Exam 1 (Chapter 1,2,5,6) Flashcards
1
Q
psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected
A
psychological disorder
2
Q
breakdown in cognitive, emotional, or behavioural functioning
A
criteria for a psychological disorder
3
Q
significant distress / impairment
A
criteria for a psychological disorder
4
Q
- not merely a deviation for the mean/average behaviour
A
criteria for a psychological disorder
5
Q
- classified as significant impairment, moderate impairment, mild impairment
A
criteria for a psychological disorder
6
Q
- clinical disorder: impairment or REALLY significant distress is occurring
A
criteria for a psychological disorder
7
Q
the scientific study of psychological disorders
A
psychopathology
8
Q
- can assess, treat, diagnose, and research
- College of Psychologists regulated
Clinical -> severe psychological problems
A
Clinical psychologists - Ph.D. (Doctor of Philosophy) OR Psy.D. (Doctor of Psychology)
9
Q
- Evidence-based practice: keep up with scientific developments and use best empirical evidence
- evaluate assessments or treatment procedures
- conduct research that produces new information about disorders or treatment
A
functions of the scientist-practitioner model
10
Q
presenting problem, predisposing factors, precipitating factors, perpetuating factors, protective factors
A
5 P’s
11
Q
concerns that clients find difficult to manage
A
presenting problem
12
Q
biological, environmental, or personality considerations that may put clients at risk
A
predisposing factors
13
Q
bring the problem about; significant events preceding the onset of the disorder
A
precipitating factors
14
Q
sustain and possibly reinforce clients’ problems - why isn’t someone getting better, why is the disorder or problem staying around
A
perpetuating factors
15
Q
help to moderate or diffuse the problem
A
protective factors
16
Q
presents to a practitioner with a set of problems (the description of the concern someone is coming to tell you about)
A
presenting problem
17
Q
of people in a population who have the disorder
A
prevalence
18
Q
of new cases occurring per year
A
incidence
19
Q
typical age to begin experiencing symptoms
A
age of onset
20
Q
characterization of how the disorder will occur in individuals
A
course
21
Q
acute or insidious
A
onset
22
Q
fast and intense onset
A
acute
23
Q
slower onset
A
insidious
24
Q
the forecast or likely course of a disorder
A
prognosis
25
why a disorder begins
etiology
26
3 important models of behaviour
supernatural, biological, psychological
27
psychological disorders understood as being possessed , deviant/bad/undesirable behaviour -> the battle of good and evil
the supernatural model of behaviour
28
exorcism, witch hunts, shackling people to church
treatments (supernatural model of behaviour)
29
Which model of behaviour ?
Hippocrates: brain is the seat of wisdom, consciousness, intelligence, and emotion
Galen: humoral theory (4 humors) (blood, black bile, yellow bile, phlegm)
- too much of these led to disease
- black bile = depression
the biological model of behaviour
30
which model of treatment?
- electric shock
- brain surgery
- pharmacological treatments (tranquillizers) reduced hallucinations, delusions, aggressive behaviour
- benzodiazepines
biological treatments
31
which ST-disease?
advanced stages: cognitive and behavioural symptoms
penicillin was a cure
syphilis
32
Which model of behaviour?
Plato: maladaptive behaviour stemmed from social and cultural influences
insane asylums and moral therapy
the psychological model of behaviour
33
Id, Ego, Superego
structure of the mind (3 parts)
Freud
34
unconscious level
- basic impulses (sex and gratification); irrational and impulsive; seeking immediate gratification, operates at unconscious level
Id
35
Operates mostly at preconscious level
-ideals and morals; striving for perfection; incorporated from parents; becoming a person's conscience.
