Exam 1 (Weeks 1-4) Flashcards
The 4 Ds of Psychopathology
Deviance (from social/cultural norms)
Distress (how distressful)
Dysfunction (disrupting day to day life)
Danger (danger to themselves, and/or others)
What are the advantages/disadvantages of the DSM-5?
Advantages
- data-based (vs expert consensus)
- increased reliability
- common language
- facilitates research & public awareness
- “living document”
Disadvantages
- still problems with reliability
- adverse effects of labeling
- socially constructed diagnoses
- over-pathologizing: hundreds of psychiatric disorders exist so it’s maybe not best to conceptualize that
- Focus on pathology vs. strength
- Pathology resides in inidivduals –> perhaps diagnosing societies/communities instead would be helpful
- assumes disorders to be a discrete entities –> this means we see it as a yes/no decision (do you have it or not), when it’s not always that. Sometimes people meet the criteria for 4/5. Maybe a continuous model would be more helpful
What are the leading models of psychopathology?
biological, socio-cultural, cognitive-behavioral, psychodynamic, humanistic
What is the biological model?
- Highly influential model
- Brain anatomy & the way the structures work → regions of the brain that function differently based on the psychopathological disorder
- Brain chemistry → different neurotransmitters
- Genetics → mental disorders have a genetic component, and run in families and are irrespective of life events
- evolution may be contributing as well, could be a mutation
What are the treatments under the biological model?
Treatments: Medication (like Zoloft), Electroconvulsive therapy, Psychosurgery
Medications include:
- anti anxiety medications to reduce tension and anxiety
- antidepressants improve mood
- mood stabilizers are often antibipolar drugs to steady moods
What is the psychodynamic model?
- Draws upon the work of Sigmund Freud
- The conscious experience, things people can freely talk about, is the tip of the iceberg → have to look into the unconscious and the things that people are not aware of
- Abnormal behavior: internal forces that are in conflict
- Looks at: Id, Ego, and Superego
Id - pleasure principle, unconscious urges and desires; Contains conscious (ideas, thoughts, and feelings of which we are aware) and preconscious (material that can be easily recalled)
Ego - self, reality principle (what are my strengths/weaknesses - how to satisfy the things that are important to me)
Superego - ego ideal, moral guardian - Past experiences with primary caregivers or trauma cause these conflicts between the different areas
- Problems we see in adulthood can be traced back to childhood experiences → correlated or directly related
What are treatments under the psychodynamic model?
- Therapy/Interventions: takes time, and involves particular strategies
- Free association – lay down on the couch, and talk about anything that comes to mind, being as open as possible → this is so the person lowers their defenses and something relevant will be discussed so that the therapist can note and interpret
- Transference - according to psychodynamic theorists
- Interpretation (of resistance and transference)
How the client reacts to the therapist that is similar as to how they would react to the significant other in the past - Uncover past traumas
- Promote emotional insight/catharsis
What is a major critique of the psychodynamic model?
- a lot of this is highly subjective, and difficult to research
- Another critique is the amount of time it can take, so people want to come in and feel like they are doing the work
- Some prevailing theories is that the therapist should act neutrally → but people still react
So this is an outdated notion
What is a major critique of the biological model?
It often oversimplifies complex behaviors, and does not consider the significant influence of environmental and psychological factors
In addition, some drugs can lead to undesirable effects like severe shaking, alarming contractions of the face and body, extreme restlessness, and others can cause serious metabolic and cerebrovascular problems
What is the cognitive-behavioral model?
- From classical conditioning to cognitive ‘distortions’
- Emotions, thoughts, behaviors are all interacting and connecting with each other
- How we are thinking about something impacts how we respond behaviorally
Behavioral influence:
- Classical conditioning: there are certain responses (salivating at the presence of food) that do not need to be learned (they are innate). Enough repetitions of certain experiences, and the other signal can trigger the innate response. - A person’s chemistry can be changed.
Ex: this model was applied to the learning of fear → certain situations trigger flight or fight.
