Katrina survivers experienced higher markers of distress and cardiovascular risk including increased:
- PTSD - Depression - Heart rate and blood pressure - Proinflammatory cytokine activity |
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14. What predicts worse mental health and social integration among child soldiers? What factors were found to be protective?
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• Worse mental health and social integration:
- Witnessing, experiencing, and perpetrating violence, younger age of involvement, and longer engagement with armed group • Protective factors: - Social support - Community acceptance • If improved, decreased depression at follow-up regardless of levels of violence exposure • If re-integrated into communities, then reduced PTSD - In school or working at the time of assessment • Retention in school= greater prosocial attitudes |
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45. What is structural vs. functional support?
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• Structural Support:
• social integration, social network • Functional: • assess the functions that social relationships serve (e.g., providing emotional, informational support) -Perceived social support: perceptions that others will provide aid if you need it |
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46. How does social support influence the immune system? What are findings regarding high levels of social support? What about for people with low levels of social support? How does social support relate to mortality?
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a. People with more social support showed signs of a stronger immune system
i. People who had 1, 2, or 3 social ties were more likely to get a cold than people who had 4, 5, or 6 social ties b. People who report lower social integration (more socially isolated) experienced greater six-year risk of coronary heart disease c. Extent and quality of social relationships linked to better health and longevity i. Lower resting blood pressure, lower cholesterol, lower heart rate, and lower levels of cortisol, epinephrine, norepinephrine d. The more social support one has the less percent there is of mortality rates |
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47. What are the key findings we discussed in class regarding active vs. passive support? What are gender differences regarding social support and cortisol reactivity? Why would this be?
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a. Active Support→ receive unambiguous emotional support from a confederate or friend
b. Passive Support→ mere presence of a friend/stranger i. Was more preferred than active support c. Gender differences i. Men showed higher levels of cortisol when no support was present than when there was support present ii. Women showed lower levels of cortisol when no support was present than when there was support present 1. Women were probably more self-conscious about themselves and what their partner thought of them when presented 2. Women are warm caregivers and typically do not judge, which is why men showed lower levels of cortisol when partner was present |
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48. Define invisible support. What was the key finding regarding the study of people taking the bar exam, conducted by Bloger et al. (2000)? How does received support differ from perceived support? List the three types for each and provide an example. Is one better than the other? What is miscarried helping and how does it relate to health?
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a. Invisible support
i. A form of support where the person has support with his or her awareness; most beneficial b. Received Support i. Naturally occurring helping behaviors that are being provided—(helping that actually happened) c. Perceived Social Support i. Belief that such helping behaviors would be provided when needed—(helping that may happen) d. Three types i. Received social support 1. Tangible help (receiving shelter, tools or equipment, money, cleaning 2. Emotional help (receiving expressions of interests, affection and assurance 3. Informational help (receiving suggestions, information on how to do something and information to understand the situation) ii. Perceived social support 1. Tangible support (having someone to go to the doctor with, someone who would lend a car) 2. Emotional support (having someone to talk to) 3. Informational support (having someone to help solve problems, someone to turn for advice) |
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49. What predicts negative reactions to victims of a traumatic event? What is meant by unconstrained social relationships? How do unconstrained social relationships relate to mental health?
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a. Prediction of negative reactions
i. Victim Distress 1. Depressed affect, negative affect 2. Dwelling on negative aspects of the situation 3. People who present themselves as “poor copers” ii. Victim coping behavior 1. Active coping techniques 2. Perceived onset of responsibility b. Social integration→ lower rates of depression |
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50. How do Eastern vs. Western cultures differ in regards to social support? What are the cultural differences in neuroendocrine responses for Eastern vs. Western cultures in a speech task? What are the implications of this finding?
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a. Eastern vs. Western
i. Eastern (collectivist): person as flexible, connected entity, bound to others, and considers groups goals as primary and personal beliefs, needs and goals as secondary ii. Western (individualistic): Self is independent, and regards a person as possessing a set of self-defining attributes, obtain individual goals; relationships are freely chosen and entail few obligations b. Neuroendocrine responses i. Asian American’s psychological and biological responses buffered with implicit support primed ii. Eastern American’s psychological and biological responses buffered with explicit support primed c. Implications i. Collectivist cultures—emphasize harmony, social support that does not bring relational “risks” might be better ii. Individualist cultures—self-expression and verbal sharing of thoughts and feelings emphasized |
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51. Stress can disrupt sleep. What are the three mechanisms? The three outcomes? What happened to the sleep of individuals who were faced with a stressor (speech task)?
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a. Mechanisms
i. Rumination ii. Worry iii. Activation of the SNS b. Outcomes i. Sleep Latency ii. Sleep Duration iii. Sleep Quality c. Speech Task i. There was a delay in sleep amongst those expecting an upcoming speech |
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52. How is sleep deprivation a stressor? We discussed four ways sleep deprivation influences physical health. List three. What are the mechanisms (i.e., hormones) involved in sleep deprivation?
