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Psycho 239 - Abnormal Psychology > Chapter 3 > Flashcards

Chapter 3 Flashcards

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1
Q

Anxiety

A
  • Anxiety is a general state of apprehension of foreboding
  • adaptive when it prompts us to seek medical attention, to study for an upcoming test or avoid a dangerous situation
    • maladaptive when the level of anxiety is out of proportion to the level of threat or when it occurs out of the blue, not in response to environmental changes
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2
Q

Anxiety Disorder

A
  • Clinical Signs: is something that is observable to anyone paying attention
    • Physical: jumpiness, jitters, increased perspiration and heart rate, shortness of breath, dizziness, nausea
    • Behavioral: the need to escape or avoid a situation, agitation, clinginess, need for reassurance
  • Patient-Reported Symptoms
    • Cognitive: excessive and prolonged worrying, overly aware of bodily sensations, jumbled thoughts, nagging thoughts
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3
Q

Anxiety Disorders – Major Types

A
  • Separation Anxiety Disorder
  • Selective Mutism
  • Specific Phobia
  • Social Anxiety Disorder (social phobia)
  • Panic Disorder
  • Agoraphobia
  • Generalized Anxiety Disorder
    • these are arranged in developmental order (age of emergence)
    • most are more common in females than males
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4
Q

An example of Unspecified Anxiety Disorder

A
  • Social Media Anxiety -affects about 20% of social media users (not yet in the DSM)
  • Signs and risk factors:
    • interrupting real time social interactions to see notifications
    • neglecting schoolwork or other responsibilities
    • loss of interest in real time social interactions
    • excessive time on social media (6 to 8 hours per day is a pathognomic indicator)
  • feelings of distress when you can’t check your phone
    • preoccupation with Likes and or number of followers
    • lying/denial about time spent on social media
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5
Q

Specific Phobias

A
  • are characterized by deep and persistent fear of an object or situation, resulting in symptoms of anxiety. Symptoms may also arise from anticipating the presence of the stimulus. An individual displaying symptom of anxiety may be experiencing:
    • increased heart rate (palpitations)
    • dizziness or unsteadiness
    • nausea
    • shaking or trembling
    • an upset stomach
    • breathlessness
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6
Q

-Five diagnostic subtypes of specific phobias

A
  • most phobias fall into five subtypes, including
    1. animal type
    2. natural environment
    3. blood-injection injury type
    4. situational type
    5. other types (e.g., phobias of choking, costumed characters or contracting an illness)
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7
Q

features of phobia

A
  • The individual suffers from a persistent fear that is either unreasonable or excessive, caused by the presence or anticipation of a specific object or situation
  • Exposure to the stimulus usually results in an anxiety response, often taking the form of a panic attack in adults, or tantrum, clinging, crying or freezing in children
  • The sufferer recognizes their fear is disproportionate to the perceived threat or danger (not always present in children)
  • Individuals take steps to avoid the object or situation they fear, or endure such experiences with intense distress or anxiety
  • The phobic reaction, anticipation or avoidance interferes with the individual’s normal routine and relationships, or causes significant distress
  • The phobia has persisted for a period of time, usually 6 months or longer
  • The symptoms cannot be attributed to another mental condition, such as obsessive-compulsive disorder or post-traumatic stress disorder
  • There is a strong relationship between age (developmental stage) and the type of phobia one is likely to develop
    • Young Children: Animals
    • Teenagers: Social
    • Adults: Agora or claustrophobia
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8
Q

DSM-5 Criteria - Panic Attack

A
  • the building block of panic disorder (defined text)
  • DSM-5: a discreate period of intense fear or discomfort, in which 4 (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
    1. palpitations, pounding heart, or accelerated heart rate
    2. sweating
    3. sensations of shortness of breath or smothering
    5. feeling of choking
    6. chest pain or discomfort
    7. nausea or abdominal distress
    8. feeling dizzy, unsteady, lightheaded or faint
    9. chills or heat sensations
    10. paresthesias (numbness of tingling sensations)
    11. derealization (feelings of unreality) or depersonalization (being detached from reality
    12. fear of losing control or “going crazy”
    13. fear of dying
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9
Q