- Objects that are not inherently dangerous can be learned to be feared
Operant conditioning
- (reinforcement/punishment) – when we notice a persistent behavior, there must be something that is reinforcing that behavior, because we avoid things that bring us punishment
- So even troubling symptoms might be maintained because something in the environment that is reinforcing that
- Ex: The withdrawal from depression could be reinforced by caretaking
- Ex: depression comes about because of the lack of reinforcing from the environment
Modeling: we are who we are because of what we have observed from our environment → we look to others in our environment to see how we should behave
- Parents and peers are often some of the most influential models
- Ex: if a person has learned through modeling that withdrawing when sad is what to do, then that gets maintained
Cognitive influences → there is a lot of rich information that people can tell you about
- Assumptions/attitudes
- Cognitive disorders
- Expectancies
What are treatments under the cognitive-behavioral model?
Cognitive behavioral therapy! Includes exposure therapy, cognitive restructuring, facing fears
What is a major critique of the cognitive-behavioral model?
- too overly simplistic and reductionist, focusing too heavily on current thoughts/behaviors as the primary cause of mental health issues
- neglects broader social contexts
- too mechanistic and fails to address the concerns of the ‘whole’ patient
- does not help everyone
- ## doesn’t always address the influence of early-life behaviors
What is the humanistic model?
- Humans have a basic need for unconditional positive regard (UPR)
- When these needs are not met ‘conditions of worth’
- they are driven to self-actualize — that is, to fulfill their potential for goodness and growth; but can only do this if they accept and recognize their weaknesses
What are treatments under the humanistic model?
What is a major critique of the humanistic model?
- concepts are too vague and subjective: makes it difficult to objectively measure and study human behavior as it heavily relies on individual experiences and interpretations fo the world rather than concrete data
- client centered therapy has not fared well in research
What is the socio-cultural model ?
Abnormal behavior is best understood in the light of the broad social forces that influence an individual → social, family, cultural forces
What are the common treatments under the socio-cultural model?
Treatments: family/couples therapy, group therapy, culturally-responsive therapies
What is a major critique of the socio-cultural model?
- can overly emphasize the influence of social context on individual development, neglecting role of individual agency and failing to account for variations in how people within the same culture may interpret and respond to their environment
- cannot be applied to all cultures
What is anxiety?
- A universal emotion → not the same as a disorder
- Emotional response typically understood as a sort of unease or nervousness about something that is possibly about to happen
Trauma vs Anxiety
Trauma is not an emotion, but rather an event → it is distinct from anxiety
Stress vs. Anxiety
Stress is a response to something that is actually happening to you, whereas anxiety is much more about feeling apprehensive about something that could happen
- Anxiety is much more pervasive
What are the physical, cognitive, and behavioral symptoms of anxiety?
Physical:
- Heightened pulse, sweaty palms, heavy breathing, shaking, jolts of adrenaline
Cognitive
- Thoughts are orientated towards threats “What if I get this wrong, what if this happens”
Behavioral
- Fidgeting, avoiding the things that make you anxious, pacing, rapid breathing
What is specific phobia disorder? (Symptoms and Behavioral explanation?)
Symptoms: persistent fear of specific object or situation; interferes with one’s life
Behavioral explanation: condition, modeling
What are some treatments for specific phobia disorder?
Treatment: exposure therapy
- Graduated exposure
- Systematic desensitization
- Flooding
What is social anxiety disorder? (core fears, symptoms, and behaviors?)
Intense fear of social situations
Core fear: rejection, negative evaluation
Behaviors: avoidance, over preparation
Symptoms: blushing, sweating, trembling, rapid heartbeat, dizziness, or nausea
Cognitive Explanation: unrealistic standards; biased views of themselves
- Expect that other people expect them to be perfect
- Thoughts: I am not good enough. People think I’m not good enough.
What are treatments for social anxiety disorder?
Talk therapy
medication
support groups
self-help
Cognitive therapy then: How likely is it that you won’t know what to say?
