5: Trauma, Anxiety, Obsessive-Compulsive and Related Disorders Flashcards
Major stress hormone of the body
Adrenocorticotropic hormone (ACTH) leading to cortisol release
Prevalence of PTSD
Lifetime - 6.8%, Current Year - 3.5%
Criteria of PTSD (6)
- Exposure to event
- Intrusion symptoms
- Avoidance symptoms
- Arousal and reactivity symptoms
- Alterations in cognition and mood
- Duration greater than 1 month
Examples of groups with elavated prevalence of PTSD
Veterans, rape victims, breast cancer patients
Special type of PTSD with disconnection to self
PTSD with prominent dissociative symptoms
Vulnerability factors for PTSD
Biology, psychology, characteristics of event, and social factors
Risk of PTSD with cortisol
Lower cortisol = higher risk
Treatments for PTSD (4)
- Trauma-focused Cog-Behav Therapy
- Stress-management/Relaxation Therapy
- Eye Movement Desensitization and Reprocessing (EMDR)
- Biological Treatments (SSRI and benzodiazepines)
Components of Trauma-focused CBT for PTSD (4)
- Psychoeducation
- Anxiety Management
- Exposure
- Cognitive Restructuring
Treatment for those unable to tolerate exposure to PTSD event
Stress-inoculation therapy (targets stress management and effects of PTSD)
EMDR
Processes distressing memories to reduce their impact using bilateral sensory input
Specific Phobia Criteria (5)
- Fear or anxiety about specific object or situation
- Stimuli provokes immediate fear or anxiety
- Avoidance or enduring stimuli
- Reaction out of proportion
- Lasts longer than 6 months
Categories of Specific Phobias (5)
- Animal
- Natural environment
- Blood-injection-injury
- Situational
- Other
Fear of places/situations that they might have trouble escaping or getting help
Agoraphobia
Best theory of phobias
Created by classical conditioning, reinforced by operant conditioning
Evolutionarily-selected rapid conditioning
Prepared classical conditioning
Treatments for phobias
- Behavioral therapy using exposure and desensitization
- Applied tension technique for blood-injection-injury phobias to avoid fainting
Social Anxiety Disorder Criteria (4)
- Fear or anxiety about social situations where exposure to scrutiny is possible
- Fear of showing anxiety symptoms
- Avoidance symptoms
- Lasts longer than 6 months
Treatments for Social Anxiety Disorder
-CBT exposure therapy
Panic Disorder Criteria (2)
- Recurrent unexpected panic attacks
2. Maladaptive behavior for at least 1 month after attack
Brain area associated with panic disorder
Locus ceruleus (of the brain stem)
The unfounded belief that bodily symptoms have harmful consequences
Anxiety Sensitivity
A heightened awareness of bodily cues
Interoceptive Awareness
The process of interpreting bodily cues as indicators of panic attacks
Interoceptive Conditioning
Association of certain situations with panic symptoms leading to avoidance of the situations
Conditioned Avoidance Response
Treatments for Panic Disorder
- Biological (SSRIs, Tricyclics, Benzodiazepines)
- CBT (Panic Control Therapy)
CBT for Panic Disorder
- Teach relaxation techniques
- Identify catastrophic cognitions
- Teach application of relaxation/accurate interpretations
- Systematic sensitization
GAD Criteria (3)
- Anxiety and worry occurring most days for 6 months
- Unable to control worry
- Physical symptoms from anxiety
Theory of GAD
-Elevated experience of negative emotions and fear associated from those emotions
Treatments for GAD
- CBT
- Biological (SSRIs, Tricyclics, Benzodiazepines)
Separation Anxiety Disorder Criteria (2)
- Excessive fear or anxiety concerning separation from an attached individual
- Lasts more than 4 weeks in children and more than 6 months in adults
Common trait in Separation Anxiety Disorder
Behavioral inhibition (retreat from novel situations)
Treatments for Separation Anxiety Disorder
- CBT
- Biological (SSRIs, Benzodiazepines)
OCD Criteria (2)
- Presence of obsessions, compulsions, or both
2. Symptoms are time-consuming (1 hr/day) or distressing
People feel they must engage in compulsions to…
…reduce anxiety
Special type of compulsion to keep possessions
Hoarding
Hair-pulling disorder
Trichotillomania
State of alarm in response to vague sense of future threat
Anxiety
Body Dismorphic Disorder
Preoccupation with imagined or exaggerated defect in appearance
Facts that make sense in light of a person’s nature
Egosyntonic
Facts that don’t make sense in light of a person’s nature
Egodystonic
Prevalence of anxiety disorders
(1 year) 20%-30% (lifetime)
Brain area related to OCD
Basal ganglia
Treatments for OCD (2)
- Biological (SSRIs, Deep Brain Stimulation)
2. Exposure and Response Prevention (ERP)
ERP
- Develop hierarchy of stressful events (SUDS 1-100 scale)
- Prolonged exposure to stimuli
- Block rituals
- Correct cognitions