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101 Cards in this Set
- Front
- Back
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a future oriented emotion |
anxiety |
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neurotransmitters associated with anxiety |
GABA, nonepinephrine, serotonin |
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plays mediator role between brain stem and cerebral cortex in regards to monitoring danger signals coming in. also known as the "emotional brain, located in the mid-brain. the responses start in the brain stem |
limbic system |
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negative mood state with an immediate reaction |
fear |
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expected OR unexpected; can come out of the blue (unexpected) or can be the result of a phobia (expected) |
panic |
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brain structures implicated in the development of anxiety |
amygdala & hippocampus |
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two brain circuits involved in anxiety |
behavioral inhibition system & autonomic nervous system - BIOLOGICAL CONTRIBUTOR TO ANXIETY |
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known as the "unexpected stimulus" example - when something traumatic occurs and causes paralysis/freezing. it is when we are evaluating a threat and that causes a freezing response |
behavioral inhibition system (BIS) |
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when you are evaluating a threat "fight or flight" are you going to fight or are you going to run? |
autonomic nervous system (ANS) |
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parents make comments about how people perform certain tasks, in many ways from this perspective, anxiety is learned based on how child interacts with parents/how parents interact with child. parents teach us to respond positively/negatively and we develop strategies on how to handle these things. from this perspective, anxiety is learned from caregivers |
childhood learning & perception of control (helicopter parents) - PSYCHOLOGICAL CONTRIBUTOR TO ANXIETY |
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actual positive or negative "coping learning" to manage stress |
PSYCHOLOGICAL CONTRIBUTION TO ANXIETY |
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stressful life events that "trigger" all psychological & biological vulnerabilities leading to anxiety. examples - marriage, divorce, school, work, traumatic events |
ENVIRONMENT-SOCIAL CONTRIBUTIONS |
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biopsychosocial model |
approach favored by Barlow |
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biological contribution, tendency to be uptight, it runs in families & we think it is a biological contribution to the anxiety disorder |
general biological vulnerability |
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taught that the "world is a dangerous place and we have little or no control in the world" |
general psychological vulnerability |
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specific learned fears "be afraid of a specific stimuli" |
specific psychological vulnerability |
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Barlow's model of anxious apprehension shows 2 coping strategies for the inherited tendency to be uptight |
1 - avoidance of stress 2 - worry (GAD) |
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diagnostic criteria for GAD |
patient must display excessive worry for more than 6 months patient must display 3 of 6 symptoms: - restlessness - easily fatigued - difficulty concentrating or mind going blank - irritability - muscle tension - sleep disturbance |
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panic disorder |
surge of intense fear that peaks in a few minutes symptoms: shortness of breath, chest pain, dizziness, fear of losing control, fear of dying, trembling |
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diagnostic criteria for panic disorder |
patient must display 4 symptoms: - heart rate increasing - sweats - trembling - choking - dizziness - derealization - fear of losing control - fear of dying |
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agoraphobia |
panic in more than 2 situations required for diagnosis with symptoms lasting more than 6 months - public transportation - open spaces - enclosed spaces - being outside of home alone |
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significant impairment in social, family, and academic-school performance. developmentally inappropriate fear/anxiety concerning separation from attachment individuals |
separation anxiety disorder
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diagnostic criteria for separation anxiety disorder |
must display 3 symptoms for more than 4 weeks in children/more than 6 months in adults - separation - worry about losing attachment - worry about something bad happening to one - staying close to home - worry about being alone - cannot sleep away from home - separation nightmares - clinical distress/impairment in functioning |
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diagnostic criteria for social anxiety |
patient must display symptoms for more than 6 months - severe anxiety in situations where one may be exposed to scrutiny by others - severe anxiety whenever one may be negatively evaluated by others - situations may be avoided or one tolerates intense activity in social situations - causes significant clinical distress/discomfort |
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the 5 domains of PTSD |
- exposure conditions - intrusion - avoidance - alterations in mood & cognition - alterations in arousal & reactivity |
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exposure conditions in PTSD |
1 out of 4 required for diagnosis: - watching trauma happen to another - learn of event with family members - repeated exposures such as police being exposed to rape interviews, etc. |
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intrusion in PTSD |
1 out of 5 required for diagnosis: - memories - dreams - dissociation experiences (flashbacks) - distress - physical |
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avoidance in PTSD |
1 out of 2 required for diagnosis: - avoid memories - avoid external reminders |
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alterations in mood & cognition in PTSD |
2 out of 7 required for diagnosis: - cannot experience positive emotions - recall problems - negative beliefs about self/others/world - negative emotional state - decrease in interest - detachment - can't experience positive emotions |
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alterations in arousal & reactivity in PTSD |
2 out of 6 required for diagnosis" - irritability - hypervigilance - problems concentrating - startle reaction - sleep - self-destructive behavior |
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treatment for PTSD |
- direct exposure (relive the event) plus stress management - 90% improvement with symptoms |
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treatment for specific phobia |
- usually short treatment time using 'fear hierarchy' plus relaxation training (ie- blood phobia) - up to 90% much improved to completely improved |
