Study Guide Exam 2 Flashcards
What is a diathesis?
biological or psychological predisposition to disorder
What is a diathesis/
vulnerability
What can diathesis be vulnerable to?
certain problem or mental disorder, but this does not mean you will necessarily develop it
According to the diathesis stress model what can combo of stress and predisposition cause?
impact development of psychological problems
What must stress interact with for a disorder to occur?
predisposition
What is anxiety?
general feelings of apprehension about possible future problem or danger
What is fear?
alarm reaction in response to immediate danger (fight or flight?
how many phobias do you need to meet the diagnostic criteria for specific phobia?
1
What is the average number of phobias that people have?
3
What are the amount with the diathesis stress models (the trends)
Combo of strong predisposition and high stress result in most
Does the diathesis stress model operate on a continuum
yep
With the diathesis stress model what may impact the development of a disorder?
combination or interaction of diathesis and stress may impact the development of a mental disorder.
What can a diathesis influence?
perception and experience of stress as well as life course and choice of experiences
What does the diathesis stress model integrate?
theoretical perspectives of mental disorder and provides information about etiology (cause), treatment, and prevention.
What are animal phobias?
fear of animals–especially dogs, rodents, insects, snakes
What are the five categories of specific phobias?
animal, natural environment, blood-injection injury, situational, other phobias
What are natural environment phobias?
involve fears of surrounding phenomena such as heights, water, and weather events such as thunderstorms.
What are blood-injection injury phobias?
fear of needles, medical procedures, harm to oneself
What are situational phobias?
Fear of specific areas such as enclosed spaces in elevators or planes
What are other phobias?
any other intense fear of a specific object (fear of poison, peanut butter, etc)
What is a phobia?
Persistent and disproportional fear of specific object or situation that presents little or no actual danger
What are the subtypes of social phobia?
performance situations, nonperformance situations
What is a panic attack?
brief period of exceptionally intense, spontaneous anxiety/fear and feelings of impending doom
If it is something you can name what is it?
phobia not panic disorder
What is the behavioral perspective with depression?
extinction of active behaviors, lack of rewards due to social skills, learned because they lead to rewards
What is learned helplessness with depression?
People act in a helpless, passive fashion upon learning their actions have little effect on their overall environment
What does learned helplessness cause?
people believe that they are incapable of changing their environments
What do performance situations include?
evaluation from others, (taking a test, recital)
What would make a disorder performance only?
fearing only speaking or performing in public
What are nonperformance situations?
Situations that cause anxiety that are not based on performance reviews
What is generalized anxiety disorder?
chronic, excessive and unreasonable worry and anxiety generalized over events in everyday life
What is vicarious learning?
learning through observation and imitation of others’ experiences, rather than through direct personal experience
What are obsessions?
anxiety-producing, persistent idea, thought, image, or impulse
What are compulsions?
overt repetitive behaviors or mental rituals that the individual is driven to perform over and over
What is a fear circuit?
primarily centered around the amygdala, that are responsible for processing and triggering fear responses when encountering perceived threats
what does the fear circuit help you do?
helps you learn from experience to recognize dangerous situations and respond appropriately.
What is body dysmorphic disorder?
preoccupation with imagined defect in physical appearance or excessive concern over slight flaw
How many people with BDD try to kill themselveS?
about half
What are common obsessions?
contamination, errors or uncertainty, sexual acts, harming self or others, symmetry or perfect order
What are some common compulsions?
cleaning, repeated checking, repeating, ordering/arranging, counting
What is hoarding disorder?
preoccupation with collecting items and a failure to discard items
What is the cognitive cause of OCD/
attention drawn more to disturbing material, low confidence in memory ability, difficulty blocking out negative thoughts
What is a stressor?
the event that causes the stress
What do stressors demand on us?
to change or react
What is a stress reaction?
person’s reaction to those demands
What is a traumatic experience?
exposure to actual or threatened death, serious injury, or sexual violation
What are the four categories for diagnoses of PTSD?
intrusion, avoidance, negative conditions and mood, arousal and reactivity
What is intrusion?
1 symptom
What is avoidance?
1 symptom
What are negative conditions and moods?
2 symptoms
What is arousal and reactivity?
2 symptoms
What is acute stress disorder?
anxiety and dissociative symptoms following a traumatic experience.
