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69 Cards in this Set
- Front
- Back
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Define phobia and give the two types
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A disruptive fear of a particular object or situation
Specific & Social (aka social anxiety disorder) |
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These criteria are for what anxiety disorder?
Unwarranted, excessive fear of specific object or situation Exposure to feared object always causes anxiety Trigger or feared object is avoided or endured with intense anxiety High comorbidity of specific phobias |
Specific phobia
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This is the etiology of what anxiety disorder?
Onset often childhood Behavioral conditioning Mowrer’s two-factor model |
Specific phobia
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What is Mowrer's 2-factor model?
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Step 1: Pairing of stimulus with aversive UCS leads to fear (Classical Conditioning)
-Onset of phobia Step 2: Avoidance maintained though negative reinforcement (Operant Conditioning) -Maintenance of phobia |
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This is the criteria of what anxiety disorder?
Persistent, intense fear of social situations Exposure to trigger leads to anxiety about being humiliated or embarrassed socially Social situations avoided or endured with intense anxiety More intense and extensive than shyness |
Social Phobia
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This is the etiology of what anxiety disorder?
Onset often adolescence Two factor model -Negative social experience -Avoidance or safety behaviors Cognitive factors -Negative self evaluation -Fear of negative evaluation by others Excessive attention to own anxiety -E.g., heart rate |
Social Phobia
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This is the criteria of what anxiety disorder?
Frequent panic attacks unrelated to specific situations Must have at least 1 month of concern about future panic attacks Panic attack: sudden, intense episode of apprehension, terror, feelings of impending doom -Accompanied by at least 4 other somatic symptoms -Other symptoms may include: -Depersonalization -Derealization |
Panic disorder
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What is this phobia?
anxiety about situations in which it would be embarrassing or difficult to escape if a panic attack occurred |
Agoraphobia
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This is the etiology of what anxiety disorder?
Often begins in adolescence Classical (interoceptive) conditioning Conditioning of panic in response to bodily sensations |
Panic disorder
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This is the criteria for what anxiety disorder?
Involves chronic, excessive, uncontrollable worry of a non-specific nature Lasts at least 6 months Interferes with daily life functioning Other symptoms: Restlessness, poor concentration, irritability, muscle tension, tires easily, sleep disturbance Common worries: Relationships, health, finances, daily hassles High comorbidity with other anxiety disorders and depression |
Generalized Anxiety Disorder (GAD)
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This is the etiology of what anxiety disorder?
Often begins in adolescence or earlier Perception of the world as dangerous Borkovec’s cognitive avoidance model |
GAD
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What is Borkovec’s cognitive avoidance model?
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Worry reinforcing because it distracts from negative emotions and images
Allows avoidance of more disturbing emotions Avoidance prevents extinction of underlying anxiety Individuals with GAD less able to identify their own negative feelings |
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This is the definition of what anxiety disorder?
Obsessions: Intrusive, persistent, and uncontrollable thoughts or urges Compulsions: Impulse to repeat certain behaviors or mental acts to avoid distress -Often chronic -Often comorbid with other anxiety disorders and anorexia |
Obsessive Compulsive Disorder (OCD)
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This is the criteria of what anxiety disorder?
Recurrent pulling out of one’s hair resulting in noticeable hair loss Increasing sense of tension immediately before pulling out the hair Pleasure, gratification, or relief when pulling out hair Not diagnosed under anxiety disorders in DSM-IV but similar to, and often comorbid, with OCD DSM-IV-TR: “impulse-control disorders not elsewhere classified” |
Trichotillomania
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This is the etiology of what anxiety disorder?