How likely is it that people will think you don’t know what you’re talking about? Are there any alternatives?
What evidence do you have that others will think you aren’t good enough?
What evidence do you have that others value your work?
Rational response → I usually have something to contribute. Most people understand that I’m just learning the job.
Culturally competent care:
- Recognizes likelihood of negative interactions/discriminations
- Focus on beliefs about self and beliefs/reactions of others
- Focus on sources of support and coping with stressors
What is panic disorders? (core fear, behaviors, symptoms)
- Panic attacks are periodic, and short bouts of intense fear
- There are recurrent attacks and persistent concern about future attacks
- A person approaches the situation that they are fearful of to try to prevent the panic attack, or be prepared in case they have one
These are called safety behaviors - You have to face the situations you have been avoiding, and experience those physical symptoms that you are fearful of
Core fear: physical sensations, “fear of fear”
Behaviors: avoidance, safety behavior
Bio-psycho-social model for Social Anxiety Disorder
Bio: genetic predisposition
Psychological: avoidance limits positive social experiences; beliefs
social/cultural: immigrated to US from Mexico as a child; lives and works primarily in a white community
Agoraphobia (fears, behaviors)
Core fear: public places/places when escape is difficult
Behaviors: avoidance, safety behavior
Generalized Anxiety Disorder (core fear, behaviors, symptoms)
Worries that people with GAD have:
- Own health
- Health of family and friends
- Finances
- Social conditions/world events
- Natural disasters or weather
- work/school
- Unlikely, remote future events
- Little things
Core fear: uncertainty
Behaviors: avoidance, reassurance seeking, planning
Experiences:
- Feel keyed up and unable to relax
- It could go on for days
- Not letting something go
- Terrible sleeping problems → waking up wired in the morning or middle of the life
- Trouble concentrated
- Lightheaded, heart racing or pounding.
- Those symptoms making people with GAD worry more.
- More frequent worry, without precipitants, more pervasive, more intense
- Perceived inability to control
- More often accompanied by physical symptoms – trouble sleeping, muscle tension, fatigue, concentration difficulties
Bio-psycho-social model with Generalized Anxiety Disorder
Bio – genetics; GABA dysfunction; hyperactive fear circuit
Benzodiazepines help regulate GABA, and gives more GABA to the synapse → very fast acting intervention, 10-15 minutes people begin to calm down
Psycho – threatening self-judgements, beliefs about worrying, intolerance of uncertainty
Social/cultural – increased risk among those experiencing trauma/stressful social situations
Panic Attacks
- Violent experience, heart pounds really hard
- False alarm of fight or flight system, strong feeling of impending doom
- There is a dread and anxiety that it’s going to happen again → very debilitating, trying to escape those feelings of panic
What are the most effective treatments for Panic Disorders?
- exposure exercise by experiencing those internal sensations that are akin to anxiety
- May have been avoiding caffeine, exercise, and sexual activity
What are some cultural variations of Panic Disorder to consider?
Ataque de nervios - Latinx and Mediterranean cultures, especially Puerto Rico → Shares some symptoms with Panic Attacks
Taijin Kyofusho syndrome (TKS) – Japan, variant of social anxiety disorder ‘
What is OCD?
- Obsessions: persistent thoughts that are intrusive and/or distressing
- Compulsions: reactions to the thoughts and are repetitive behaviors or mental acts; performed in order to prevent or reduce anxiety
Typical formats:
- Overly concerned with germs, checking stoves/windows, keeping things organized, worried about harming others, seeing certain numbers as omens, religious obsessions, etc
- Many people have intrusive thoughts, but people with OCD perseverate on these thoughts and get into habits/cycles of needing to reduce the doubt, and thus associated distress
- Obsessions → distress → compulsions → relief (and repeats)
Treatments for OCD?
