COGNITIVE BEHAVIOURAL THERAPY OF ANXIETY AND DEPRESSION Flashcards
What is the Yerkes-Dodson law?
performance increases with physiological or mental arousal (stress) but only up to a point. When the level of stress becomes too high, performance decreases.
what are some physical symptoms of anxiety?
muscle tension (headaches, pain and fatigue) hyperventilation (can lead to respiratory alkalosis= decrease in nerve transmission=tingling in fingers and toes) can get tetany
what are the effects of sympathetic overactivity in anxiety?
increased heart rate, ectopic beats, sweating, pale skin, dry mouth, nausea, loose motions and frequent urination
what are some of the psychological symptoms of anxiety?
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
what are some treatment options for anxiety?
education relaxation (e.g. controlled breathing) CBT SSRIs benzodiazepines beta-blockers
what is cognitive behavioural therapy?
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)
what are some of the questions to think about when clinically assessing anxiety?
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)?
describe Clark’s cognitive theory of panic disorder?
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
what is learning (in psychology terms)?
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
what happens in the brain as you learn?
neuroplasticity- the creation of new connections between your neurons
and increased efficiency of neurotransmitter release between neurones
what is the amygdala?
an almond shaped structure in temporal lobes involved in learning and expressive fear
what is associative learning?
learning that certain events go together
what is vicarious learning?
learning by direct observation
what is complex learning?
the integration of knowledge, skills and attitudes
what is classical conditioning?
a learning process where a previously neutral stimulus becomes associated with another stimulus by repeated pairing
what is operant conditioning?
the alteration of behaviour by reward or punishment. e.g. the certain responses are learned because of their effect
what is an example of classical conditioning?
Pavlov’s dogs
food poisoning
what are examples of operant conditioning?
positive reinforcement
negative reinforcement
punishment
extinction
what is positive reinforcement?
presenting a pleasant stimulus after a desired behaviour has occurred to increase the likelihood of that behaviour again
what is negative reinforcement?
removing an unpleasant stimulus after a desired behaviour has occurred to increase the likelihood of that behaviour again
what is punishment
presenting an unpleasant stimulus after an undesired behaviour occurs to decrease the likelihood of the undesired behaviour
what is extinction?
removing a previously pleasant stimulus to decrease the likelihood of the undesired behaviour
what are the 2 types of reinforcement?
continuous and partial
what is continuous reinforcement?
every response is reinforced
what is partial reinforcement?
reinforcement occurs but not after every response .
e.g. it may depend on the number of responses or a time interval
what type of reinforcement do people work the hardest for?
partial unpredictable reinforcement e.g. gambling
what happens in CBT?
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.
what is a phobia?
A marked and persistent fear triggered by a specific object/situation. It leads to avoidance of that situation
what is agoraphobia?
fear of crowds and public places
what maintains a phobia?
negative reinforcement
- phobic stimulus
- anxiety
- avoidance
- anxiety reduced
what is the treatment of phobias?
CBT, mindfulness, graded exposure
what is graded exposure?
deliberate confrontation of a feared object or situation until the anxiety reduces
what are problems with punishment?
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
how do we recognise depression?
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)
how is depression graded?
by the number of symptoms…
4= mild depression
5/6= moderate depression
7+= severe depression
what must be taken into account when considering a diagnosis of depression?
the number of symptoms
have the symptoms been there for over 2 weeks?
how is functioning of daily life?
what are the treatment options for depression?
CBT or medication
describe the cycle of depression and negative thinking?
low mood leads to negative thoughts which leads to an even lower mood. it spirals!
What is Beck’s cognitive triad?
Depression is caused and maintained by negative views of:
The Self
The World/others
The Future
what is the cognitive model of depression?
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
describe the cycle of depression and inactivity?
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
what is Seligman’s theory of learned helplessness?
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.