Hyperactive regions of the brain: Orbitofrontal cortex: involved in decision-making, emotion, and reward Caudate nucleus: involved in learning and memory Anterior cingulate: involved in decision-making, reward anticipation Operant reinforcement Compulsions negatively reinforced by the reduction of anxiety Cognitive factors People with this disorder may try hard to suppress intrusive thoughts White bear study and ironic rebound effect |
OCD
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What are the disorders are characterized by:
Characterized by: -Sadness -Feelings of worthlessness and guilt -Withdrawal from others -Changes in sleep and appetite -Symptoms not due to normal bereavement -Different from sadness Categorized under Mood Disorders in DSM-IV-TR |
Depressive Disorders
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This is the criteria of what depressive disorder?
The presence of one or more Major Depressive Episode Depressed mood OR anhedonia over a 2 week period Four of the following symptoms: -Change in sleep patterns (sleeping more or less) -Change in appetite or weight (eating more or less) -Psychomotor agitation or retardation -Loss of energy, fatigue -Feelings of self-blame, worthlessness, guilt -Difficulty concentrating, indecisiveness -Thoughts of death or suicide -There has never been a manic episode |
Major Depressive Disorder (MDD)
*Which is episodic and recurrent* |
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These are the symptoms for what depressive disorder?
Chronic depression Less symptomatic than MDD Some consider it a personality trait In a 10-year study, 95% of patients with this disorder developed MDD (Klein et al., 2006) “Double depression” |
Dysthymia
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This is the criteria for what depressive disorder?
-Depressed mood for at least 2 years -Plus 2 other symptoms: -Poor appetite or overeating -Insomnia or hypersomnia -Low energy or fatigue -Low self-esteem -Poor concentration or difficulty making decisions -Feelings of hopelessness No major depressive episode (MDE) within the first 2 years -May have full remission of MDE 2 months before onset of dysthymia -May be diagnosed with MDD after initial 2 years |
Dysthymic Disorder
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This is the etiology of what kind of disorders?
Genetic factors Heritability estimates: 37% for MDD Neurotransmitters Dopamine and serotonin receptors may lack sensitivity in MDD Life events -42-67% report a stressful life event in year prior to depression onset -e.g., romantic breakup, loss of job, death of loved one Interpersonal Difficulties -Behavior of depressed people often leads to rejection by others -e.g., reassurance seeking, negative self disclosures, slow speech |
Depressive Disorders
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Beck's cognitive theory includes what?
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-Negative triad: negative views of the self, the world (the person's own situation), and the future
-NEGATIVE SCHEMATA: (underlying beliefs that shape the way a person makes sense of his experiences) cause COGNITIVE BIASES (tendencies to process information in certain negative ways) |
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What are characteristics of bipolar disorders?
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Mood disorders characterized by manic episodes
Termed “bipolar” because most experience depression at some point Mixed episode Hypomania |
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This is the criteria of which bipolar disorder?
The presence of one (or more) manic or mixed episode(s) Manic episode: -Abnormally elevated or irritable mood lasting 1 week -At least three of the following symptoms -Inflated self-esteem or grandiosity -Decreased need for sleep -More talkative than usual -Flight of ideas or racing thoughts -Distractibility -Increase in goal-directed activity (e.g., work, school) -Excessive involvement in pleasurable activities that may have negative consequences (e.g., over spending, sexual indiscretions) Mixed episode: -Criteria met for both a manic episode and major depressive episode (except duration) during a 1-week period |
Bipolar I Disorder
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What is the severity of Bipolar I Disorder?
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-Severe mental illness
-High likelihood of hospitalization -Approx. 1 in 3 individuals with Bipolar Disorder attempt suicide -Completed suicide occurs in 10% to 15% -Tends to be recurrent -Over 90% have more than one manic episode -Poorer prognosis with rapid-cycling (4 episodes in one year) |
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This is the criteria of what Bipolar disorder?
Presence (or history) of at least one major depressive episode Presence (or history) of at least one hypomanic episode Persistently elevated or irritable mood, lasting at least 4 days that is different from typical nondepressed mood At least three symptoms of mania No psychotic features, no significant impairment in occupational functioning There has never been a manic or mixed episode |
Bipolar II Disorder
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What is the difference between Bipolar Disorders I and II?
