chapter 6 Flashcards
soaring elation or deep depression
extreme emotions or affect (present in all mood disorders)
often characterized by intense and unrealistic feelings of excitement and euphoria,
mania
which usually involves
feelings of extraordinary sadness and dejection.
depression
the person experiences only depressive episodes,
unipolar depressive disorders
the person experiences both manic and depressive episodes.
bipolar and related disorders
a
person must be markedly depressed or lose interest in formerly pleasurable activities (or both) for at least two weeks. Other symptoms such as changes in sleep or appetite, or feelings of worthlessness must also be present
major depressive disorder
the person shows a markedly elevated, euphoric,
or expansive mood, often interrupted by occasional outbursts of intense irritability or even violence—particularly when others refuse to go along with the manic person’s wishes and schemes.
manic episode
in which a person experiences abnormally elevated, expansive, or irritable mood for at least 4 days.
hypomanic episode
feeling after the loss of a loved one
bereavement/grief
This disorder is diagnosed if a woman has had a certain
set of symptoms in the majority of her menstrual cycles for the past year.
premenstrual dysphoric disorder
a person must have a
persistently depressed mood most of the day, for more days than
not, for at least 2 years (1 year for children and adolescents).
persistent depressive disorder (dysthymia)
a group of disorders—that
share obvious symptoms of clinically significant fear or anxiety.
anxiety disorders
are persistent and highly recurrent intrusive thoughts or images that are experienced as disturbing and
inappropriate.
obsessions
are repetitive behaviors (such as handwashing or checking) that the person feels must be performed
in response to the obsession
compulsions
involves a general feeling of apprehension about
possible future danger,
anxiety
an alarm reaction in response to immediate danger/ a basic emotion (shared by many animals) that involves activation of the “fight-or-flight” response of the autonomic nervous system.
fear
To Freud, these disorders developed when
intrapsychic conflict produced significant anxiety.
neurotic disorders
in Freud’s formulation, this is a sign of an inner battle or conflict between
some primitive desire (from the id) and prohibitions against its
expression (from the ego and superego).
anxiety
When the fear response
occurs in the absence of any obvious external danger, we say
the person has had a spontaneous or uncued _____? often
accompanied by a subjective sense of impending doom, including fears of dying, going crazy, or losing control.
panic attack
3 components of fear and panic
cognitive, behavioral and physiological component
People with this disorder experience both frequent
panic attacks and intense anxiety focused on the possibility of
having another one.
panic disorder
exhibit many anxiety symptoms about the possibility of
encountering their phobic situation, but they may also experience a fear or panic response when they actually encounter the
situation.
specific/social phobias
People with this phobia go to great lengths
to avoid a variety of feared situations, ranging from open streets,
bridges, and crowded public places.
agoraphobia
) mostly experience a general sense of diffuse anxiety
and worry about many potentially bad things that may happen; some may also experience an occasional panic attack, but
it is not a focus of their anxiety.
generalized anxiety disorder
—a proneness or
disposition to experience negative mood states that is a common risk factor for both anxiety and mood disorders
neuroticism
also called the emotional brain. centrally involved in mood disorders
limbic system
neurotransmitters that are involved in mood disorders
Gamma AminoButyric Acid, Norepinephrine, Serotonin
medications often used to treat anxiety disorders (except specific phobias)
antianxiety medications (anxiolytics) and antidepressant medications
is a
persistent and disproportionate fear of some specific object or
situation that presents little or no actual danger and yet leads to a
great deal of avoidance of these feared situations.
