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137 Cards in this Set

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stress
experiencing events that we perceive as being endangering to physical well-being.
reactions-stress responses
causes-stressors

unpredictability and uncontrollableness make events more stressful
safety signal hypothesis
with unpredictable events people feel that they cannot relax b/c events may occur at any time
bodily responses to stress
liver releases extra sugar/glucose to fuel the muscles, hormones are released to stimulate conversion of fats and protiens to sugar; heart rate and blood pressure increase and the muscles tense; less important things such as digestion and are curtailed. saliva and mucous dry up to increase air passage size; endorphines (body's natural painkiller) are realeased, surface blood vessels constrict to reduce injury; spleen releases more red blood cells to carry oxygen.
automatic nervous system
adrenal-cortical system
both systems are controlled by the hypothalamus and help induce the bodily changes due to stress; prepare the body for fight or flight
fight-or-flight response
natural stress response. to attack something or run away from it
hypothalamus first activates the sympathetic nervous division of the ANS -- acts directly to smooth muscles and internal organs to produce a change such as increased heart rate or elevated blood pressure; homrmones are released
cortisol
a hormone related to stress; results from the ACTH stimulating the outer layer of the adrenal gland

amt. of coetisol in blood and urine samples is used to measure stress
general adaptation syndrome
organ's and the body's repsonse to stress

Phases:
1. alarm - the body prepares to confront a threat by triggerin synaptic nervous system activity
2. resistance - the organism makes efforts to cope with the threat by fighting or fleeing from it
3. exhaustion - the organism is unable to fight off the threat or flee from it which depletes physiological resources
Hans Seyle
came up with "gen. adaptation sydrome"; argued that wide variety of physical and and psych. stressors trigger a repsonse pattern and that stress is responsible for a wide variety of diseases. created health psychology
Taylor, Icano, and MacGue
argued that men and woman have diff. repsonses to stress; females "tend and befriend" and join social groups to avoid stressors since they cannot fight them off as well; men
health psychology
investigates the effects of stress and other psych. stressors on the body

1. direct effects - psych. factors (stress, personality, etc.) directly cause phsical changes which lead to disease

psych factors --> phys. changes --> disease

2. interactive model: psych. factors interact with biological vulneribility to disease for a person to develop health problems.

psych. factors>>
vulnerability >>> psy. changes --> disease

3. indirect effects: psych. factors affect disease largely according to people's health habits (ex. smoking, eating habits, etc.)

psych. factors --> health behaviors --> disease
PTSD
* part of DSM-IV
* 3 types of symptoms:
- reliving the traumatic event
- emotional numbing/detachment
- hypervigilance and chronic arousal
acute stress disorder
much like PTSD in the way that it is induced by trauma and has similar symptoms

however unlike PTSD it occurs one month within the event and is much more shortlived, lasting no more than 4 weeks

dissociative symptoms are also part of the disorder

like PTSD the victim rexperiences the trauma, they avoid things that remind them of it, and they experience increased anxiety and arousal

people with this disorder still have a high risk of experience PTSD symptoms months later
dissociative symptoms
symptoms that indicate detachment from the trauma; people become extremely emotionally unresponsive and they may have difficulty concentrating, feel detached from themselves or in a dream state, have difficulty recalling events of the trauma;
adjustment disorder
consists of emotional and behavioral symptoms (depression symptoms, anxiety, antisocial behavior)

arise within 3 months of the onset of the stressor

stressors can be of any severity

this disorder lacks some of the PTSD and acute symptoms such as reliving the event

a residual category -- people are diagnosed when they experience disorders that do not fit anywhere else
traumas involved in PTSD
natural disasters
abuse
combat and war related
common traumatic events
factors that cause PTSD, besides trauma
environmental and social factors:
- severity, duration, and proximity of the trauma
- social support

psychological factors:
- shattered assumptions
--personal invulernability: people know bad things happen, but never think it will happen to them
- preexisting distress
- coping styles

biological factors:
- physiological hypersenstivity(ex. less cortisol during resting, but exaggerated stress symptoms)
-
PTSD: cognitive behavioral therapy
-systematic desensitization
proven to be effective in treatment of adults

