notes in class test 2 Flashcards
what can give us anxiety and what can these things be considered
war, tests, public speaking, relationships (judgment, rejection, etc), the future/unknown, money & bills, responsibilities
-all of these are worry or fear
are anxiety and fear helpful or harmful
they can be both helpful or harmful
-helpful when it protects you
ex. leaving a party that eventually gets busted when “something doesn’t feel right”
what is the difference between anxiety and fear
there is a fine line between them
-fear comes when there is a real threat whereas anxiety is more vague than a real threat
ex. tiger enters room
fear: this tiger will eat me
anxiety: if this tiger eats me i cant study for my test on thursday
how do fear and anxiety affect the body
they both affect the body in the same way
-anxiety is the same reaction someone would have in a life-threatening situation
what are the physical symptoms for anxiety and fear
stomach, jumpiness, tingling, jitters, sweating, lightheaded, hold breath/difficulty breathing, heart pounding, stiff back
what are the cognitive symptoms for fear and anxiety
-worry, dead, apprehension about the future, loss of control, worry about everything, hard to think when this stuff happens- people often think they will die or world will end
what are the behavioral symptoms for fear and anxiety
avoidance behavior (avoid thinking these things which could actually make it worse) ex. avoid studying for test, then its too late to study which makes you anxious
cling/dependent behaviors (can affect relationships)
agitated behavior
what does it mean when someone says anxiety is a cycle
these disorders are vicious cycle, anxiety causes clingy behavior which affects relationships which make you anxious
what are anxiety disorders characterized by in the DSM
excessive and maladaptive anxiety reactions
- depends on person and situation
- both of these descriptors are hard to establish
- *have to look for clinically significant impairment**
- usually across more than one setting
can someone ever diagnose themselves with something
no because we are biased and cannot be trusted
what can make us prone to anxiety
1) traumatic childhood
- children cannot gain perspective so things are extra traumatic (don’t understand explanations)
- parents who work with kids in positive and predictable ways provides security and teaches what they can/cant control in life
2) social contributions
- our environment (where we grow up)
- social stressors (racism, sexism, etc)
what do all of the acronyms mean (Sx, Px, etc)
Sx= symptoms Px= problems Hx= history Bx= behavior Tx= treatment Rx=prescription Dx=diagnosis
is it fair to assume are physiological responses are valid
no, not always true
what is generalized anxiety disorder
persistent and excessive anxiety and worry about numerous events and activities
-maladaptive, usually clinically significant impairment
how many people report generalized anxiety disorder
18% of population reports it
-29% of population will develop disorder, but only 1/3 of these people will receive treatment
what do people do if they dont get help for anxiety
cope in healthy or unhealthy ways
ex. getting self help books vs. doing drugs
ex. college students drink a lot to reduce anxiety
what constitutes GAD
- for 6 months or more: disproportionate, uncontrollable anxiety
- distressful, causes impairment, and three symptoms (tense, on edge, poor sleep, etc)
what are the sociocultural effects (theory) of GAD
poor people are more likely to develop anxiety
- there is also less qualified clinicians in this area and poor health insurance (insurance affects how mental health is treated, wealthier people don’t have to worry about it)
- race, ethnicity and sex play a role as well
explain the graduated cylinder analogy
- there are generalized things in life that cause anxiety, go up and down with daily life
- those in poverty start at a different point (in a heightened society that makes them more pre-disposed to anxiety)
what is the psychodynamic theory for anxiety
Freud hypothesized that all kids face anxiety because at first they have no awareness and will do anything
- when they begin to see consequences of their actions this causes anxiety (this is called realistic anxiety)
- overprotective parents when their kid gets hurt might reinforce their kids behavior because the kid gets attention this way (usually happens when parents dont give attention)
what is neurotic and moral anxiety in the psychodynamic theory
neurotic: prevented from experiencing our impulses
moral: occurs when we are punished for our impulses (ex. kids being shamed when they are potty training for having an accident)
what contributes to longer lasting anxiety in psychodynamic theories
if defense mechanisms of children are not effective in relieving anxiety
what is the humanism theory of anxiety
- anxiety comes when humans don’t have an honest or accepting perspective of themselves
- without unconditional positive regard: lower self esteem and more self judgement
- allowed to make mistakes, have to own them and change them in the future
what is the cognitive behavioral theory of anxiety
- anxiety comes from problematic behaviors and the way we think about them (dysfunctional thoughts)
