Lecture 15 (Chapter 14) Flashcards
Differences between anxiety and fear
Anxiety: Future oriented, mood state, feeling that one can not predict or control upcoming events
Fear: Present oriented, emotional alarm reaction to present danger, emergency “fight or flight” response
What is a panic attack
Discrete period of intense fear/discomfort in which at least 4 symptoms develop abruptly and reaches a peak within 10 minutes
Symptoms of panic attack
Palpitations, pounding/racing heart
Sweating
Trembling/shaking
Shortness of breath/smothering sensations
Feeling of choking
Chest pain/discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, faint or light headed
Derealization or depersonalization
Fear of losing control or going crazy
Fear of dying
Paresthesias (numbness)
Chills or hot flushes
DSM-V anxiety disorders
Panic disorder with/without agoraphobia
Specific phobia
Social phobia
Generalized Anxiety disorder
What is panic disorder
- recurrent unexpected panic attacks
- One month of concern about additional attacks
- Worry about the implications of the attack or its consequences
- A significant change in behaviour related to the attacks
Agoraphobia
- Anxiety about being in places/situations from which escape might be difficult or embarrassing in the event of a panic attack
- Situations are avoided or endured with marked distress or anxiety about having a panic attack OR require the presence of a companion
Typical agoraphobic situations
- shopping malls
- Crowds
- Elevators
- Restaurants
- Buses
- Theatres
What is specific phobia
- Marked and persistent fear that is excessive or unreasonable, cued by a specific object or situation
- Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response (panic attack)
- Phobic situation/object is avoided or endured with intense anxiety and distress
Specific phobia types
- Animal
- Natural environment (heights)
- Blood injection injury type
- Situational (planes)
- Other (choking, vomiting)
Social phobia
- Marked and persistent fear of social or performance situations
- Situations involve exposure to unfamiliar people or to possible evaluation by others
- Individual fears that he/she may do something humiliating or embarrassing
Obsessive - compulsive and related disorders
OCD - recurrent and persistent obsessions and/or compulsions
- Symptoms cause marked distress
- Time consuming (more than 1 hour/day)
- Interferes significantly with person’s normal routine
Another example is trichotillomanic and body dysmorphic disorder
Obsessions vs compulsions
Obsessions
- persistent and intrusive thoughts, impulses, images
- Inappropriate, caused marked anxiety or distress
- Person usually attempts to ignore or suppress them
… OR neutralize them with some other thought or action
Compulsions
- repetitive behaviours or mental acts
- performed to prevent or reduce anxiety/distress, not to provide pleasure or gratification
Body Dysmorphic Disorder
A. Preoccupation with an imagined defect in appearance, or if a slight physical anomaly is present, the person’s concern is excessive
B. Significant distress or impairment
Stressor Related Disorders
PTSD: develop after an individual experiences or witnesses a traumatic event
Adjustment Disorder: when an individual experiences significant emotional or behavioral symptoms in response to a stressful or significant life event
Reactive Adjustment Disorder: type of adjustment disorder that occurs after an individual reacts emotionally or behaviorally to a significant life change or traumatic event. an emotional reaction to a life event that may not fit into the more severe categories of mental health disorders
Mood Disorders prevalence rates
Lifetime prevalence rates of
depressive disorders:
13% men
25% women
Lifetime prevalence rates of bipolar disorders (not a mood disorder):
less than 1% for men and women
15% complete suicide
Types of Mood Episodes
- Major Depressive Episode
- Manic Episode
- Hypomanic Episode
- Mixed Episode
Major Depressive Episode
- Depressed mood
- Loss of interest (anhedonia)
- Significant weight loss or gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Worthlessness or guilt
- Diminished ability to concentrate, indecisiveness
Manic episode
- Abnormally and persistently elevated, expansive, or
irritable mood - Inflated self-esteem and grandiosity
- Requiring very little sleep
- Talkativeness
- Flight of ideas
- Distractibiltiy
- Psychomotor agitation
- Buying sprees, sexual indiscretions, foolish business
investments
- Hypomanic Episode
Symptoms are milder than a Manic Episode
* Less intense and last at least four days
