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Abnormal Psychology PSYCH303 > Chapter 4 in class notes > Flashcards

Chapter 4 in class notes Flashcards

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1
Q

Fear vs Anxiety

A

Fear:

  • a present-oriented mood state
  • flight or fight
  • sympathetic nervous system involved

Anxiety:

  • from normal to disorder
  • Characteristic of anxiety disorder
  • symptoms of anxiety and fear
  • avoidance and escape
  • distress and impairment
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2
Q

What are Panic Attacks?
A. description
B. how common?
C. two types

A 
A. Abrupt experience of intense fear
- physical symptoms
- cognitive symptoms
B. very common
C. Unexpected - first one
Expected (classical conditioning after 1st)
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3
Q

Biological contributions to Panic Attacks

A
  • Genetic vulnerability - runs in families
  • limbic system - amygdala
  • fight/flight system (FFS) - more easily triggered
  • amygdala and serotonin (amygdala controls fear and aggression/anger)
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4
Q

Psychological contributions to Panic Attacks
A) Early childhood…
B) Behavioral and cognitive views
C) comorbidity

A
  • correlation not causation
    A) Early childhood uncontrollability and unpredictability - hyperalert stage
    B) conditioning. catastrophic thinking (world is going to end, glass half empty)
    C) depression, alcoholism, substance abuse

also stressful life events can trigger vulnerabilities

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5
Q

3 components of Triple Vulnerability Model
A) B…
B) S…
C) G…

A

A) Biological vulnerability (heritable contribution to negative affect. Glass is half empty)
B) Specific psychological vulnerability (e.g. physical sensations are potentially dangerous – anxiety about health)
C) Generalized psychological vulnerability (sense that events are uncontrollable/unpredictable)

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6
Q

Categories of Anxiety Disorders
1
2
3

A
  1. Anxiety Disorders (separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder).
  2. Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder).
  3. Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder).
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7
Q 
Anxiety Disorders
1
2
3
4
5
6
7
A
  1. Generalized Anxiety Disorder GAD
  2. Panic Disorder PD
  3. Agoraphobia
  4. SAD Social Anxiety Disorder
  5. Specific phobias
  6. Selective Mutism
  7. Separation anxiety disorder

First 5: symptoms first show in childhood - diagnosed in adulthood.

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8
Q

Agoraphobia is what kind of disorder?

A

anxiety

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9
Q

Selective Mutism is what kind of disorder?

A

anxiety

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10
Q

A) What is Generalized Anxiety Disorder?
B) Overview and defining feature
C) Associated symptoms
D) gen population and female:male ratio

A

A) chronic worry.
B) Excessive uncontrollable.
Multiple areas of life (not one area only)
6+ months of symptoms
C) restlessness or feeling keyed up or on edge. Being easily fatigued. Difficulty concentrating or mind going blank. Irritability. Muscle Tension.
alcohol use/abuse, depression, suicide
D) 3.1% of gen population - probably underestimate in US.
2:1 ratio for females to males. Women more likely to get treatment

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11
Q 
Statistics for Generalized Anxiety Disorder
A) general population
B) Ratio females to males
C) Onset
D) Elderly
E) Familial pattern
A

A) 3.1% of general population - probably underestimate - in US.
B) 2:1 ratio for females to males. Women more likely to get treatment.
C) Onset 13-20 years old. Seek treatment around 30 yrs old
D) More common because they’re losing control of their life (medication, living, people dying)
E) runs in families

1% of lifetime

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12
Q

Generalized Anxiety Disorder associated symptoms

A

restlessness or feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle Tension.
alcohol use/abuse, depression, suicide

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13
Q 
GAD treatment
A) effectiveness
B) C
C) M
D) P
A

A) generally weak treatments
B) Cognitive Behavioral Therapy and exposure/response - can’t treat all triggers
C) Meditation therapy and mindfulness
D) Pharmacotherapy - effective but have to keep using it

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14
Q

GAD pharmacotherapy treatments

A

Benzodiazepines - as needed, works for 6-8 hours

Antidepressants - can’t choose when to take it, every day

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15
Q

Panic Disorder

A

Anxiety about having a panic attack — that’s when it turns to panic disorder.

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16
Q

Agoraphobia

A

Fear of being trapped in a place you can’t escape

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17
Q

Panic disorder and agoraphobia

Can exist …

A

.. together or can be independent.