ex. thinking “I need to be perfect”
-maladaptive or irrational assumptions about reality or yourself in that reality
what is meta-worry
- worrying about worrying
ex. taking out causes of anxiety, and leaving the symptoms is enough to cause anxiety - disorder creates the thing it needs to perpetuate itself (anxiety causes anxiety, full circle)
what are the biological theories of anxiety and the GABA neurotransmitter
genetic predispositions towards higher levels of anxiety (biology does make an impact)
GABA neurotransmitter exists in the fear circuit, anxiety could be caused by not enough of this
-prefrontal cortex and amygdala also help in fear (fight, flight, or freeze)
what happens because of GABA in regards to anxiety
there are drug therapies to reduce anxiety (benzodiazepines)
- valium: anxiety drug that is addictive and has high withdrawal (past used drug, lower now but still used) people using this drug had high rates of suicide
- then went to zanax (less addictive, but still addictive, not as intense of a withdrawal)
what is a phobia
intense and persistent fears that are resistant to information (irrational fears)
- a fear without knowledge is a good things**
ex. you should be afraid when you see a snake unless you are a snake doctor and know its not harmful
- a fear without knowledge is a good things**
explain the stipulations of species having specific biological predispositions
- through our evolutionary path we all should be concerned/fearful about things with specific themes (storms, blood, animals, etc)
- so phobias are only diagnosed with clinically significant impairment
how can there be some “healthy” and “unhealthy” fears
explain chart as well
phobias are subjectively defined
phone normal fear
what is a specific phobia
irrational fear of specific thing
what is agoraphobia
called “fear of the marketplace”, fear of a public place where escape might be difficult
why is agoraphobia separated from specific phobia
phobias cause flight, fight or freeze reaction (kind of like panic attack) but for no reason, you cannot have these without being noticed (sweating, heavy breathing, mimics heart attack so other people call 911)
- you can develop agoraphobia from specific phobias because of the bad reactions (kind of like a meta-phobia that prevents people from going out, phobia of phobias)
- agoraphobia is often an indication of how severe a specific phobia is (but can have it on its own)
what percent of the population has specific phobias
10% and they exist for all sorts of things
what is the difference between reactive and endogenous onset of mental illness
reactive: coming from an environmental thing (suffering from trauma, etc.), present, in the moment, something just happened
endogenous: comes from internal causes, personality, who you are, outlooks, etc. has a slower onset
explain some stats about phobias (who is more likely to get it and treatment stats)
women are more likely to develop phobias than men
-very few people receive treatment because the treatment entails facing the phobia which is very scary and their phobia feels so real and normal/natural (the treatments for phobias are being presented to the thing you are afraid of)
ex. people barely raise hand in class and say they are confused because of fear of criticism (public speaking/performance anxiety)
what is the most reinforcing thing
the removing of pain
-we learn quickly how to get rid of pain
-we avoid things with a phobia, this causes us to avoid the pain and discomfort that what we fear brings, this is reinforcing behavior
what is social anxiety disorder
fear of social situations, worry about being criticized/scrutinized
- has to be clinically significant impairment
- fear of negative evaluation or offending other people
what are the treatments for phobia
exposure therapy and systematic desensitization coupled with relaxation techniques
flooding: giving person what they fear immediately, more intense and repeatedly
what are the treatments for social anxiety disorder
- some exposure training (presenting patient to social situations)
- some anxiety meds
- mindfulness techniques
what may people with social anxiety disorder lack
- social skills training
- antisocial parents can cause kids to have similar problems
social media affect on social anxiety disorder
comparison of likes, fear of being scrutinized on social media exists as well
-increases anxiety
what are the symptoms of panic disorder and how many do you have to have to be diagnosed
4 and must cause impairment
heart palpitations, tingling of limbs/hands/feet, shortness of breath, sweating, hot/cold flashes, chest pain, faintness, dizziness
explain the feeling of unreality as a symptom of panic disorder
derealization: reality feels strange and alien
depersonalization: your self feels strange and alien
(dissociative)
when do panic attacks usually occur and what are some general stats about them
- usually in absence of real threat but body reacts like there is
- happens to 3% of population, 5% experience a panic attack at least once, more common in white people, only 50% of people get treatment
how do clinicians diagnose panic disorder