Superego
36
Operates mostly at conscious level but also at preconscious level
- executive mediating between id impulses and superego inhibitions; testing reality; rational
ego
37
to uncover unconscious mental processes is the purpose of which therapy?
psychoanalytic psychotherapy
38
free association and dream analysis is associated with which therapy?
psychoanalytic psychotherapy
39
feelings about past relationships redirected unconsciously to the therapist
transference (psychoanalytic psychotherapy)
40
therapists project own personal issues or feelings onto the patient
countertransference (psychoanalytic psychotherapy)
41
focusing on unconscious = early childhood experiences
psychoanalytic psychotherapy
42
the hierarchy of needs (what theory?)
humanistic theory
43
self-actualization
esteem
love/belonging
safety
physiological
Maslow's hierarchy of needs
44
we can reach our best potential if the conditions are right
self-actualization
45
person centered therapy (what theory?)
Humanistic theory
46
unconditional positive regard, empathy vs. sympathy, genuineness
3 conditions for growth in person-centred therapy
47
- almost unqualified acceptance of most of the client’s feelings and actions
unconditional positive regard
48
emphasized the positive, optimistic side of human nature
Jung and Adler
49
portrayed life as a battleground where we are constantly in danger of being overwhelmed by our darkest forces.
Freud
50
the therapist takes a passive role, making as few interpretations as possible
person-centered therapy
51
the sympathetic understanding of an individuals particular view of the world
empathy
52
being who you are, the most true version of yourself
genuineness
53
a new model formed as a reaction to psychoanalysis
the behavioural model
54
behaviour strengthened or weakened depending on the consequences
Thorndike's Law of Effect
55
the new, scientific method, systematic desensitization, reinforcement vs. punishment
the behavioural model
56
(1) a psychological dysfunction within an individual that is (2) associated with distress or impairment
in functioning and (3) a response that is not typical
or culturally expected. All three basic criteria must be met; no one criterion alone has yet been identified that defines the essence of abnormality.
A psychological disorder
57
concerned with the scientific
study of psychological disorders.
psychopathology
58
keep up with latest findings, use scientific data to evaluate own work, conduct research within clinics/hospitals
scientist-practitioner
59
description, causation, and treatment/outcomes
three basic categories of research about psychological disorders
60
abnormal behavior is attributed to agents outside our bodies or social environment, such as demons, spirits, or the influence of the moon and stars;
the supernatural tradition
61
disorders are attributed to disease or biochemical imbalances;
biological tradition
62
abnormal behaviour is attributed to faulty psychological development and to social context
psychological tradition
63
emphasize physical care and the
search for medical cures, especially drugs.
biological treatments
64
use psychosocial treatments, beginning with moral
therapy and including modern psychotherapy.
psychological approaches
65
genetic contributions, nervous system, behavioural and cognitive processes, emotional influences, social and interpersonal influences and developmental factors
multidimensional integrative approach to the causes of psychological disorders
66
influences much of our development and most of our behaviour, personality, and even IQ score (polygenic)
genetic influence
67
influenced by many genes
polygenic
68
individuals are assumed to inherit certain vulnerabilites that make them susceptible to a disorder when the right kind of stressor comes along
Diathesis-stress model
69
the individual's genetic vulnerability toward a certain disorder may make it more likely that the person will experience the stressor that triggers the genetic vulnerability and thus the disorder
gene-environment correlation model
70
inherited tendency for vulnerability to a disorder
diathesis
71
circumstance that creates stress and elicits development of a disorder
stressor
72
without stressor occurring in the environment, the disorder may have never developed
diathesis-stress model
73
genes may increase probability of experiencing stressful events
the gene-environment correlation model
74
people may impact their environment through their genes - E.g., someone with depression may be genetically predisposed to seek out situations/relationships that lead to depression
the gene-environment correlation model
75
excitatory neurotransmitter
glutamate
76
turns on many different neurons, leading to action potential
Glutamate
77
inhibitory neurotransmitter
GABA
78
regulates transmission of information and action potentials
GABA
79
approximately 6 major circuits of this neurotransmitter
serotonin
80
contributes to regulation of our behaviour, moods, and thought processes
serotonin
81
low activity of this neurotransmitter may lead to problematic behaviour without directly causing it
Serotonin
82
SSRI's act on this neurotransmitter to treat anxiety, mood, and eating disorders by blocking reuptake
serotonin
83
also known as noradrenaline
norepinephrine
84
many circuits of this neurotransmitter in the CNS
norepinephrine
85
drugs can block receptors so response to this neurotransmitter is reduced
norepinephrine
86
may be connected to panic
norepinephrine
87
a major neurotransmitter in the monoamine class
dopamine
88
implicated in schizophrenia and addiction
dopamine
89
may play a role in depression and ADHD
dopamine
90
a theory on dopamine that needs updating
dopamine hypothesis
91
______ lead to positive psychological expectations
placebos
92
brief ______________ therapy can change brain function dramatically
exposure-relateed
93
psychosocial influences: OCD treatment
exposure and response prevention
94
how we acquire and process information
and how we store and ultimately retrieve it
cognitive science
95
complex cognitive, as well as emotional, processing of information is involved when conditioning occurs, even in animals
cognitive influences on behaviour
96
when rats or other animals encounter conditions over which they have no control
learned helplessness
97
if animals learn their behaviour has no effect on their environment, they give up attempting to cope and seem to develop the animal equivalent of depression
learned helplessness
98
learning from observing others or situations
modeling/observed learning
99
Social learning theory experiment?
