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104 Cards in this Set
- Front
- Back
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diathesis
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heritable tendency toward anxiety
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trait neuroticism
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relative frequently and ease with which negative emotions are generated- risk factor
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autonomic restrictors
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lower responses to physiological measures of heart rate and blood pressure but higher muscle tension
decreased activity in the right hemisphere, which is associated with low levels of image processing, and show increased activity in the left hemisphere, which is associated with increased verbal processing images evoke higher levels of autonomic arousal and distress, and so by avoiding the processing of the image, their worrying is negatively reinforcing, don't actually face though, avoiding anxiety |
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behavioral inhibition system
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-in septohippocampal system
-rich in serotonin and norepinephrine receptors: low levels (less activation) tend towards antisocial, high activation tend towards anxiety -triggered by impending non-reward, punishment, novelty -bottom-up and top-down -activation: emotions of anxiety and frustration; behaviors of stop, slow down, freeze, observe, etc. |
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three “anomalies” in research regarding the role of cognitive change in effective cognitive behavioral
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-no added value for cognitive intervention
-changes before changed cognitions -no documentation for mediation effects for cognitive change |
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depressed thinking
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-increased building on negative thinking
-stuck on negative thoughts -deficits in cognitive control when processing negative information |
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empirically supported treatment
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clearly specified psychological treatments shown to be effective in repeated experimental studies
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depression and circadian rhythm
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not regulated, too much or too little sleep
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Interpersonal and Social Rhythm Therapy
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-sleep and social rhythm interventions- get history, track events, stabilize rhythms and manage symptoms, find strategies for future success
-addition of the emphasis on social and biological rhythms |
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eating disorder NOS
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-subthreshold of anorexia or bulimia
-combinations of different specifics -binge eating |
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transdiagnostic treatment of eating disorder- overview
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-the specific eating disorder is not of relevance – but its specific psychopathological features and the processes maintaining them
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4 core features of eating disorders (maintaining mechanisms)
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-mood intolerance
-interpersonal difficulties -clinical perfectionism -low self-esteem |
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anorexia/bulimia difference
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"refusal" to maintain normal body weight (<85% expectation)- "success" in losing weight
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anorexia death rate
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20% (30% of that suicide)
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social effects of starvation
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-heightened preoccupation with eating
-social withdrawal |
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surprising about the finding that Interpersonal Psychotherapy is an effective treatment for bulimia nervosa
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effective even though not specifically targeting disordered eating
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why does a craving last for years?
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-enduring cellular changes- sensitization of pathways to incentive salience through dopamine effects (craving)
-makes it easy to relapse |
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behavioral activation system
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"pleasure pathway"
-mesolimbic system: amygdala, nucleus accumbens, prefrontal cortex- neurological circuit -rich in dopamine receptors -triggered by presence/possibility of reward -activation triggers: emotions of hope and relief, approach behavior |
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which neurotransmitter plays a key role in activation in response to alcohol-related cues
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glutamate
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avoidant PD
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avoid because scared of criticism/fear of rejection, want relationships
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schizoid PD
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doesn't want relationships
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what is unique about personality disorders?
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more pervasive/inflexible, less responsive to treatment, stable pattern of long duration
-Axis II |
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"borderline" origins
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between neurotic and psychotic
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biosocial theory of etiology (Linehan)- emotional vulnerability; biologically driven emotion dysregulation
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-high sensitivity to emotional stimuli
-intense emotional responses -slow return to emotional baseline (each leads to next) |
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five components of emotional modulation in Linehan’s model of the etiology of borderline personality disorder
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-inhibiting mood-dependent behaviors
-organizing behavior in the service of goals, independent of current mood (can't do something if inconsistent w/ mood) -modulating physiological arousal as needed -distracting attention from emotionally evocative stimuli -experiencing emotion without immediate withdrawal or generation of extreme secondary emotions |
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three components of invalidating environments in Linehan’s model of the etiology of borderline personality disorder
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-indiscriminate rejection of private experiences and self-generated behavior
-punish emotional displays and intermittently reinforce emotional escalation (when ppl pay attn) -oversimplify the ease of problem solving and goal attainment |
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childhood sexual abuse and borderline
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almost if not all- more (severe) abuse correlates with more symptoms
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five behavioral skills addressed in the skill development component of borderline personality disorder
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-distress tolerance
-emotion regulation -interpersonal effectiveness -self-management -nonjudgemental awareness (mindfulness) |
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why borderline so challenging?
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dissociation, missed/late to sessions, 3 am crisis calls, verbal attacks on the therapist
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why dialectical behavior therapy "third wave"?