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stress stimulus leads to |
anxiety disorder |
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4 major goals of treatment of the anxiety disorders |
1 - learn to cognitively-emotionally focus on the feared stimulus (left & right brain activation) 2 - learn to tolerate greater degrees of discomfort without "avoidance" 3 - don't avoid the gear stimulus (counter-condition avoidance behavior with approach behavior) 4 - learn to cope with "feared" stimulus |
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developmental cognitive-emotional impairment coming from abuse and/or emotional/physical neglect (child functioning in adult body: preoperational functioning) |
persistent depressive disorder (PDD) |
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symptoms of persistent depressive disorder (PDD) |
- helplessness & hopelessness - lack of feelings of interpersonal safety - perceptual disconnection from interpersonal world of others ("circle of sameness") with inability to be informed/influenced by interpersonal environment |
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somatic symptom disorder diagnostic criteria |
patient must display one or more symptom for more than 6 months: - excessive time/energy devoted to symptoms, health concerns - disproportionate/persistent thoughts about symptom's seriousness - high levels of health-related anxiety (worry about illness) |
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most individuals of this type are diagnosed with somatic symptom disorder; however, when anxiety is THE prominent symptom the correct diagnosis is |
illness anxiety disorder |
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illness anxiety disorder |
- no symptoms present (or only mildly present) but severe anxiety or preoccupation about developing or having a serious disease - symptoms may not be present - high levels of health-related anxiety - repeated checking oneself about health status/symptoms - Duration: more than 6 months |
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no neurological problems found on medical examination; problems can be better explained by another medical or mental disorder; symptoms cause significant distress; symptoms are of altered voluntary motor and/or sensory functions |
conversion disorder |
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conversion disorder diagnostic criteria |
patient must display one or more symptoms - paralysis - blindness - lack of feeling in limbs - etc acute: less than 6 months persistent: more than 6 months |
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experiences of unreality, detachment, being an outside observer in regards to one's thoughts, feelings, behaviors; emotional numbing |
depersonalization |
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experiences of unreality or detachment with respect to surroundings (environment experienced as unreal, dreamlike, foggy, etc) |
derealization |
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presence of one or both: depersonalization & derealization |
depersonalization-derealization disorder (persistent/recurrent) |
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- inability to recall important autobiographical information; beyond ordinary forgetting, mostly for localized or selected events - cannot recall important personal information - symptoms cause significant distress |
dissociative amnesia |
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moving to another location and amnestic for the move |
dissociative fugue |
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- severe disruption of identity characterized by two or more distinct personality states (marked discontinuity in sense of self and sense of who one is) - alters; switching - "host" identity - developmental histories are catastrophic |
dissociative identity disorder (DID) |
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- learning to recognize your "impact" can be empowering - learning to take seriously your interpersonal impact value can be life changing and keep you out of a lot of trouble with others - we impact others - others impact us - both persons are changed through interactions with the other; this is the ultimate relational and learning paradigm/model for empathy |
the interpersonal model of functioning |
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the highest level of interpersonal functioning |
empathy |
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result of perceptual disengagement from or avoidance of the social environment of others may lead to two outcomes involving psychopathology |
1 - avoidance 2 - detachment/withdrawal |
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goal of psychosocial (psychotherapy) treatment |
- connect/reconnect patients to the social-interpersonal environment; first to the psychotherapist, then to others outside of therapy |
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dominate pulls for |
sumbissive |
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hostile pulls for |
hostile |
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friendly pulls for |
friendly |
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always "below" normal mood baseline |
unipolar disorders |
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"cycling" above and below normal mood baseline |
bipolar disorder |
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major depression (acute/episodic) |
symptoms: - depressed mood most of the day - diminished interest/pleasure in almost all activities - weight loss (5% of body weight in last month) - insomnia/hypersomnia nearly every day - psychomotor agitation/retardation - fatigue/loss of energy - feelings of worthlessness - diminished ability to think or concentrate - recurrent though of death or suicide |
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dysthymia |
depressed mood for most of the day, more days than not for at least 2 years with 2 or more symptoms - poor appetite or overeating - insomnia or hypersomnia - low energy/fatigue - low self-esteem - poor concentration or diiculty making decisions - feelings of hopelessness |
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GRIEF vs. MAJOR DEPRESSION GRIEF: - predominant affect are feelings of 'emptiness' and 'loss' - intensity will likely decrease over time (days/weeks) - affect in occurs in 'waves' with periods associated with memories/thoughts of the deceased - pain is often accompanied by humor/pleasant memories - thought content may be accompanied with happiness - thought content is NOT self-critical or pessimistic - rarely is affect accompanied by feelings of 'worthlessness' |
GRIEF vs. MAJOR DEPRESSION MAJOR DEPRESSION: - persistent depressed mood and inability to anticipate happiness or pleasure - will not decrease over time - is persistent - not accompanied by humor/pleasant memories - thought content not accompanied with happiness - though content is self-critical or pessimistic - feelings of 'worthlessness' are present |
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distinctly elevated/expansive/irritable mood for more than 4 days |
hypomania |
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hypomania |
