Psych 8 Flashcards
Diagnostic criteria/time frame for panic attacks
♣ Recurrent unexpected panic attacks (periods of intense fear and discomfort) without an identifiable trigger
♣ One or more panic attacks followed by > 1 month of continuous worry about future attacks
Tx of specific phobia
Exposure therapy
Tx of social phobia related to performance anxiety
Beta blockers or short acting benzos prn
Tx for general social anxiety disorder
First line = SSRI/SNRI
Benzos PRN
Tx of OCD
SSRI - requires higher doses than needed to treat depression
Tx of Generalized anxiety disorder (GAD)
SSRI, Buspirone, TCAs, short-term benzos
Tx of Panic disorder
- First line = SSRI
- Can switch to TCA if SSRI not effective
- Benzos until SSRI kicks in + PRN
Defense mechanism:
- Consciously replacing an unacceptable wish with a similar but acceptable course of action
- E.g. Redirection of aggression towards father into sports
Sublimation
- Alleviating negative feelings via unsolicited generosity
- E.g. Mafia boss donates to charity
Altruism
- Intentionally withholding idea or feeling from awareness temporarily
- E.g. Don’t worry about big game until it’s time to play
Suppression
- Appreciating amusing nature of anxiety-provoking situation
- Expressing unpleasant or uncomfortable feelings without causing discomfort to self or others
Humor
• Regulating situations and events of external environment to relieve anxiety
Controlling
- Transferring avoided feeling or ideas to a neutral person
- Shifting emotions from an undesirable situation to one that is personally tolerable
- E.g. Father yells at child because his boss yelled at him
Displacement
- Avoiding negative feelings by excessive use of intellectual functions and by focusing on irrelevant details
- E.g. Physician dying from cancer describe the pathophysiology of his disease in detail to his 12-year-old son
Intellectualization
- Separating feelings from ideas and events
- Unconsciously limiting the experience of feelings or emotions associated with a stressful life event in order to avoid anxiety
- E.g. Describing murder in detail without an emotional response
Isolation of affect
- Explanations of an event in order to justify outcomes or behaviors and to make them acceptable
- E.g. My boss fired me because she is not meeting her quota, not because I am underperforming
Rationalization
- Unconsciously replacing warded-off feelings by emphasis on its opposite
- Doing the opposite of an unacceptable impulse
- E.g. Really sexual person becomes a monk
- E.g. Man in love with his married coworker insults her
Reaction formation
- Involuntarily withholding an idea or feeling from consciousness
- E.g. Child does not remember sexual abuse
Suppression
- Giving in to an impulse, even if socially inappropriate, in order to avoid the anxiety of suppressing that impulse
- E.g. Man who has been told his therapist is going on vacation “forgets” his last appointment and skips it
Acting out
- Not accepting reality that is too painful
* E.g. Woman scheduled for breast biopsy cancels appointment because she believes she is healthy
Denial
- Performing behaviors from an earlier stage of development in order to avoid tension associated with current phase of development
- E.g. Adult bring teddy bear when they have to spend the night in the hospital
Regression
- Attributing unacceptable internal impulses to an external source
- E.g. Accusing wife of cheating because of your desire to cheat
Projection
- Modeling behavior after another person who is more powerful
- E.g. Abused child becomes an abuser
Identification
- Labeling people as all good or all bad
* Often seen in borderline personality disorder
Splitting
- Attempting to reverse a situation by adopting a new behavior
- E.g. Man who has had a brief fantasy of killing his wife by sabotaging her car takes the car in for a complete checkup
Undoing
What is psychoanalysis
♣ Goal is resolve unconscious conflicts by bringing repressed experiences and feelings into awareness and integrating them into the patient’s conscious experience
♣ Best suited patients: not psychotic, intelligent, and stable in relationships and daily living
What disorders do psychoanalysis work best for
- Cluster B and C personality disorders
- Anxiety disorders
- Problems coping with life events
- Sexual disorders
- Persistent depressive disorder
What is transference
o Projection of unconscious feelings regarding important figures in the patient’s life onto the therapist
o E.g. Patient with repressed feeling of abandonment by her father becomes angry when therapist is late for appointment
What is counter-transference
o Projection of unconscious feelings about import figures in therapist’s life on the patient
o Therapist must be aware of this so as not to let it interfere with objectivity
What is behavioral therapy
♣ Seeks to treat psychiatric disorders by helping patients change behaviors that contribute to their symptoms
What are the theories that suggest how behaviors are learned
- Classical conditioning = A stimulus can evoke a conditioned response (e.g. Pavlov’s dog)
- Operant conditioning
= Behaviors can be learned when followed by positive or negative reinforcement (e.g. rat learns to press lever when it receives food)
What is systematic desensitizon
o Patient performs relaxation techniques while being exposed to increasing doses of an anxiety-provoking stimulus
What is flooding and implosion
o Through habituation, the patient is confronted with a real (flooding) or imagined (implosion) anxiety-provoking stimulus and not allowed to withdraw from it until he or she feels calm and in control
o E.g. a patient with fear of flying is forced to fly on an airplane
What is aversion therapy
o A negative stimulus (e.g. electric shock) is repeatedly paired with specific behavior to create an unpleasant response
o Used to treat addictions or paraphilia (e.g. Antabuse for alcoholics)
What is token economy
o Rewards are given after specific behaviors to positively reinforce them
What is biofeedback
o Physiological data (such as HR and BP) are given to patients as they try to mentally control physiological states
o Can be used to treat anxiety disorders, migraines, hypertension, chronic pain, asthma, and incontinence
What is cognitive therapy
♣ Seeks to correct faulty assumptions and negative feelings that exacerbate psychiatric symptoms
♣ The patient is taught to identify maladaptive thoughts and replace them with positive ones
What is CBT
♣ Focuses on patient’s current symptoms and problems by examining the connection between thoughts, feelings, and behaviors
Tx of borderline personality disorder
DBT
What is DBT
♣ A form of CBT that is effective in reducing the urges to engage in self-harm behavior and reduces hospitalizations in patients with borderline personality disorder
4 components of DBT
- Mindfulness = being fully aware and present in the moment
- Distress Tolerance = tolerating pain in difficult situations
- Interpersonal Effectiveness = how to ask for what you want and say no while maintaining self-respect and relationships with others
- Emotion Regulation = changing emotions that you want to change
