Psychological Disorders & Interventions Flashcards
what is a panic attack?
discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feeling of impending doom.
what are the symptoms of panic attack?
During these attacks, symptoms such as:
- shortness of breath
- palpitations
- chest pain or discomfort
- choking or smothering sensations
- fear of “going crazy” or losing control
- sweating, chills/hot flushes
- shaking
- dyspnoea
- dizziness
- feelings of detachment from reality
- fear of dying
- paraesthesia
what is agoraphobia?
arises by the fear of having a panic attack in a setting from which escape is difficult (or embarrassing)
develops as a complication of panic attacks
what does the behavioural approach describe about maladaptive behaviours?
Maladaptive behaviours are not merely symptoms of the underlying problems – the behaviours are the problem.
Problem behaviours are learned in the same way normal behaviours are learned (by conditioning)
how is exposure therapy carried out?
- based on classical and operant conditioning approaches
- Treat phobias through the exposure to the feared CS (trigger at present) in the absence of UCS (trauma)
- does induce anxiety for short periods of time but highly effective
what is CBT?
changing behaviour around the thoughts, behaviours and emotions, focussing on problematic behaviours and beliefs that maintain the disorder.
A stimulus leads to a response and therapy enables the cognition stage in-between to be corrected so the response is not harmful.
what causes emotional distress?
interpretation of events, not the events themselves.
what is the advantage of using CBT in treating emotional distress inducing phobias/disorders?
Relapse rates are also much lower vs. medication
what can be treated using CBT?
- Depression
- OCD
- Social anxiety
- Bulimia
- PTSD
- Panic disorders and specific phobias
- Generalised anxiety disorder - Schizophrenia
considered 1st line of treatment by NICE
what does someone with cognitive appraisal problems do?
they catastrophise the perceived threat (misinterpret physical and emotion symptoms)
what contributes to wellbeing?
o A sense of individual vitality.
o Undertake activities which are meaningful, engaging, and make them feel competent and autonomous.
o A stock of inner resources to help them cope and to be resilient.
how is a panic disorder diagnosed?
o Recurrent, unexpected panic attacks (DSM)
o At least one of the attacks is followed by 1 month or more of the following:
- Persistent concern about more attacks.
- Worrying about implications of such attacks.
- Change in behaviour as to avoid such attacks – i.e. avoid getting in cars.
what is systemic desensitisation?
gradually exposing the patient to more anxiety inducing stimuli
what is mindfulness-based cognitive therapy?
paying attention in a particular way, in the moment and non-judgmentally.
Recognising thoughts as thoughts and not ‘you’ or ‘reality’.
what is motivational interviewing? what can it be used for?
identifies the unhealthy behaviour thoughts and feelings and allows them to change their behaviour
used for smoking, alcohol use, weight loss, etc.
how can pain be managed in the long term?
teaching relaxation techniques, changing beliefs, building coping strategies, often with CBT
what is Acceptance and Commitment Therapy?
People can open up to unpleasant feelings, and learn not to overreact to them, and not avoid situations where they are invoked. This enables escape from the vicious cycles of pain.
Its therapeutic effect is a positive spiral where feeling better leads to a better understanding of the truth.
what are the key symptoms of depression?
- depressed mood
- lack of interest
- psychomotor agitation
- suicidal ideation
- inability to concentrate/think
- insomnia/hyposomnia
- loss of appetite
- worthless
- inappropriate feeling of guilt
- fatigue
- recurrent thoughts of death
who should not receive antidepressant medication?
DO NOT use antidepressants for sub-threshold depressive symptoms (benefit-risk ratio is poor)
who should be given antidepressant medication?
- Past history of moderate-severe depression
- chronic sub-threshold depressive symptoms
- mild depression after other interventions
what is cognitive theory behind CBT?
- identify nature of thoughts (dont have to be true to affect emotion)
- learn about common biases in the thoughts
- label thoughts as “guesses” or “hypotheses” about the world
what are the psychological interventions in healthcare?
1) CBT
- for those who have relapsed despite antidepressant usage
- for significant history of depression and residual symptoms despite meds
2) mindfullness based cognitive therapy
- for those who are currently well but have had 3 or more episodes of depression
what are the advantages and disadvantages of antidepressants?
positive: placebo effect, convenient
negative: high relapse rate, aversive discontinuation syndrome
CBT on the other hand offers a potential cure and coping+ problem solving skills
