exam 2 Flashcards
is a negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future.
anxiety
immediate alarm reaction to danger
fear
experience the alarm response of fear when there is nothing to be afraid of – kind of like a false alarm
panic
an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and dizziness.
panic attack
you know you have certain fears and the panic attack almost always occurs in these situations
expected (cued) panic attaks
you don’t have a clue when or where the next panic attack will occur.
unexpected (uncued) panic attacks
activated by signals from the brain stem of unexpected events, such as major changes in body functioning that might signal danger
behavioral inhibition system (BIS)
when stimulated in animals, this circuit produces an immediate alarm-and-escape response that looks very much like panic in humans
fight/flight system
A tendency to be tense, uptight, and anxious is inherited.
No single gene seems to cause anxiety or panic.
Come from different groups of genes and chromosomes. Stress, or other factors in the environment can “turn on” these genes.
Anxiety is associated with specific brain circuits and neurotransmitter systems.
biological contribution to anxiety
Stressful life events trigger our biological and psychological vulnerabilities to anxiety
Most are social and interpersonal in nature (death, divorce, work)
Some are physical (injury or illness)
Social stressors can trigger physical reactions (headaches, hypertension)
social contributions to anxiety
Events are not always in our control (childhood)
Parents who interact in a positive, predictable way in responding to children’s needs (attention, food, relief from pain) are important in their child’s psychological development regarding anxiety.
Teach them they have control over the outcome of their environment and that people will respond to them when they share their needs.
Secure home base from which to explore
Determines our vulnerability to anxiety later in life
psych contributions to anxiety
theory that integrates bio, gen psych, specific psych vulnerabilities to describe the dev of anxiety
triple vulnerability theory
anxiety is inherited
generalized bio vulnerability
the world is dangerous and out of control
generalized psych vulnerability
being taught by parents what should be feared
specific psych vulnerability
co-occurrence of two or more disorders in a single individual
comorbidity
anxiety disorder characterized by intense, uncontrollable, unfocused, chronic, and continuous worry that is distressing and unproductive, accompanied by phys symptoms of tenseness, irritability, and restlessness
generalized anxiety disorder
which population of people is GAD most prevalent in? (ie middle aged, children, adolescents, etc)
older adults 45+ years
showing less responsiveness on most phys measures, such as heart rate, blood pressure, skin conductance, and respira
autonomic restrictors
treatment for gad?
drugs- benzos and antidepressants
therapy
experience severe, unexpected panic attacks; think they’re dying or losing control;
panic disorder
fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hospital in the event of a developing panic symptom or other physical symptoms such as loss of bladder control. It’s the lack of control or the unknown occurrence that causes this
agoraphobia
Greek word for fear of the marketplace
agora
avoidance of internal phys sensations
introceptive avoidance
who suffers from agoraphobia the most
women
what age does the onset of panic disorder usually occur
early adulthood
how do most males culturally deal with their panic attacks
by consuming alcohol
fright disorder in Latin America that is characterized by sweating, increased heart rate, and insomnia but not by reports of anxiety or fear, even though a severe fright is the cause
susto
anxiety related, culturally defined syndrome prominent among Hispanic Americans, particularly those from the Caribbean. it is quite similar to those of a panic attack, although such manifestations as shouting uncontrollably or bursting into tears may be associated more often than panic
ataques de nervios
panic disorder among Khmer (Cambodian) and Vietnamese refugees in the US. panic attacks assoc. w orthostatic dizziness and sore neck
kyol goeu
dizziness from standing up too quickly
orthostatic dizziness
what is the concept of kyol goeu or “wind overload”
too much wind or gas in the body, which may cause blood vessels to burst
what times do 60% of people w panic disorder exp nocturnal attacks
1:30 am-3:30 am
when do nocturnal panics occur
delta waves
children wake up screaming and running around (don’t wake up) (no memory of the event)
sleep terrors (related disorder)
occurs in the transitional state between sleep and waking, falling asleep or waking up – but mostly waking up; unable to move, vivid hallucinations, surge of terror
isolated sleep paralysis
cues becoming associated with a number of diff internal and external stimuli through a learning process
learned alarms
treatment for panic disorder and agoraphobis
meds- benzos and SSRIs
therapy
concentrates on exposing patients w panic disorder to the cluster of interoceptive (phys) sensations that remind them of their panic attacks
panic control treatment (PCT)
irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function.
