Psych quiz 2 Flashcards
Characteristics of anxiety
Fear - is a more primitive emotion and occurs in response to a real or perceived threat happening in the here and now.
- a response to danger and elicits fight or flight response.
Anxiety/ worry - an affective state where the individual feels threatened by the potential occurrence of a future negative event.
Panic- can be described as a false alarm that is triggered in the absence or a concrete identifiable death. (panic attacks are uncommon in children)
Separation Anxiety Disorder - DSM criteria
Children have a lot of fears and can have separation anxiety but this is normal - what matters is the duration and the intensity of it.
after 3-5 this behavior becomes a typical.
(criteria - you need to have baseline for what is typical for a kid that age)
Distress when separated from the attachment
* Full-blown panic
* Diagnosis before puberty -(rare to be diagnosed as teenager or adult but possible)
* 1/3 develop other anxiety disorders or
depressive disorders
* SAD (separation anxiety) : specific worry VS GAD: worry in multiple domains (generalized)
you have to observe 3 or the following symptoms.
- Recurrent excessive distress when anticipating or experiencing separation
- Persistent and excessive worry about losing MAF or about possible harm to them
- Persistent and excessive worry about losing major attachment figures or about possible harm to them experiencing an untoward event that causes separation from a MAF
- Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation
- Persistent and excessive fear of or reluctance about being alone or without MAF at home/else
- Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a MAF
- Repeated nightmares involving the theme of separation
- Repeated complaints of physical symptoms when separation from MAF occurs or is anticipated 5
1/3 with develop GAD if that happens they are more prone to having depression and or substance abuse problems.
MAF = Major attachment Figures.
Comorbidity of SAD
they are more predisposed to having more than one anxiety disorder or some sort of depressive disorder - generalized anxiety disorder, specific phobia, social anxiety etc…
Etiology of SAD
there is a link with temperament, which is based on your genes.
brain is highly reactive to stress
(behavioral inhibition) - usually shy, and super reactive to their environment.
BI may be due to abnormal functioning in the amygdala
uncomfortable in new situations - shut down and want to avoid a lot of those situations
Elevated levels of cortisol in the mother during pregnancy
SAD etiology part 2
See that other people in the family are anxious. They might suffer from different anxiety disorders, but it really is something not specific that they inherited.
(environment is also shaping you)
Learn to fear by observing fear reactions in their parents
an anxiety disorder is just increasing your risk. So this predisposition will be expressed more strongly when it’s combined with
SAD treatment
CBT - common in children because they have a harder time elaborating on their symptoms - help them to feel that they have more control, and they can do it and make them proud that they manage to be alone.
they were able to use relaxation techniques during that time to make them feel better.
expose them to those situations that makes them feel uncomfortable, so that the fear response extinguishes
For TEENAGERS - a form of medication on top of therapy - Tricyclic antidepressants and benzodiazepines (common, but efficacy
is questionable - because you didnt stop the feelings yourself the meds did)
NEUROSIS
it was used for anxiety disorders for a long time. - used for people who are not psychotic don’t have this break reality, but that are they’re dealing with emotional problems (depression or anxiety)
implied that the cause of of the neurosis is due to a disturbance in your central nervous system.
ETIOLOGY - BIOLOGICAL FACTORS
Heritability is lower than other disorders
High neuroticism. Is also connected to depression. - means you’re more likely to feel anxious, worried, and easily upset. People with high neuroticism often think about things that went wrong and focus on the negative side of life, like seeing the glass half empty instead of half full
neural fear circuit begins with just
processing information, registering what’s going on in your environment? In your life. And this is with the thalamus and then the information is sent to the amygdala And then view areas of your hypothalamus
through the midbrain and the brain stem, and finally to your spinal course. So the later areas are really connected to automatic and behavioral outputs. That will be your fear response.
GABA, norepinephrine, and serotonin play a role in this.
PSYCHOLOGICAL FACTORS
Anxiety and fear are acquired through learning
Fears are sometimes acquired in the absence of classical conditioning
PANIC DISORDER
Panic attacks are very sudden, out of the blue. -
Interpersonal etiology SAD
Helicopter parents - excessive control, fostering beliefs of helplessness, & failing to promote self-efficacy and
independence
DSM -5 PANIC DISORDER
Palpitations, pounding hear, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization
(being detached from oneself)
12. Fear of losing control or ‘going crazy’
13. Fear of dying
Agoraphobia
Not only experiences experiencing those continuous panic attacks
and like feeling all distress, but also, you’re avoiding situations because you’re afraid to have a panic attack in those situations, and some people will not go out anymore. They will stay in their house. They will, you know. Not drive under bridges or tunnel etc..