an important part of this:
-systematic desensitization therapy: the client identifies thoughts and situations that create anxiety, ranking them from most anxiety causing to least; the therapist takes the patient through techniques to treat each symptom;

also imagining the event repeatedly and discussing it is part of this therapy; it helps the client to seperate it from reality work through it

also people are taught positive images to help get rid of nightmares
PTSD: stress management
when people cannot meaning in the trauma, it can be helpful to teach them to block intrusive thoughts
thought-stopping techniques
include a client yelling NO loudly when an intrusive thought is coming on, or learning to engage in positive activities to distract attention from these thoughts

part of stress management
stress-management interventions
teaches clients skills for overcoming probs. in their lives that are increasing in their stress and may be the result of PTSD(ex. marital probs. or social isolation)
eye movement desensitization and reprocessing (EMDR)
highly controversial therapy for trauma survivors

created by Francine Shapiro

client thinks about and imagines the trauma while moving their eyes with a target or therapists hand which creates jerky side to side eye movements

very effective and takes multiple sessions

helps to restructure clients thoughts on the trauma
PTSD: biological therapies
selective serotonin reuptake inhibitors (SSRIs) and to a lesser extent benzodiazepines are useful and treating PTSD, esp. sleep problems; patients can remain symptom free for 5 months but longer if they continue to take SSRIs
PTSD: sociocultural issues
certain cultures are more likely to suffer from PTSD b/c they experience more traumas; sometimes there needs to be treatement at a community level
cross-cultural issues
all cultures have different ways of dealing with trauma, some healthier than others. for example some asian cultures think it is taboo to express emotion over trauma while native americans have a 7 day cleansing ritual
community level interventions
when communities suffer from a tragedy mental health professionals are brought in to help and cater to the needs of the culture
PTSD
* part of DSM-IV
* 3 types of symptoms:
- reliving the traumatic event
- emotional numbing/detachment
- hypervigilance and chronic arousal
acute stress disorder
much like PTSD in the way that it is induced by trauma and has similar symptoms

however unlike PTSD it occurs one month within the event and is much more shortlived, lasting no more than 4 weeks

dissociative symptoms are also part of the disorder

like PTSD the victim rexperiences the trauma, they avoid things that remind them of it, and they experience increased anxiety and arousal

people with this disorder still have a high risk of experience PTSD symptoms months later
dissociative symptoms
symptoms that indicate detachment from the trauma; people become extremely emotionally unresponsive and they may have difficulty concentrating, feel detached from themselves or in a dream state, have difficulty recalling events of the trauma;
adjustment disorder
consists of emotional and behavioral symptoms (depression symptoms, anxiety, antisocial behavior)

arise within 3 months of the onset of the stressor

stressors can be of any severity

this disorder lacks some of the PTSD and acute symptoms such as reliving the event

a residual category -- people are diagnosed when they experience disorders that do not fit anywhere else
traumas involved in PTSD
natural disasters
abuse
combat and war related
common traumatic events
factors that cause PTSD, besides trauma
environmental and social factors:
- severity, duration, and proximity of the trauma
- social support

psychological factors:
- shattered assumptions
--personal invulernability: people know bad things happen, but never think it will happen to them
- preexisting distress
- coping styles

biological factors:
- physiological hypersenstivity(ex. less cortisol during resting, but exaggerated stress symptoms)
-
PTSD: cognitive behavioral therapy
-systematic desensitization
proven to be effective in treatment of adults

an important part of this:
-systematic desensitization therapy: the client identifies thoughts and situations that create anxiety, ranking them from most anxiety causing to least; the therapist takes the patient through techniques to treat each symptom;

also imagining the event repeatedly and discussing it is part of this therapy; it helps the client to seperate it from reality work through it

also people are taught positive images to help get rid of nightmares
PTSD: stress management
when people cannot meaning in the trauma, it can be helpful to teach them to block intrusive thoughts
thought-stopping techniques
include a client yelling NO loudly when an intrusive thought is coming on, or learning to engage in positive activities to distract attention from these thoughts