Mixed episode
Both a Major Depressive Episode and a Manic Episode nearly everyday for at least a one week period
Major Depressive Disorder
- One or more Major Depressive Episodes
- No history of Manic, Hypomanic or Mixed Episodes
Dysthymic Disorder
* Less severe but more chronic than Major Depressive Disorder
* Symptoms are milder but remain unchanged over long periods of time
Bipolar I Disorder
- One or more Manic or Mixed Episodes
- Often individuals have also had one or more Major Depressive Episodes
Bipolar II Disorder
- Presence (or history) of one or more Major Depressive Episodes
- Presence (or history) of at least one Hypomanic Episode
- There has never been a Manic Episode or a Mixed Episode
Cyclothymic Disorder
- Less severe but more chronic than Bipolar Disorder
- Symptoms of hypomania and depression are milder but remain unchanged over long periods of time
DSM-IV specifiers
Specifiers: specifiers help to further refine diagnoses and ensure that treatments are tailored to the individual’s specific needs
1. Chronic
2. Psychotic
3. Melancholic
4. Atypical
5. Catatonic
6. Postpartum Onset
7. Seasonal Pattern
8. Rapid Cycling Pattern
Somatoform Disorders:
– Hypochondriasis
– Somatization Disorder
– Conversion Disorder
– Factitious Disorder
– Body Dysmorphic Disorder
Hypochondriasis
DSM-IV Criteria
A. Preoccupation with the belief that one has
a serious disease
B. The preoccupation persists despite
medical evaluation and reassurance
C. Not delusional
D. Distress or impairment
E. Lasts at least 6 months
Somatization Disorder
A. History of many physical complaints beginning before age 30 that result in treatment being sought or significant impairment
B. Each of the following criteria must have been
met:
1. Four pain symptoms
2. Two gastrointestinal symptoms
3. One sexual or reproductive symptom
4. One neurological symptom
C. Symptoms cannot be fully explained by a known
medical condition
D. The symptoms are not intentionally produced or
feigned
Causes and treatment of somatization disorder
Causes: unclear, anxiety, secondary gain
Treatment: gatekeeper physician, work, treatment
for anxiety and depression
Conversion Disorder
A. One or more symptoms or deficits affecting voluntary motor or sensory function that suggests a neurological or general medical condition
B. Preceded by a conflict or stressor
C. Not intentionally produced
D. Cannot be fully explained
by a medical condition
E. Significant distress or impairment or warrants
medical evaluation
Dissociative Identity Disorder
A. The presence of two or more distinct identities or personality states
B. At least two of these identities recurrently take control of the person’s behaviour
C. Inability to recall important personal information that is too excessive to be explained by forgetfulness
Dissociative identity disorder: Host identity, alternate identities and switch
Host Identity: typically the individual’s original or dominant identity, the one most often in control of the person’s behavior and awareness
Alternate identities: distinct, fully developed personalities or identity states within a person with DID. These identities may have their own unique characteristics, memories, preferences, behaviors, and even physiological responses
Switch: A Switch is the process through which one identity transitions or shifts into another identity, taking control of the individual’s behavior and consciousness.
Causes and treatment of Dissociative identity disorder
Causes: abuse, neglect, iatrogenic, feigned
* Treatment: skillful therapist, build a therapeutic alliance, ground rules, reintegration: process trauma & dissociative
defenses, post integration therapy
Eating Disorders
- Females 10 x more likely to develop an eating disorder
- Around 5% of young women will develop an eating disorder
- Course and outcome of eating disorders is highly variable
- Eating disorders are associated with serious complications, and have the highest mortality rate
Schizophrenia
- Delusions and Irrational thought
- Deterioration of Adaptive Behaviors
- Hallucinations
- Disturbed Emotion
- Paranoid, Catatonic, Disorganized, Undifferentiated
- Positive vs. Negative symptoms
- Chronic, resistant to treatment
Factitious disorder
Mental health condition where a person deliberately produces or exaggerates symptoms of illness to assume the sick role. This can include fabricating symptoms, falsifying medical history, or even self-harm to create symptoms. The motivation isn’t for external rewards, like financial gain; instead, it often stems from a deep need for attention, care, or validation.