phobia
if she or
he shows strong and persistent fear that is triggered by the
presence of a specific object or situation
specific phobia
intensely afraid of closed spaces
claustrophobia
Afraid of heights
acrophobia
Subtype of specific phobia (spiders, dogs, snakes)
animal phobia
Subtype of specific phobia (storm, heights, water)
natural environment
Subtype of specific phobia (seeing blood, receiving shots, seeing a person on a wheelchair)
blood-injection-injury
Subtype of specific phobia (public transpoetation, tunnel, flying, driving, elevators, bridges, enclosed spaces)
situational
Subtype of specific phobia ( choking, vomiting, space phobia)
others
Fear of falling down if away from walls or other support
Space phobia
In this phobia, they also show a unique physiological response. Rather than
showing the simple increase in heart rate and blood pressure seen
when most people with phobias encounter their phobic object,
these people show an initial acceleration, followed by a dramatic
drop in both heart rate and blood pressure. This is very fre-
quently accompanied by nausea, dizziness, or fainting, which do
not occur with other specific phobia
Blood-injection-injury phobia
condition-
ing in which a person has a terrifying experience in the pres-
ence of a neutral object or situation
Direct traumatic conditioning
Simply watching a
phobic person behaving fearfully with his or her phobic object
can be distressing to the observer and can result in fear being
transmitted from one person to another
Vicarious conditioning / Observational classical conditioning
For example, this effect
suggests that a person who acquired, a mild fear of driving fol-
lowing a minor crash might be expected to develop a full-blown
phobia if he or she later were physically assaulted, even though
no automobile was present during the assault
inflation effect
This learning occurs because,
over the course of evolution, those primates and humans who
rapidly acquired fears of certain objects or situations that
posed real threats to our early ancestors may have enjoyed a
selective advantage
prepared learning
One of the variants of serotonin-transporter gene which has been linked to heightened neuroticism
the s allele/ 5-HTTLPR
Toddlers (who are excessively timid, shy, easily distressed,
behaviorally inhibited toddlers
A form of behavior therapy which
is the best treatment for specific phobias—involves controlled
exposure to the stimuli or situations that elicit phobic fear
exposure therapy
A variant of exposure therapy in which Here the
therapist calmly models ways of interacting with the phobic stim-
ulus or situation (
participant modeling
is a collection of nuclei in front of the hippocampus in the limbic system of the brain that is critically involved
in the emotion of fear.
Amygdala
A drug which is known to facilitate
extinction of conditioned fear in animals, may enhance the effectiveness of small
amounts of exposure therapy for fear of heights in a virtual
reality environment
d-cycloserine
as the DSM-5
describes it, is characterized by disabling fears of one or more
specific social situations (such as public speaking, urinating in a
public bathroom, or eating or writing in public
social phobia (social anxiety disorder)
Most common type of social phobia
intense fear of public speaking
2 subtypes of social phobia
centers on performance/
Nonperformance situations/
in this technique, the therapist attempts to help clients with social phobia identify their underlying negative, automatic thoughts.
After helping clients understand that such automatic thoughts
(which usually occur just below the surface of awareness but can
be accessed) often involve cognitive distortions, the therapist helps
the clients change these inner thoughts and beliefs through logical
reanalysis.
cognitive restructuring
most effective and widely used medication for social phobia
monoamine oxidase inhibitors(MAOI’s)/ selective serotonin reuptake inhibitors (SSRI’s)
3 psychological factors of social phobia and 2 biological factors
psychological (learned behavior, evolutionary context ((phobic and non phobic cues)), unpredictability and uncontrollability, cognitive biases) BIOLOGICAL ( genetic and temperamental factors (Behavioral inhibitions)
is defined and characterized by
the occurrence of panic attacks that often seem to come “out of
the blue.”
panic disorder
must have been persistently concerned about having another panic attack
or worried about the consequences of having an attack for at least
a month
anticipatory anxiety
(a feeling of
being detached from one’s body)
depersonalization
a feeling that the
external world is strange or unreal
derealization
panic attack that occurs while asleep
nocturnal panic
one of symptoms of panic attacks that means numbness or tingling sensations
paresthesias
people with this phobia are anxious about being in places
or situations from which escape would be physically difficult or
psychologically embarrassing, or in which immediate help would
be unavailable if something bad happened
agoraphobia
also called blue spot, part of the brain stem involved in the neurobiology of panic attacks, principal site for the brain synthesis of norepinephrine
locus coeruleus
(also a part of the limbic system, below
the cortex, which is very involved in the learning of emotional
responses
hippocampus
At present, two primary neurotransmitter systems are most
implicated in panic attacks
noradrenergic and serotonergic system
initial panic attacks
become associated with initially neutral internal
and external cues
interoceptive conditioning/ exteroceptive conditioning
initial panic attacks
become associated with initially neutral internal
and external cues
interoceptive conditioning/ exteroceptive conditioning
3 components of panic disorder
panic attacks, agoraphobic fears, anticipatory anxiety
is a trait-like belief that
certain bodily symptoms may have harmful consequences.
anxiety sensitivity
medications often used for panic disorders
anxiolytics and anidepressants
in the benzodiazepine category, these 2 particular anxiolytics were often given for panic disorders
alprazolam (xanax) and clonazepam (klonopin) (bonus: side effects, drowsiness and sedation)
3 antidepressants primarily used for the treatment of panic disorder
tricyclics, SSRIs, SNRIs (Selective norepinephrine reuptake inhibitors) (bonus: side effects (such as dry mouth, constipation, and blurred vision with the
tricyclics, and interference with sexual arousal with the SSRIs)
One technique involves the variant on exposure
meaning deliberate exposure to
feared internal sensations.
interoceptive exposure
targets both agoraphobic
avoidance and panic attacks.
