Exam 2 Material Flashcards
What are stressors?
External demands or events
What is stress?
the byproduct of poor or inadequate coping
What are the 5 stress risk factors?
Genetics
Experience of 1+ crisis
Significant life events
Individual perception of stressor
Individual stress tolerance/threshold
What are the 7 stress protective factors?
Male gender
older age
higher education
economic resources
positive outlook
self-confidence
social support
What are the 6 key factors of stress?
Severity
Chronicity
Timing
Degree of Impact on life
Predictability/level of expectation
Controllability
What are the other factors of stress?
Crises
Life changes
What does the sympathetic-adrenomedullary (SAM) system do?
Fight or Flight
What does the Hypothalamus-pituitary-adrenal (HPA) system do?
Produces cortisol
What are the short-term implications of stress?
compromised immune system
What are the long term implications of stress?
Global immunosuppression
Inflammation –> health problems like cardiovascular disease, diabetes, osteoporosis
Psychiatric problems
What is Adjustment disorder?
Adjustment disorder is STRESS (not trauma) specific
An atypical psychological response to a “common” stressor
What is the time period for Adjustment Disorder
Symptoms emerge within 3 months of the stressor but do not persist for more than and additional 6 months
What is the prevalence of adjustment disorder?
Very common!
May be used more for insurance coding
5-20% in outpatient setting
50% in inpatient setting
What are the comorbidities of adjustment disorder?
medical illness and injury
What is trauma?
A very difficult or unpleasant experience that causes someone to have mental or emotional problems for a long time
NOT something that is common to the human experience
What is Acute Stress disorder?
Acute stress is TRAUMA related
it is a psychological response to a “traumatic” stressor/trauma
What is the timeline for acute stress disorder?
Symptoms must last at least 3 days and up to 1 month after traumatic event
What are the five categories for Acute Stress Disorder symptoms?
Intrusion Symptoms
Negative Mood
Dissociative Symptoms
Avoidance Symptoms
Arousal Symptoms
What is the prevalence of Acute Stress Disorder?
<20% in non-interpersonal trauma (not perpetrator)
20-50% in interpersonal trauma (perpetrator)
What is Post-Traumatic Stress Disorder (PTSD)?
Psychological response to a “traumatic” stressor / trauma
What is the timeline for PTSD?
Symptoms must remain present for 1+ month(s) (no cap for how long these can persist)
What are the four categories for PTSD symptoms?
Intrusion Symptoms (1+)
Avoidance Symptoms (1+)
Negative Alterations in Cognition and Mood (2+)
Arousal and Reactivity Symptoms (2+)
What is the difference between Depersonalization and Derealization?
Depersonalization: persistent/recurrent experiences of feeling detached from body (dream state; self or body isn’t real; time moving slowly)
Derealization: persistent/recurrent experiences that world is unreal, dreamlike, distant or distorted
Why does PTSD develop?
The SAM systems does not turn off following the threat or trauma
Our SAM system is our smoke alarm: it needs to go off when there is smoke, but it starts to go off with non-threatening smoke (birthday candle, steam, toaster)
PTSD is a snowball effect
What is the prevalence of PTSD?
Lifetime prevalence in the US is 6.8%
Highest rates (33-50%) among survivors of military combat and/or captivity, rape, politically or ethnically motivated internment and genocide
What are the comorbidities of PTSD?
80% more likely to have at least one other diagnosis
depression, bipolar, anxiety, or substance abuse disorder
What are the Biological and Sociocultural causal factors of PTSD?
Gender: females have higher cortisol levels
Genetics
Reduced Hippocampus size
Higher risk for PTSD with a membership in a minority group
What are some preventions of PTSD?
Psychological debriefing
Stress Inoculation (talking you through the stress)
What are some treatments for Stress Disorders?
Pharmacotherapy: antidepressants or anti-psychotics
Prolonged Exposure
Cognitive Processing Therapy: thinking about trauma differently
Cognitive-Behavioral Conjoint Therapy: couples-base intervention
How does having a relationship effect those with PTSD?
Having a supportive environment can “buffer” effects of trauma
Disclosure strengthens the relationship and lowers PTSD symptoms
What is fear?
a state of alarm in response to a specific immediate threat
What is anxiety?
a state of alarm in response to a vague sense of danger
What is the difference between fear and anxiety?
Physiological:
fear: increased heart rate, sweating
anxiety: tension, chronic over-arousal
Behavioral:
fear: desire to run or escape
anxiety: general avoidance
What is the prevalence of an Anxiety disorder?
Most common disorder in the US
18% - annual prevalence in adults
29% - lifetime prevalence in adults
What is the comorbidity of an anxiety disorder?
One anxiety disorder only: 19%
Two or more independent anxiety disorders: 26%
Two or more anxiety disorders, one caused by the other: 55%
What is the timeline for Generalized Anxiety Disorder?
Person must experience symptoms for 6 months
What is the prevalence of GAD?
6% lifetime prevalence
3% annual prevalence
What are the Psychodynamic Formulations of GAD?
and what are the 3 types?
Belief from Freud that everyone experiences anxiety and uses defense mechanisms to help control it
1. Realistic: results from actual danger
2. Neurotic: results from fears of expressing conflicting or unconscious impulses
3. Moral: results from conflicts between underlying impulses and the conscience
What are the cognitive Formulations of GAD?
the result of feeling a lack of control
Included: perception of uncontrollability and unpredictability, negative consequences of worry, and cognitive biases
What are the biological formulations of GAD?
Genetics
Neurotransmitters: GABA and serotonin
HPA system: CRH
What are the treatments for GAD?
finding a combination between therapy and medication
Cognitive-Behavioral Therapy: cut out avoidance strategies
Psychopharmacology: Anxiolytic drugs (Benzodiazepines) or Buspirone
Why are benzodiazepines not always the best treatment for GAD?
They provide modest temporary relief, but can cause rebound anxiety, withdrawal, physical dependence, side effects. Their addictive properties are incredible high
What are Phobias?
Strong, persistent, unreasonable fear of a particular object, activity, or situation
Characterized by avoidance
What is Blood-injection-injury phobia?
One of the only phobias that doesn’t activate the SAMs system like the other phobias. It causes a quick spike and then a drop in blood pressure. Often leads to passing out
What is the prevalence of Phobias?
lifetime prevalence: 12%
What is the psychanalytic explanation for phobias?
They are a defense against anxiety stemming from repressed id impulses