Together - fear is having panic attacks so they avoid going places for fear of having a panic attack

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18
Q

PD and Agoraphobia - more severe

A

When together

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19
Q

Panic Disorder - facts and statistics
A) % of general population
B) Onset
C) Females vs Males

A

A) 2.7% of general population
B) 18-25 years
C) Females more than males

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20
Q

Panic Disorder risk factors
A) _______ reactivity
B) __________ reaction
C) ___________ thinking

A

A) emotional (sensitive person)
B) Physical alarm (startle reaction)
C) Catastrophic (doomsday)

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21
Q

[EXAM] Interoceptive

A

Relating to stimuli produced within an organism, especially in the gut and other internal organs

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22
Q

[EXAM] Interoceptive avoidance (with Panic Disorder)

A

Fear/avoidance of internal queues - heart beat, tingling in neck.
Does not like to acknowledge internal experiences. Doesn’t want to notice heart rate, breathing.

“Physical sensations that serve as triggers for anxiety or as reminders of past traumatic events.”

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23
Q

[exam] Panic Disorder treatments
A) Pharmeceutical
B) Psychological (2) [exam!!]

A

A) SSRIs (Prozac and Paxil) or benzodiazepines (Ativan). Relapse rates are high following discontinuation.
B) 1) Panic Control Treatment (PCT) — Cognitive treatments and exposure
2) CBT. Combined treatments - BEST LONG TERM OUTCOME [exam]***

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24
Q 
Specific Phobias - overview and defining features
A) Extreme \_\_\_\_\_
B) A
C) U
D) I
A

A) irrational fear
B) avoidance
C) unreasonableness
D) Impairment

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25
Q

Specific Phobias statistics
A) Females vs males
B) general population %
C) _____ disorder

A

A) 1:1 - equally likely
B) 12.5% general population (1 of 9 could get diagnosed)
C) Chronic

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26
Q

Common specific phobias

A

Animals - ducks, centipedes, clowns
Nature - environment - trees
Situational - elevators, tight spaces, height, flying, driving
Blood injection injury - feels nauseous, fainting

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27
Q

Vasovagal response

A

fainting response - blood injection injury

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28
Q

[exam] Acquisition of most anxiety-based disorders is

A

classical conditioning

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29
Q

Possible causes of phobias

A

biological component

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30
Q

[exam] Behavioral treatments for specific phobias

A

CBT - extremely effective

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31
Q

Exposure treatments for specific phobias
1)
2)
3)

Which is most effective?

A

1) systematic desensitization - small steps, better tolerated
2) modeling - therapist experiences thing client is afraid of and the client watches
3) flooding - spider right next to you in a container, lid opened. 45 mins of touching the spider.

Flooding is most effective with least amount of time.

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32
Q

systematic desensitization (specific phobias)

A

small steps of exposure

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33
Q

modeling for specific phobias

A

therapist experiences thing client is afraid of and the client watches

34
Q

flooding for specific phobias

A

spider right next to you (client) in a container, lid opened. 45 mins of touching the spider.

35
Q

Cultural factors with specific phobias

A

strong indication phobias are biological (evolutionary beneficial) as the phobias are pretty universal across cultures.

36
Q

Social Anxiety Disorder (SAD)- defining features
1)
2)
3)

A

1) Fear or discomfort in social or performance situations
2) impairment
3) avoids or endures with distress

37
Q

Performance-only subtype of SAD

A

Incredibly common

Presentation, talk, read, musical performance

38
Q

Facts and Statistics for Social Anxiety Disorder SAD

1) Prevalence
2) Females vs Males
3) Onset

A

1) 5% - though probably low estimate
2) 2:1 females to males
3) adolescent years - more presentations, social comparison

39
Q

Causes of SAD
A)
B)
C)

A

A) Biological and evolutionary vulnerability (runs in family)
B) Learning and conditioning - avoiding eye contact perceived more negative
C) Cognitive perspective - depressive/negative triad

40
Q

Psychological Treatment for SAD
A)
B)

C) Which is most effective?

A

A) CBT
B) CB group treatment (CBGT) - $50-100/session - natural exposure, flooding, modeling. slowly easing in.

C) CBGT

41
Q

Medication Treatment for SAD

A

SSRIs
Benzo
Relapse rates are high following discontinuation

42
Q

Separation Anxiety Disorder

1) Characterized by ___
2) Can’t have ___
3) Concerned about ___

A

1) Unrealistic and persistent worry
2) Trauma-related – needs to be irrational
3) physical danger (to me or someone I love) Abandonment

43
Q

Separation Anxiety Disorder – outcomes

A

Nightmares or refusing to go to school. Refuse to go to store if they think parent will leave them at store.

