COGNITIVE BEHAVIOURAL THERAPY OF ANXIETY AND DEPRESSION

Question 1

What is the Yerkes-Dodson law?

Answer 1

performance increases with physiological or mental arousal (stress) but only up to a point. When the level of stress becomes too high, performance decreases.

Question 2

what are some physical symptoms of anxiety?

Answer 2

muscle tension (headaches, pain and fatigue)
hyperventilation (can lead to respiratory alkalosis= decrease in nerve transmission=tingling in fingers and toes)
can get tetany

Question 3

what are the effects of sympathetic overactivity in anxiety?

Answer 3

increased heart rate, ectopic beats, sweating, pale skin, dry mouth, nausea, loose motions and frequent urination

Question 4

what are some of the psychological symptoms of anxiety?

Answer 4

poor concentration, memory and feeling unreal. Fear, panic, worry, irritability. Thoughts are usually about future danger, fear of dying or losing control. worrying about worrying

Question 5

what are some treatment options for anxiety?

Answer 5

education
relaxation (e.g. controlled breathing)
CBT
SSRIs
benzodiazepines
beta-blockers

Question 6

what is cognitive behavioural therapy?

Answer 6

a psychological treatment that teaches us how to feel better by changing the way we feel think and behave = change behaviour (eg graded exposure) and/ or change thinking (eg anxiety is unpleasant but not dangerous)

Question 7

what are some of the questions to think about when clinically assessing anxiety?

Answer 7

Is this a normal reaction to stress?
Is this primary anxiety or is it secondary to physical or mental illness?
Is this a lifelong personality trait or state?
Has it been triggered by a phobia or is it free floating?
If free floating, is it present from time to time (panic) or all the time (generalised anxiety)?

Question 8

describe Clark’s cognitive theory of panic disorder?

Answer 8

that individuals who experience recurrent panic attacks do so because they have an enduring tendency to misinterpret benign bodily sensations as indications of an immediately impending physical or mental catastrophe. e.g. they interpret a pain in the chest as something wrong with the heart

Question 9

what is learning (in psychology terms)?

Answer 9

a relatively permanent change in behaviour that occurs as a result of experience that enables the person to adapt to the environment and increase their chances of survival

Question 10

what happens in the brain as you learn?

Answer 10

neuroplasticity- the creation of new connections between your neurons
and increased efficiency of neurotransmitter release between neurones

Question 11

what is the amygdala?

Answer 11

an almond shaped structure in temporal lobes involved in learning and expressive fear

Question 12

what is associative learning?

Answer 12

learning that certain events go together

Question 13

what is vicarious learning?

Answer 13

learning by direct observation

Question 14

what is complex learning?

Answer 14

the integration of knowledge, skills and attitudes

Question 15

what is classical conditioning?

Answer 15

a learning process where a previously neutral stimulus becomes associated with another stimulus by repeated pairing

Question 16

what is operant conditioning?

Answer 16

the alteration of behaviour by reward or punishment. e.g. the certain responses are learned because of their effect

Question 17

what is an example of classical conditioning?

Answer 17

Pavlov’s dogs

food poisoning

Question 18

what are examples of operant conditioning?

Answer 18

positive reinforcement
negative reinforcement
punishment
extinction

Question 19

what is positive reinforcement?

Answer 19

presenting a pleasant stimulus after a desired behaviour has occurred to increase the likelihood of that behaviour again

Question 20

what is negative reinforcement?

Answer 20

removing an unpleasant stimulus after a desired behaviour has occurred to increase the likelihood of that behaviour again

Question 21

what is punishment

Answer 21

presenting an unpleasant stimulus after an undesired behaviour occurs to decrease the likelihood of the undesired behaviour

Question 22

what is extinction?

Answer 22

removing a previously pleasant stimulus to decrease the likelihood of the undesired behaviour

Question 23

what are the 2 types of reinforcement?

Answer 23

continuous and partial

Question 24

what is continuous reinforcement?

Answer 24

every response is reinforced

Question 25

what is partial reinforcement?

Answer 25

reinforcement occurs but not after every response .

e.g. it may depend on the number of responses or a time interval

Question 26

what type of reinforcement do people work the hardest for?

Answer 26

partial unpredictable reinforcement e.g. gambling

Question 27

what happens in CBT?

Answer 27

you work with a therapist to identify and challenge any negative thinking patterns and behaviour which may be causing you difficulties. In turn this can change the way you feel about situations, and enable you to change your behaviour in future.

Question 28

what is a phobia?

Answer 28

A marked and persistent fear triggered by a specific object/situation. It leads to avoidance of that situation

Question 29

what is agoraphobia?

Answer 29

fear of crowds and public places

Question 30

what maintains a phobia?

Answer 30

negative reinforcement

1. phobic stimulus
2. anxiety
3. avoidance
4. anxiety reduced

Question 31

what is the treatment of phobias?

Answer 31

CBT, mindfulness, graded exposure

Question 32

what is graded exposure?

Answer 32

deliberate confrontation of a feared object or situation until the anxiety reduces

Question 33

what are problems with punishment?

Answer 33

Physical or emotional harm or injury
Paradoxical attention: can act as positve reinforcer of negative behaviour (any attention better than none)
Teaches aggression as model to solve difficulties
Leads to fear/dislike of person = classical conditioning

Question 34

how do we recognise depression?

Answer 34

D = Depressed Mood 
E = Energy Loss
P = Pleasure Lost (Anhedonia)
R = Retardation or Agitation 
E = Eating Changed (Appetite /Weight) 
S = Sleep Changed
S = Suicidal Thoughts (or Future bleak)
 I = I’m A Failure (Loss Of Confidence/Self Esteem) 
0 = Only Me To Blame (Guilt) 
N = No Concentration (Not able to function)

Question 35

how is depression graded?

Answer 35

by the number of symptoms…
4= mild depression
5/6= moderate depression
7+= severe depression

Question 36

what must be taken into account when considering a diagnosis of depression?

Answer 36

the number of symptoms
have the symptoms been there for over 2 weeks?
how is functioning of daily life?

Question 37

what are the treatment options for depression?

Answer 37

CBT or medication

Question 38

describe the cycle of depression and negative thinking?

Answer 38

low mood leads to negative thoughts which leads to an even lower mood. it spirals!

Question 39

What is Beck’s cognitive triad?

Answer 39

Depression is caused and maintained by negative views of:
The Self
The World/others
The Future

Question 40

what is the cognitive model of depression?

Answer 40

the presence of negative life events in addition to one’s perception of or reaction to those events may impact the development and maintenance of depressive symptoms

e.g. early life experiences lead to core beliefs which can cause unhelpful assumptions later on in life which can then cause depression when triggered by an incidence that resonates with the early experience

Question 41

describe the cycle of depression and inactivity?

Answer 41

low mood means no pleasure so we do less which means we achieve less and confidence falls so we get no rewards and therefore more time thinking negative thoughts

Question 42

what is Seligman’s theory of learned helplessness?

Answer 42

a mental state in which an organism forced to bear aversive stimuli, or stimuli that are painful or otherwise unpleasant, becomes unable or unwilling to avoid subsequent encounters with those stimuli, even if they are “escapable,” presumably because it has learned that it cannot control the situation.