Exam 3 Flashcards
1
Q
OCD Gender and Course
A
- more female (55-60%)
- chronic; waxes and wanes
2
Q
Biological Theories of OCD
A
- Injury or illness: only anxiety disorder that has a link to injury or illness (can develop as a response to these) i.e. PANDAS-strep throat activates OCD in some children; brain tumors; pospartum women
- frontal lobes increased activity (obsesions): over concern with own thoughts and can’t filter out irrelevant stimuli
- basal ganglia increased activity: motor behavior, compulsions i.e. tourettes
- decreased levels of serotonin
3
Q
Cognitive Theories of OCD
A
- belief that things are not complete-brain never tells them they’re done now and to move on
- belief that thinking about something will cause it to occur
- try thought suppression: makes it worse
4
Q
Treatment for OCD
A
- exposure to obsessions and response prevention for compulsions (very behavioral; not allowed to make ritualistic behavior she normally would (i.e. morgan-shows her her mom won’t die if she doesn’t do them)
- people don’t want to do these things because they’re painful but they really do work
- all about empirically supported treatment: scientifically evaluate if treatments are working/successful
5
Q
Treatment of Phobia: Behavioral (Learning)
A
- desensitization and exposure
- systematic desensitization
- substitute response incompatible with anxiety=progressive relaxation (cannot be relaxed and anxious at the same time) ex: can’t eat and digest and be anxious so some people eat during anxious times
- application of systematic desensitization –> introduce tension into muscles then slowly release it
- application 2 make hierarchy of anxiety producing situations (kathy fears birds) then relax while imagining the situations and work through the hierarchy moving up when you can imagine one without anxiety
- in vivo exposure: like systematic desensitization but can actually experience the anxiety provoking stimulus in real life (not always possible)
- flooding=exposure to most feared object/situation for extended period and not allowed to escape (most effective but people hardly agree to it)
6
Q
Treatment of Panic Disorder: Behavioral (Learning)
A
-panic control treatment=exposure to own physical symptoms to learn they won’t kill you
7
Q
Treatment for Anxiety Disorders: Cognitive
A
- identify automatic negative thoughts
- catastrophizing: going to worst case scenario and exaggerating importance of things (ex: exams I’m going to fail which means I’ll have no success in life; GAD worries about same things as everyone else but thinks the worst possible thing happened)
- retrain thinking: identify thought and challenge it; create more adaptive
8
Q
CBT
A
- cognitive behavioral therapy
- very effective
- challenges negative patterns of thoughts about the self and world to alter unwanted behavior patterns or treat mood or anxiety disorders
9
Q
Treatment for Anxiety Disorders: Biological
A
- antidepressants: SSRI (prozac, paxil, lexapro, zoloft) serotonin reuptake inhibitors so serotonin stays in synapse space longer (can be anti-depressive and anti-anxiety)
- SNRIs (Effexor, celexa) norepinephrine reuptake inhibitors (only anti-anxiety)
- anxiolytics: Buspirone (Buspar) serotonin-GAD; not sedating; not addictive (takes several weeks to begin to work and need to take it daily)
- Benzodiazepines: (Xanax, Valium) severe anxiety, panic; act quickly (30 min-1hr); addictive, build up tolerance, go through withdrawals
- surgery: severe OCD cingulotomy
10
Q
Morgan
A
- compulsions: ordering, touches everything to left
- obsession: that her mother is going to die
- compulsions don’t have to be logically connected to obsessions
- good exampel of diathesis stress model: not enough to have stressor, have to have genetic predisposition (diathesis); her friends don’t develop the disorder but when their parents died she did
- believes she’s pleasing god by doing rituals and that he will keep her mom alive
- experiencing distress and it interferes with her functioning: sometimes can’t get out of bed because she doesn’t wan to start ritualizing
- if her mother passed away she would feel responsible and her obsession would probably pass onto another object and she would try even harder to please god
- treatment: exposure to idea that something bad could happen to her mother and she’ll want to do her compulsions but they won’t let her
11
Q
Mood Disorders 2 Distinctions
A
- Depression: major depressive disorder (like flu; intense symptoms, lasts short time) or dysthymic disorder (like cold; less severe, but lasts longer
- Mania and Depression (bipolar): bipolar disorder (flu) or cyclothymic disorder (cold)
12
Q
Depression Major Depressive Episode Criteria (ESSAY)
A
- symptoms must be present during the same 2 week period and represent a change from previous functioning
- at least one of the symptoms is depressed mood or loss of interest or pleasure in things you would normally enjoy (anhedonia)
- other symptoms
- depressed mood most of the day, nearly every day
- markedly diminished interest or pleasure in all activities most of the day, nearly every day
- significant weight loss when not dieting or weight gain (5% of body weight in month) or decrease or increase in appetite every day