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deals with trigger factors and context and experiential change as opposed to only treating symptoms
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ADHD adverse outcomes
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-risky behaviors- more accidents/health care
-comorbidity -increased traffic offenses -more early smoking -reduced life expectancy -more peer/sibling conflict -increased HS dropout rate |
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problems associated with the DSM-IV approach to subtyping of ADHD
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the disorder does not describe the condition- subtypes (ex. can have without inactivity); less symptoms as older but impairment can last
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“spectrum” disorder
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wide variations of symptoms and severity of symptoms
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splinter skills
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autism- great at something but no applicable skill (ex. birthdays)
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spared skills
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autism- undamaged
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Yokohama study
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proved no correlation by vaccines
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“theory of mind”
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separating your perspective from someone else's (ex. knowing that someone else doesn't know what you know)
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mirror neurons and how are the implicated in the etiology of autism
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less responsively (or fewer)
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“expressed emotion” schizophrenia
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-triggers relapse
-familial, expresses: -criticism -animosity -emotional overinvolvement |
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Assertive Community Treatment
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treatment for scizophrenia- go out into community and try to get people help in a non-hospital setting
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prevalence rate of schizophrenia
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1%
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hypofrontality and how is it related to dopamine
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underractivity to dopamine in frontal cortex, causes negative symptoms
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positive symptoms of schizophrenia caused by
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hyper-reactivity in the striatal system
overreactive to dopamine, positive symptoms; dopamine agonists increase symptoms (antagonists given as treatment, can cause Parkinson's-like symptoms) |
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panic attacks symptoms
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abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and possibly dizziness
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three categories of panic attack
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-Situationally bound-attack is cued by a particular setting or situation
-Unexpected-no clear cue or trigger for the attack -Situationally predisposed-cues may, but don’t inevitably, cause an attack |
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treatment of panic disorder
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benzos, SSRIs, exposure therapy (+interoceptive exposure)
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generalized anxiety disorder
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at least 6 months of excessive anxiety and worry that is ongoing for more days than not and is difficult to forget
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GAD (symptoms) and panic attacks physiological?
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GAD is characterized by muscle tension and mental agitation, fatigue, irritability, and difficulty sleeping
Panic attacks are associated with autonomic arousal |
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different types of phobia
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-blood-injury-injection
-situational phobias -natural environmental phobias (natural events eg. tornadoes etc.) -animal phobias -other |
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how phobias acquired
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-classical conditioning
-may learn vicariously -being warned repeatedly 1. traumatic experience 2. fear develops more easily if "prepared" to fear (actually dangerous) 3. one must be susceptible to developing anxiety that the event will happen again |
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acute stress disorder vs. PTSD
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acute stress disorder within 1st month
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mania
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characterized by exaggerated elation euphoria, little sleep, rapid speech, and grandiose plans
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causes and treatments for seasonal affective disorder
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winter, in cold environments
excess sleep, increased appetite, and weight gain may produce too much melatonin, disrupted circadian cycles |
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relationship between depression and anxiety
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almost all depressed patients are anxious, but not all anxious patients are depressed
-anhedonia is key to depression, the key to anxiety is the experience of autonomic activation, which can also occur in depressed people |
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role of neurotransmitters, brain-wave activity, and negative cognitions in the etiology and treatment of depression
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norepinephrine and dopamine out of whack because low levels of serotonin
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fight or flight system (FFS)
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-panic circuit
-responds to unconditioned or innately aversive stimuli -brain stem, hypothalamus, amygdala, central gray matter -activation triggers emotion of fear, behaviors of alarm and escape |
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schizophrenia disorganized symptoms
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erratic behaviors in many domains
disorganized speech (tangents, cognitive slippage, loose associations) unusual behaviors (catatonia) |
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schizophreniform disorder
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full range of symptoms, rapid onset, brief duration
-less than 6 month |
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schizoaffective disorder
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mood disorder- hallucinations or delusions without mood symptoms
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delusional disorder
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only delusions, no other positive symptoms or negative symptoms
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brief psychotic disorder
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one or more positive symptoms for less than one month
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anorexia subtypes
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restricting type
binge-eating and purging type |
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bulimia
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characterized by binge eating and compensatory behavior (vomiting, laxatives, etc.)