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a. Normal decline in stress hormones doesn’t occur
b. Increases in cortisol c. Impairs learning and memory d. Suppresses aspects of the immune system |
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53. What is explicit vs. procedural memory?
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a. Explicit (declarative) memory
i. Concerns facts and events, conscious b. Procedural Memory i. Skills and habits, you can do without even really thinking |
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39. What are the three main ways meditation practices differ? We discussed several types of mediation in class. Pick two and describe. What are the four forms of meditation?
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c. Three main differences
i. Type of attention 1. Concentration meditation a. Focuses on one object – breath or inner sound 2. Awareness or open meditation a. Fluid attention to multiple or successively chosen objects ii. The relationship to cognitive processes 1. Observe cognitions (thought or images) 2. Deliberatively modify them iii. The goal 1. Foster general mental development and well-being 2. Focus on specific mental qualities a. Concentration, love, wisdom d. Types of meditation i. Transcendental Meditation 1. Mantra (inner sound) 2. Concentrative, but in advanced stages awareness becomes panoramic ii. Mindfulness 1. Open focus or awareness 2. Associated with vipassana (clear seeing) insight meditation |
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54. What are four physical health benefits of meditation?
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a. Helps with:
i. Hypertension ii. Asthma iii. Stuttering iv. PMS |
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55. What is MBSR vs. and what are three of the potential effects? How could MBCT influence Major Depressive Disorder?
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a. MBSR= Mindfulness based Stress reduction. More energy, Less pain, Less perceived stress, higher well-being, less depression.
b. The individual can notice the depressive thought, but not act on it and revert to positive feelings; detach from negative thoughts |
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56. What is dialectical behavioral therapy? Describe the key components. What is meant by a dialectical world view?
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a. Developed by Linehan to treat borderline personality disorder
b. Mindfulness skills taught in the context of synthesizing acceptance and change c. Key Components i. 3 mindfulness “what” skills 1. Observe, describe, participate ii. 3 mindfulness “how skills 1. Non judgment, one-mindfully, effectively d. Dialectical world view i. Reality consists of opposing forces ii. Synthesis of these forces leads to a new reality and a process of change iii. Relationship between acceptance and change 1. Encouraged to accept self, history and current situation exactly as they are, while working intensely to build a better life |
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57. We discussed several possible mechanisms behind the efficacy of mindfulness. Pick three and describe each. What were the three benefits of mindfulness and at-risk youth?
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a. Self-management
i. Coping skills ii. Detection of early problem (relapse prevention) iii. “One-mindfully” b. Relaxation i. May help with stress-related medical disorders such as psoriasis and fibromyalgia, but not the primary outcome of meditation c. Acceptance i. Of pain, thoughts, feelings, urges, or other bodily, cognitive or emotional phenomena, without trying to change, escape or avoid them |
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58. What is compassion meditation? What is lojong? What were the main findings regarding the possible physiological effects of such practices? How does the brain relate to emotion regulation and the brain? What are the neurophysiological effects that occur during mediation? What happens to the limbic system during meditation?
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a. Compassion meditation: participation in a health discussion control group
b. Lojong (Two primary elements): i. Initial phase in which various arguments are examined that challenge one’s common sense notion of other people as falling into the categories of “friend, enemy, and stranger” ii. One practices developing spontaneous feelings of empathy and love for an ever expanding circle of people, beginning with the self and extending eventually with those with whom one has problems conflicts or dislikes |
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59. What are the four quadrants associated with emotions according to Buddhist practices?
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a. Sympathetic
b. Avoid c. Parasympathetic d. Approach |
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61. How is meditation different from traditional relaxation?
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a. Paralimbic and fronto-limbic affective and fronto-parietal attention networks
b. May contribute to deeper control of autonomic system and interoceptive awareness i. Dose-effects observed within subjects: fronto-parietal and fronto-limbic brain activation stronger and deeper compared to initial, lighter states |
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62. What is complementary and alternative medicine? Define alternative and integrative medicine.
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a. Group of diverse medical and health care systems, practices, and products
b. Alternative medicine→ used in place of conventional medicine c. Integrative medicine→ combines conventional and CAM treatments |
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63. What are the acute effects of yoga? What are three of the health possible benefits of yoga? What were two of the findings regarding yoga and cancer survivors?
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a. Acute effects: increases in heart rate, blood pressure while practicing, but reductions in exercise-induced increases in BP and HR observed after yoga training
b. Benefits i. Reductions in depression ii. Reductions in anxiety iii. Better sleep c. Cancer survivors i. Decreased fatigue (severity and duration) ii. Improvements in depressive symptoms and quality of life iii. Improved physical performance |