First, clients are educated about the nature of anxiety and panic
and how the capacity to experience both is adaptive. A second
part of the treatment involves teaching people with panic disorder
to control their breathing. Third, clients are taught about the
logical errors that people who have panic disorders are prone to
making and learn to subject their own automatic thoughts to a
logical reanalysis. Finally, they are exposed to feared situations and
feared bodily sensations to build up a tolerance to the discomfort
Panic Control Treatment
this suggests that the meaning that people
attach to their bodily sensations; they will experience panic
only if they make catastrophic interpretations of certain bodily
sensations.
cognitive model theory
this suggests that anxiety and panic
attacks can be triggered by unconscious interoceptive cues
interoceptive model theory
DSM-5 criteria specify that the worry must occur
on more days than not for at least 6 months and that it must be
experienced as difficult to control (see DSM-5 criteria box). The
worry must be about a number of different events or activities,
and its content cannot be exclusively related to the worry associated with another concurrent disorder, such as the possibility
of having a panic attack.
generalized anxiety disorder (formerly known as free-floating anxiety
3 benefits that people with
GAD most commonly think derive from worrying
superstitious avoidance of catastrophe, avoidance of deeper emotional topics, coping and preparation
A newer medication from a
different medication category is also effective, and it neither is
sedating nor leads to physiological dependence. It also has greater
effects on psychic anxiety than do the benzodiazepines in treating GAD
buspirone
disorder that involves skin picking
excoriation disorder
involves pulling of the hair
trichotillomania
is defined by the occurrence of unwanted and intrusive obsessive thoughts or distressing
images. These are usually accompanied by compulsive behaviors performed to undo or neutralize the obsessive thoughts or
images or as a way of preventing some dreaded event or situation
obsessive compulsive disorder
involve persistent and recurrent intrusive thoughts, images, or impulses that are experienced
as disturbing, inappropriate, and uncontrollable
obsessions
Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating
words silently) that the individual feels driven to perform in
response to an obsession or according to rules that must
be applied rigidly.
compulsions
difficulty discarding or parting with
possessions,
hoarding disorder
five primary types of compulsive rituals
cleaning, repeated checking, repeating, ordering or arranging, counting
For a smaller number of people, the compulsions are to perform various everyday acts (such as eating or dressing) extremely slowly
primary obsessional slowness
According to this theory, neutral stimuli become associated
with frightening thoughts or experiences through classical conditioning and come to elicit anxiety. For example, touching a
doorknob or shaking hands might become associated with the
“scary” idea of contamination. Once having made this association, the person may discover that the anxiety produced by
shaking hands or touching a doorknob can be reduced by hand
washing.
two process theory of avoidance learning (mowrer’s)
In turn, in some vulnerable people,
this inflated sense of responsibility can be associated with beliefs
that simply having a thought about doing something (e.g., attacking a patient) is morally equivalent to actually having done it (e.g.,
having attacked a patient), or that thinking about committing a
sin increases the chances of actually doing so. T
thought-action fusion
a disorder characterized by
severe chronic motor and vocal tics that is known to have a
substantial genetic basis
tourette’s syndrome
this is where primitive urges
regarding sex, aggression, hygiene, and danger come from (the
“stuff of obsessions”
orbital frontal cortex
a tricyclic drug that is often effective in the treatment of OCD even though other tricyclic antidepressants are
generally not very effective (
anafril (clomipramine)
r antidepressant drugs from the SSRI category that also
have relatively selective effects on serotonin, have also been shown to be about equally effective in
the treatment of OCD
fluoxetine (prozac)
This treatment involves having
the OCD clients develop a hierarchy of upsetting stimuli and
rate them on a 0 to 100 scale according to their capacity to evoke
anxiety, distress, or disgust. Then the clients are asked to expose
themselves repeatedly (either in guided fantasy or directly) to
stimuli that will provoke their obsession (such as, for someone
with compulsive washing rituals, touching the bottom of their
shoe or a toilet seat in a public bathroom). Following each exposure, they are asked to not engage in the rituals that they ordinarily would engage in to reduce the anxiety or distress provoked
by their obsession.
exposure and response prevention
People with this are obsessed with some perceived or imagined
flaw or flaws in their appearance to the point they firmly believe
they are disfigured or ugly
body dysmorphic disorder
variant of panic disorder in latin america
ataque de nervios
Another culture-related syndrome that occurs in places like
China and other Southeast Asian countries which for men
involves intense, acute fear that the penis is retracting into the
body and that when this process is complete the sufferer will die.
in women, for whom the fear is that
their nipples are retracting and their breasts shrinking.
koro
people with this are concerned about doing something that will embarrass or offend
others
taijin kyofusho