Bobo Doll Experiment
100
1. noticing the model’s behaviour (attention),
2. remembering the model’s behaviour (retention),
3. exhibiting the model’s behaviour (reproduction).
steps of social learning
101
noticing the model's behaviour
attention
102
remembering the model's behaviour
retention
103
exhibiting the model's behaviour
reproduction
104
More likely to reproduce behaviours that have been rewarded vs. those that have been punished
social learning theory
105
targets automatic thoughts, attitudes, behaviours that maintain anxiety, depression, problems
cognitive behavioural therapy
106
negative views about the world -> negative views about the future -> negative views about oneself -> neg view about world ......
the cognitive triad
107
hardwired into us (e.g., fight or flight)
emotions
108
great behaviour motivators
emotions
109
behaviour, physiology, cognition
3 components of emotions
110
a persistent period of emotionality
mood
111
consider all the various paths to a particular outcome, not just the result (multidimensional integrative approach to psychopathology)
equifinality
112
we have become highly prepared for learning about certain types of objects or situations over the course of evolution because this knowledge contributes to the survival of a species
prepared learning
113
states that behaviors are learned by connecting a neutral stimulus with a positive one, such as Pavlov's dogs hearing a bell (neutral) and expecting food (positive). The learned behavior is called a conditioned response.
classical conditioning
114
a method of learning that uses rewards and punishment to modify behavior.
behavior that is rewarded is likely to be repeated, and behavior that is punished will rarely occur.
operant conditioning
115
sympathetic nervous system and parasympathetic nervous system
autonomic nervous system
116
autonomic nervous system and somatic nervous system
peripheral nervous system
117
The primary duties of this system are to regulate the cardiovascular system (for example, the heart and blood vessels) and the endocrine system (for example, the pituitary, adrenal, thyroid, and gonadal glands) and to perform various other functions, including aiding digestion and regulating body temperature
Autonomic nervous system
118
This nervous system controls the muscles, so
damage in this area might make it diffi cult for us to engage in any voluntary movement, including talking
somatic nervous system
119
this system is closely related to the immune system (which is also implicated in a variety of disorders)
endocrine system
120
each endocrine gland produces its own chemical messenger: called a _______
hormone
121
the adrenal glands produce this neurotransmitter
epinephrine (AKA Adrenaline)
122
the area of the frontal lobe that is the area responsible for higher cognitive functions such as thinking and reasoning, planning for the future, as well as long-term memory
prefrontal cortex
123
areas of the brain that researchers focus on in psychopathology
frontal lobe, limbic system, and the basal ganglia
124
lobe associated with recognizing various sights and sounds, and long-term memory storage
temporal lobe
125
lobe associated with recognizing various sensations of touch and monitoring body positioning
parietal lobe
126
lobe associated with integrating and making sense of various visual inputs
occipital lobe
127
which 3 lobes located towards the posterior of the brain, work together to process sight, touch, hearing, and other signals from our senses
temporal, occipital, parietal
128
system at the base of the forebrain, just above the hypothalamus and thalamus
limbic system
129
limbic system structures
hippocampus, congulate gyrus, septum, amygdala
130
this system helps regulate our emotional experiences and expressions, and, to some extent, our ability to learn and to control our impulses
limbic system
131
this system is involved with the basic drives of sex, aggression, hunger, and thirst
limbic system
132
