Exam 2 Flashcards
Both ___________ and__________ play a significant role in anxiety disorders.
anxiety, fear
Anxiety often involves __________ arousal, and fear involves ___________ arousal.
moderate, higher
Anxiety is a ________-oriented mood state
future
concern about something negative that could happen at some point in the future, close to a mood (experience that persists)
Fear is a ________-oriented mood state
present
a threat is happening right now, close to an emotion
High Road to Fear
one signal goes to cerebral cortex, slow but accurate
Low Road to Fear
one signal goes to limbic system/amygdala and other related areas, rapid but not always accurate
Anxiety and fear can be…
adaptive (helpful) and maladaptive
In some anxiety disorders, the fear system seems to _________ — a person experiences fear even when no danger is present in the environment
misfire
The balance of _____________ neurons and ______________ neurons in the central nucleus of the amygdala may calibrate fear responses.
oxytocin-sensitive, vasopressin-sensitive
Role of ___________ is stronger for some disorders than others
environment
Neuroticism
personality trait associated with frequent experience of negative affect, tends to worry a lot, experiences negative moods
those high in neuroticism are ______ more likely to develop anxiety disorder
2x
Behavioral inhibition
tendency to become agitated (or overly cautious) in the presence of novelty
infants high in behavioral inhibition are ________ more likely to develop social anxiety disorder as an adolescent
3x
___________ disorders are the most common type of psychological disorder
anxiety
- Excessive uncontrollable apprehension and worry about number of events
- 6 months+
Generalized Anxiety Disorder (GAD)
Only ________% of people with GAD receive treatment
10
Probability Overestimation (common cognitive error in GAD)
overestimates the probability that a negative event is going to happen
CBT treatment for GAD is a ________-term treatment approach
short
CBT has a __________ effect size than medication
larger
A person perceives a garden hose and immediately screams as if it is a real snake. This fear response is primarily due to:
Information relayed quickly via the sensory thalamus (low road)
Heritability studies suggest that the underlying cause of most anxiety disorders is likely due to:
Unique environment
A defining feature of GAD is:
Uncontrollable worry about a lot of different things
Panic attacks reach a peak within _____ minutes and last no more than _____ minutes
10, 30
Report a fear of dying, heart attack, going crazy
panic attack
Persistent anxiety or worry about having another panic attack
panic disorder
Agoraphobia
fear or avoidance of situations/events
symptoms and concern for panic disorder persists for ____ month or more and impacts _____________
1, functioning
__________ is a major source of norepinephrine in the brain
Locus coeruleus
Locus coeruleus fires in response to ________, releases _______________, increased heart rate, sweating
stress, norepinephrine
Locus coeruleus may be more easily activated in people with _____________
panic disorder
When _____________ is part of a treatment package, this creates the largest treatment effect for panic disorder
exposure
An intense and persistent fear of an object or situation that does not pose a real threat
specific phobia
Onset of specific phobia tends to __________ onset of another disorder
precede
Specific phobias treatment requires _________ and __________ exposure to feared stimuli
structured, consistent
Key elements of exposure treatment for specific phobias:
graduated exposure
activate fear and learn not in danger
learn anxiety will peak then subside
generalization and overcoming avoidance
Two of the more common phobias:
claustrophobia and acrophobia
acrophobia
fear of heights
a person with a specific phobia for one type of object or situation is very likely to have a specific phobia for a second object or situation—that is, specific phobias are highly ____________
comorbid
The core feature of _________________ is a persistent, unrealistically intense fear of social situations that might involve being scrutinized by, or even just exposed to, unfamiliar people.
social anxiety disorder
______________ is characterized by recurrent panic attacks that are unrelated to specific situations and by worry about having more panic attacks
Panic disorder
depersonalization
a feeling of being outside one’s body
derealization
a feeling of the world not being real
the criteria for panic disorder specify that panic attacks must be ____________
recurrent
______________ is defined by anxiety about situations from which it would be embarrassing or difficult to escape if anxiety symptoms occurred
Agoraphobia
a state of apprehension often accompanied by mild autonomic arousal
anxiety
thinking about potential problems, often without settling on a solution
worry
In epidemiologic studies that conduct just one interview with people about whether they met diagnostic criteria for an anxiety disorder, the estimated lifetime prevalence of anxiety disorders is:
28%
The key symptom of GAD is: _________
worry
____________ are more vulnerable to anxiety disorders, with several studies documenting a 2 to 1 gender ratio
Women
______________, a disorder that is similar to panic disorder, occurs among the Inuit people of western Greenland; seal hunters who are alone at sea may experience intense fear, disorientation, and concerns about drowning.