specific phobia
unreasonable fear and avoidance of exposure to blood, injury, or the poss. of an injection. victims exp fainting and a drop in blood pressure
Runs in families more strongly than any phobic disorder we know of
blood-injection-injury phobia
developing fears of situations or events occurring in nature
natural environment phobia
fear of animals and insects
animal phobias
fear of public transportation or enclosed places
situational phobia
how are most phobias formed
acquired by “direct experience” where real danger or pain results in an alarm response (a true alarm)
what are the three other ways to exp a phobia
panic attack
vicarious exp
information transmission
Observing someone else experiencing severe fear
vicarious exp
being told about danger
info transmission
treatment of phobias
structured and consistent exposure-based exercises
unrealistic and persistent worry that something will happen to their parents or other important people in their life or that something will happen to the children themselves that will separate them from their parents (lost, kidnapped, killed or hurt)
separation anxiety disorder
who usually exp separation anxiety the most
young children
treatment for separation anxiety
cbt
ssris
extreme, enduring, irrational fear and avoidance of social or performance situations
social anxiety disorder
what group is more likely to have social anxiety disorder
adolescents
rare childhood disorder characterized by a lack of speech in one more settings in which speaking is socially expected
selective mutism
Exposure to a traumatic event during which an individual experiences or witnesses death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation. Learning that the traumatic event occurred to a close family member or friend, or enduring repeated exposure to details of a traumatic event
ptsd
similar to PTSD, occurred within the first month after the trauma, but the diff name emphasizes the severe reaction that some people have immediately
acute stress disorder
criterion a for ptsd
stressor
criterion b for ptsd
intrusion symptoms
criterion c for ptsd
avoidance
criterion d for ptsd
negatived alterations in cog and mood
criterion e for ptsd
alterations in arousal and reactivity
criterion f for ptsd
duration
criterion g for ptsd
functional sig
criterion h for ptsd
exclusion
experience of being an outside observer of or detached from oneself (e.g., feeling as if “this is not happening to me” or one were in a dream).
depersonalization
experience of unreality, distance, or distortion (e.g., “things are not real”).
derealization
reliving emotional trauma to relieve emotional suffering
catharsis
the content of trauma and the emotions associated with it are worked through systematically, has been used for decades
imaginal exposure
psychological technique used to help survivors of trauma make sense of their experiences, while also acting as a form of exposure to painful memories. the story of a traumatic experience will be told repeatedly through verbal, written, or artistic means.
trauma narrative
stands for Behavior, Affect, Sensation, and Knowledge. So, memories can be dissociated into those categories
BASK model
techniques to bring you back to right now and safety when reliving trauma
grounding techniques
anxious or depressive reactions to life stress that are gen milder than one would see in acute disorder or PTSD but are nevertheless impairing in terms of interfering with work or school performance, interpersonal relationships, or other areas of living
adjustment disorders
refers to disturbed and dev inappropriate behaviors in children , emerging before five years of age in which the child is unable or unwilling to form normal attachment relationships with caregiving adults
attachment disorders
attachment disorder where the child will very seldom seek out a caregiver for protection, support, and nurturance and will seldom respond to offers from caregivers to provide this kind of care
reactive attachment disorder
a similar set of child rearing circumstances–perhaps including early persistent harsh punishment–would result in a pattern of behavior in which the child shows no inhibitions whatsoever to approaching adults
disinhibited social engagement disorder
The devastating culmination of anxiety disorders; exp severe gad, recurrent panic attacks, debilitating avoidance, and major depression
obsessive-compulsive disorder
intrusive and mostly nonsensical thoughts, images, or urges that the individual tries to resist or eliminate
obsessions
- repetitive behaviors (handwashing, ordering, checking) or mental acts (praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
- The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
compulsions
obsession of needing things to be symmetrical/aligned just to do so. urges to do things over and over until they feel “just right”
symmetry/exactedness/”just right”
obsession of fears, urges to harm self or others
fears of offending god
forbidden thoughts or actions
obsession of germs
fears of germs of contaminants
cleaning/contamination
fears of throwing anything away
hoarding
what group(s) is most affected by OCD
women and men are equally affected
children presenting with OCD and tics suggest that these problems have occurred bc of strep throat
PANDAS
treatment for OCD
the reuptake of serotonin, drugs like clomipramine or SSRIs
some relatively normal-looking people think they are so ugly they refuse to interact w others or otherwise function normally for fear that people will laugh at their ugliness
body dysmorphic disorder
fear of ugliness
dysmorphobia
prevalence of body dysmorphic disorder?