a system of brain structures at the base of the forebrain that includes the caudate (tailed) nucleus
basal ganglia
133
system that is believed to control motor activity
basal ganglia
134
largest part of the forebrain containing more than 80% of all neurons within the CNS
cerebral cortex
135
this part of the brain provides us with our distinctly human qualities, allowing us to look to the future and plan, to reason, and to create
cerebral cortex
136
cerebral area that is divided into two hemispheres
cerebral cortex
137
hemisphere that is responsible for verbal and other cognitive processes
left cerebral hemisphere
138
the hemisphere that is better at perceiving the world around us and creating images
right cerebral hemisphere
139
the space between the axon of one neuron and the dendrite of another
synaptic cleft
140
biochemicals that are released from the axon of one neuron and transmit the impulse to the dendrite receptors of another neuron
neurotransmitters
141
the brain uses an average of 140 billion nerve cells, called ______, to control every thought and action
neurons
142
_______ transmit information throughout the nervous system
neurons
143
the typical neuron contains a central cell body, called a _____
soma
144
______ have numerous receptors that receive messages in the form of chemical impulses from other nerve cells
dendrite
145
dendrites have numerous ________ that receive messages in the form of chemical impulses from other nerve cells, which are converted into electrical impulses
receptors
146
an _____ transmits these impulses to other neurons
axon
147
which division of the parasympathetic nervous system controls voluntary muscles?
autonomic nervous system
148
expends energy
sympathetic nervous system
149
conserves energy
parasympathetic nervous system
150
controls voluntary muscles and conveys sensory information to the central nervous system
somatic nervous system
151
brain and spinal cord
central nervous system
152
usually short-lived, temporary states lasting from
several minutes to several hours
emotions
153
refers to the momentary emotional tone that accompanies what we say or do; can also be used more generally to summarize commonalities
among emotional states characteristic of an individual.
affect
154
someone who tends to be fearful, anxious, and depressed (affect)
experiencing negative affect
155
tendencies to be pleasant, joyful, excited (affect)
experiencing positive affect
156
Appraisals, attributions, and other ways of processing the world around you that are fundamental to
emotional experience.
cognitive aspects of emotion
157
Emotion is a brain function involving (generally) the more primitive brain areas.
Direct connection between these areas and the eyes may allow emotional processing to bypass the influence of higher cognitive processes.
physiology of emotion
158
Basic patterns of emotional behavior (freeze, escape,
approach, attack) that differ in fundamental ways.
Emotional behavior is a means of communication.
emotion and behaviour
159
The emotion of ______ is a subjective feeling of terror, a strong motivation for behavior (escaping or fighting), and a complex physiological or arousal response.
fear
160
an action tendency
emotion
161
more social relationships and contacts equals ________
longer lifespan expectation
162
relationships protect against ___________ & __________ disorders
physical and psychological
163
social isolation increases the risk of ______ as much as smoking and more than physical inactivity or obesity
death
164
mood state characterized by physical tension and apprehension about the future
ANXIETY
165
includes a subjective state, behaviours, and physiological responses
anxiety
166
an immediate alarm reaction to danger
fear
167
a future-oriented mood state, characterized by apprehension because we cannot predict or control upcoming events.
an immediate emotional reaction to current danger characterized by strong escapist action tendencies and often a surge in the sympathetic nervous system.