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Bipolar I has manic or mixed episodes as it's main issue
Bipolar II Has NO manic or mixed episodes; it has depressive or hypomanic episodes |
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This is the criteria of what bipolar disorder?
For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode Not without symptoms for more than 2 months at a time No major depressive, manic, or mixed episode during the first 2 years |
Cyclothymic Disorder
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This is the etiology of what kind of disorders?
Strong genetic influence 71% to 93% heritability estimate Social and psychological factors -Triggers of depressive episodes: -Negative life events -Negative cognitions -Lack of social support -Precursors of manic episodes: -Positive life events or successes -High responsivity to rewards -Increase in confidence related to success |
Bipolar Disorders
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What are the gender differences of suicide?
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Women three times more likely than men to make suicide attempt
Men four times more likely than women to complete suicide |
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What are the models of suicide?
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-Psychological Disorders
-Social & Media Influences -Psychological model |
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What is the psychological disorder model of suicide?
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-About 90% of those who attempt suicide have a mental disorder
-½ of suicide attempters are depressed -Suicide common among those with borderline personality disorder, anorexia |
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What is the social and media influence model of suicide?
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Increase in suicide after highly publicized suicides
Discussion of suicidal ideation in group psychotherapy increases risk among group members |
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What is the psychological model of suicide?
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Interpersonal
-theory of suicide |
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What are warning signs of suicide?
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-Ideation (thinking, talking or wishing about suicide)
-Purposelessness or hopelessness -Withdrawal from family, friends, work, school, activities, etc. -High risk-taking behavior -Talking about suicide -Looking for ways to die (e.g., obtaining means, researching methods) -Preoccupation with death -Suddenly happier, calmer -Loss of interest in things one cares about -Visiting or calling people one cares about -Making arrangements; setting one's affairs in order -Giving things away, such as prized possessions |
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What is dissociation?
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Sudden disruption in the continuity of:
-Consciousness -Memory -Identity Some aspect of cognition or experience becomes inaccessible to consciousness Dissociative disorders are manifestations of severe dissociation -Often related to a traumatic experience |
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What part of memory does dissociation effect?
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Memory deficits in explicit but not implicit memory
Explicit memory -Involves conscious recall of experiences Implicit memory -Underlies behaviors based on experiences that cannot be consciously recalled |
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What are other causes of memory loss from dissociation?
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-Degenerative brain disorders
-e.g., Alzheimer's Disease -Not linked to stress -Involves gradual decline over time -Accompanied by other cognitive deficits -Inability to learn new information -Substance Abuse -Linked to use of drugs or alcohol |
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What are 4 types of dissociative disorders?
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Dissociative amnesia
Dissociative fugue Depersonalization disorder Dissociative identity disorder |
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These are the characteristics of what dissociative disorder?
-Inability to recall important personal information -Usually about a traumatic experience -Not ordinary forgetting -Not due to physical trauma -May last hours or years -Occurs outside of other disorders related to dissociation (e.g., PTSD) -Onset and remission usually occurs spontaneously -Memory returns in bits and pieces |
Dissociative Amnesia
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These are the characteristics of what dissociative disorder?
-Amnesia plus flight -Rarest dissociative disorder -Sudden, unexpected travel with inability to recall one’s past -Assume new identity -May involve new name, job, personality characteristics -More often of brief duration (1-4 weeks) -Most have one episode -Tracking devices used for those with recurrent episodes -Remits spontaneously |
Dissociative Fugue
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These are the characteristics of what dissociative disorder?
-Perception of self is altered -Feelings of detachment or disconnection -Watching self from outside -Floating above one’s body -Emotional numbing -Unusual sensory experiences -Limbs feel deformed or enlarged -Voice sounds different or distant -Triggered by stress or traumatic event -No psychosis or loss of memory -Often comorbid with anxiety, depression, or Personality Disorders -Typical onset in adolescence -Chronic course |
Depersonalization Disorder
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This is the criteria of what dissociative disorder?