part of stress management
stress-management interventions
teaches clients skills for overcoming probs. in their lives that are increasing in their stress and may be the result of PTSD(ex. marital probs. or social isolation)
eye movement desensitization and reprocessing (EMDR)
highly controversial therapy for trauma survivors

created by Francine Shapiro

client thinks about and imagines the trauma while moving their eyes with a target or therapists hand which creates jerky side to side eye movements

very effective and takes multiple sessions

helps to restructure clients thoughts on the trauma
PTSD: biological therapies
selective serotonin reuptake inhibitors (SSRIs) and to a lesser extent benzodiazepines are useful and treating PTSD, esp. sleep problems; patients can remain symptom free for 5 months but longer if they continue to take SSRIs
PTSD: sociocultural issues
certain cultures are more likely to suffer from PTSD b/c they experience more traumas; sometimes there needs to be treatement at a community level
cross-cultural issues
all cultures have different ways of dealing with trauma, some healthier than others. for example some asian cultures think it is taboo to express emotion over trauma while native americans have a 7 day cleansing ritual
community level interventions
when communities suffer from a tragedy mental health professionals are brought in to help and cater to the needs of the culture
specific phobias
conform more to popular conceptions of phobia; most fall into one four categories: animal type, natural environmental type, situational type, and blood injection type; when people with phobias encounter what they are afraid of their anxiety is intense and they may encounter panic attacks and those types of symptoms
animal type phobias
focused on specific animals or insects; snake phobia appears to be the most common in the US; people who come across the feared animal will startle and probably move away quickly; people are generally diagnosed with this type of phobia because they encounter the animal on a daily basis
natural environment type phobias
focused on events or situations in the natural environment (ex. storms, heights, water, etc.). mild to moderate fears of these things are extremely common but irrational fears are not
situational type phobias
usually involve fears of things such as public transportation, tunnels, bridges, elevators, etc. or claustrophobia; people with this phobia tend to have panic attacks when put in these situations
blood-injection type phobias
people with this type of phobia are extremely afraid of seeing blood or an injury. runs more strongly in families than other types; people experience significant drops in blood pressure and heart rate and are likely to faint
social phobia
not categorized as a specific phobia b/c in instead of being afraid of a specific thing, people are very afraid of being embarassed or judged in public

more likely to severely disrupt a person's life then specific phobias

in social situations, these people will get severely nervous and may start trembling or perspiring, feel confused or dizzy, have heart palpations, and panic attacks

may avoid eating in public as well as using public restrooms , writing in public, or speaking in public

think people will judge them as weak, stupid or crazy

three typical groups: people who are afraid of speaking in public, people who have moderate anxiety about social situations, or people who have severe fear of almost all situations, even conversations

relatively common -- about 7% prevalence

women are more likely then men to develop this

develop in preschool years or early adolescent years

sometimes it is triggered by a traumatic experience, other times it just develops

most people with it do not seek treatment and it is chronic
psychodynamic theories of phobias
freud's theory is the most well known

he believes that phobias result from unconscious anxiety and is displaced on an object ex.: Oedipus complex

not very credible
behavioral theories of phobias
very successful in explaining phobias

classical conditioning leads to the fear or something and operant conditioning helps to maintain it

Watson and Raynor

most people develop a phobia to avoid being exposed to the feard object, which means they avoid exposure that could get rid of the phobia

running away reduces the anxiety -- negative reinforcement

some think that phobias can develop through observational learning
prepared classical conditioning
a behavioral theory

due to evolution things such as spiders, heights, etc. are more rapidly made into phobias than things such as flowers, which are harmless
cognitive theories of phobias
primarily focused on the development of social phobia

people w/ it have extremely high standards for their performance and tend to focus on the negative side of their interactions

overly perceptive; biases to attention

the enter situations assuming that people will find things wrong with them

could have to do with the environments that people have grown up in
biological theories of phobias
first degree relatives of ppl. with phobias are 3 to 4 times more likely to develop phobias
then ppl. who do not have relatives with phobias

due in part to genetics

gender differences: females are more likely to inherit agoraphobia

phobias themselves may not be very hereditary but the predisposition to anxiety is

people who were inhibited as young children are more likely to develop social phobia
behavioral treatment of phobias

the 3 elements
helps to extinguish fear of the object by exposing the person to it

very effective

elements:

1. systematic desensitization: clients create a heirarchy of things that they fear and learn relaxation techniques to reduce this fear

2. modeling: used with systematic desensitization; the therapist will perform the tasks the patient fears and then have the patient do it; helps to patient begin to expose themselves to calm reactions

3. flooding: to intensely put the client in front of the feared thing until the fear extinguishes; the therapist first teaches the client relaxation techniques to use
applied tension technique
helps to increase blood pressure and heart rate in blood injection type phobics to stop them from fainting

systematic desensitization element of behavioral therapy
cognitive-behavioral therapy for phobias
more effective then SSRIs

group therapy is often used

observational learning

more effective at preventing relapse than drugs
self efficacy expectations
creating expectations in clients that they have already made so much progress and that they will make more
specific phobias
conform more to popular conceptions of phobia; most fall into one four categories: animal type, natural environmental type, situational type, and blood injection type; when people with phobias encounter what they are afraid of their anxiety is intense and they may encounter panic attacks and those types of symptoms
animal type phobias
focused on specific animals or insects; snake phobia appears to be the most common in the US; people who come across the feared animal will startle and probably move away quickly; people are generally diagnosed with this type of phobia because they encounter the animal on a daily basis
natural environment type phobias
focused on events or situations in the natural environment (ex. storms, heights, water, etc.). mild to moderate fears of these things are extremely common but irrational fears are not
situational type phobias
usually involve fears of things such as public transportation, tunnels, bridges, elevators, etc. or claustrophobia; people with this phobia tend to have panic attacks when put in these situations
blood-injection type phobias
people with this type of phobia are extremely afraid of seeing blood or an injury. runs more strongly in families than other types; people experience significant drops in blood pressure and heart rate and are likely to faint
social phobia
not categorized as a specific phobia b/c in instead of being afraid of a specific thing, people are very afraid of being embarassed or judged in public

more likely to severely disrupt a person's life then specific phobias

in social situations, these people will get severely nervous and may start trembling or perspiring, feel confused or dizzy, have heart palpations, and panic attacks

may avoid eating in public as well as using public restrooms , writing in public, or speaking in public

think people will judge them as weak, stupid or crazy

three typical groups: people who are afraid of speaking in public, people who have moderate anxiety about social situations, or people who have severe fear of almost all situations, even conversations

relatively common -- about 7% prevalence

women are more likely then men to develop this

develop in preschool years or early adolescent years

sometimes it is triggered by a traumatic experience, other times it just develops

most people with it do not seek treatment and it is chronic
psychodynamic theories of phobias
freud's theory is the most well known

he believes that phobias result from unconscious anxiety and is displaced on an object ex.: Oedipus complex

not very credible
behavioral theories of phobias
very successful in explaining phobias

classical conditioning leads to the fear or something and operant conditioning helps to maintain it

Watson and Raynor

most people develop a phobia to avoid being exposed to the feard object, which means they avoid exposure that could get rid of the phobia

running away reduces the anxiety -- negative reinforcement

some think that phobias can develop through observational learning
prepared classical conditioning
a behavioral theory

due to evolution things such as spiders, heights, etc. are more rapidly made into phobias than things such as flowers, which are harmless
cognitive theories of phobias
primarily focused on the development of social phobia

people w/ it have extremely high standards for their performance and tend to focus on the negative side of their interactions

overly perceptive; biases to attention

the enter situations assuming that people will find things wrong with them

could have to do with the environments that people have grown up in
biological theories of phobias
first degree relatives of ppl. with phobias are 3 to 4 times more likely to develop phobias
then ppl. who do not have relatives with phobias

due in part to genetics

gender differences: females are more likely to inherit agoraphobia

phobias themselves may not be very hereditary but the predisposition to anxiety is

people who were inhibited as young children are more likely to develop social phobia
behavioral treatment of phobias

the 3 elements
helps to extinguish fear of the object by exposing the person to it

very effective

elements:

1. systematic desensitization: clients create a heirarchy of things that they fear and learn relaxation techniques to reduce this fear