- Prozac can help with OCD
- “Exposures give you chance to test the boundaries”
- Exposures will spike anxiety, but you want to start with exposures that are somewhere in the middle
- You want the client to see that the contamination is not something to fear
- Sometimes you have to go to the home itself, and the office won’t produce the same exposures
- 75% of people with OCD get better with cognitive behavioral therapy
- Strategy: Externalizing OCD
- The client was really getting down on herself – you externalize OCD, so that the client/therapist can align and go against something
- There is a sense of not being able to meet the demands of the environment
Pathways of a Stressor in the Sympathetic Nervous System Pathway
Stressor –> Hypothalamus –> Sympathetic Nervous System –> Various organs (direct activation) –> arousal & fear rejection
Stressor –> Hypothalamus –> Sympathetic Nervous System –> Adrenal medulla (released epinephrine & norepinephrine) –> various organs –> arousal & fear rejection
Pathways of a stressor in the Hypothalamus pituitary-adrenal (HPA) Pathway
Stressor –> Hypothalamus –> Pituitary gland (releases ACTH) –> adrenal cortex (releases corticosteriods) –> various organs –> arousal & fear reaction
What is the distinction between a trauma and a stressor?
Traumas: fearing for their lives, or fearing for the lives of others (it is possible to say that you’ve experienced a trauma if you’ve watched an accident happen)
Community violence
Childhood abuse
Sexual assault
Accidents
Natural disasters, combat, war zones
Simply experiencing a traumatic event does not lead to a disorder, but people can recover and most of the time, without any intervention
Common reactions to trauma
- Feeling hopeless about the future
- Feeling detached
- Having trouble concentrating
- Feeling jumpy and getting startled easily at sudden noise
- Feeling on guard and constantly alert
- Having disturbing dreams and memories or flashbacks
- Having work/school problems
- Trouble sleeping and feeling very tired
- Pounding heart, rapid breathing, feeling edgy
- Sweating
- Severe headache if thinking of the event
- Stomach upset and trouble eating
- Failure to engage in exercise, diet, safe sex, regular health care
- Excess smoking, alcohol, drugs, food
- Having your ongoing medical problems get worse
Acute Stress Disorder
- in the month following a traumatic event, this is an early response
- It is a temporary, extreme response that does not necessarily need more treatment
- Once the one-month passes, it becomes PTSD
- the symptoms are the same, it’s just the time frame that is different
PTSD Symptoms
Re-experiencing the traumatic event
- Nightmares about this event
- There are also conscious flashbacks to what the trauma was like
Avoidance
- People work hard to avoid things associated with the trauma - not going back to a particular location
- Strategizing to avoid talking about it, or thinking about it, avoiding those reminders (things you drank, or smelled)
Negative alterations in mood/cognition
- Most people with PTSD showed depressive symptoms, numbing, lost interest in things
- They notice this and wish they could have the same levels of joy that they used to
- How is the person thinking about themselves and thinking about the world
- They shift their worldview to anticipate danger
- Self-blame is also very common
Increased arousal
- Feeling constantly on edge, irritable with loved ones
- Hypervigilance, on guard for any potential threat
What is therapy like with PTSD
- The place of therapy is remembering, talking about it, and put this memory in its place
- The symptoms pop up because it is like you are walking around with a sensitive wound that is untreated
What are the pre-trauma risk factors for PTSD?
- Biological vulnerability
- Sympathetic nervous system preparing us
- Neurochemical and hormonal throughout the body
- So there are certain individuals that are sensitive to that and that exists before the trauma happens - History or presence of other psychiatric disorder
- Will make it difficult to cope with trauma one it occurs - Previous exposure to trauma
What are the trauma characteristics that influence the risk factor for PTSD?
- Trauma severity – there are types of trauma that are more likely to result in PTSD (combat, sexual assault) and the extent.
- Extent of exposure – Length of exposure, and how long the event lasted
- Dissociation – the person has an outer body experience, and loses the sense of what is happening
- protective/coping strategy in the face of something horrific
- It is a visceral response, not conscious, and innately happens
- If this is part of your experience during the trauma, you are at higher risk for developing PTSD
What are the post-trauma risk factors for PTSD?