-Presence of two or more personalities -At least two of the personalities recurrently take control of behavior -Inability of at least one of the alters to recall important personal information |
Dissociative Identity Disorder (DID)
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What are the characteristics of DID?
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Multiple distinct and fully developed personalities (alters)
-Each with unique behaviors, memories, and relationships -Memory gaps common for periods of time when alters are in control |
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What is DID often comorbid with, and what are other symptoms?
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Often comorbid with:
PTSD, major depression, borderline personality disorder, substance abuse, phobias Other symptoms: headaches, hallucinations, self harm, suicide attempts |
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What are the two major theories of the etiology of DID?
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-Posttraumatic Model
-Sociocognitive Model |
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This is which model theory of DID?
-DID results from severe physical, psychological and/or sexual abuse in childhood -Children who dissociate to cope with abuse more likely to develop DID |
Posttraumatic model
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This is which model theory of DID?
DID a form of role-play in suggestible individuals -Occurs in response to prompting by therapists or media -Iatrogenic effect of treatment--alters reinforced in therapy -No conscious deception |
Sociocognitive Model
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What are the characteristics of Somatoform disorders?
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Psychological problems take a physical form
Bodily symptoms have no known physical cause Not intentionally produced or under voluntary control Individuals seek medical, not psychological, treatment |
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What are 5 somatoform disorders?
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Pain disorder
Body dysmorphic disorder Hypochondriasis Somatization disorder Conversion disorder |
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These are the characteristics of what somatoform disorder?
Person experiences severe, prolonged pain -Cannot be accounted for by organic pathology Individual may be unaware of psychological origins Diagnosis often challenging Relatively common in the U.S. -Many adults have some form of work disability due to back pain alone Can occur at any age Women tend to show higher rates of some forms of pain than men, e.g., headaches, muscle and joint pain Duration of pain varies Many take opioid pain medication |
Pain disorder
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What are the characteristics of Somatization Disorder?
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Multiple, recurrent somatic complaints with no apparent physical cause—beginning before age 30
Four pain symptoms Two gastrointestinal symptoms One sexual symptom One pseudoneurological symptom Seeks treatment, usually from multiple physicians Hospitalization, medications, surgery common Exaggerated presentation of symptoms and complaints |
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These are the characteristics of what Somatoform disorder?
Preoccupation with and extreme distress over imagined or exaggerated defect in appearance -e.g., “My nose is hideously large” Constant examination of self in mirror or avoids mirrors completely Some become housebound Attempt to camouflage or hide defect -¼ have plastic surgery |
Body Dysmorphic Disorder
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What are the characteristics of Hypochondriasis?
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Preoccupation with fears of having a serious disease
This headache must mean I have a brain tumor! Despite medical reassurance, fears persist for at least 6 months Critical of medical professionals See them as incompetent and uncaring Often comorbid with mood and anxiety disorders |
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What is Conversion Disorder?
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Sensory or motor function impaired but no known neurological cause
-Vision impairment or tunnel vision -Partial or complete paralysis of arms or legs -Coordination problems -Anesthesia -Loss of sensation -Aphonia -Whispered speech -Anosmia -Loss of smell |
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What is the treatment of Pain Disorder?
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Antidepressants
Psychotherapy -Validation of patient’s pain -Relaxation training -Reinforce shift of focus away from pain -Help patient develop ability to cope with stress and gain sense of control over pain -Good prognosis associated with continuing day-to-day activities despite pain |
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What is the Etiology of Somatoform Disorders?
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No evidence of genetic heritability
Cognitive behavioral model -Extreme responses to physical symptoms -Patients with somatoform disorders pay more attention to physical health in attention studies -Negative attributions about symptoms -Reinforcement in the environment |
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What is the treatment for Specific Phobias?
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Systematic desensitization
Person enters a relaxed state Graded exposure to the feared stimulus Virtual Reality |
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What is the treatment for Social Phobias?