Kayak-angst
Countries with high levels of income inequality, such as _________________, have much higher rates of anxiety disorders than do most other regions of the world
the United States and European countries
Mowrer’s two-factor model
Mowrer’s theory of conditioning according to which (1) fear is attached to a neutral stimulus by pairing it with a noxious unconditioned stimulus, and (2) a person learns to avoid the conditioned stimulus and so extinction of the conditioning is prevented.
Neutral predictable unpredictable (NPU) threat task
A laboratory task designed to test sensitivity to unpredictable versus predictable threats. Participants are exposed to threat conditions in which they could receive a shock. In the predictable threat condition, there is a cue warning when the shock will occur. In the unpredictable threat condition, there is no cue warning when the shock will occur.
A set of brain structures is engaged when people feel anxious or fearful. Although some have referred to this set of regions as the ___________, this label has been criticized because these structures are also activated during many different emotion-related experiences.
fear circuit
The _______________ helps to regulate amygdala activity—it is involved in extinguishing fears, in conscious processing of anxiety and fear, and in regulation of emotions
medial prefrontal cortex
The anxiety disorders appear to be related to heightened activity in the ______________ and diminished activity of the _______________ in response to threatening stimuli.
amygdala, medial prefrontal cortex
_____________ allow a person to maintain overly negative cognitions
safety behaviors
tendency of people with social phobia to avoid looking at other people (so as to avoid perceiving negative feedback) is an example of
a safety behavior
tendency of people with panic disorder to avoid exercise (so as to avoid somatic arousal that could trigger a panic attack)
a safety behavior
Cognitive variables found to correlate with anxiety disorders include:
attention to signs of threat, lack of perceived control
A key structure related to anxiety disorders is the:
amygdala
The first step in Mowrer’s two-factor model involves __________________ conditioning, and the second step involves __________________ conditioning.
classical, operant
evolution may have biologically “prepared” us to learn fear of certain stimuli very quickly and automatically; hence, this type of learning is called ______________.
prepared learning
Interoceptive conditioning
Classical conditioning of panic attacks in response to internal bodily sensations of arousal (as opposed to the external situations that trigger anxiety).
The propensity toward catastrophic interpretations can be detected before panic disorder develops, most commonly using the Bodily Concerns subscale of the ____________________, which measures the extent to which people respond fearfully to their bodily sensations
Anxiety Sensitivity Index
The principal cognitive model for the etiology of agoraphobia is the ______________, which suggests that agoraphobia is driven by negative thoughts about the consequences of experiencing anxiety in public.
fear-of-fear hypothesis
Core to this model is the finding that people diagnosed with GAD find it highly aversive to experience rapid shifts in emotions. According to this theory, to ward off sudden shifts in emotion, people with GAD find it preferable to sustain a chronic state of worry and distress.
contrast avoidance model
Drugs that reduce anxiety are referred to as __________
anxiolytics
Two types of medications that are most commonly used for the treatment of anxiety disorders:
benzodiazepines (e.g., Valium and Xanax) and antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs)
List two reasons antidepressant medications are preferred to benzodiazepines for the treatment of most anxiety disorders.
Side effects are more severe with benzodiazepines compared with antidepressant medications; there is a risk of addiction with benzodiazepines
Uncontrollable, reoccurring thoughts that cause anxiety are called:
Obsessions
Preoccupation with imagined defect in appearance is a key feature of:
Body dysmorphic disorder
Which treatment is typically ineffective for body dysmorphic disorder?
Plastic surgery
Most people who experience a trauma will develop PTSD.
