Lecture 21 Flashcards
What is the DSM-V definition of Agoraphobia (Part A)?
a Marked fear or anxiety (2 or more)
- Using Public Transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line
- Being outside of home alone
What is part B of the DSM definition of Agoraphobia?
- Fears or avoids these situations (part A)
- Situations almost always provoke fear and anxiety
- Situations actively avoided
- Fear and anxiety is out of proportion
- Fear and anxiety is persistent
- Causes clinically significant distress
What does “Human emotions were road tested in the stone age” refer to?
A lot of what we fear has evolutionary significance
What is a fear of heights called?
Acorophobia
What is a fear of men called?
Androphobia
What is a fear of snakes called?
Ophidiophobia
What is a fear of making decisions called?
Decidophobia
What is a fear of bad breath called?
Halitophobia
What is a fear of the pope called?
Papaphobia
What is interesting about patients with phobias?
they realize that the fear is excessive and unreasonable
What makes phobias so difficult to treat?
Avoidance learning is negatively reinforced
What is Traumatic Avoidance Learning?
ex: dogs put in compartment A when light turns on a shock happens then they jump to B
can show the dog that there won’t be a shock and they will still jump
how to teach them? tranquilizers + exposure
What is Selective association?
we have an evolutionary sensitivity to be afraid of certain things
ex: monkey sees another monkey afraid of snakes -> becomes afraid of snakes
sees another monkey who has been conditioned to be afraid of flowers -> does not become afraid of flowers
Trait differences: some people more at risk than others
What is the Psychoanalytic Explanation for phobias?
Little Hans: Oedipus stage -> castration anxiety -> projected onto horses
How do you treat phobias?
Exposure:
Systematic desensitization
What is the Hierarchy method of desensitization?
Exposure done in a progressive manner
start with what the person can best tolerate, teach them to tolerate it and move on to more frightening stimuli
_________ & ___________ used to be called Hysteria
Conversion Disorder
Dissociative Disorders
What are Conversion symptoms now seen as?
Somatoform Disorder
What is Conversion Disorder?
looks like a neurological disorder but it’s not. It’s psychological
What is the DSM definition of Conversion Disorder?
- One or more symptoms of altered voluntary motor or sensory function
- Evidence of incompatibility between the symptom and neurological condition
- Not explained by another disorder
- Causes distress/Impairment
What is the big problem with the definition of Conversion Disorder?
you cannot prove something doesn’t exist
What are the sensory symptoms of Conversion Disorder?
- Anesthesia: That does not conform with neurostructure
Conforms to how we think the nervous system operates
ex: glove anesthesia/paralysis - Hyperesthesia (excess sensation)
- Paresthesia (Burning/ticking of skin)
- Visual (blindness, tunnel vision)
- Audition
What are the motor symptoms of Conversion Disorder?
- Paralysis (yet still have reflexes and lack of atrophy)
- Aphonia (inability to speak)
- Dyskinesia (impaired movements)
- Convulsions/Fainting (yet don’t injure themselves when they fall)
What are the 3 Dissociative Disorders?
- Dissociative Amnesia
- Depersonalization Disorder
- Dissociative Identity Disorder
What is Dissociative Amnesia?
- Can’t remember important autobiographical info
- Causes significant distress/impairment
- Not attributable to…
- Not better explained by…
with or without dissociative fugue
What does Fugue mean?
Flight -> end up in a different city don’t know what you’re doing there
What is Depersonalization/Derealization Disorder?
Either or Both (persistent)
- Depersonalization -> experiences of unreality, detachment or being an outside observer with respect of oneself
- Derealization: Experiences of unreality etc with respect to ones surroundings
What is Dissociative Identity Disorder?
- Disruption in identity characterized by 2 or more distinct personality states
- Recurrent gaps in recall of every day events, trauma, personal info
- Causes distress/impairment
- Not part of a cultural/religious practice
- Not attributable to…
Who was the first person to be judged not guilty by reason of insanity? (multiple personality disorder)
Billy Milligan
How did the # of cases of multiple personality disorder evolve
1970: 79 cases of multiple personality disorder published in the world
1985-1995: 40,000