anxiety vs. fear
168
an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and possibly, dizziness
Panic Attack
169
we inherit a tendency to be tense, uptight, and anxious
biological explanations of anxiety
170
associated with specific brain circuits and neurotransmitter systems
biological explanations of anxiety
171
the corticotropin-releasing factor (CRF) system and the amygdala's role in anxiety
biological explanations of anxiety
172
the area of the brain most often associated with anxiety
the limbic system
173
______________ system is activated by signals from the brain stem of unexpected events, such as major changes in body functioning that might signal danger
the behavioural inhibition system (BIS)
174
When stimulated in animals, this circuit produces an immediate alarm-and-escape response that looks very much like panic in humans
Fight/flight system
175
__________ ______________ thought anxiety was the product of early classical conditioning, modeling, or other forms of learning
Behavioral theorists
176
the actions of parents in early childhood seem to do a lot to foster this sense of control or a sense of uncontrollability
psychological explanations of anxiety
177
parents who are overprotective and overintrusive and who “clear the way” for their children, never letting them experience any adversity, create a situation in which children never learn how to cope with adversity when it comes along. These children don't learn that they can control their environment
psychological explanations of anxiety
178
These cues, or conditioned stimuli, provoke the fear response and an assumption of danger, even if the danger is not actually present
psychological explanations of anxiety
179
places or situations similar to the one where the initial panic attack occurred
external cues
180
increases in heart rate or respiration that were associated with the initial panic attack (even if they are normal changes such as exercise)
internal cues
181
the first vulnerability or diathesis (a generalized biological vulnerability)
the second vulnerability ( a generalized psychological vulnerability)
the third vulnerability ( a specific psychological vulnerability)
the triple vulnerability theory
182
a tendency to be uptight or high strung might be inherited. A generalized biological vulnerability to develop anxiety is not sufficient to produce anxiety itself
The first vulnerability theory (or diathesis) is a generalized biological vulnerability
183
You might also grow up believing the world is dangerous and out of control and you might t not be able to cope when things go wrong based on your early experiences. If this perception is strong you have.....
The second vulnerability ( a generalized psychological vulnerability)
184
you learn from early experiences, such as being taught by your parents, that some situations or objects are fraught with danger (even if they really aren't)
the third vulnerability (a specific psychological vulnerability)
185
heritable contribution to negative affect
biological vulnerability
186
the third vulnerability (e.g.,
physical sensations are
potentially dangerous)
specific psychological vulnerability
187
the sense that events are uncontrollable/unpredictable
generalized psychological vulnerability
188
If individuals possess all three, the odds are greatly increased that they will develop an anxiety disorder
after experiencing a stressful situation.
the three vulnerabilities that contribute to the development of anxiety disorders
189
disorders of _________ often co-occur
anxiety
190
by far, the most common additional diagnosis for all anxiety disorders was ________ ____________
major depression
191
_______ is equally as common among anxiety disorders and depression
suicide
192
diagnosis of an ________ disorder increases chances of suicidal ideation or suicide attempts
anxiety
193
anxiety disorders and depression combine to make the risk of ________ significantly greater than the risk of someone with depression alone
suicide
194
worry is useful as what?
motivation
195
excessive worry?
severe impairment
196
catastrophizing, worst-case scenario, predicting negative outcomes, black and white thinking
Generalized anxiety disorder symptoms
197
A. Excessive anxiety and worry, occurring more days than not for at least 6 months, about many events or activities.
B. The individual finds it difficult to control the worry
C. Three of:
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
Criteria for Generalized Anxiety Disorder
198
runs in families
genetic causes of GAD
199
1. Intolerance of uncertainty
2. Positive beliefs about worry
3. Poor problem orientation
4. Cognitive avoidance
heightened sensitivity to threats
four cognitive characteristics of people diagnosed with GAD
200
for which disorder is psychological treatment effective in short-term AND better in long-term than medication?