- Inflexible coping style – rely heavily on one strategy (avoidance, for example) means they are at higher risk
- Additional loss or intrusive repeated reminders
- Absence of social support
What are the possible psychotherapies for PTSD?
- Prolonged exposure → repeated exposure to the memory, mechanisms: habituation and emotional processing
- Cognitive processing therapy → re-evaluation of cognitive appraisals about self and world, mechanisms, strengthening of new beliefs
- Other considerations: ongoing threats, safety in therapy
How are dissociative disorders characterized?
Characterized by changes in memory, without physical cause
What is dissociative amnesia?
lost track of memory. May not lead to much impairment, unless progressed to dissociative fugue
What is dissociative fugue?
subset of this amnesia, but they have traveled away from their home, no memory of that travel, and they are disconnected from their identity, who they are, relatives, and then go to a new place. This is an experience that lasts for several hours, and then regain themselves
- It is triggered by something in their environment that was very stressful and traumatic
What is dissociative identity disorder - the switching in personalities?
- Some people in the field question the validity of this disorder
- Not a controversy of existence, but rather a controversy of etiology
Post-traumatic model vs. socio-cognitive model
In trauma: the trauma creates a boundary between the person and someone else, they create another individual that the trauma happens
Psychopathology
The scientific study of mental difficulties or disorders, including: their explanations, causes, progression, symptoms, assessment, diagnosis, and treatment
Norms and culture in psychopathology
Norms = a society’s stated and unstated rules
Culture: a people’s common history, values, institutions, habits, skills, technology, and arts
Cultural humility
A process in which clinical scientists or practitioners continuously examine their own beliefs and cultural identities, explore individuals cultures and historical realities that differ from their own, seek to understand the cultural context of each person’s mental health challenges and respond accordingly
Humors
According to the Greeks and Romans, bodily chemicals that influence mental and physical functioning
Moral treatments
a 19th century approach to treating people with mental dysfunction that emphasized moral guidance and humane and respectful treatment - declined by the 1850s
What are the early 20th century perspectives?
Somatogenic Perspective: the view that psychology has physical cases
Psychogenic Perspective: the view that the chief causes of psychopathology are psychological factors
Psychoanalysis
Many forms of psychological functioning — both pathological and nonpathological — are psychogenic. Unconscious psychological forces especially are the root of functioning
Psychotropic medications
Drugs that mainly affect the brain and reduce many symptoms of mental dysfunction
What practice began in the 1960s?
Deinstitutionalization - hundreds of thousands of patients from public mental hospitals were released
Positive Psychology
The study and enhancement of positive feelings, traits and abilities
What is multicultural psychology?
The field that seeks to understand how the varied histories, opportunities, and barriers experienced by people of different races, ethnicities, genders, sexual orientations, disabilities, languages, and other such factors affect behavior, emotion, and thought
Intersectionality
The cumulative experiences and psychological effects that result when multiple factors, such as race, sexual orientation, gender, discrimination, and poverty intersect and interact for a given person
How has technology impacted the field of psychology?
There is telemental health - the use of remote technologies, such as long-distance videoconferencing to deliver mental health services without the therapist being physically present
Internal validity vs. external validity
Internal validity: the accuracy with which a study can pinpoint one factor as the cause of a phenomenon
External validity: the degree to which the results of a study may be generalized beyond that study
Correlation & Correlational Method
Correlation: the degree to which events or characteristics vary along with each other
Correlational method: a research procedure used to determine how much events or characteristics vary with each other
What is single-blind study and placebo therapy?
single-blind study: a feature of an experiment in which participants do not know whether they are in the experimental condition or the control condition
Placebo therapy: a pretend treatment that the participant in an experiment believes to be genuine
What is a qualitative study?
An exploratory research strategy that examines variables in their unfiltered and natural states, often through open-ended questioning, to gather rich descriptive accounts in great depth
What is a matched design?
