Chapter 4 and 5

Question 1

What specific parts of the brain play a role in anxiety disorders?

Answer 1

The Amygdala and Hippocampus/Prefrontal Cortex

Question 2

The Amygdala

Answer 2

The part of the brain that helps us form and store memories associated with emotional events; Plays a central role in triggering a state of fear or anxiety; Is involved in our recollection of intense emotions, particularly memories associated with danger. (When we react to a fearful situation, two separate neural pathways are activated); When we encounter a possible threat, the potentially dangerous stimulus rapidly activates it, triggering the hypothalamic-pituitary- adrenal (HPA) axis to prepare for immediate action, the “fight or flight” response.

Question 3

Hippocampus and Prefrontal Cortex

Answer 3

The stimulus simultaneously activates the second and slower pathway in which sensory signals travel to the hippocampus and prefrontal cortex; (Process sensory input and evaluate any potential danger associated with the situation); If this secondary fear circuit determines that no threat exists, signals are sent to the amygdala to curtail the HPA axis activity, thus overriding the initial fear response.

Question 4

Example of the brains role in anxiety disorders

Answer 4

If you were on an airplane, sudden turbulence might activate your amygdala and produce an immediate fear response. However, more precise mental processing of the event involving your hippocampus and prefrontal cortex, putting the turbulence in context perhaps by activating memories of prior air travel where you remained safe despite turbulence, would provide reassurance, inhibit your fear, and reduce your anxiety.

Question 5

Medications influence on the brain in anxiety disorders

Answer 5

Medication appears to directly decrease activity in the amygdala and thus “normalize” anxiety reactions, whereas therapy appears to reduce physiological arousal by strengthening distress tolerance and the ability of the prefrontal cortex to inhibit fear responses

Question 6

What is negative appraisal?

Answer 6

Interpreting events, even ambiguous ones, as threatening (Psychological characteristics can also interact with biological predispositions to produce anxiety symptoms); Engaging in this increases the likelihood of developing an anxiety disorder.

Question 7

What are some examples of “safety behaviors” in SAD?

Answer 7

Avoiding eye contact, talking less, sitting alone, holding a glass tightly to prevent tremors, or wearing makeup to hide blushing (also tend to be socially submissive in an effort to avoid conflicts with others)

Question 8

What type of phobia has the earliest onset?

Answer 8

Animal phobias tend to have the earliest onset (age 7); ( followed by blood phobia (age 9), dental phobia (age 12), and claustrophobia (age 20))

Question 9

Applied tension is a treatment most useful for which type of phobia?

Answer 9

Blood and injection phobia; (at least for individuals who show the physiological pattern of a sudden drop in blood pressure)

Question 10

What is involved in CBT for panic disorder?

Answer 10

A therapy that encouraged clients to accept personal control over their panic reactions; Learned to view their gains as a result of their own efforts rather than due to medication; Strategies included sharing information about panic disorders, challenging catastrophic misinterpretations, considering alternative explanations for bodily sensations, practicing relaxation strategies, facing feared situations, and understanding the implications of having a panic disorder.

Question 11

What part of the brain cortex has been implicated in OCD?

Answer 11

The Orbitofrontal Cortex (Frontal lobe of the left hemisphere); Alerts the rest of the brain when something is wrong. When it is hyperactive, it may not only trigger the feeling that something is not right but also produce the feeling that something is “deadly wrong.”

Question 12

How many people treated for hoarding don’t complete treatment…and why?

Answer 12

About half of the individuals treated for hoarding disorder do not complete treatment due to their extreme distress at the idea of parting with their possessions

Question 13

What are the symptoms of adjustment disorder?

Answer 13

Occurs when someone has difficulty coping with or adjusting to a specific life stressor, the reactions to the stressor are disproportionate to the severity or intensity of the event or situation

Question 14

What is the criteria for adjustment disorder?

Answer 14

1. Exposure to an identifiable stressor that results in the onset of significant emotional or behavioral symptoms (mood or behavioral changes, symptoms of anxiety or depression) that occur within 3 months of the event.
2. Emotional distress and behavioral symptoms that are out of proportion to the severity of the stressor and result in significant impairment in social, academic, or work-related functioning, or other life activities.
3. These symptoms last no longer than 6 months after the stressor or consequences of the stressor have ended.

Question 15

What are the common stressors that precipitate this diagnosis of adjustment disorder?

Answer 15

Common stressors such as interpersonal or family problems, divorce, academic failure, harassment or bullying, loss of a job, or financial problems may lead to an AD

Question 16

Which types of factors increase the risk of PTSD after a trauma?

Answer 16

The type of trauma and degree of perceived threat, the magnitude of the event, the extent of exposure to the stressor, and risk and protective factors specific to the individual. (Intentional Trauma, Close relationship with the perpetrator); Also person’s cognitive style, childhood history, genetic vulnerability, and availability of social support also influence the impact of a traumatic event

Question 17

Psychotherapy Options for Trauma-Related Disorders

Answer 17

Prolonged Exposure Therapy, Cognitive-Behavioral Therapy (CBT) and Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), Therapy involving education about PTSD, Eye movement desensitization and reprocessing (EMDR)

Question 18

Prolonged Exposure Therapy

Answer 18

Involves imaginary and real life exposure to trauma-related cues. Prolonged exposure to avoided thoughts, places, or people can help individuals with PTSD realize that these situations do not present a danger and thus extinguish associated fear reactions. The process of exposure sometimes involves asking participants to recreate the traumatic event in their imagination; (Ex. Trauma survivors may be asked to repeatedly imagine and describe the event “as if it were happening now,” verbalizing not only details, but also their thoughts and emotions regarding the incident. This exposure process allows extinction of the fear to occur)

Question 19

Cognitive-Behavioral Therapy (CBT) and Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)

Answer 19

Uses a combination of CBT techniques and trauma- sensitive principles, focus on helping clients identify and challenge dysfunctional cognitions about the traumatic event and current beliefs about themselves and others. These therapies address underlying dysfunctional thinking or pervasive concerns about safety; (Ex. battered women with PTSD often have thoughts associated with guilt or self-blame. Cognitions such as “I could have prevented it,” “I never should have…” or “I’m so stupid” can maintain PTSD symptoms.)

Question 20

Therapy involving education about PTSD

Answer 20

Developing a solution-oriented focus, reducing negative self-talk, and receiving therapeutic exposure to fear triggers (such as photos of their abusive partner or movies involving domestic violence) reduced PTSD symptoms in 87 percent of battered women receiving this treatment. Mindfulness training, which involves paying attention to emotions and thoughts on a nonjudgmental basis without reacting to symptoms, also shows promise as an intervention for PTSD

Question 21

Eye movement desensitization and reprocessing (EMDR)

Answer 21

A nontraditional and somewhat controversial therapy used to treat PTSD. In this unique approach, clients undergoing EMDR visualize their traumatic experience while following a therapist’s fingers moving from side to side. The therapist prompts the client to substitute positive cognitions (e.g., “I am in control”) for negative cognitions associated with experience (e.g., “I am helpless”); Processing the trauma in a more relaxed state allows the client to detach from negative emotions and replace them with more adaptive appraisals of the trauma. After a series of EMDR sessions, many individuals with PTSD find significant reductions in hyperarousal and other symptoms associated with PTSD