GAD
201
CBT: approach rather than avoid threats
mindfulness and ACT effective
GAD psychological treatments
202
benzodiazepines, antidepressants effective with fewer side effects
GAD psychopharmacological treatments
203
come on within seconds, minutes
physiological symptoms and fears like dying or losing control
fear occurring at inappropriate times
own disorder or specified for other disorders
Panic attack
204
A. Recurrent unexpected panic attacks – plus 4 of the following: (SEE PICTURE)
B. At least one of the attacks has been followed by 1 month+ of one or both of the following:
1. Persistent concern or worry about additional panic attacks or their consequences.
2. A significant maladaptive change in behavior related to the attacks
Panic disorder criteria
205
- always provokes fear or anxiety
- active avoidance, need a companion, or are endured with intense fear or anxiety
- fear/anxiety out of proportion to the actual danger posed
- 6+ months
agoraphobia criteria
206
A. Marked fear/anxiety about 2+ of following:
1. Using public transportation
2. Being in open spaces
3. Being in enclosed places
4. Standing in line or being in a crowd.
5. Being outside of the home alone.
B. Avoids situations because of thoughts that escape might be difficult or help might not be available if panic-like symptoms/other incapacitating/ embarrassing symptoms arise
agoraphobia
207
avoidance of internal physical sensations that may resemble a panic attack starting
interoceptive avoidance
208
after an unexpected panic attack or like sensations, vulnerable to anxiety about the possibility of another panic attack, normal body sensations interpreted catastrophically
panic and agoraphobia causes
209
panic control treatment (PCT)
interoceptive exposure
exposure-based interventions
psychological intervention for panic and agoraphobia
210
stepped care approach
combined psychological and drug treatments for panic and agoraphobia
211
benzodiazepines, SSRIs, SNRIs
medication treatments for panic and agoraphobia
212
This is the criteria for which disorder?
A. Anxiety about a specific object or situation
B. Almost always provokes immediate anxiety
C. Actively avoided or endured with intense fear or anxiety
D. Out of proportion to the actual danger posed
- 6+ months
specific phobia
213
for which disorder do are these contributing factors: traumatic experiences, vicarious experiences, panic attack, social and cultural factors impact, higher rates in women
specific phobia
214
exposure-based exercises
- modify neural pathways in amygdala, insula, cingulate cortex
virtual reality exposure therapy
specific phobia treatments
215
A. Marked fear or anxiety about 1+ social situations where scrutiny by others possible.
B. Fears show anxiety symptoms or being negatively evaluated.
Almost always provoke fear or anxiety.
Avoided or endured with intense fear or anxiety.
Out of proportion to the actual threat.
6+ months
social anxiety disorder (social phobia) criteria
216
- Biological vulnerability
- Biological tendency to social inhibition
- Conditioned panic attack in a social situation
- Experience of a difficult social experience
causes of social anxiety disorder
217
- Cognitive-behavioural group therapy (CBGT)
- Virtual reality therapy
- SSRIs??
treatment of social anxiety disorder
218
*A. 1+ somatic symptoms that are distressing or result in significant disruption of daily life
*B. Excessive thoughts, feelings, and behaviours related to somatic symptoms or health concerns as manifested by at least 1 of:
*1. Disproportionate and persistent thoughts about the seriousness of symptoms.
*2. Persistently high level of anxiety about health or symptoms.
*3. Excessive time and energy devoted to these symptoms or health concerns.
*C. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically 6+ months).
somatic symptom disorder (and other related disorders) criteria
219
- Severe pain exacerbated by psychological factors
- Leads to anxiety and distress
- May not be a clear physical reason for pain
- DSM-5 emphasizes psychological symptoms
somatic symptom disorder clinical description
220
- Formerly known as “hypochondriasis”
- Physical symptoms are absent or mild
- Concern is “idea” of being sick
- Reassurance from physicians is not helpful
illness anxiety disorder
221
A. Preoccupation with having/acquiring serious illness.
B. Somatic symptoms are not present or are mild if present. The preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, easily alarmed about personal health status.
D. Performs excessive health-related behaviours or exhibits maladaptive avoidance.
E. Illness preoccupation present for 6+ months
illness anxiety disorder crteria
222
The following are causes of which two disorders?
- Enhanced perceptual sensitivity to illness cues
- Interpret ambiguous stimuli as threatening
- Genetic causes
- Negative life events
- “Attention seeking” through illness
somatic symptom disorder
illness anxiety disorder
223
- hard to treat
- CBT
- reduce stress
- minimize help-seeking behaviours
- relating to others
treatment of somatic symptom and illness anxiety disorder
224
- Unconscious conflicts expressed through (converted to) physical symptoms
- Way to deal with extreme stress
- “Functional”: Severe physical dysfunction without an organic cause
- Not common
- AKA Functional Neurological Symptom Disorder
conversion disorder
225
A. 1+ symptoms of altered voluntary motor or sensory function.
B. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions.
