Anxiety

Question 1

What did Dr. Schwartz do?

Answer 1

The Brain-Lock theory comes from a self-help book Dr. Schwartz published to help people with OCD overcome their disorder.

Question 2

Why does it take so long for OCD to be treated?

Answer 2

Onset is generally during adolescence to mid-20s.
Average time to begin treatment is 11 years after onset (typically out of embarrassment).

Question 3

What is OCD general criteria?

Answer 3

obsessions and/or compulsions.
appreciate your obsessions and compulsions are
excessive or unreasonable.
obsessions and/or compulsions disrupt daily life.

Question 4

What criteria must thoughts reach to diagnose OCD?

Answer 4

recurring and persistent thoughts, impulses or images that interfere with your life and cause distress.

thoughts are not just worrying about actual problems
know that these thoughts, impulses or images are due to imagination.

try to ignore or suppress the
intrusive thoughts, impulses or images.

Question 5

What criteria must actions reach to diagnose OCD?

Answer 5

Repetitive behavior that you feel driven to perform,
such as hand washing, or repetitive mental acts, such
as counting silently.

Question 6

Why is OCD a thing in the body?

Answer 6

These behaviors or mental acts are meant to prevent
or reduce distress about unrealistic obsessions.

Question 7

What are common obsessions of OCD?

Answer 7

*Aggression - Thoughts of hurting someone
*Contamination – Becoming infected or dirty by touching something others have touched.
*Repeated doubts – Did I remember to lock the door?

Question 8

What are common compulsions of OCD?

Answer 8

Checking – Repeatedly checking to see if a door is
locked.
Cleaning – Repeated hand washing.
Ordering – Reordering objects to make them balanced and symmetrical.
Repetitive actions – Walking in and out of a doorway a
fixed number of times.
Mental acts – Silently repeating words or phrases.

Question 9

What is the YBOCS OCD assessment scale and what does it measure?

Answer 9

helps to diagnose people with OCD
time spend on obsessions, if it interferes with daily life, is it a source of distress, how much control the individual has

Question 10

What are the steps to error correction over OCD?

Answer 10

*Recognize the error
*Motivated to correct the error
*Once corrected, we move on

Question 11

Why is OCD referred to as a brain lock?

Answer 11

Individuals with OCD have lost the ability to ‘move on’,
(the brain locks up and stays in that place)

Question 12

What are the 4 steps to brain lock therapy?

Answer 12

relabel, reattribute, refocus, revalue

Question 13

What happens in the relabel step of brain lock therapy?

Answer 13

relabelling the action or thought to what it really is and to notice and recognize urges
understand that the feeling is just a false alarm,
with little or no basis in reality.

Question 14

What happens in the reattribute step of brain lock therapy?

Answer 14

reattributing symptoms of OCD to the idea that OCD is the problem and not you
recognize that the feeling and the discomfort are due to a
biochemical imbalance in the brain.

Question 15

What happens in the refocus step of brain lock therapy?

Answer 15

Knowing when and how to switch to another activity and distract from the urges
redirecting attention from the OCD to something healthier

Question 16

What happens in the revalue step of brain lock therapy?

Answer 16

revalue those thoughts and urges that,
before behavior therapy, would invariably lead you to perform compulsive behaviors.

Question 17

What are the steps to making a mistake (both the steps and the region of the brain) and what part is wrong in someone with OCD?

Answer 17

Orbital Frontal Cortex: Mistake detection
Parietal Cortex (cingulate cortex): Motivate to correct
Caudate: Complete task and ‘move on’
in someone with OCD, they can’t move on

Question 18

How is the frontal lobe related to ocd?

Answer 18

Stimulation of frontal lobes produces OCD symptoms.
Damage to the frontal lobes (lobotomy) produces a care-free attitude with a general lack of worry.

Question 19

How is the cingulate cortex related to ocd?

Answer 19

Activation of the cingulate cortex (motivation to correct)
was much greater in OCD individuals than in controls
when errors were made during a task that intentionally
produces a high error rate.

Question 20

Why is deep brain stimulation not standard practice for treating ocd?

Answer 20

invasive and only works 50% of the time

Question 21

electrodes placed in the ____ (laughter sites) are better for therapeutic outcomes

Answer 21

nucleus accumbens

Question 22

What does transcranial magnetic stimulation do?

Answer 22

Magnetic stimulation can be applied over an area of the cortex.
That stimulation can alter activity in the area directly, but also indirectly to other regions that are part of the circuit.

Question 23

Why is it believed that individuals can cure themselves of ocd?

Answer 23

sham/placebo therapies work almost as well as treatment

Question 24

What are some drugs (what do they do) to treat ocd?

Answer 24

anti-depressants that boost serotonin help patients but it does not cure them, just treats a symptom

Question 25

What are the symptoms of a panic attack?

Answer 25

Difficulty breathing, pounding heart, intense feeling of dread, sensation of choking or smothering, trembling, sweating, nausea, tingling/numbness in the fingers and toes, chills or hot flashes, fear that you are losing control or are about to die

Question 26

Where does panic disorder come from?

Answer 26

repeated panic attacks and the fear that a new panic attack
can occur any time without warning

Question 27

What phobia does panic disorder lead to?

Answer 27

agoraphobia

Question 28

How does the amygdala interact with anxiety?

Answer 28

with panic you lose that cortical control over your worry, in other words your ability to effectively evaluate the situation.

Question 29

What does the amygdala do?

Answer 29

neural system for processing fearful and threatening stimuli

Question 30

How does the amygdala interact with panic?

Answer 30

The amygdala is activated during panic attacks. The idea here is that the heightened activity in the amygdala induces an uncontrolled fear reaction.

Question 31

How is CO2 connected with panic?

Answer 31

Individuals sensitive to panic attacks are more likely to suffer a panic attack when breathing air with high CO2 levels.
they are more sensitive to it

Question 32

How are serotonin and panic connected?

Answer 32

Tryptophan is used to make serotonin. With a
tryptophan-free diet there is less serotonin in
the brain. This lowered serotonin boosts the panic response to CO2, but only in individuals with panic disorder.

Question 33

What is cortosol?

Answer 33

Cortisol is a stress hormone released by the adrenal
gland. Oddly, panic attacks are not associated with
stress activation.

Question 34

What are treatment options for panic attacks?

Answer 34

*Cognitive Behavioral Therapy
*Breathing/Relaxation
*Self-help Programs
*Medications (antidepressant/anti-anxiety agents)
*Eliminating nicotine/caffeine

Question 35

What are characteristics of ptsd?

Answer 35

Re-experiencing traumatic event, repetitive dreams, flashbacks, numbed response to outside world, anxiety, increased startle, sleep disturbance, avoidance of cues associated with the event

Question 36

What does the hippocampus do?

Answer 36

an area involved in both memory and stress regulation

Question 37

How is the hippocampus and ptsd related?

Answer 37

There is a smaller hippocampus volume in people with PTSD

Question 38

How is the prefrontal cortex and ptsd related?

Answer 38

The prefrontal cortex has lower activity in PTSD
modulates fear memories, so the loss of cognitive control in this area lets the fear memories take over.

Question 39

What are the drug treatments for ptsd?

Answer 39

The primary effective drug treatments for PTSD are the SSRIs (Selective Serotonin Reuptake Inhibitors):

Zoloft (sertraline)
Paxil (paroxetine)

Question 40

What makes medication less effective?

Answer 40

side effects
feeling medication is a “crutch” and that taking it is a
weakness.
taking the medication only occasionally when symptoms get severe.
using “self medication” with alcohol or drugs