- insomnia or hypersomnia nearly every day
- psychomotor agitation or retardation nearly every day observable to others (change)
- fatigue or loss of energy nearly every day
- feelings of worthlessness or excessive or inappropriate guilt nearly every day
- diminished ability to think or concentrate, or indecisiveness nearly every day
- recurrent thoughts of death, recurrent suicidal ideation or suicide attempt or specific plan (fear that if you ask your friend if they feel this way it will put the thought in their head-not really the case, it may actually help them address it and feel like they can talk to you about it)
- symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning
- symptoms not due to direct effects of substance use or general medical condition
- symptoms not better accounted for by bereavement (death of someone important to person) after loss (no longer put a classification on how long bereavement can last, because it often takes a whole year have to experience every yearly milestone without the person)
13
Q
Bipolar Disorder Manic Episode Criteria
A
- only need to have one to be considered bipolar
- considered adult disorder
- distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week (or any duration if hospitalization is needed)
- each symptom has to be noticable change from normal behavior
- inflated self-esteem or grandiosity (Mary=spy for Jesus)
- decreased need for sleep (so much energy even though she didn’t sleep the night before-can go days without)
- more talkative than usual or pressure to keep talking (mary asks if she can keep talking–> about outdoors and living under bridge)
- flight of ideas or racing thoughts (leads to pressure of speech)
- distractibility (attend to unimportant/irrelevant stimuli)-mary asking if she’s in focus while in the middle of another thought
- increase in goal-directed activity (social, work, sex) or psychomotor agitation (feels like she could get everything done that she needed to-cheats on husband)
- excessive involvement in pleasurable activities that have high potential for painful consequences (buying sprees, sexual indiscretions, business investments) Mary cheats on husband
- mood disturbance severe enough to cause marked impairment (NOT DISTRESS) in occupational functioning or in usual social activities or relationships with others or to necessitate hospitalization to prevent harm to self or others or there are psychotic features
- not due to substance or medical condition
14
Q
Hypomanic Episode
A
- same as Manic Episode but not as intense and differs in 2 ways
- elevated, expansive, irritable mood lasts at least 4 days
- episode not severe enough to cause marked impairment in functioning, or to necessitate hospitalization; no psychotic features
15
Q
Mary Bipolar Depressive Episode
A
- also having psychotic symptoms that aren’t associated with depression
- affect: no eye contact, dark clothes, difficulty concentrating
- psychomotor retardation
- hearing voices may happen in manic episodes but rarely seen in depressive
- got in a fight with a lady
- expresses feelings of worthlessness (feels fat and ugly)
- self medicating (smokes pot)
- burns herself with cigarettes because she thinks her husband is cheating on her
16
Q
Mary Bipolar Manic Episode
A
- acts over the top
- feels on top of the world but can also feel irritable as she does toward her husband and she beats him up because he made her mad
- spy for Jesus
- says she can control the weather
- religiosity: so it makes sense her symptoms relate back to her religion
- asked if she would take out her gum-refused and said she had strong teeth, offered to therapist, then laughed uncontrollably
- asked what makes her cry, talked about her mom’s death, asked if she was in focus and started laughing
- can hear pressure of speech when she talks about her mom
- says she can get drunk off water, coffee, kool aid when in a manic episode
- says manic episode only feels unpleasant when she can’t sleep but she still feels fully rested
- cheats on husband-gets her in trouble
- experiences psychotic symptoms as well though they’re not in mania criteria but hey can happen
- says she’s a “morphodite” (hermaphrodite) with both organs and that she thinks this is how god is in heaven
17
Q
Major Depressive Disorder
A
- episodic: symptoms are present for a period of time, then clear
- episodes tend to recur
- untreated episode: may last 5 months or longer
- never had manic or hypomanic episode (the minute you do it’s becomes bipolar diagnosis)
- clinical vs. subclinical depression: number of symptoms (less than 5) and length of episode (less than 2 weeks)
18
Q
Disruptive Mood Dysregulation Disorder
A
- for children because they cannot be included in bipolar disorder-start to include children, you’ll pick up a lot more cases because kids are typically irritable
- issue: stigma and medication (very strong for bipolar disorder and could majorly affect developing brain)
- in DSM-V new diagnosis to try to get to the kids who are abnormally irritable (gets to point where it interferes with functioning)
- severe and recurrent temper outbursts that are way out of proportion