44
Q

Separation Anxiety Disorder statistics

1) __% of Children
2) ___% of adults
3) ___% symptoms in adulthood if untreated
4) Onset

A

1) 4.1%
2) 6.6%
3) 35%
4) Bimodal - as children and another group as adults

45
Q

Separation Anxiety Disorder Treatment

A 
Exposure Therapy (most recommended)
- Dr. Marsha M. Linehan
46
Q

Trauma and Stress or Related Disorders (separate in DSM 5)
1) Shared origin of ___
2)

A

1) Anxiety

2)

47
Q 
PTSD
A. Criteria A
B. Criteria B:
C. Criteria C:
D. Criteria D
E. Criteria E

Required for diagnosis is:

A

A. Trauma - required (must be extreme and life threatening. Watching trauma counts too)
B. Re-experiencing - cognitive or physical (nightmares, flashbacks)
C. Avoidance - cognitive or physical (i.e. avoiding weather if they have hurricane PTSD)
D. Change in thoughts or moods (irritable = highly anxious)
E. Hyper-vigilance, reactivity & chronic arousal (concerned with only one exit in a room. very sensitive to sound)

A is required and any of B,C,D, or E

48
Q

PTSD Required…

  1. ___ or ____
  2. time period of symptoms
A

1) Distress or impairment

2) 1+ months of symptoms

49
Q

PTSD - Delayed onset moderator

1) description
2) Prognosis

A

1) they experience trauma, don’t get PTSD immediately

2) much worse - suppressing/hiding symptoms. They don’t seek treatment right away.

50
Q

[exam] PTSD:

1) Prevalence [exam]
2) Ratio
3) Symptom presentation

A

1) 7% if you look across all traumas [exam]
2) 1%
3) Vary by age, changes with time. Young children with play. Adults - anxiety

51
Q 
Types of traumas (PTSD)
1)
2)
3)
4)
A

1) Natural disasters (hurricane, tornado) (1:1 Female-Male)
2) Trauma events (death of loved one, violent loss of loved one, kidnapping
3) Sexual assaults / domestic violence (5:1 Female to male)
4) Human made disaster (genocide, combat, POW (1:5 female to male)

52
Q

Differential diagnosis PTSD

1) less than one month called –
2) Adjustment Disorder

A

1) acute stress disorder (ASD). Same symptoms as PTSD but PTSD is worse. One one month hits – changes to PTSD.
2) doesn’t require trauma (not life threatening, upsetting event) any stressor - e.g. divorce, having a child, getting married

53
Q

What is Acute Stress Disorder?

A

ASD

Same symptoms as PTSD but less than a month. Once a month hits - changes to PTSD.

54
Q

Adjustment disorder

A

any stressor - e.g. divorce, having a child, getting married

doesn’t require trauma (not life threatening, upsetting event)

55
Q

PTSD Treatment - Medication

1) Most common
2) effectiveness %
3) relapsel rate %

A

1) SSRI - effective - suppresses anxiety
2) 60-70%
3) 100% relapse.

56
Q 
PTSD Treatment - Psychological
1) \_\_\_ most effective (what %?) (what relapse?
Subtypes:
A) 
B) 
C)
A

1) CBT - 80% effectiveness - low relapse

A) Graduated or massed (e.g. flooding) imaginal (imagine experience to get over)

B) Narrative development (relatively new, quite effective) - they tell you what happened to them over and over and add more detail every time. Doesn’t matter if it’s all true.

C) Challenge maladaptive thoughts (both above strategies address this) - “my fault”

57
Q

Graduated or massed CBT - describe

A

(e.g. flooding) imaginal (imagine experience to get over)

58
Q

Narrative development CBT - describe

A

(relatively new, quite effective) - they tell you what happened to them over and over and add more detail every time. Doesn’t matter if it’s all true.

59
Q

Challenge maladaptive thoughts CBT - describe

A

“my fault” thoughts

60
Q

OCD cycle

A

Anxiety > Compulsion (thoughts or actions to neutralize anxious thoughts) > Decrease in Anxiety > Event/Anxiety > Obsession (intrusive and nonsensical thoughts, images, or urges) > Anxiety > Compulsion

61
Q

Types of Obsessions and Compulsions

A

A) Symmetry/Exactness/”Just Right”
B) Forbidden Thoughts or Actions (Aggression, sex, religious)
C) Cleaning/Contamination

62
Q

Symmetry/Exactness/”just right”
A) Obsession*
B) Compulsion

A

A) needing to be aligned or symmetrical. Urges to do thing over and over until perfect
B) putting things in certain order. Repeating rituals

63
Q

Forbidden thoughts or actions
A) Obsession
B) Compulsion

A

A) Fears, urges to harm self or others. Fears of offending God or other being.
B) Checking* Avoidance, Repeated requests for reassurance

64
Q

Cleaning/Contamination
A) Obsession
B) Compulsion

A

A) Germs. Fears of germs or contaminants (not just contaminate me - I would contaminate loved ones and they die too)
B) Repetitive or excessive washing. Using gloves, masks to do daily chores.