hard to figure out bc it is secretive
compulsively hoard things, fearing that if they throw something away then they might urgently need it
hoarding disorder
urge to pull out one’s own hair from anywhere on the body, including the scalp, eyebrows, and arms
trichotilomania
(skin picking disorder) repetitive and compulsive picking of the skin leading to tissue damage
excoriation
specifier that the individual recognizes that ocd beliefs are definitely or probably not true or that they may or may not be true
with good or fair insight
specifier that the individual thinks that the ocd beliefs are probably true
with poor insight
specifier that the person in completely convinced that ocd beliefs are true
with absent insight/delusional
specifier that the individual has a current or past history of a tic disorder
tic related
involuntary movement
tic disorder
medically unexplained physical symptoms
somatic symptoms disorders
body
soma
disorder in which individuals feel detached from themselves or their surroundings and reality, exp, and identity may disintegrate
dissociative disorder
Feeling “detached” from yourself or surroundings
dissociation
unexplained phys symptoms indicated by the conversion of unconscious emotional conflicts into a more acceptable form
conversion hysteria
suggested a specific cause for certain disorders. eliminated from the diagnosis in 1980 bc of how vaague it was
neurosis
prev known as somatoform disorders. disorder involving extreme and long-lasting focus on mult. phys symptoms for which no med cause is evident
somatic symptom disorder
phys symptoms are either not exp at present time or are very mild, but severe anxiety is focused on the poss. of having or dev. a serious disease
idea of being sick instead of the physical symptom itself
illness anxiety disorder
is somatic symptom disorder chronic?
ya
presence of a diagnosed medical condition clearly caused by that medical condition that is adversely affected by one or more psych or behavioral factors
psych factors affecting medical condition
generally have to do with phys malfunctioning, such as paralysis, blindness, or difficulty speaking, without any phys or organic pathology to account for the malfunction
conversion disorders
sensation of a lump in the throat that makes it difficult to swallow, eat or sometimes talk
globus hystericus
deliberate faking of a phys or psych disorder motivated by gain
malingering
patients with conversion reactions had the same quality of indifference to the symptoms thought to be present in some people with severe somatic symptoms disorder
la belle indifference
the symptoms are under voluntary control, as with malingering, but there is no obvious reason for voluntarily producing symptoms except to assume the sick role and to other members of the family
factitious disorder
when an individual deliberately makes someone else sick
factitious disorder imposed on another (munchausen syndrome by proxy)
what group of people are somatic symptom disorders and conversion disorders found in
women
4 basic processes in dev of conversion disorder
#1 individual experiences a traumatic event #2 person represses the conflict #3 person “converts” it into physical symptoms to reduce anxiety #4 greatly increased attention and sympathy
when feelings of unreality are so severe and frightening that they dominate an individual’s life and prevent normal functioning
depersonalization-derealization disorder
dissociative disorder ft the inability to recall personal info, usually of a stressful or traumatic nature
dissociative amnesia
people who are unable to remember anything, including who they are
gen amnesia
failure to recall specific events, usually traumatic, that occur during a specific period
localized or selective amnesia
type of dissociative amnesia ft sudden, unexpected travel away from home, along with an inability to recall the past, sometimes w assumption of a new identity
dissociative fugue
meaning “flight”
fugue
individuals in this trancelike state often brutally assault and sometimes kill people or animals and not remember
amok
altered state of consviousness in which people firmly believe they are possessed by spirits; considered a disorder only when there is distress and dysfunction
dissociative trance
a disorder in which as many as 100 personalities or fragments of personalities coexist within one body and mind
dissociative identity disorder
transition from one personality to another
instantaneous
switch
people who are suggestible may be able to use dissociation as a defense against extreme trauma
autohypnotic model
gross deviations in mood
mood disorders
- absence of manic or hypomanic episodes
- if two or more major depressive episodes occurred and were separated by at least 2 months during which the individual was not depressed, it is noted as being recurrent.