C. The symptom or deficit is not better explained by another medical or mental disorder.
conversion disorder criteria
226
- Malingering (i.e., faking)
- Factitious disorders
- Factitious disorder imposed on another
Closely related disorders to conversion disorder
227
A. Presence of obsessions, compulsions or both:
Obsessions are defined by (1) and (2):
- 1. Recurrent/persistent thoughts, urges, or images that are intrusive and cause marked anxiety or distress
- 2. Attempts to ignore/suppress/neutralize such thoughts, impulses, or images with some by performing a compulsion
*
Compulsions are defined by (1) and (2):
- 1. Repetitive behaviors or mental acts driven to perform in response to obsession or rigid rules
- 2. Behaviors/mental acts used to prevent/reduce distress, or a dreaded event or situation; however, they either are not realistically connected with what they are designed to neutralize or are clearly excessive.
B. Obsessions or compulsions are time-consuming (e.g., 1+ hours per day) or cause clinically significant distress or impairment
OCD Criteria
228
the vicious cycle of OCD
229
the avoidance peak
230
- Symmetry/exactness/“just right”
- Checking
- Forbidden thoughts or actions (harm, sexual, scrupulosity)
- Cleaning/contamination
- Hoarding
common types of obsessions and compulsions
231
- 1.6%–2.3 %: lifetime prevalence of OCD
- Continuum arrangement
- Male-to-female ratio is 1:1; in childhood, more boys than girls
- Gender minorities 4-6x more likely to be treated for OCD (Pinciotti et al., 2022)
- Onset in early adolescence to mid-20s
- Chronic when develops
OCD
232
- Thoughts regulated by brain circuits
- Early experiences
- “thought-action fusion”
- Thought suppression leads to compulsions
causes of OCD
233
- Exposure and Response Prevention
- SSRIs
- Should not be treated with anxiolytics
treatment of OCD
234
- Preoccupation with some imagined defect in appearance
- “Imagined ugliness”
- Repeated looking in mirrors
- Co-occurs with OCD, maybe on continuum
body dysmorphic disorder
235
A. Preoccupation with 1+ defects or flaws in physical appearance that are not observable or appear slight to others.
B. At some point, the individual performs repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing appearance with others) in response to the appearance concerns.
body dysmorphic disorder criteria
236
- Insufficient information on psychological or biological predisposing factors
- SSRIs
- CBT: Exposure and response prevention
causes and treatments of body dysmorphic disorder
236
- Insufficient information on psychological or biological predisposing factors
- SSRIs
- CBT: Exposure and response prevention
causes and treatments of body dysmorphic disorder
237
- Skin treatments most sought
- Many patients of plastic surgeons return for additional surgery
- 8%–25% who request plastic surgery have BDD
medical "treatments" for body dysmorphic disorder
238
- Appears as a separate disorder in DSM-5
- Hoarding starts early in life; chronic and progressive
- Can be hazardous
- Patients come for treatment after age 50
hoarding disorder
239
CBT treatment
hoarding disorder
240
- Disorder has severe social consequences
- 1%–5% college students: more in females
trichotillomania (hair pulling disorder)
241
- Afflicts 1%–5% of general population
- Scabs, scars, open wounds common
excoriation (skin-picking disorder)
242
Treatment: habit reversal training
for both trichotillomania and excoriation
243
severe anxiety focused on the possibility of having a serious disease, reassurance from physicians does not help
hypochondriasis
244
focuses on avoiding frightening or repulsive intrusive thoughts (obsessions) or neutralizing these thoughts through the use of ritualistic behaviour (compulsions)
OCD
245
a process whereby the rituals are actively prevented and the patient is systematically and gradually exposed to feared thoughts or situations
exposure and ritual prevention (ERP)
246
what is the average age when people come for treatment (after many years of hoarding)?
50