A research design that matches the experimental participants with control participants who are similar on key characteristics
What is a natural experiment vs analogue experiment?
Natural experiment: an experiment where nature (not the experimenter) manipulates an independent variable
Analogue experiment: a research method in which the experimenter produces psychopathology-like behavior in laboratory participants and then conducts experiments on the participants
What is a single-case experimental design?
A research method in which a single participant is observed and measured both before and after the manipulation of the independent variable
What is an epidemiological study?
A study that measures the incidence and prevalence of a problem, such as a disorder, in a given population
What are ego’s defense mechanism?
this is in the psychodynamic perspective — according to the psychoanalytic theory, strategies developed by the ego to control unacceptable id impulses and to avoid or reduce the anxiety they arouse
What are the developmental stages in psychodynamic theory?
Freud proposed that at each stage of development, from infancy to maturity, new events challenge individuals and require adjustments in their id, ego, and superego. The adjustments, if they are successful, lead to a personal growth. If they are not, the person becomes fixated, or stuck, at an early stage of development. Then all subsequent development suffers, and the individual may well be headed for maladaptation and psychopathology
Parents are often seen as the cause of improper development
Gestalt Theory and Therapy
- a humanistic approach developed in 1950s
- guide clients towards self-recognitions, and self-acceptance but they do this by challenging and even frustrating their clients
- demand that they stay in the here and now during therapy discussions and pushing them to embrace their real emotions
Existential Theories and Therapy
- people are encouraged to accept responsibility for their lives and their difficulties
- try to help clients recognize their freedom so that they may choose a different course and live with greater meaning
- precise techniques vary from clinician to clinician but most emphasize the relationship between therapist and client to create an atmosphere of honesty, hard work, and shared learning & growing
Family systems theory
A theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules
Interpersonal Psychotherapy
A therapy that addresses 4 interpersonal problem areas that may be leading to psychopathology, interpersonal losses, interpersonal role disputes, interpersonal role transitions, and interpersonal deficits
How do multicultural theorists explain psychopathology?
- When multicultural theorists now explore differences between cultural groups, they are careful to not imply that marginalized groups are in between cultural groups, they are careful not to imply that marginalized groups are in some way inferior or less adequate than a country’s dominant population
- Focus as much on differences within cultural groups as on differences between cultural groups
- Consider that an individual is often a member of multiple diverse groups
What are some multicultural treatments?
- Greater sensitivity to cultural issues
- Inclusion of cultural morals and models in treatment
- Develop culturally responsive theories
Developmental psychopathology
A perspective that uses a developmental framework to understand how variables and principles from the various models may collectively account from human functioning
Equifinality
The principle that a number of different developmental routes can lead to the same psychological disorder
Multifinality
The principle that persons with similar developmental histories may nevertheless have different clinical outcomes or react to comparable situations in different ways
Protective factor
A positive developmental variable such as effective parenting that helps to offset the impact of negative variables such as unfavorable genes or a difficult temperament
What is the process of clinical assessment, treatment, and diagnosis BROADLY like?
When faced with new clients, collect idiographic, individual information about them. To overcome problems, clinicians must fully understand the client and the client’s particular difficulties. To gather such individual information, clinicians use the procedures of assessment and diagnosis. Then they are in a position to offer treatment.
Reliability vs validity
Reliability = a measure of the consistency of a test or research results
Validity = a measure of the accuracy of a test’s or study’s results
An assessment tool should not be used unless it has high predictive validity or concurrent validity — what are those?
Predictive validity: tool’s ability to predict future characteristics or behaviors
Concurrent validity: the degree to which the measures gathered from one tool agree with the measures gathered from other assessment techniques
What is a mental status exam?
A set of interview questions and observations designed to reveal the degree and nature of a client’s psychopathology
What is a clinical test and projective test?
Clinical test is a device for gathering information about a few aspects of a person’s psychological functioning from which broader information about the person can be inferred.