- unipolar depression is often a chronic condition that waxes or wanes over time but seldom disappears.
major depressive disorder
most common and severe exp of depression, include feelings of worthlessness, disturbances in bodily activities and inability to exp pleasure persisting at least 2 weeks
not chronic
major depressive episode
loss of energy and inability to engage in pleasurable activities or have any “fun”
anhedonia
individuals find extreme pleasure in every activity
mania
express so many ideas at once
flight of ideas
a less severe version of a manic episode that does not case marked impairment in social or occupational functioning and need last only 4 days rather than a full week
hypomanic episode
individuals who exp either depression or mania bc their mood remains at one “pole” of the usual depression-mania
unipolar mood disorder
condition in which the individual exp both elation and depression or anxiety at the same time
mixed features
occurring often or repeatedly
recurrent
- fewer symptoms than major depressive disorder
- depression remain relatively unchanged for long periods of time
- lasts at least two years
persistent depressive disorder
both major depressive episodes and persistent depression with fewer symptoms
double depression
specifier to describe depression; hallucinations or delusions
psychotic feature
seeing or hearing things that are not there
hallucinations
strongly held but inaccurate beliefs
delusions
inaccurate belief about the person’s physical body injured/sick
somatic (physical) delusions
hearing voices that aren’t there
auditory hallucinations
a person tends to remember information that is consistent with their particular mood.
mood congruent
the fixed, false belief that one possesses superior qualities such as genius, fame, omnipotence, or wealth.
delusions of grandeur
- presence and severity of accompanying anxiety
- might be a comorbid anxiety disorder or anxiety symptoms
- the presence of anxiety indicates a more severe condition, makes suicidal thoughts and completed suicide more likely, and predicts poorer outcome from treatment
anxious distress specifier
- depressive episodes that have at least three symptoms of mania either in a major depressive disorder or in a persistent depressive disorder
mixed features specifier
- only with diagnosis of major depressive episode;
- somatic symptoms – early-morning awakenings, weight loss, loss of libido, excessive or inappropriate guilt, and anhedonia
- signfies a severe type of depressive episode
melancholic specifier
- can occure in manic episode, but rare
- an absense of movement in which muscles are waxy and semirigid
- or excessive but random or purposeless movement
catatonic features specifier
muscles are waxy and semirigid so the parent’s arms or legs remain in any position in which they are placed
catalepsy
- applies to both depressive disorders
- consistently oversleep and overeat during their depression and therefore gain weight leading to a higher incidence of diabetes;
- considerable anxiety – can react with interest or pleasure
- greater percentage of women and an earlier age of onset
- more symptoms, more severe symptoms, more suicide attempts, higher rate of comorbid disorders including alcohol abuse
atypical features specifier
- ”Peri” means “surrounding” – in this case just before and after birth
- applies to both major depressive and manic episodes
- peripartum period is pregnancy and the 6 month period immediately following birth
- can be psychotic depressive or manic episodes
- could be associated with rapid decline in reproductive hormones
- all women experience very substantial shifts in hormone levels after delivery – only a few develop a depressive disorder
preipartum onset specifier
women who just gave birth and was diagnosed w depression
peripartum depression
- occurs during certain seasons
- depression often occurs late fall until early spring
- bipolar – depressed in winter, manic in summer
- occurs for at least two years with no evidence of non-seasonal episodes (seasonal affective disorder)
- related to daily and seasonal changes in the production of melatonin
seasonal pattern specifier
depressive disorder that begins in late fall and ends w beginning of spring with no nonseasonal major depressive eps
seasonal affective disorder (SAD)
irritability, listlessness, and similar symptoms resulting from long confinement or isolation indoors during the winter.