during the period of mood disturbance, more than 3 of the symptoms are present, more than 4 symptoms if predominant mood is 'irritability' - inflated self-esteem/grandiosity - decreased need for sleep (rested if 3 hours of sleep obtained) - more talkative than usual - flight of ideas/subjective sense that 'thoughts' are racing - distractibility to unimportant stimuli - increased goal-directive avtivity (social, sexual, academic, etc.) - excessive involvement in pleasurable activities with potential for harm (buying spress, sexual indiscretions, foolish business investments) |
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what distinguishes hypomania from mania? |
in hypomania, behavior is NOT 'severe' enough to cause marked impairment in social, familial or occupational functioning |
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distinct period of abnormally, persistent elevated mood, expansive or irritability affect that lasts more than 1 week |
manic episode |
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major way to differentiate mania from hypomania |
in mania, mood disturbance is sufficiently severe to cause marked impairment in social, familial, and/or occupational functioning; or the necessitate hospitalization to prevent harm to self or others (or, there are psychotic features)
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- 2 years where hypomania and depressive periods have been present for at least half the time - the individual has not been without the symptoms form ore than 2 months "convention formula" for starting the clinical course timeline over - criteria for mania and major depression have never been met |
cyclothymia |
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you can evaluate any treatment program in the mental health field by asking 3 questions |
1 - what is the major problem? 2 - what is the way to "fix" the problem? 3 - what does the outcome look like? |
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increases output of neurotransmitter at synapse |
agonist effect |
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decreases utilization of neurotransmitter at synapse |
antagonistic effect |
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tricyclic antidepressants affect _____ and _____ tracks by _______ pre-synaptic reuptake |
norepinephrine, serotonin, blocking |
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amitriptyline, imipramine, nortiptyline |
examples of tricyclic antidepressants |
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_____________ inhibitors affect norepinephrine and serotonin tracks (and has a BOOSTING effect), inhibiting the breakdown of norepinephrine and serotonin at the pre-synaptic site |
monoamine oxidase (MAO) |
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phenelzine, parnate |
examples of monoamine osidase (MAO_ |
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_________ affect the serotonin an norepinephrine tracks and blocks pre-synaptic release of neurotransmitter |
serotonin-specific reuptake inhibitors (SSRIs) |
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these medications have an antagonistic effect |
- SSRIs - tricyclic antidepressants |
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these medications have an agonist effect |
monamine oxidace (MAO) |
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sertraline, fluoxetine, cetalopram |
examples of SSRI's |
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- mood stabilizer that impacts neurotransmitters and neurohormones - serves a mania prevention function in bipolar disorder |
lithium carbonate |
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most prescribed mood stabilizer today; prevents mania recurrence in 60% if maintenance treatment adhered) |
valproate (depacon) |
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CBT: "the problem" |
negative thinking |
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CBT: "the fix" |
recognize & correct thinking errors |
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CBT: "the solution" |
thinking errors corrected [thoughts aligned with reality] |
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created cognitive behavioral therapy (CBT) |
beck |
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created behavioral activation treatment (BA) |
neil jacobson |
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BA: "the problem" |
decreased activity (lowered self-esteem) |
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BA: "the fix" |
increase activity levels |
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BA: "the solution" |
increase self-concept/decrease depression |
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created interpersonal psychotherapy (IPT) |
g. klerman |
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IPT: "the problem" |
interpersonal role disruptions (grief, role disputes, role transitions, social deficits) |
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IPT: "the fix" |
repair role distruptions |
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IPT: "the solution" |
role competence, depression decrease |
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created cognitive behavioral analysis system of psychotherapy for chronic depression (CBASP) |
dr. jp mccullough |
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CBASP: |
developmental disruption (traumas, psychological insults) ---> interpersonal |
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CBASP: "the fix" |
repair disruption: 1 - replace interpersonal fear-avoidance with safety 2 - connect person perceptually to his/her E 3 - replace avoidance with interpersonal approach behaviors |
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CBASP: "the solution: |
decrease depression |
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characteristics of jean piaget's preoperational stage |
- pre-logical thinking (causal/logical resoning has no informing effect on behavior) - extreme egotism; total self-focus - talks in a monologue fashion - emotionally out-of-control - global thinker (cannot focus; cannot problem solve) - no ability to generate empathy |
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8th leading cause of death in the US |
suicide |
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suicidal ideation |
probability; fleeting thought; thinking about how to do it; formal plan in place |
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emile durkheim: types of suicides (social pressures) |
1. formalized (hara kiri) 2. altruistic (dishonor on family) 3. egoistic (lacks social support) 4. anomic (life disruptions) 5. fatalistic (loss of control of one's destiny) |
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e. shneidman on suicide risk factors |
1. family history 2. neurobiology 3. existing psychological disorders 4. severe stressful life events (predominantly shame, humiliation or failure) |
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contemporary research on risk factors by dc clark, j fawcett, wa scheftner, l fogg in 1990 |
1. severe panic attacks 2. severe insomnia 3. severe psychic anxiety 4. diminished concentration 5. alcohol abuse 6. severe loss of interest |
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:) |
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