DSM-5 – Panic Disorder

A

A. recurrent unexpected Panic Attacks and
B. at least one the attacks has been followed by one month (or more) of one (or more) of the following:
1. persistent concern about having additional attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”)
2. a significant maladaptive change in behavior related to the attacks
C. the Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism)
D. the Panic Attacks are not better accounted for by another mental disorder -1-5% prevalence (lifetime)

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10
Q

Coping with a Panic Attack

A
  • breathe slowly and deeply
  • Talk yourself down
  • Try to relax
  • find someone to help you through the attack
  • don’t become house bound
  • if you are uncertain about the physical sensations, seek medical advice
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11
Q

Agoraphobia

A
  • (fear of the marketplace) accompanies panic attacks/disorders in a large minority of cases (30-50%; other writers report up to 75%)
    • when it does, it is usually fear of having another panic attack that is most impairing
    • makes treatment less likely unless patients get strong support to attend, or phycologists makes house calls
  • Even without agoraphobia, panic disordered patients are often reluctant to discuss their episodes for fear or triggering another attack
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12
Q

Generalized Anxiety Disorder (GAD)

A
  • an anxiety disorder characterized by general feelings of dread, foreboding, and heightened states of sympathetic arousal
    • not linked to any one fear or trigger
    • formerly referred to as free-floating anxiety
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13
Q

DSM-5 Criteria – GAD

A

A. At least 6 months of “excessive anxiety and worry” about a variety of events and situations. Generally, “excessive” can be interpreted as more than would be expected for a particular situation or event
a. Most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation
B. There is a significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met
a. Telling them not to worry is unlikely to be enough
C. The presence for most days over the previous 6 months of 3 or more (only 1 for children) of the following symptoms:
1. Feeling wound-up, tense or restless
2. Easily becoming fatigued or worn-out
3. Irritability
4. Significant tension in muscles
5. Difficulty with sleep

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14
Q

-Obsession

A

an intrusive, unwanted, and recurrent thought, image or urge that seems beyond a person’s ability or control, they are anxiety driven

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15
Q

-Compulsion

A

a repetitive behavior or mental act that a person feels compelled or driven to perform

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16
Q

-Adjustment Disorders

A
  • maladaptive reactions to an identified stressor or stressors that occur shortly following exposure to the stressor(s) and result in impaired functioning or signs of emotional distress that exceed what would normally be expected in the situation
  • differential from PTSD and ASD: the reaction may be resolved if the stressor is removed, or the individual learns to adapt to it successfully
17
Q

Features of Traumatic Stress Reactions (ASD and PTSD)

A
  • extreme anxiety or dissociation (feelings of detachment from oneself or one’s environment)
  • intrusive memories and flashbacks
  • heightened arousal or vigilance
  • difficulty concentrating
18
Q

-Acute Stress Disorder (ASD)

A

a traumatic stress reaction occurring in the days and weeks following exposure to a traumatic event
=further characterized by extreme anxiety and dissociation
-differential with PTSD: it last 4 weeks or less

19
Q

-Post-traumatic stress disorder (PTSD):

A

a prolonged reaction to a traumatic event that threatened death or serious injury to one own or another’s physical safety

- may have delayed onset
- has all the traumatic stress symptoms mentioned earlier as well as 
	- avoidance of thoughts, feelings or physical sensations that bring up memories of the traumatic event
	- avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event
	- can have with panic disorder specifier
- Differential with ASD: it lasts more than 4 weeks
20
Q

Theoretical Perspectives

-Psychodynamic Perspective

A
  • anxiety is a warning sing that some unconscious conflict is approaching consciousness
    • Projection: anxiety is brought about by the perception that some external threat is posed by someone or something else
    • Anxiety likely to be more specific in focus
  • Displacement: Anxiety more likely to be generalized
21
Q
  • Learning Perspective

- Two Factor Model: O. Hobart Mowrer

A
  • Classical and Operant Conditioning
    - the fear component of a phobia is acquired by means of classical conditioning (pairing of neutral stimulus to an aversive stimulus), and the avoidance component is learned by means of operant conditioning (relief from anxiety negatively reinforces avoidance behavior)
    • classical conditioned anxiety, operant conditioned escape behavior.
22
Q

-Prepared conditioning

A

-the reason we seem to develop phobias to some things more readily than others – a diathesis