cabin fever
acute grief – finality of death and its consequences are acknowledged and the individual adjusts to the loss; often recurs at significant anniversaries, birthdays, holidays, meaningful occasions;
integrated grief
sometimes occurs after major depressive disorder has been diagnosed, sometimes not; the strong yearning is associated with the activation of the dopamine neurotransmitter system; different than with major depressive disorder; interventions don’t work; treat it more like PTSD;
complicated grief
2% to 5% of women suffer from severe and sometimes incapactitating emotional reactions during the premenstrual period; extreme symptoms;
a comb of phys symptoms, severe mood swings and anxiety are assoc. w incapacitation during this period of time
premenstrual dysphoric disorder
- instead of bipolar disorder NOS; children with chronic irritability, anger, aggression, hyperarousal, and frequent temper tantrums, but don’t cycle like manic episodes; show no mania; increased risk for additional depressive and anxiety disorders rather than manic episodes; often misdiagnosed as ADHD or conduct disorder;
disruptive mood dysregulation disorder
tendency of manic eps to alternate w major depressive eps
bipolar disorder
chronic alternation of mood elevation and depression that does not reach the severity of manic or major depressive episodes; tend to be one mood state or another for years with relatively few periods of neutral mood. Pattern must last for two years; a lot of times they’re considered “moody”; increased risk to develop the more severe bipolar I or bipolar II
cyclothymic disorder
major depressive eps alternate w hypomanic eps rather than full manic eps
bipolar 2 disorder
major depressive episodes alternate w full manic eps
bipolar 1 disorder
period of abnormally elevated or irritable mood that may include inflated self-esteem, decreased need for sleep, pressured speech, flight of ideas, agitation, or self-destructive behavior, and excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
manic ep
*unique to bipolar I and II; at least four manic or depressive episodes within a year is considered to have a rapid-cycling pattern; severe variety of bipolar that does not respond well to treatment;
*higher probability of suicide attempts
does not seem to be permanent
rapid-cycling specifier
prevalence of a given disorder in the first-degree relatives of the individual known to have the disorder
proband
examining the frequency with which identical twins have the disorder, compared with fraternal twins
twin studies
hormones that affect the brain and are increasingly the focus of study in psychopathology
neurohormones
responsible for keeping stress hormones in check and serves important functions in facilitating cog processes such as STM
hippocampus
our eyes move back and forth and we dream
REM
- not so much the situation, but how it affects the individual;
- predisposed to mood disorder
stress
- anxious and depressed when there is no control over stress
- anxiety it the first response to a stressful situation
- depression follows when hopeless about coping with the stress
learned helplessness
3 attributional styles for depression
internal
stable
global
attributes negative events to personal failings (all my fault)
internal
after a negative event passes, additional bad things will be my fault
stable
extend across a variety of issues
global
when a depressed individual emphasizes the neg rather than the pos aspects of the situation
arbitrary inference
draw a conclusion or make a statement about (something) that is more general than is justified by the available evidence.
overgeneralization
thinking negatively about the immediate world, future. and themselves together
depressive cog triad
a medication used in the treatment of disorders that is effective in preenting and treating pathological shifts in mood
mood stabilizing drug
bio treatment for severe, chronic depression involving the application of electrical impulses thru the brain to produce seizures
electroconvulsive therapy
theory that the role of deep-seated neg thinking in gen depression
cog therapy
focuses on resolving probs in existing relationships and learning to form impt new interpersonal relationships
interpersonal psychotherapy
study risk factors of suicide by studying conditions and events that make person vulnerable
psychological autopsy