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Exposure
-Role playing or small group interaction Social skills training -Reduce use of safety behaviors Cognitive therapy -Challenging beliefs about the appraisals of others -Turn focus away from anxiety |
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What is the treatment for Panic and Agoraphobia?
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Cognitive behavioral treatments have best outcomes
Panic Control Therapy (Craske & Barlow, 2001) -Exposure to somatic sensations associated with panic attack in a safe setting -Use of coping strategies to control symptoms -PCT benefits maintained after treatment ends |
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What is the treatment for Generalized Anxiety Disorder?
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Relaxation training
-Muscle relaxation is key Cognitive Behavioral methods -Identify bodily symptoms as cues for anxiety -Challenge and modify negative thoughts -Increase ability to tolerate uncertainty -Worry only during “scheduled” times -Focus on present moment |
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What is the treatment for OCD?
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Exposure plus response prevention—Very behavioral
-Most widely used treatment -Two main components: --Expose client to triggering stimulus --Do not allow them to engage in compulsion Cognitive therapy -Challenge beliefs about anticipated consequences of not engaging in compulsions --Usually involves exposure as well |
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What is the treatment for Depressive Disorders?
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Classes of antidepressants
-Effective for MDD and dysthymia Cognitive therapy—Aaron Beck -Monitor and identify automatic thoughts -Look for evidence for and against negative thoughts -Replace negative thoughts with more neutral or positive thoughts Behavioral activation -Increase participation in reinforcing activities -“The hands teach the mind, not the mind teaches the hands” --As effective as antidepressant medication, more effective than cognitive therapy (Dimidijian et al., 2006) Mindfulness based cognitive therapy (MBCT) -Strategies, including meditation, to prevent relapse -“A thought is just a thought,” “I am not my thoughts |
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What is the treatment for Bipolar Disorder?
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-Mood Stabilizers
-Antidepressant medication often prescribed to treat depressive symptoms Psychoeducational approaches -Provide information about symptoms, course, triggers, and treatments -Improves medication adherence Family-focused treatment (FFT) -Educate family about disorder, enhance family communication, improve problem solving -Helps increase social support and improve symptoms of depression |
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What is the treatment for DID?
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Mainstays of most treatments
-Empathic and supportive therapist -Goal: integration of alters into one fully functioning individual -Improved coping skills Psychodynamic treatments most common -Overcome repressions through free association, hypnosis -Re-experience the traumatic event through hypnosis ---Age regression |
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What is the treatment for Somatization Disorder?
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Most accepted approach:
-Medical professionals don’t dismiss physical complaints -Minimize use of diagnostic tests and medication -Avoid providing attention only when patient is complaining ---Stay in contact on a regular basis Cognitive behavior therapy -Treat underlying depression and anxiety when present -Re-interpret physical symptoms -Less focus on physical symptoms |
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What is the treatment for Body Dysmorphic Disorder?
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Cognitive Behavioral Therapy
-Exposure plus response prevention (developed for OCD) -Prevent individual from checking appearance -Antidepressant medications also used |
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What is the treatment of Hypochondriasis?
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Cognitive Behavioral Therapy
-Reduce excessive attention to bodily sensations -Challenge negative perceptions about sensations -Discourage reassurance seeking from medical professionals Antidepressant medication |
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What is the treatment of Conversion Disorder?
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No controlled studies have found reduced symptoms to date
Psychoanalytic treatments have not demonstrated usefulness Reinforcement of high functioning behavior may help |
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What is the treatment of Pain Disorder?
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Antidepressants
-More effective than placebo even with low dosages that don’t alleviate depressive symptoms Components of psychotherapy for pain disorder -Validation of patient’s pain -Relaxation training -Reinforce shift of focus away from pain -Help patient develop ability to cope with stress and gain sense of control over pain -Good prognosis associated with continuing day-to-day activities despite pain |