23
Q

-Superstition:

A

OCD
-wore a shirt and won some money, creates an association in the mind, so in behavioral terms there is something reflected between a non-causal event and some outcome, either positive or negative outcome in the mind

24
Q

-Cognitive Perspective

A
  • self-defeating or irrational beliefs
    - can heighten and perpetuate anxiety disorders.
    • oversensitivity to threat
      • is a cardinal feature of anxiety disorders. Phobias can make safe situations appear dangerous to those who suffer the affliction
    • Anxiety sensitivity
      • is the fear of fear and refers to the belief that internal emotions or states of bodily arousal will get out of control and lead to harmful consequences. Important risk factor for panic attacks
    • misattributions for panic attacks
      • panic attacks involve catastrophic misinterpretations of bodily sensations as heart palpitations, dizziness, or light-heatedness. They believe that they are going crazy or may die from normal functions of the body that other people would not notice or just ignore
25
Q

-Biological Perspective

A
  • Genetic Factors
    - higher concordance rates MZ twins
    - PTSD and social anxiety are somewhat influenced by genes
    - neuroticism – personality trait
    - higher likelihood of experiencing anxiety disorders, depression and other emotional problems
  • The Fear Network. In panic attacks, responses to fear are mediated by the “fear network” centered in the amygdala and involve interaction with the hippocampus and the medial prefrontal cortex
  • Neurotransmitters
    - Gamma-aminobutyric acid (GABA)
    - inhibitory neurotransmitter believed to play a role in regulating anxiety
    - Benzodiazepines
    - class of minor tranquilizers, includes valium and Ativan
26
Q

-Biological aspects of panic disorder

A
  • hyperventilation – can bring about panic-like symptoms

- bodily symptoms that can make the person think they are going to die

27
Q

-Biological aspects of obsessive-compulsive disorder

A

-the brain may be constantly sending signals that there is something wrong, leading to obsessional thoughts and repetitive, compulsive behaviors

28
Q

Treatment-Psychodynamic Approaches

A
  • free association and psychoanalysis to resolve the deeper conflict
    • phobic objects are symbolic of those conflicts
29
Q

-Humanistic Approaches treatment

A

-unconditional positive regard allows integration of inauthentic social presentation with authentic self

30
Q

-Biological Approaches treatment

A
  • medications
    • Antidepressants – treats PTSD, anxiety, OCD
      • SSRIs /SNRIS – less likely to have enduring benefit that CBT
    • anxiety responds to both SNRI and SSRI
      • OCD responds to SSRI which increase serotonin in the brain
    • surgery can be an option in some cases
31
Q

-Cognitive Approaches treatment

A
  • irrational beliefs, bolstering self-efficacy, individual meaning, regular “worry periods”
    • fear-stimulus hierarchy – ordered series of increasingly fearful stimuli. Used in the behavioral techniques of systemic desensitization and gradual exposure
32
Q

-Learning-Based Approaches treatment

A
  • Best approaches combine exposure with response prevention
    • Systemic Desensitization
      • fear-stimulus hierarchy
      • gradual exposure
    • Behavioral treatment of social phobia
  • those with social anxiety are mostly afraid of being humiliated and embarrassed
  • cognitive restructuring – method that involves replacing irrational or self-defeating thoughts with rational alternatives
33
Q

-Behavioral Treatment of Agoraphobia

A

-gradual exposure to fear inducing stimuli, treatment is taken in steps

34
Q

-Behavioral Treatment of OCD

A

-placing oneself in obsessive/compulsive environment, and then physically stop the compulsions or obsessions from taking place, a type of extinction

35
Q

-Cognitive-Behavioral Treatment of GAD

A

-relaxation training, substation to intrusive thoughts,

36
Q

-Cognitive-Behavioral Treatment of Panic disorder

A

-breathing retaining, exposure to situations that may induce attacks, think differently about their bodily cues,

37
Q

-Virtual Reality phobia therapy research

A
  • researcher testing a virtual reality therapy system to treat spider phobia (arachnophobia)
    • for combat vets with PTSD
    • the system contains eye-tracking software to study a person’s response when exposed to a virtual combat environment

Psycho 239 - Abnormal Psychology (13 decks)

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