What is a projective test: a test consisting of ambiguous material that people interpret or respond to
What are some examples from projective tests?
The Rorschach test (the inkblot test), the TAT test, sentence-completion test, drawings
What are personality inventories and responsive inventories?
Personality inventories: designed to measure broad personality characteristics, consisting of statements about behaviors, beliefs, and feelings that people evaluate as either characteristic or uncharacteristic
Responsive inventories: designed to measure a person’s response in one specific area of functioning, such as affect, social skills, or cognitive processes
What is a psychophysiological test?
A test that measures physical responses (such as heart rate and muscle tension) as possible indicators of psychological conditions
Ex: MRI, CAT, PET
Evidence-based treatment
Therapy that has received clear research support for a particular disorder and has corresponding treatment guidelines
What is the DSM-5 checklist for Generalized Anxiety Disorder?
- 6 months or more: the person experiences disproportionate, uncontrollable, and ongoing anxiety and worry about multiple matters
- the symptoms include at least 3 of the following: edginess, fatigue, poor concentration, irritability, muscle tension, and sleep problems
- significant distress or impairment
What is the rapprochement movement?
A movement to identify a set of common factors, or common strategies, that run through all successful therapies
What is the socio-cultural perspective of generalized anxiety disorder?
- most likely to develop in people who are faced with ongoing societal conditions that are dangerous
- people who are living in poverty
- societal danger and stress can also come from widespread contagious diseases
What is the psychodynamic perspective of GAD?
- early developmental experiences may produce an unusually high level of anxiety in certain children
- a child’s ego defense mechanisms may be too weak to cope with even mild levels of anxiety
- most psychodynamic theorists believe that GAD can be traced back to difficulties in the early relationships between children and their parents
What is the humanistic perspective of GAD?
- propose that GAD arise when people stop looking at themselves honestly and acceptingly and repeatedly deny their true thoughts, feelings, and emotions –> this makes them extremely anxious and unable to fulfill their true potential
- children who fail to recieve unconditional positive regard from others may become overly critical of themselves and develop harsh self-standards (conditions of worth) –> they try to meet these standards by repeatedly distorting and denying their true thoughts and experiences
- controlled studies have failed to offer strong support for this approach
What is the cognitive behavioral perspective of GAD?
- many focus on the cognitive aspect of GAD
- early on: cognitive behavioral theorists believed that people with GAD had basic-irrational assumptions (inaccurate and inappropriate beliefs held by people with various psychological disorders)
- newer explanations: metacognitive theory – people with GAD hold positive and negative beliefs about worrying and the negative beliefs open the door to the disorder. This theory has received a lot of research support
- intolerance of uncertainty theory: some people cannot tolerate the knowledge that negative events MAY occur, even if the possibility of them is super small –> so people with GAD continually worry as they try to find ‘correct’ solutions
- avoidance theory: people with GAD have greater bodily arousal (higher heart rate, perspiration, respiration) than other people and that worrying serves to reduce this arousal, perhaps by distracting people from those physical feelings –> has been supported by research
What is rational-emotive therapy?
A cognitive therapy developed by Albert Ellis that helps clients identify and change the irrational assumptions and thinking that help cause their psychological disorder
What is the biological perspective for GAD?
- anxiety is caused chiefly by biological factors
- was supported for years by family pedigree studies, where researchers determine how many and which relatives of a person with a disorder have the same disorder
- the closer the relative, the greater likelihood that the relative will also have the disorder
What is the biological explanation of GAD?
Benzodiazephine receptors ordinarily recieve GAVA neurotransmitters in the brain. GABA carries inhibitory messages, so that when it is received at the receptor, it causes the neuron to stop firing (and helps anxiety subside). So many researchers believe that GABA activity throughout the brain may be deficient in people with GAD
Studies have also shown the the fear circuit is excessively active in people with GAD, which produces experiences of fear and worry that are excessive in number and duration
What is the DSM-5 checklist for Specific Phobias?