DSM05 FPOr ACCUTE STRESS DISORDEr
What is adjustment disorder?
maladaptive reaction to distressing life events that develop within 3 months of the onset of the stressor
What must adjustment disorders lead to ?
significant impairment or marked emotional distress exceeding what is normally expected
What are physiological pathways?
if stressor doesn’t go away right away the HPA axis kicks in and releases cortisol and the stress response is released
What is criterion 1 for bipolar 1 disorder?
criteria for at least 1 manic episode (a-D under manic episode)
What gender especially has symptoms of rapid cycling?
females
For bipolar II to happen what must the condition not be caused by?
medical problem or substance
What criteria must have been met for a qualification of bipolar 2 disorder?
One hypomanic criteria and one major depressive episode
What must there have never been for bipolar 2 disorder?
Manic episodes
what does the symptoms of bipolar 2 cause?
clinically significant distress or impairment in social, work, or other important areas of functioning
What is the relation with comorbidity and anxiety disorders?
many people with anxiety have other disorders, it has a very high comorbidity rating
What is prepared learning?
predisposed to learn behaviors that help them survive and reproduce, and why some associations are easier to learn than others
What is light therapy?
mimicking natural light
When must the diagnostic criteria of postpartum disorder have to have been met?
Within four weeks of childbirth
Are women who have had children more likely to experience depression?
no
What gender is more likely to have depression?
women
what gender is more likely to have bipolar disorder?
men and women are equal
What is disruptive mood dysregulation disorder?
kids having extreme, continuous temper tantrums
What are biological factors involved with depressive disorders?
genetic factors
biochemical factors
hormonal factors
sleep dysregulation
neuroanatomy
What is the psychodynamic theory of depression?
individual’s current life situation is significantly influenced by their childhood experiences, unresolved conflicts, and past relationships
What is the behavioral explanation for depression?
environmental changes/ avoidant behaviors inhibit individuals from experiencing environmental reward/ reinforcement, subsequently leading to the development/maintenance of depressive symptoms.
What is the cognitive explanation for depression?
a person’s thoughts, attitudes, and interpretations can increase their risk of developing depression
What is the HPA axis related to?
Stress response
What can chronic stress produce in regard to the HPA axis?
long term HPA dysregulation
What are the three forms that Beck’s inner statements take?
1.) may exaggerate magnitude of obstacles, responding to minor frustrations
2.) may interpret relatively trivial events as important losses
3.) continually self-disparaging, magnifying criticisms and insults
What are the three elements of Beck’s Cognitive mode?
Negative
What are the elements of the negative triad?
Self, world, future
What is the hormonal influence of depression (map)
Environmental stress
NE in hypothalamus
Pituitary
Adrenal glands
Release of cortisol (stress hormone)
What may the hormonal influence in depression explain in regard to gender”
differences in unipolar mood disorders
What does Becks cognitive model explain?
person’s perception of a situation impacts their emotional, behavioral, and physiological reactions
Is depression more common within families?
yes sir
What is the heritability rate for twins in depression?.
42 females
29 males
What is the serotonin transporter gene associated with?
increased risk of depression following stressful life events
Is depression higher within first degree relatives?
yes
What is the monoamine hypothesis?
depression is caused by a deficiency of monoamine neurotransmitters, such as norepinephrine, serotonin, and dopamine, in the brain
Why does a person feel depressed in Beck’s cognitive model?
people engage in depressed ways of thinking
What do people focus on with depression in Becks cognitive model?
negative interpretations
What do people feel with depression in Beck’s cognitive model ?
helpless, hopeless or not in control
What do people believe when they are experiencing learned helplessness?
have little or no control over events of their life, responses have no connections with outcomes
What does unavoidable stress from learned helplessness decrease the levels of ?
NE
What did Seligman study?
relationship of fear conditioning to instrumental learning
What was Seligman’s experiment?
dogs received an inescapable shock in learning a future task where they could avoid the shock by jumping over a barrier
What is depressive attributional style?
depression caused depressive style that employs internal, stable, global accounts of personal problems
What are the three dimensions of the attributional model?
internal-external
stable-unstable
global-specific
What is introjection (psychodynamic)
internalizing the characteristics of others
What is the psychodynamic theory in regard to depression (quilt version)
intrapsychic process that originate early in life in development of depression
What is depression related to with behavioral perspectives?
elative loss of positive reinforcement and pleasure.
