midterm 1 study Flashcards
stress vs anxiety
Stress is a response to a threat in a situation
Stress comes from the pressures we feel in life
Anxiety is a reaction to stress
Anxiety may continue after that stressor is gone
Anxiety is a feeling of apprehension or fear
what is anxiety
an emotion without a specific object, subjectively experienced by the individual
A diffuse apprehension,
vague
uncertainty and helplessness
uneasiness and discomfort
A feeling of terror or dread
Occurs as a result of a threat to a person’s being, self-esteem or identity
normal anxiety responses
Normal response to anxiety consists of three parts:
- Physiologic arousal (fight or flight response – signal of a threat/stressor)
- Cognitive processes (identification of a threat and whether it should be approached or avoided)
- Coping strategies (strategies employed to resolve the threat)
Normal anxiety may be experienced in anticipation to a stressful event or as resulting from this event (mild anxiety)
abnormal anxiety levels
Mild Anxiety
- Associated with tensions of daily living
Moderate Anxiety
- Person focuses on immediate concerns, narrowing of perceptual field
- Person hears, sees, grasps less
Severe Anxiety
- Significant reduction in perceptual field (person focuses on specific detail and not anything else)
- All activity directed to relieving anxiety
- Focused on self, environment blocked out, sense of pending doom
panic
what happens
Associated with awe, dread, terror
- Person unable to do things even with direction
- loss of rational thought
- Distorted perception, emotionally paralyzed
- Unable to communicate and function
Anger vs rage
Anger: normal emotional response that can be released appropriately or inappropriately, suppressed over periods of time (bullying, cyberbullying, oppression), or controlled in its release.
Rage: Uncontrollable state of anger. Thinking is illogical and unclear. Behavioural interventions are useless.
Etiology – Expression of Anger
Biological
Brain tumors, dementia, severe behavioural disorders,
Neurotransmitters/hormones: Low serotonin, high level of dopamine, combination of high testosterone and low cortisol, etc.
Psychological
Reaction to a perceived threat to the self or environment
Locus of control (internal or external)
Cognition (how we view ourselves in relation to others)
Social
Anger = social learning (parents, video games, social media, etc.)
**Be careful with cultural differences in the way anger is expressed
Es of trauma
Event
Experience
Effect
ACE study findings
ACE Scores (0-10)
Score of 4 or more:
2x as likely to smoke
7 x as likely to have struggles with alcohol
10 x as likely to have injected illicit street drugs
12 x as likely to have attempted suicide
Found that for each additional adverse experience reported, the damage in later life increases
important concepts
ethnocentrism, acculturation, assimilation
Ethnocentrism:
Perception that our values and behaviours are superior to others
Acculturation:
Learning and adopting beliefs, values and practices of a cultural setting different from ours.
Assimilation:
Adoption of beliefs, values and practices of a new culture to the point where they become more natural than the ones from their culture of origin
agression and violence
Aggression: Emotion that results in a verbal or physical attack.
Violence: Aggression with the intent to harm. It includes psychological, emotional, damage to property, suicide and self-harm.
sexual assault (rape trauma syndrome) acute phase
Acute phase: immediately after rape and lasts 2-3 weeks
Disorganisation in the person’s life
Somatic symptoms are common
Shock, numbness & disbelief – dissociation
Impaired cognitive functions (memory, attention, decision making, etc.)
Possible hysteria,
sexual assault (rape trauma syndrome) long term phase
Long-term phase: 2 or more weeks after the rape
Intrusive thoughts of the sexual assault (visions, flashbacks, etc.)
Increased activity due to fear that perpetrator will return (trips, talking to friends, etc.)
(Lability) – anxiety, mood swings, crying, depression
Disruption of sex life
anxiety related disorder
Panic disorder
Panic Disorder (Panic Attacks)
Discrete episodes of intense anxiety that begin abruptly and reach a peak within minutes.
Intense feeling of impending doom, apprehension.
panic pharmacotherapies and psychotherapies
Psychotherapies
CBT = first-line treatment in panic disorder.
Systematic desensitization (Phobias)
Exposure therapy (Phobias)
Modelling (Phobias)
Pharmacotherapy
Benzodiazepine treatment (acute phase)
SSRI treatment (maintenance)
generalized anxiety disorder treatment
Pharmacotherapy
Benzodiazepines are no longer because of the chronic nature of GAD
SSRIs and SSNRIs are now the pharmacological treatment of choice.
Psychotherapy
CBT = psychological intervention of choice.
Goal = Address (distorted) thoughts that cause feelings of anxiety
what is a somatic symptom disorder
conversion and hypochondria
Expression of anxiety through physical symptoms
Treatment: Address underlying cause of anxiety
Illness Anxiety Disorder (previously: hypochondria)
Anxiety secondary to believing one has a serious illness / imminent death
Extreme worry about having a disease
Conversion Disorder
Neurological symptoms in absence of neurological disorder: deficits in voluntary motor or sensory functions, paralysis, blindness, gait disorder, numbness, paresthesia, burning sensations, seizures
Lacking emotional response to the symptoms
Dissociative disorders
depersonalization
dissociative amnesia
DID
Depersonalization/Derealization Disorder
Person feels detached from their body (or parts of their body) = “out of body experience” = they can see their body from above
Derealization: Person feels their surrounding are unreal
Dissociative Amnesia
Inability to recall autobiographical information (pieces of it - feelings, activities, persons, etc.) – may be accessible with retrieval cues
Dissociative Identity Disorder
Presence of two or more ‘personality states’ –
severe childhood trauma (1) fixated on the traumatic experience / (2) avoidant of it
‘Host personality’ unaware of others; perplexed by lost time and clothes changes / may last from minutes to months.
OCD
obsessions vs compulsions
OCD = Severe obsessions and compulsions that significantly interfere with normal daily living
Obsessions: Unwanted, intrusive and persistent thoughts, impulses, or images that cause anxiety and distress.
Compulsions: Behaviours that are performed repetitively, in a ritualistic fashion, with the goal of preventing or relieving anxiety and distress caused by obsessions.
Typical age of onset of OCD is in the early 20s to mid – 30s
PTSD
Acute emotional response to a traumatic event or situation involving severe environmental stress
Re-experiencing the event – to which the person responded with intense fear, helplessness or horror
Symptoms may appear within 3 months of trauma, but delay may also occur (several months to years)
trauma and stressor related disorders
Reactive attachment disorder
Disinhibited social engagement disorder
Adjustment disorder
Prolonged grief disorder
Acute distress disorder
Post traumatic stress disorder