avoiding places or situations that might cause panic
panic disorder and agoraphobia - can be comorbid or exist on their own
Etiology: A Problematic Cycle
A Cognitive Perspective (panic disorder)
panic attacks arise
from catastrophic misinterpretation, like cognitive distortions. That are gonna be activated when you have those bodily sensations.
arousal related bodily sensation. So your heartbeat is a bit faster. You start to have a little problem breathing, etc. And then, if you start to have catastrophic misinterpretation at that time that could lead you to a panic attac
Panic Disorder
Diagnosis and assessment
Panic Disorder vs other anxiety disorder
* Uncued/unexpected panic attacks VS in response to a specific situation
* A multi-method assessment includes:
* Interviews
* Behavioural assessment called a behavioural avoidance test
* Symptom induction test: Observing the individual’s reactions to uncomfortable bodily sensations
(Ex. Spin in a chair to induce dizzy feeling)
Specific Phobia
Marked and persistent fear and avoidance of a
specific object or situation
* Ex. animals, heights
* Excessive and disproportionate fear
* Must interfere significantly with the person’s life.
Five subtypes: (1) animal phobia, (2) natural environmental phobia, (3) blood- injection-injury phobia, and (4) situational phobia, and (5) an “other” category
Specific Phobia
Etiology
Associative model
* Criticism: Equipotentiality premise
* Non-associative model
* Biological predisposition for acquiring certain phobias
* Failure to habituate + genetic vulnerability to anxiety = specific phobias
* Disgust sensitivity (ex. spiders, rodents)
Generalized Anxiety Disorder
Chronic, excessive and
uncontrollable worry and anxiety
* 3 out of 6 symptoms:
1. Restlessness, feeling on the
edge
2. Being easily fatigued
3. Difficulty concentrating, mind
going blank
4. Irritability
5. Muscle tension
6. Sleep disturbances
GAD tends to be more like depression than the other anxiety
disorders
Obsessive-Compulsive Disorder
Obsessions are thoughts, images, or urges that are persistent, unwanted and markedly distressing.
Compulsions are repetitive behaviours (e.g., checking) or mental acts (e.g., counting) that a person performs
to reduce anxiety/distress or to prevent a
feared outcome.
Neutralizations are brief behavioural or mental acts that individuals employ in response to an intrusion, to prevent or “undo” the feared situations that appear in their intrusive thought.
The obsessions or compulsions
are time-consuming (ex. take
more than 1 hour per day) or cause
clinically significant distress or
impairment in social, occupational,
or other important areas of
functioning
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Obsessive-Compulsive Disorder
Etiology
So there are structural and functional abnormalities in the brain’s brain system that may be responsible for the compulsions and obsession. So patients with Ocd. Have less brain volume in parts of the frontal cortex and more in the basal ganglia
Obsessions are caused by the person’s reaction to
their own intrusive thoughts
Catastrophic misinterpretations of these thoughts Unhelpful efforts to control the intrusions (ex.thought suppression)
Posttraumatic Stress Disorder
A) Exposure to actual or threatened death, serious injury, or sexual violence in
one (or more) ways
B) Presence of one (or more) of intrusion symptoms associated with the
traumatic event(s), beginning after the traumatic event(s) occured
C) Persistent avoidance of stimuli associated with the traumatic event(s),
beginning after the the traumatic event(s) occured
D) Negative alternations in cognitions and mood associated with the traumatic
event(s)
E) Marked alterations in arousal and reactivity associated with the traumatic
event(s), beginning or worsening after the traumatic event(s) occured
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Major Depressive Disorder (MDD)
Prevalence: 5% of Canadians suffer from depression
* Typical age of MDD onset: mid-twenties
* 50% of patients with MDD also have an anxiety disorder
* More severe and chronic depression
* Slower and less complete response to treatment
* Relapse following a first episode is high; greater risk with each episode
DSM-5 Diagnostic Criteria for
Major Depressive Disorder
Depressed mood most of the day as indicated by either subjective
(e.g., feels sad, empty, hopeless) or observation made by others
(e.g. appears tearful).
2. Markedly dimished interest or pleasure in all, or almost all, activities
3. Significant weight loss when not dieting or weight gain, or decrease
or increase in appetite
4. Insomnia or hypersomnia *nearly every day
- Psychomotor agitation or retardation
you’re having a hard time just articulating. It’s just like talking is like an effort. So you’re like, tone of voice. Your articulation
- Speech
- Facial expression
- Eye movements
- Speed and degree of movements
- Posture
- Self-touching
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5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive or inappropriate guilt
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Hypomania
less severe form of mania that involves a similar number
of symptoms to mania, but need only be present for four days.