2. modeling: used with systematic desensitization; the therapist will perform the tasks the patient fears and then have the patient do it; helps to patient begin to expose themselves to calm reactions

3. flooding: to intensely put the client in front of the feared thing until the fear extinguishes; the therapist first teaches the client relaxation techniques to use
applied tension technique
helps to increase blood pressure and heart rate in blood injection type phobics to stop them from fainting

systematic desensitization element of behavioral therapy
cognitive-behavioral therapy for phobias
more effective then SSRIs

group therapy is often used

observational learning

more effective at preventing relapse than drugs
self efficacy expectations
creating expectations in clients that they have already made so much progress and that they will make more
biological treatments of phobias
benzodiazepines are used to help treat phobias; helps to create temporary relief and reduce anxiety;

antidepressants and SSRIs are often used to treat social phobia but there are bad side effects and people will often relapse
generalized anxiety disorder (GAS)
people are anxious in almost all situations and almost all of the time

they worry about everything and focus of worries shifts frequently

symptoms can include muscle tension, sleep disturbances, chronic restlessness

they report feeling tired a lot, probably due to loss of sleep and muscle tension

prevalence - 5% in women, 3% in men

over half of people with GAD also develop another anxiety disorder such as another anxiety disorder, such as phobias or panic disorder;

70% end up experiencing a mood disorder and about 1/3 experience substance abuse

many people experience it all of their lives and it commonly first shows in childhood or adolescence
psychodynamic theories of GAD


3 types of anxiety
freud

1. realistic anxiety: occurs when we face real danger of threat
2. neurotic anxiety: occurs when we supress our id impulses
3. moral anxiety: occurs when we have been punished for expressing id impulses

GA occurs when our defense mechanisms can no longer contain our impulses and we cannot find healthy ways to express them

recent theories focus on upbringing and early relationships and their effects
humanistic and existential theories of GAD
people strive to meet the unrealistic conditions of worth due to the way they have been treated by significant others

they become chronically anxious or depressed b/c they cannot meet these standards

people face existental anxiety and can avoid it by facing lifes issues and trying to make life meaningful

not very researched or credible
conditions of worth
humanistic/exsistential approach


harsh standards people feel they must meet in order to feel acceptable

comes from negative feedback from significant others
existential anxiety
a universal human fear of the limits and responsibilities of ones exsistance
cognitive theories of GAD
cognitions of people with GAD are focused on threat at the conscious and unconscious level

people have maladaptive assumptions that set them up for anxiety

most of these issues deal with being in control and losing it

people believe that worrying can prevent bad events from happening

they avoid visual images of what they worry about, which does not allow them to condsider how they would cope

automatic thoughts: maladaptive assumptions lead people to thoughts that stir up anxiety

unconscious cognitions appear to be about deleting possible threats

stroop color test
biological theories of GAD
benzodiazepines reduce increase GABA activity, a nuertotransmitter that carries inhibitory messages from neurons; people may have a deficency of GABA and GABA receptors which results in excessive nueron firing particularly in the limbic system which is involved behavioral responses which leads to chronic anxiety

modestly hereditary
cognitive behavioral treatments for GAD
focuses on helping people confront the issues that they worry most about

help develop new coping strategies

more effective then medical or humanistic therapies
biological treatments of GAD
benzodiazepines (xanax, valium, etc.) provide short term relief from anxiety but can be addictive and people will relapse right away

busoprine(buspar) helps to eliminate GAD from some; few side effects and non addictive; blocks serotonin; azaspirones

tricyclic antidepressant imiparmine (Tofanil) and SSRIs paxil do a good job at reducing anxiety
obsessions
thoughts, images, ideas, or impulses that are persistent, the person feels intrudes on his or her consciousness without control and that cause significant anxiety of distress
compulsions
repetitive acts that a person feels they must perform
obsessive compulsive disorder (OCD)
classified as an anxiety disorder b/c people with it experience anxiety as a result of their obsessional thoughts when they cant carry out their compulsions

may soon no longer be considered an anxiety disorder

begins at a young age

chronic if left untreated

66% of people with it are depressed and panic attacks, phobias and substance abuse are common