- marked, persistent, and disproportionate fear of a particular object or situation, usually lasting at least 6 months
- exposure to the object produces immediate fear
- avoidance of the feared situation
- significant distress or impairment
What is the cognitive-behavioral perspective for phobias?
- fears can be acquired through classical conditioning or modeling
- some studies have supported this, some have not because several lab studies have failed to condition these fear reactions
- research has not established that disorder is ordinarily acquired in this way
What is the treatment of systematic desensitization?
- an exposure treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations that they dread
What is the treatment of flooding?
- an exposure treatment for phobias in which clients are exposed repeatedly and intensively to a feared object and made to recognize that it is actually harmless
What is the DSM-5 checklist for Social Anxiety Disorder?
- pronounced, disproportionate, and repeated anxiety about social situation(s) in which the individual could be exposed to possible scrutiny by others; typically lasting 6 months or more
- fear of being negatively evaluated by or offensive to others
- exposure to the social situation almost always produces anxiety
- avoidance of feared situations
- significant distress or impairment
Symptoms of a panic attack?
hits at least 4 of the following:
- palpitations of the heart
- tingling in the hands/feet
- shortness of breath
- sweating
- hot/cold flashes
- trembling
- chest pains
- choking sensations
- faintness
- dizziness
- feeling of unreality
What is the DSM-5 checklist for panic disorder?
- unforeseen panic attacks occur repeatedly
- one or more attacks precede either of the following systems:
- at least a month of continual concern about having additional attacks
- at least a month of dysfunctional behavior changes associated with the attacks (for example, avoiding new experiences)
What is the biological explanation for panic disorder?
- the panic circuit in the brain is hyperactive in people with panic disorder
- there is a predisposition to develop such irregularities, and if a genetic factor is at work, close relatives should have higher rates than distant relatives
What is the cognitive behavioral explanation for panic disorder?
- panic-prone people may be very sensitive to certain bodily sensations, when they unexpectedly experience such sensations, they misinterpret them as signs of a medical catastrophe
- EXAMPLE: people with panic disorder hyperventilate in stressful situations, makes them think they are in danger of suffocation, so they panic
- people may be prone to these misinterpretations because they actually experience more frequent, confusing, or intense bodily sensations than other people do OR panic-prone people have had more trauma-filled events over the course of their lives than other people, leading to higher expectations of catastrophe.
What is the DSM-5 definition of obsessive-compulsive disorder?
- when obsessions or compulsions feel excessive or unreasonable, cause great distress, take up much time, and interfere with daily functions
What is the psychodynamic perspective of OCD?
- there is a battle between anxiety-provoking id impulses and anxiety-reducing defense mechanisms that is not buried in the unconscious, but is played out in overt thoughts and actions
- id impulses are obsessions; ego defenses are compulsive actions
- research has not clearly supported this
What is the cognitive-behavioral perspective of OCD?
- people who develop OCD typically blame themselves for such thoughts and expect that somehow terrible things will happen
- to avoid such negative outcomes, they try to neutralize the thoughts by thinking or behaving in ways meant to put matters right or make amends
- eventually the neutralizing act is used so much that it becomes an obsession or compulsions
What is the exposure and response prevention?
- a cognitive-behavioral technique used to treat obsessive-compulsive disorder that exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing compulsive acts
What is the biological perspective for OCD?
- direct evidence that biological factors play a role in OCD
- there are gene anomalies that characterize individuals with this disorder
- also a brain circuit involved with primate impulses is hyperactive in people with OCD
What are the obsessive-compulsive-related disorders?
- hoarding disorder: people feel compelled to save items and become very distressed if other people try to discard them –> results in an accumulation of items
- trichotillomania: hair-pulling disorder, repeatedly pulling out hair from scalp, eyebrows, or eyelashes
- excoriation (skin-picking) disorder: keep picking at their skin –> triggered or accompanied by anxiety or stress
- body dysmorphic disorder: preoccupied with the belief that they have a particular defect or flaw in their physical appearance