False
Person has uncontrollable, reoccurring thoughts and/or behaviors that he or she feels the urge to repeat over and over
Obsessive Compulsive Disorder
Repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought
compulsions
A person with OCD generally can’t control his or her thoughts or behaviors even when they are ____________
excessive
Demanding therapy can be difficult to engage patients in ______________
ERP (Exposure with Response Prevention)
Associated behaviors with Body Dysmorphic Disorder:
compulsive checking (mirror checking, touching)
Significant efforts to hide imagined defect
Avoidance of normal (often social) activities
Not restricted to weight or body fat
The onset for Body Dysmorphic Disorder is usually in _____________
adolescence (teenagers)
psychoeducation, cognitive restructuring, exposure and ritual prevention, strategies to modify self-defeating assumptions about the importance of appearance
CBT for BDD (CBT-BDD)
nondirective therapy emphasizes psychoeducation, therapeutic relationship, and self-esteem
supportive treatment for BDD
For PTSD, symptoms have to last for at least _______ month
1
Acute Stress Disorder is considered ______________ following trauma
3 days to 1 month
________________ to help in aftermath of trauma, focusing on addressing initial needs and concerns by providing support and resources
psychological first aid
______________ is generally not recommended for Acute Stress Disorder and can even lead to worse outcomes than no treatment.
psychological debriefing
Which mood disorder is defined by severe temper outbursts in childhood?
Disruptive mood dysregulation
Which gender has the highest rates of major depressive disorder:
Women
Life stress always precedes onset of MDD.
False
Cognitive-behavioral treatment for depression is much more effective (in the LONG-TERM) than ____________
medication
For someone who has not responded to a variety of previous depression treatments, which treatment is most likely to be successful?
Electroconvulsive therapy (ECT)
Persistent Depressive Disorder (Dysthymia)
sad most of the day, nearly every day + 3 additional symptoms of MDD for at least a 2 year period
anhedonia
lack of interest in things that one used to enjoy
average duration of major depressive disorder
4-9 months
mean age of onset for major depressive disorder is ________
25
Younger age cohorts are more likely to experience ____________ than older age cohorts
MDD
___________ is the tendency to repetitively think about one’s shortcomings or failures
Rumination
Cognitive Behavioral Therapy (CBT) for depression was developed by __________
Aaron Beck
Cognitive Behavioral Therapy (CBT)
Brief, structured, directive, treatment focused on symptoms
Increase behavioral activity to counteract anhedonia, can be stand-alone treatment or combined with cognitive therapy
Behavioral Activation (BA)
____________ are most commonly prescribed for MDD because they are more tolerable and have fewer ____________
selective serotonin reuptake inhibitors (SSRIs), side effects
Increases in ____________ volume with ECT
grey matter
______________ is a region that is implicated in the processing of sadness, helps regulate sleep and appetite, emotion responses, and memory
subgenual cortex
Follow-up studies suggest high rates of relapse for ______________
electroconvulsive therapy (ECT)
suicidal ideation
thoughts of killing oneself
suicide attempt
behavior intended to kill oneself
suicide
death from deliberate self-injury
non-suicidal self-injury (NSSI):
behaviors intended to cause immediate injury to oneself without intent to die
men are more likely to ________ suicide than women
complete
use more lethal methods (guns)
women are more likely to ________ suicide than men
attempt
use less lethal methods (pills)
most gun deaths in the US are due to _________, not __________
suicide, homicide
One of the only interventions to show a reduction in death by suicide in a randomized controlled trial
Caring contact
For depression, thoughts and movements may slow for some (_________________), but others cannot sit still—they pace, fidget, and wring their hands (_________________).
psychomotor retardation, psychomotor agitation
Rather, depressive severity appears to operate as a continuum, with increases in functional impairment and suicidality as the number of ___________ increases.
symptoms
Major depressive disorder (MDD) is an ___________ disorder, because symptoms tend to be present for a period and then clear. Even though episodes tend to dissipate over time, an untreated episode may persist for 6 months or even longer.
episodic
Cases of winter depression, or ________________, are more commonly reported farther from the equator, where winter days are shorter.
seasonal affective disorder
effective treatment for patients with seasonal depression
light therapy
Moirama says that during her episode of major depression, she was unable to get out of bed, and did not eat or shower. Which characteristic of a mental disorder best describes this aspect of Major Depressive Disorder?
disability
The rate at which women experience depression is ________ that of men.
twice
In the United States, what ratio of women will experience depression at some time in their lives?
one out of five
Major depressive disorder is diagnosed based on at least _________ symptoms lasting at least _________ weeks.
five (including mood), two
Approximately _________% of people will experience major depressive disorder during their lifetime.
16.2
Chronicity; MDD is diagnosed on the basis of five symptoms lasting at least 2 weeks; persistent depressive disorder requires only __________ symptoms, but they must be present for 2 years (or 1 year in children and adolescents)
two
The criteria for diagnosis of bipolar I disorder (formerly known as manic-depressive disorder) include at least ______ episode of mania during a person’s life.
one
In fact, even someone who experienced only 1 week of manic symptoms years ago is still diagnosed with bipolar I disorder.