1-3% will develop it at some point
OCD symptoms`
most common type of obsession focuses on dirt and contamination

others include agressive impulses, sexual thoughts, immoral impulses, etc.

they do not always carry out their impulses, and feel extremely guilty about them

checking compulsions are common

people often believe that the reptiation of rituals will ward off danger
biological theories of OCD
neurobiological disorder

circuit in the brain that is involved with exection of primitive patterns of behavior

caudate nucleus - allows only strongest impulses to be carried out

dysfunction in this circuit may result in system's inability to turn of primitive impulses

PET scans show more activity in these areas

ppl. often get relief when they take drugs that reguare serontonin

these people probably have depleted serotonin

OCD can run in families
biological treatments of phobias
benzodiazepines are used to help treat phobias; helps to create temporary relief and reduce anxiety;

antidepressants and SSRIs are often used to treat social phobia but there are bad side effects and people will often relapse
generalized anxiety disorder (GAS)
people are anxious in almost all situations and almost all of the time

they worry about everything and focus of worries shifts frequently

symptoms can include muscle tension, sleep disturbances, chronic restlessness

they report feeling tired a lot, probably due to loss of sleep and muscle tension

prevalence - 5% in women, 3% in men

over half of people with GAD also develop another anxiety disorder such as another anxiety disorder, such as phobias or panic disorder;

70% end up experiencing a mood disorder and about 1/3 experience substance abuse

many people experience it all of their lives and it commonly first shows in childhood or adolescence
psychodynamic theories of GAD


3 types of anxiety
freud

1. realistic anxiety: occurs when we face real danger of threat
2. neurotic anxiety: occurs when we supress our id impulses
3. moral anxiety: occurs when we have been punished for expressing id impulses

GA occurs when our defense mechanisms can no longer contain our impulses and we cannot find healthy ways to express them

recent theories focus on upbringing and early relationships and their effects
humanistic and existential theories of GAD
people strive to meet the unrealistic conditions of worth due to the way they have been treated by significant others

they become chronically anxious or depressed b/c they cannot meet these standards

people face existental anxiety and can avoid it by facing lifes issues and trying to make life meaningful

not very researched or credible
conditions of worth
humanistic/exsistential approach


harsh standards people feel they must meet in order to feel acceptable

comes from negative feedback from significant others
existential anxiety
a universal human fear of the limits and responsibilities of ones exsistance
cognitive theories of GAD
cognitions of people with GAD are focused on threat at the conscious and unconscious level

people have maladaptive assumptions that set them up for anxiety

most of these issues deal with being in control and losing it

people believe that worrying can prevent bad events from happening

they avoid visual images of what they worry about, which does not allow them to condsider how they would cope

automatic thoughts: maladaptive assumptions lead people to thoughts that stir up anxiety

unconscious cognitions appear to be about deleting possible threats

stroop color test
biological theories of GAD
benzodiazepines reduce increase GABA activity, a nuertotransmitter that carries inhibitory messages from neurons; people may have a deficency of GABA and GABA receptors which results in excessive nueron firing particularly in the limbic system which is involved behavioral responses which leads to chronic anxiety

modestly hereditary
cognitive behavioral treatments for GAD
focuses on helping people confront the issues that they worry most about

help develop new coping strategies

more effective then medical or humanistic therapies
biological treatments of GAD
benzodiazepines (xanax, valium, etc.) provide short term relief from anxiety but can be addictive and people will relapse right away

busoprine(buspar) helps to eliminate GAD from some; few side effects and non addictive; blocks serotonin; azaspirones

tricyclic antidepressant imiparmine (Tofanil) and SSRIs paxil do a good job at reducing anxiety
obsessions
thoughts, images, ideas, or impulses that are persistent, the person feels intrudes on his or her consciousness without control and that cause significant anxiety of distress
compulsions
repetitive acts that a person feels they must perform
obsessive compulsive disorder (OCD)
classified as an anxiety disorder b/c people with it experience anxiety as a result of their obsessional thoughts when they cant carry out their compulsions

may soon no longer be considered an anxiety disorder

begins at a young age

chronic if left untreated

66% of people with it are depressed and panic attacks, phobias and substance abuse are common