because panic disorders can lead to agoraphobia
diagnosis panic disorder with out without it
insight? the person knows it is a panic disorder, there is not actually a threat -> this can lead to agoraphobia which is the fear of panic attacks happening in public
what are some things that must be true for panic disorder to be diagnosed
- happen repeatedly in panic disorder (cannot be sporadically)
- need 1 month of this dysfunction to be considered for treatment
what are some instances where people might think they are having a panic attack but are not
misattribution/learning how to regulate feelings
- experiences where people think they have panic disorder but don’t
ex. carsick, think it is anxiety; kids regulate their NS and throw up
what is affect
observable expressions of emotion
what happens pre-therapy vs post-therapy with panic disorders
pre-therapy there is an extreme rise to panic,
post therapy the hope is the rise to panic is more gradual and becomes little things adding up and working on those little things so that they eventually never lead to panic at all
show diagrams if necessary
how does biology play a role in panic disorder
panic attacks caused by abnormal norepinephrine activity (misfiring of neurons)
- amygdala having imbalances
- predispositions also exist (maybe back in the day people with more anxiety were good hunters and that trait got pass on, could be evolutionary)
what are the drug therapies for panic disorder
- to reduce physiologically and calm person down, doesnt cause full recovery but can allow people to easily go into public
- benzodiazepines
- some people report that just having the meds makes them feel better
explain cognitive behavioral theory and panic disorder
not just biology, misattribution -> we think there is a catastrophe because our body is telling us there is one (the only way to fix this is fight, flight or freeze)
-body sensations misinterpreted and dispositions to anxiety play a role too (anxiety sensitivity can come from parens and how they attended to needs)
explain cogntiive therapy and panic disorders
- works with person to address misattributions
- panic attacks are natural, it is just unnatural to have them in certain situations
- teach them how to cope with and manage stress
what is OCD
made up of obsessions and compulsions
obsessions: persistent thoughts, ideas, impulses that are invasive
compulsions: repetitive and rigid behaviors patterns
what is the difference between clinically obsessed and obsessed
obsession is focusing on something in general,
clinical obsession is when the thoughts are hard to control and they prevent you from focusing on other things
what is the purpose of compulsions
we feel as though compulsions reduce the anxiety that comes from obsessiveness
- removal of pain is extremely reinforcing
- does not actually stop obsessive thought, just pauses it, so a vicious cycle that causes the disorder
what is one of the most common OCD
cleanliness, handwashing, etc
in extreme cases people will wash their hands with bleach until the skin comes off
what is OCPD
obsessive compulsive personality disorder
-people repack and unpack suitcase because it has to be perfect based on their personality
how can obsessions feel voluntary and how is OCD different than “routine”
once you have a routine of doing something a certain way and then are forced to do it another way it can feel like an obsession/ feel uncomfortable
ex. sleeping a certain way- when sleeping a different way it feels uncomfortable (OCD is feeling like this but multiplied)
when does OCD start and what does it need in order to be diagnosed
during childhood and then develops overtime
repeating, take up a lot of time and be a clinically significant impairment (impairment and distress)
do a lot of people with OCD get treatment
no because many think that it is normal and nothing is wrong
what happens when you try to stop obsessions
anxiety gets worse the longer you hold off
what are the themes of obsessions
- dirt/contamination (has always been a concern)
- violence/aggression (survival, defending self)
- religion (afterlife concepts, Thanatos principle, why we’re here)
- orderliness (knowing where things are)
- sexuality
what are some characteristics of compulsions
voluntary behaviors, but feel involuntary/ mandatory
-most people know that they are unreasonable (insight), but thoughts and anxiety tells you to do it anyways
how do compulsions alleviate anxiety
performing the behaviors alleviates the anxiety and it takes away pain which is extremely reinforcing (becomes a ritual)
what are the themes of compulsions
cleaning, checking, touching, verbalizing, counting and ordering
what is checking
looking at/for certain things
ex. pimples
what is verbalizing
saying things out loud
do you need to have obsessions to have compulsions
no, you can have one or the other or both
what are hoarding disorders
getting rid of things creates anxiety, so things you have pile up
what is Trichotillomania
hair pulling / twisting disorder
-pulling out eyebrow hairs one at a time
what are other examples of compulsions
skin pulling disorder and body dysmorphic disorder (Michael Jackson, over focus on body, take extreme measures to fix/remediate part of body)