What is the behavioral perspective of depression similar to ?
state of extinction
What does apathy and lack of responsiveness stem from?
lack of positive reinforcement
What are treatments for depressive disorders?
Medication
CBT
Interpersonal therapy
SSRIs
Tricyclcics
MAO inhibitors
ECT
TMS
What are tricyclics and MAO inhibitors?
unpleasant side effects, less effective for depression with psychotic features
Does MAO require multiple doses per day?
Yes
What is transcranial magnetic stimulation
stimulation of the Cortex
What is interpersonal therapy?
identification and improvement of a person’s difficulties in interpersonal functioning.
What are the statistics of ECT?
Works more quickly and with a higher percentage of patients.
Response rates for those who do not respond to medication: 50%-60%
Is depression necessary for bipolar 2?
yes
Are there psychotic symptoms with bipolar 2?
no
What is a treatment for bipolar disorders?
Lithium (mood stabilizer)
What are some risk factors for suicice?
Previous suicide attempt
Contemplated method
Male gender
Hopelessness
Diagnosis of a mood disorder
Previous psychiatric admissions
Why might suicide be performe?
escape from bad situation
experiencing intense emotions
aggression
act of sacrifice
to prove oneself
What is Mowrer’s two factor model>?
Involvement of both classical and operant conditioning
- Initial event creates association
- Operant conditioning maintains association through negative reinforcement
Causal factors in anxiety disorders: Psychodynamic
Little Hans
Id impules produce anxiety in the ego
the ego can usually calm them
What are psychodynamic treatments for anxiety:
tend to not be that effective with anxiety
What are biological treatments for anxiety disorders?
anxiolytics
antidepressants
What are behavioral treatments for anxiety disorders?
systematic desensitization
exposure
What are cognitive treatments for anxiety disorders?
CBT
Interoceptive exposure
What is interoceptive exposure?
internal feelings of anxiety
What is RCC>
oversensitivity
debated
play a role in panic
What is the limbic system?
fear networks
What are biological factors with regard to neurotransmitters and anxiety?
HPA Axis
- stress response
Serotonin
- most implicated
- deficiencies
- affects mood
Norepinephrine
- increased levels
- fight or flight
- arousal
- increases anxiety
GABA
- deficiencies
- inhibits anxiety
Causal factors in anxiety: Cognitive
Anxiety Sensitivity
- tend to misinterpret ambiguous stimuli as more threatening
Greater Attention to Threat
- take it to a catastrophic level
- panic disorder stems from a tendency to make catastrophic misinterpretations of physiological sensations
Perceived Control
- perceived lack of control = increased risk
What are biological factors in OCD?
genetics
moderate heritability
Neurotransmiter (serotonin)
strongest implication, too much serotonin , drugs make symptoms worse at first
Brain structure
limbic system (emotional brain)
hypothalamus (feeding, fighting, fleeing, fucking)
Frontal cortex/lobes: worrying grooming
Causal Factors in Obsessive-Compulsive and Related Disorders: Cognitive
Attention drawn more to disturbing material.
- exaggerated threat estimation
- individuals overestimate threat
Low confidence in memory ability.
- Accounts for having to do the rituals over and over again
- Having to check and recheck
Have difficulty blocking out negative thoughts.
- lack of control of thoughts
Individuals with these disorders try harder to suppress these thoughts
Causal Factors in Obsessive-Compulsive and Related Disorders: Behavioral
Mowrer’s Two-Factor Theory:
Excessive hand washing
- traumatic event with being dirty or germs
- exposure to similar events induces anxiety or fear
- hand washing is negatively reinforced by the reduction in anxiety
Most accepted
- bc most treatments involve exposure.
Causal Factors in Obsessive-Compulsive and Related Disorders: Sociocultural
Early childhood trauma
- abuse (physical or sexual)
- parents over controlling, critical, etc.