1-3% will develop it at some point
OCD symptoms`
most common type of obsession focuses on dirt and contamination

others include agressive impulses, sexual thoughts, immoral impulses, etc.

they do not always carry out their impulses, and feel extremely guilty about them

checking compulsions are common

people often believe that the reptiation of rituals will ward off danger
biological theories of OCD
neurobiological disorder

circuit in the brain that is involved with exection of primitive patterns of behavior

caudate nucleus - allows only strongest impulses to be carried out

dysfunction in this circuit may result in system's inability to turn of primitive impulses

PET scans show more activity in these areas

ppl. often get relief when they take drugs that reguare serontonin

these people probably have depleted serotonin

OCD can run in families
psychodynamic theories of OCD
particular obsessions of compulsions of people with OCD are symbolic of the unconscious conflicts that they are gaurding against

people can be treated for OCD by gaining insight into these conflicts

not effective
cognitive-behavioral therapies
everyone has intrusive thoughts, but people with OCD have difficult turning off these thoughts

this may be b/c they are depressed or anxious so even minor events can induce these thoughts

they judge the thoughts more and become more anxious and feel more guilty over having the thoughts and anxiety makes it harder to dismiss these thoughts

they believe that they should be able to control all thoughts, although no one actually can

compulsions develop through operant conditioning; negative reinforcement of the behaviors occurs b/c people find relief in compulsions
biological treatments of OCD
antidepressants can help relieve symptoms in many patients by b/c of the effect of the level of serotonin(prozac, paxil, zoloft, etc.) 50-80% experience reduction in compulsions

many people respond to SSRIs, but there are a lot of side effects
cognitive behavioral treatments for OCD
many people believe that drugs and cog.-behavioral treatments must be combined to get treatment

focuses on repeatedly exposing the clients to the client to their obsessions and preventing compulsive responses to the anxiety

this is thought to decrease the amt. of anxiety and the person must be prevented by following through with the compulsion

leads to a significant improvement for most but not all patients
social approaches to anxiety disorders
people in unstable countries undergoing many changes are more likely to experience anxiety then those living in stable countries
gender differences in anxiety disorders
overall, a lot more women deal with anxiety disorders than men do

this has to do with their place in society, their relationships, and what is expected of them

also coping styles play a role

however men do not always seek appropriate help for anxiety and sometimes substance abuse can be a problem

women are more succeptable to violence, which is a factor
cross-cultural differencs in anxiety
"attack of the nerves" common in latino communities

in japan there is a great fear of offending others
somatoform disorders
group of disorders in which people experience signigcant physical symptoms for which there is no organic cause

people w/ the disorder usually do not consciously produce or control the symptoms and the symptoms pass only when the psych. issues are resolved

unlike psychosomomatic b/c tests show no medical probs.
psychosomatic disorders
medical disorders in which the person has an actual physical illness or defect that can be documented with medical tests and that is worsened b/c psych. factors
malingering
people fake a symptom or disorder in order to avoid an unwanted situation
factitious disorders
a person deliberately fakes an illness to gain medical attention

completely intentional, unlike malingering

ex. Munchausen's sydrome
factitious disorder by proxy
parents fake or create illnesses in their children in order to gain attention for themselves

many parents are extremely good at hiding it
conversion disorder
type of somatoform disorder

people lose funcioning in part of their bodies, apparently due to nuerological or medical issues.

common symptoms include paralysis, blindness, hearing loss, muteness, anesthesthia in a limb, loss or coordination, etc.