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consequences of starvation (physiological)
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amenorrhea (absence of menstruation), hair loss, lanugo, impaired temperature regulation, heightened sense of fullness
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comorbidity in anorexia nervosa
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33% depression
OCD overlap, often associated with substance abuse (with substance abuse increases suicide risk) |
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orthorexia
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obsessive preoccupation with eating healthy food
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bulimia nervosa treatment
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CBT and IPT (50% effective), SSRIs (short-term effective)
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anorexia nervosa treatment
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family therapy (no strong evidence for effectiveness), hospitalization
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substance abuse
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impairment or distress over a 12 month period; dysfunction, more about how it effects your life than how it effects physiologically (failure to fulfill obligations, creation of physical hazards, continued use in spite of social issues, etc.)- dependence takes precedent, "step above"
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substance dependence
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-implies abuse criteria also met
-impairment or distress over a 12 month period -dysfunction (more physiological; tolerance, withdrawal effects, higher doses or longer duration than intended, attempts to stop without success, etc.) |
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alcohol sensitivity
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1st drink big effect, later drinks have less effect (early sensitivity, later insensitivity)- leads to drinking more to get same effect
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why we like alcohol
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-behavioral activation system ("pleasure pathway)
-dopamine- need to feel good, positive reinforcement |
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GABA and glutamate in alcoholism
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GABA- inhibitory neurotransmitter, decreases sensitivity to other neurotransmitters (alcohol inhibits)
glutamate- excitatory neurotransmitter, shift from dopaminergic regulation to glutamate regulation in frontal cortex (move from pleasure to craving) |
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personality disorder- enduring pattern of atypical behavior in two or more areas
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-cognition
-affectivity -interpersonal functioning -impulse control |
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controversies of personality disorders
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-comorbidity rule rather than exception
-poor empirical basis -challenges categorical approach of DSM-IV -extremes of personality; dimensional phenomena |
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3 clusters of personality disorders
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-eccentric group
-dramatic-emotional group -anxious-fearful group |
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eccentric group of personality disorders
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-paranoid
-schizoid -schizotypal |
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dramatic-emotional group of personality disorders
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-antisocial
-borderline -histrionic -narcissistic |
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anxious-fearful group of personality disorders
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-avoidant
-dependent -obsessive-compulsive |
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borderline symptom picture
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-extreme efforts to avoid real or imagined abandonment
-unstable interpersonal relationships -identity disturbance -impulsivity -suicidal and parasuicidal behavior (self-injuring) -affective instability -anger -dissociation etc. |
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borderline personality disorder suicide rate
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6%
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biosocial theory of borderline personality disorder (Linehan)
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most with vulnerability to emotion dysregulation do not develop BPD
-invalidating environments -high incidence of childhood sexual abuse |
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emotional vulnerability for borderline personality disorder- the experienced process
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-freezing or dissociating in the face of intense emotions
-rage -intense dispair |
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dialectical behavioral therapy
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3rd wave empirically supported behavioral treatment for borderline personality disorder
1. attaining basic capacities 2. posttraumatic stress reduction 3. resolving problems in living and increasing respect for self 4. attaining the capacity for freedom and sustained contentment -ultimate goal: "having a life worth living" |
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Broca's area in schizophrenia
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involved in speech production, activated- like "talking to self"
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alogia
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not talking
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avolition
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apathy
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negative symptoms in schizophrenia
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avolition
alogia anhedonia affective flattening |
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delusion
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gross misrepresentations of reality, disorder of thought content
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hallucinations
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sensory experience in absence of environmental stimuli or input
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diagnosis of schizophrenia
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2 or more symptoms for at least one month
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onset of schizophrenia- gender differences
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men- earlier onset and likelihood of onset diminishes with age
women- onset later and likelihood of onset diminishes with age |
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ADHD subtypes
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-inattentive subtype
-hyperactive-impulsive type -combined type -NOS |
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ADHD must have clinically significant impairment in which settings?
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social, academic, or occupational (two or more)
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ADHD and behavioral interventions?
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-no empirical support; only experimental
-can help to treat comorbidities |
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core symptoms of autism
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-social impairment
-communication impairment -repetitive (stereotypes) behaviors and interests |
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explanations for possible increase of autism rates
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-changes in diagnostic criteria
-finding more individuals with autism -actual increase- pseudoscience, toxic exposure (potentially during a specific critical point in development) -past- refrigerator mothers |
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4 types of medications for ADHD
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amphetamines
methylphenidate atomoxetines guanfacine |
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antisocial personality disorder
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irresponsible, impulsive, deceitful behavior that violates social and legal norms
lack conscience and empathy |
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paranoid-type schizophrenia
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characterized by delusions and hallucinations that have a theme, typically of grandeur or persecution
do not show disorganized speech or flat affect better prognosis |
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catatonic-type schizophrenia
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unusual motor responses, including remaining in fixed positions and engaging in excessive activity
odd facial and physical mannerisms, may also mimic speech |
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undifferentiated-type schizophrenia
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includes people who have the major symptoms of schizophrenia but do not meet the criteria for the other types
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residual-type schizophrenia
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people who have had at least one episode of schizophrenia but who no longer manifest major symptoms of the disease
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schizophrenia prenatal cause
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fetal exposure to viral infection, pregnancy complications, and delivery complications have all been implicated in schizophrenia
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