- parental neglect
Societal values
- western society is pretty focused on physical appearance
Treatments in Obsessive-Compulsive and Related Disorders: Biological:
- SSRIs
- Effective in 40% of individuals
— might decrease symptoms by 30-40% - High relapse for individuals who go off of medication
Treatments in Obsessive-Compulsive and Related Disorders: Cognitive
- CBT & cognitive restructuring
- challenging cognitions and identifying pathways
- in conjunction with behavioral modification techniques (ERP)
Treatments in Obsessive-Compulsive and Related Disorders: behavioral
- Exposure and Response Prevention
— requires prolonged and repeated exposure to the obsession, while the compulsive act is prevented
— most effective (70%-80% of patients)
Describe PTSD:
After exposure to intense trauma, recurrent recollection and distress related to the trauma with marked arousal.
Dysfunction may be especially severe and long-lasting if the precipitating stressor is intentional and interpersonal.
DSM-3 Diagnosis for PTSD
- Traumatic event outside the range of usual human experience that would cause significant symptoms of distress in almost anyone
DSM-4 criteria for PTSD
- Required person’s response to involve “intense, fear, helplessness or horror”
Is the diagnostic criteria for acute stress disorder the same as PTSD?
yes
What is the quilt definition for acute stress disordeR?
After exposure to intense trauma, recurrent recollection and distress related to the trauma with marked arousal.
For adjustment disorders what is the time frame?
development of behavioral or emotional symptoms within 3 months of onset of stressor
What must adjustment disorder symptoms lead to?
Significant impairment
Marked emotional distress, exceeding what is normally expected
What may dysfunction manifest as?
depressed mood, anxiety, disturbance of conduct, or combo of symptoms
Are adjustment disorders time-limited?
yes
When is the stressor of adjustment disorders expected to remit?
within 6 months
Trauma and Stress-Related Disorders: Risk Factors Related to the Event(s)
Degree of exposure to trauma:
- Higher degree of exposure:
— Individuals who were actually exposed to it, not secondary exposure.
- Greater degree of exposure causes a greater rate of disorders.
Severity of trauma.
- More severe the trauma the higher the likelihood that an individual will develop symptoms
Trauma and Stress-Related Disorders: Risk Factors Related to the Person or Social Environment
(1) History of childhood abuse, assault or poverty.
- More severe environments in childhood are at a greater risk for developing disorders.
- Can make your receptors less receptive to cortisol
(2) Genetic vulnerability.
- Twin studies
— Not a really strong effect related to PTSD but for anxiety disorders there tends to be a link.
- Hormonal system
- Personality characteristics: neuroticism
- Negative attitudes
(3) Lack of social support.
- Associated with low social support growing up and (more so) low social support when the traumatic event happens.
(4) Poor coping skills.
- Three major categories:
Avoidance Coping:
- drugs, etc.
Emotion Focused Coping:
- talk to friend & family
- women are more likely to use
Problem Focused Coping
- deal with the issue directly
- take active approach strategies
- men are more likely to use
- most effective in everyday life unless problem cannot be helped
(5) Feeling shame/dissociative experiences.
- Associated with poor outcomes
(6) Pre-existing depression or anxiety.
- If you’re already diagnosed you are at risk
(7) Family history of depression, anxiety or substance abuse problems.
- At higher risk
Treatments in Trauma and Stress-Related Disorders:
Drug Therapies
- For the most part, not super effective
- Most effective: SSRIs
— In conjunction with other therapies
- Others:
— Antipsychotics
Exposure Therapy and CBT
- Most effective
— when linked with cognitive restructuring therapy
- A whole lot of people drop out of therapy because it is very anxiety-provoking
- Continual exposure & getting them to talk about it.
- Telling & remembering
- Confront irrational thinking
Critical Incident Stress Debriefing (CISD)
- On site crisis counseling
- Decrease chances that they will develop PTSD in the future.
- Research shows that only doing that, with no follow up counseling, can lead to an increase in PTSD
Causal Models in Trauma and Stress-Related Disorders:
(1) Mowrer’s Two-Factor Theory
Classical conditioning, anxiety associated with it
- avoid thinking about it etc, reinforcement
(2) Biological processes
Maybe some differences in cortisol levels
Link between hippocampus and amygdala (“fear center”)
- associated with emotion and memory
- individuals with PTSD show decreased volume in hippocampus
— can’t determine if it preceeded the event
With abnormal anxiety what happens with the level of cortisol?
cortisol levels remain high even when threat subsides