65
Q 
OCD Statistics
A) % of general population
B) Onset for Males
C) Onset for Females
D) Cultural differences
E) Prognosis is worse for which gender? Why?
A

A) 2% - likely accurate due to how disabling
bimodal onset:
B) onset 15-25 years old and then peter out
C) onset 25-35 years old
D) More in US than other countries - obsession w germs
E) Males due to getting it younger, brain still developing. Interfere longer.

66
Q 
OCD Causes
A) \_\_\_ throat
B) Family
C) 
D) not being able to separate thoughts from behavior "if i have a thought then it is reality" called \_\_\_\_\_
A

A) strep throat - multiple bouts are more susceptible. Fever above 104 degrees = neuronal death. Strep attacks basal ganglia – OCD
B) runs in family
C) Cognitions
D) Thought-action fusion

67
Q

thought-action fusion

A

not being able to separate thought from behavior “if i have a thought then it is reality”

68
Q

OCD - Biological (Rx) Treatment
A)
B) extreme cases

A

A) Clomipramine and other SSRIs

B) Extreme cases - psychosurgery - corpal collosum

69
Q

OCD - psychological treatment
A)
B)

A

A) ERP - exposure response/ritual prevention - exposing to anxiety not allowing ritual
B) combining CBT with medication

70
Q

Trichotillomania (what is it)

A

Hair pulling disorder

71
Q

Trichotillomania
A) falls into what category?
B) what happens
C) Treatment

A

A) OCD (related to tourette syndrome)
B) find a foreign hair on their body - different one strand to another, become convinced it doesn’t belong on their body.
C) behavioral habit reversal - habit/behavior of hand-to-head –force hand down

72
Q

Dermatillomania (skin picking) - Excoriation
A) ___ category
B) end up on what meds?
C) Treatment

A

A) OCD
B) Anxiety - don’t want to go outside or see people.
C) behavioral habit reversal - habit/behavior of hand-to-head –force hand down

73
Q

Trichotillomania/Dermatillomania BY PROXY

A

pulling hair off of someone else or picking someone else

74
Q

Body Dysmorphic Disorder BDD
A) Fear of ___
B) Causes
C) ___ behaviors

A

A) imagined ugliness
B) distress/impairment
C) compulsive behaviors - checking, excessive exercise, plastic surgery

75
Q 
Statistics of Body Dysmorphic Disorder
A) % of general population
B) % of college status
C) \_\_\_\_ correlation with socioeconomic status
D) Males to Female ratio
A

A) 1-2%
B) 4-28%
C) Positively correlated - ^ wealthy -> ^ disorder
D) 1:1 ratio - women focus on nose, stomach, breasts. Men focus on arms, abs.

76
Q 
Body Dysmorphic Disorder 
A) Prognosis
B) Causes
C) Treatment
D) Medication
A

A) chronic disorder, doesn’t remit. Peaks between 20-40 years old.
B) unknown. Familial pattern. Similarities with OCD.
C) Treatment
D) SSRI, benzo. Relapse with stopping meds.

77
Q

Body Dysmorphic Disorder Causes

A

Unknown. Familial pattern. Similarities with OCD

78
Q

Body Dysmorphic Disorder Treatment

A

parallels OCD - CBT, exposure

79
Q

Body Dysmorphic Disorder Medication

A

SSRI, benzo.

Relapse with stopping meds.

80
Q

Body Dysmorphic disorder prognosis

A

chronic disorder. doesn’t remit. peaks between 20-40 years old.

81
Q

Plastic surgery and BDD
A) % seek plastic surgery
B) ___% who request plastic surgery may have BDD
C) May ____ condition

A

A) 76.4%
B) 8%-25%
C) worsen. Unlikely to help

82
Q

Corticotropin-releasing factor (CRF) system

A

central to the expression of anxiety (and depression) and the groups of genes that increase the likelihood that this system will be turned on.

Abnormal Psychology PSYCH303 (23 decks)

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