DSM-5 Diagnostic Criteria for Manic Episode
A distinct period of abnormally and persistently elevated,
expansive, or irritable mood and abnormally and persistently
increased goal-directed activity or energy, lasting at least 1 week
and present most of the day, nearly every day (or any duration if
hospitalization is necessary
. During the period of mood disturbance and increased energy or activity, three (or more)
of the following symptoms (four if the mood is only irritable) are present to a significant
degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. More talkative than usual or pressure to keep talking.
3. Decreased need for sleep (e.g., feels rested after only three hours of sleep)
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external
stimuli), as reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences
(e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business
investments).
Bipolar 1
Had at least 1 manic episode
Bipolar 2
Never had manic episode
1 hypomanic episode
1 major depressive disorder episode
Etiology of Mood Disorders
Can be genetic, or because of life events - pre existing vulnerabilities. (not part or genes more so our experiences.)
there needs to be a trigger in the environment or their life for the first episode.
inherit some genes. That kind of predispose you to a mood disorder.
genes that make people less resilient to stress.
DSM-5 Diagnostic Criteria for Schizophrenia
Criteria A: Two or more of the following symptoms, each present for a significant portion of time during a 1-month period. At least one must be (1), (2), or (3):
1. Delusions: False beliefs that are not based in reality. 2. Hallucinations: Seeing or hearing things that don’t exist. 3. Disorganized Speech: Incoherent or illogical speech. 4. Grossly Disorganized or Catatonic Behavior: Strange movements or lack of movement. 5. Negative Symptoms: Reduced ability to function normally, such as lack of emotion or motivation.
Other Criteria: Symptoms must affect the person’s ability to function in daily life and persist for at least 6 months.
What is Schizophrenia?
Schizophrenia is a chronic brain disorder that affects less than 1% of the U.S. population. It is characterized by delusions, hallucinations, disorganized speech, and other symptoms that cause social or occupational dysfunction
Symptoms (positive) (Schizophrenia)
Positive Symptoms: Symptoms that add abnormal experiences.
* Delusions: Beliefs that are not true and are resistant to change. * Hallucinations: Sensing things that aren’t there, especially hearing voices. * Disorganized Speech: Jumbled or nonsensical speech. * Disorganized Behavior: Erratic or abnormal behavior.
Negative Symptoms (Schizophrenia)
Symptoms that take away normal abilities.
* Avolition: Lack of motivation or interest in daily activities. * Anhedonia: Inability to feel pleasure. * Flat Affect: Reduced expression of emotions.
Etiology (Schizophrenia)
Biological Factors:
* Genetics: Schizophrenia runs in families, suggesting a genetic link. * Brain Structure: Differences in brain structure, such as larger ventricles and reduced gray matter. * Neurotransmitters: Imbalances in brain chemicals like dopamine.
Environmental Factors: (Schizophrenia)
Prenatal Factors: Complications during pregnancy, such as exposure to the flu virus.
* Stress: High-stress situations may trigger symptoms in those at risk.
* Urban Upbringing: Growing up in a city environment is linked to a higher risk.
Diathesis-Stress Model: This model suggests that schizophrenia develops due to a combination of genetic vulnerability (diathesis) and environmental stressors.
Differential Diagnosis (Schizophrenia)
Schizoaffective Disorder:
Similarities: Includes symptoms of schizophrenia and a major mood disorder (depression or bipolar).
* Differences: Psychotic symptoms (hallucinations and delusions) occur without mood symptoms for at least two weeks.
Major Depressive Disorder (MDD) with Psychotic Features: Schizophrenia
Similarities: Includes depressive episodes with psychotic symptoms.
* Differences: Psychotic symptoms only occur during mood episodes.
Bipolar Disorder with Psychotic Features: Schizophrenia
- Similarities: Includes manic or depressive episodes with psychotic symptoms.
- Differences: Psychotic symptoms only occur during mood episodes
Comorbidity (Schizophrenia)
Substance Abuse: Many individuals with schizophrenia also struggle with alcohol or drug addiction.
* Anxiety Disorders: High prevalence of anxiety disorders in individuals with schizophrenia.
* Depressive Disorders: Co-occurrence with depression is common.
Schizophrenia - Treatment
Medications:
* Antipsychotics: Primary treatment to reduce symptoms. * First-Generation: Chlorpromazine. * Second-Generation: Risperidone, Olanzapine. * Side Effects: Weight gain, drowsiness, and more.