___________ is a state of intense elation or irritability, along with abnormally increased activity and other symptoms shown in the diagnostic criteria.
Mania
During manic episodes, people may be difficult to interrupt and may shift rapidly from topic to topic, reflecting an underlying _____________.
flight of ideas
For a manic episode:
Symptoms last at least 1 week, require hospitalization, or include psychosis
Symptoms cause significant distress or functional impairment
For a hypomanic episode:
Symptoms last at least 4 days
Clear changes in functioning are observable to others, but impairment is not marked
No psychotic symptoms are present
__________________ is defined by at least one hypomanic episode and at least one depressive episode during a person’s life.
Bipolar II disorder
In _______________, the person has frequent but mild symptoms of depression, alternating with mild symptoms of mania.
cyclothymic disorder
Bipolar disorder is much __________ than MDD.
rarer
Bipolar Disorder has also been referred to as ________.
manic depression
Bipolar Disorder must include episodes of ________, but may also include episodes of ________
mania; depression
When Doug mentions going “up and down,” he is referring to the manic and depressive episodes involved in Bipolar Disorder. This recurring change from one episode to another is referred to as ________.
cycling
Doug states, “I can’t do anything when it comes to real life.” Which of the following characteristics of a mental disorder best describes Doug’s statement?
Both disability and distress
What treatment is not commonly used for Bipolar Disorder?
Psychotherapy alone
Dr. Andrew Stoll describes a state in which a person has a deep dark mood, low energy, can’t sleep, and can’t eat. He is referring to what type of episode involved in Bipolar Disorder?
Depressive
Bipolar I disorder is diagnosed on the basis of manic episodes, which are more severe than the ___________ episodes that are the core criterion for bipolar II disorder.
hypomanic
Bipolar disorder is among the most __________ of disorders
heritable
Dopamine plays a major role in the sensitivity of the ______________ in the brain, which is believed to guide pleasure, motivation, and energy in the context of opportunities to obtain rewards
reward system
people with __________ syndrome, which involves overly high levels of cortisol, frequently experience depressive symptoms
Cushing
Cortisol levels increase sharply as people wake and then in the 30–40 minutes after waking, a pattern that is called the ___________________
cortisol awakening response (CAR)
____________________—defined as a family member’s critical or hostile comments toward or emotional overinvolvement with the person with depression.
expressed emotion (EE)
Several longitudinal studies suggest that _______________, a personality trait that involves the tendency to experience frequent and intense negative affect, predicts the onset of depression
neuroticism
Aaron Beck (1967) argued that depression is associated with a _______________: negative views of the self, the world, and the future.
negative triad
Once activated, negative schemas are believed to cause negative _________________, or tendencies to process information in certain negative ways.
information-processing biases
According to _______________, the most important trigger of depression is hopelessness, which is defined by the belief that desirable outcomes will not occur and that there is nothing a person can do to change this. The model places emphasis on two key dimensions of ______________—the explanations a person forms about why a stressor has occurred
hopelessness theory, attributions
Susan Nolen-Hoeksema (1991) suggested that a way of thinking called _______________ may increase the risk of depression. ______________ is defined as a tendency to repetitively dwell on sad experiences and thoughts or to chew on material again and again.
rumination, Rumination
polymorphism of the ________________ that appears to be related to MDD
serotonin transporter gene
Depression is tied to what indicator of HPA activity?
heightened cortisol awakening response
One brain region that appears to be overly active in response to emotion stimuli among people with mood disorders is the:
amygdala
An adaptation of CT called _____________________ focuses on preventing relapse after successful treatment for recurrent episodes of major depression
mindfulness-based cognitive therapy (MBCT)
Because depression is often tied to relationship problems, including marital distress, researchers have studied ________________ as a treatment for depression. In this approach, researchers work with both members of a couple to improve communication and relationship satisfaction.
behavioral couples therapy
___________ is designed to help people learn about the symptoms of the disorder, the expected time course of symptoms, the triggers for symptoms, and treatment strategies.
Psychoeducation
Educating people about their illness is a common component of treating many disorders, including bipolar disorder and schizophrenia.