usually follows some sort of psych. stressor

extremely rare
la belle indifference
"the beautiful difference"

in conversion disorders, people appear to unconcerned about their loss of functioning
theories of conversion disorder
originally it was believed that only women developed this

people thought it had to do with a "wandering womb"

common during the world wars

more common among sexual abuse survivors and can occur in children

these people are highly hypnotizable and the fake problems may result from self hypnosis
glove anesthestia
part of conversion disorder

a person losing feeling in their hand, but no in their whole arm

it usually went away when under hypnosis people recalled the stressful event leading to it

freud
distinguishing coversion disorder from a physical one
it is not always easy to rule out physical causes

many times, it turns out that people diagnosed with conversion disorder actually truly were suffering from a medical disorder that could not be identified at the time
treatment of conversion disorder
psychoanalytic: focuses on expression of painful emotions and memories and insight into the relationship b/t these and conversion symptoms

behavioral treatment: focus on relieving the person's anxiety around the initial trauma that caused the symptoms and on reducing any benefits the person may be receiving from the symptoms

these people are difficult to treat b/c they do not believe that anything is wrong with them
somatization disorder
the person has a long history of complaints about physical symptoms affecting many different areas of the body for which medical attention has been sought but there does appear to be a physical cause; the person must complain of pain symptoms in at least 4 areas of the body, in including 2 intestinal symptoms, a sexual symptom, and a neurological symptom; often goes from doctor to doctor; may also report lost of functioning in part of the body; people may be prone to periods of anxiety; more common in women; europeans are least likely to suffer from it; long term problem
pain disorder
people who complain only of chronic pain

patient may insist on procedures and surgeries

people may be prone to periods of anxiety

similar to somatization disorder
theories of somatization disorder and pain disorder
disorders run in families, primarily among female relatives while male relatives of these people are more predisposed to alocholism and personality disorder

not clear whether it has to do with genetics

cognitive theory suggests that persons w/ these disorders tend to experience body sensations more intensely than others and catastrophize symptoms; all of this affects the way the person will present symptoms to people;

may be part of PTSD

refuguess and immigrants have increased chance of developing disorder b/c
treatment of somatization and pain disorder
it is hard to convince people that they have these disorders

psychodynamic therapies: provide insight into connections b/t emotions and physical symptoms by helping people recall events and memories that may trigger the symptoms

behavior therapies attempt to determine the reinforcements the person receives for their symptoms and then eliminate them

cognitive therapies help people learn to appropriately interpret physical symptoms

antidepressents can help to improve these probs.
hypochondriasis
people worry that they have a disease but not always experience the symptoms of it and believe that they should seek out medical help immediately

may go from doctor to doctor, sure that they have the disease

often mistake for somatization

not very common
body dysmorphic disorder
people are excessively preoccupied with a part of their body that they believe is defective

they spend hours obsessing about the body part

often goes along with OCD
dissosciatve disorders
mild experiences disorders are common

being completely detached from a situation
dissociative identity disorder
(DID)
people with this disorder have more than one distinct personality and many people have over a dozen

these alters can all have their own distinct traits

males appear to be more agressive than females
symptoms of DID
presence of multiple alters with disctinct personalities

child alters are most common

childhood trauma or abuse is often assosciated with this disorder

persecutor personality: inflicts pain or punishment on the host and other personliaties

helper personality: offer advice to the other personalities; sometimes control the switiching of personalities

people calim to have period of amnesia or blank spells

self-destructive behavior is common

behavioral and emotional problems

people report hearing voices in their heads
issues in diagnosis of DID
people are reluctant to diagnose it

more commonly diagnosed in americans an latinos
explanations of DID
it is often viewed as a result of coping used by people faced with intolerable trauma

previously may have endured sexual or physical abuse

these people are highly hypnotizable and may use self hynotism

may use it to help them cope
treatment of DID
can be extremely challenging

integration of all of the alter personalities into 1
dissociative fugue
person will suddenly pick up and move to a new place, assume a new identity, and have no memory of the previous one; suddenly he may return to his home and resume his previous identity as if nothing has happened

can last for days or years

some but not all do it in a response to trauma
dissociative amnesia
the person cannot remember important facts about their lives and their identities and are usually aware that there are large gaps in their memory
organic amnesia
comes from a medical cause
anterograde amnesia
inability to remember new info.
psychogenic amnesia
amnesia from psych. causes; rarely involves anterograde amnesia; possible that is the brains way of shutting out intolerable memories
retrograde amnesia
inability to remember info. from the past; can have both organic and psychogenic causes
depersonalization disorder
people have frequent episodes where they feel detached from their bodies as if they are outside observers of themselves

occasional episodes are not uncommon