___________, a naturally occurring chemical element, was the first mood stabilizer identified.
Lithium
Which psychotherapies have obtained support from randomized controlled trials in the treatment of MDD?
interpersonal psychotherapy, behavioral activation therapy, and cognitive therapy
The most efficacious treatment for MDD with psychotic features is:
ECT
Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are more popular than other antidepressants because they:
have fewer side effects
Beyond prevention programs that target high-risk individuals, another approach to suicide prevention is ___________, which involves making highly lethal methods less available
means restriction
Suicide rates increase after media reports of both noncelebrity and celebrity suicides.
False
____________ is defined as apprehension over an anticipated problem
Anxiety
___________ is defined as a reaction to immediate danger.
fear
For people with _________________, the need to acquire is excessive, but the bigger problem is that they abhor parting with their objects, even when others cannot see any potential value in them.
hoarding disorder
Gavin describes how he must scratch both the left side and the right side of his face. Next, since he already scratched the left side first, now he must scratch the right side of his face and then the left side. This is an example of “evenness,” which is a common focus of obsessions and compulsions in OCD. This theme is typically referred to as _____.
symmetry
Gavin states that he often does behaviors in fours, or four times four. It is common for individuals with OCD to focus on certain numbers they believe are “safe.” This type of compulsion is typically referred to as _____.
counting
Brain-imaging studies indicate that three regions of the fronto-striatal circuits are unusually active in people with OCD: the _____________ (an area of the medial prefrontal cortex located just above the eyes), the ______________ (part of the basal ganglia), and the __________________
orbitofrontal cortex, caudate nucleus, anterior cingulate cortex
Several researchers have shown that people with OCD tend to believe that (1) thinking about something is as morally wrong as engaging in the action or (2) thinking about an event can make it more likely to occur. These types of beliefs have been labeled as _______________.
thought–action fusion
To rid themselves of these uncomfortable thoughts, people with OCD are more likely to attempt _________________________
thought suppression
The most widely used psychological treatment for obsessive-compulsive and related disorders is _________________.
exposure and response prevention (ERP)
Ken says left his wife and family because he was dissatisfied and “drawn to something else - there was something else I had to be doing, and staying with the marriage wasn’t it.” Which symptom of PTSD may account for this behavior?
Feeling of detachment or estrangement from others
What treatment is most effective in treating PTSD?
exposure therapy
Jennifer says she avoids situations in films and media that will get her worked up because of their similarity to the traumatic events she experienced. These experiences are grouped into which of the major categories of PTSD symptoms?
Avoidance
Jennifer says she will watch something upsetting and know she is getting worked up, but be unable to calm down. These experiences are grouped into which of the major categories of PTSD symptoms?
Increased arousal
________________________ and ________________________ are FDA-approved for treatment-resistant OCD.
Deep transcranial magnetic stimulation (dTMS), deep brain stimulation (DBS)
___________________ entails an extreme response to a severe stressor.
Posttraumatic stress disorder (PTSD)
______________ is the most common type of trauma preceding PTSD for men.
Military trauma
Like PTSD, ______________________ is considered as a diagnosis when symptoms occur after a trauma. The symptoms are similar to those of PTSD, but the duration is shorter; this diagnosis is applicable only when the symptoms last for 3 days to 1 month.
acute stress disorder (ASD)
The _________ diagnosis can be considered when symptoms have lasted less than 1 month, whereas the _________ diagnosis can be considered when symptoms have lasted at least 1 month
ASD, PTSD
four clusters of symptoms considered in the diagnosis of PTSD:
intrusion symptoms, avoidance symptoms, negative alterations in cognition and mood, and changes in arousal and reactivity
People with PTSD show heightened activation of the ____________ when completing various tasks.
hippocampus
Survivors of natural disasters, such as the Japanese earthquake in 2011, are at risk for PTSD, but their risk may not be as high as that of people who experience…
traumas caused by humans, such as assaults
Much of the work on avoidance coping focuses on symptoms of _____________, such as feeling removed from one’s body or emotions or being unable to remember the event.
dissociation
Psychological treatments are more powerful than medications for the treatment of ____________
PTSD
Often, it may not be feasible or safe to return to the scene of a horrible trauma, and therapists use __________________—that is, the person deliberately remembers the event.
imaginal exposure
Cognitive therapy, when added to exposure for PTSD, is particularly helpful in addressing:
guilt
__________ may be more easily activated in people with panic disorder
Locus coeruleus
