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CU: Abnormal Psychology > Test 2: Anxiety, Stress, Trauma, and Obsessive Compulsive Related Disorders > Flashcards

Test 2: Anxiety, Stress, Trauma, and Obsessive Compulsive Related Disorders Flashcards

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1
Q

Define fear:

A

An immediate, present-oriented response caused by activation of the sympathetic nervous system

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2
Q

Define Anxiety:

A

An apprehensive, future-oriented emotion with somatic symptoms of muscle tension, restlessness, and elevated heart rate

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3
Q

Define panic attack. What are the two types?

A

An abrupt experience of intense fear with
- physical symptoms of heart palpitations, chest pain, dizziness, sweating, chills or heat sensations, etc
- cognitive symptoms of fear of losing control, dying, or going crazy
Types:
- Expected/Cued (specific stimulus)
- Unexpected (panic disorder)

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4
Q

Read Through DSM 5 for each disorder

A

In the textbook

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5
Q

What are the general biological contributions to anxiety?

A
  • Polygenetic influences: corticotropin releasing factor (CRF) and its affects of the HPA axis (hypothalamic-pituitary-adrenocortical)
  • Brain circuits and neurotransmitters
  • Limbic system
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6
Q

How do brain circuits and neurotransmitters affect anxiety?

A
  • Brain circuits are shaped by environment: ie smoking that has an interactive relationship with the somatic symptoms
  • Neurotransmitters:
    – decreased GABA,
    – noradrenergic system: decreased
    norepinephrine
    – serotonergic system: decreased serotonin
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7
Q

How does the limbic system affect anxiety?

A
  • Behavioral Inhibition System: BIS
    (receives danger signals from brain stem and septal-hippocampal system)
  • Fight/flight system: FFS
    (panic circuit, alarm/escape response)
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8
Q

What are Freud and the Behaviorist’s suggestions as to the psychological contributions of anxiety?

A
  • Freud:
    – anxiety is a psychic reaction to danger
    – and a reactivation of infantile fear situation
  • Behaviorists:
    – Classical and operant conditioning: symptoms are result of learned associations
    – Modeling: anxious behavior
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9
Q

What are the social contributions to anxiety?

A

Biological vulnerabilities are triggered by stressful life events
- Family
- Interpersonal
- Occupational
- Educational

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10
Q

What is triple vulnerability?

A
  • Generalized biological vulnerability (Diathesis)
  • Generalized psychological vulnerability (beliefs/perceptions)
  • Specific psychological vulnerability (learning/modeling)
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11
Q

What are the rates, commonalities, and linked physical disorders of anxiety comorbidities?

A
  • Rates: 55-76%
  • Commonalities: Features & vulnerabilities
  • Physical disorders: GI, migraines, arthritis, and allergies
  • Suicide: similar to major depression
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12
Q

What disorder is described as
- shift from possible crisis to crisis
- worry about minor, everyday concerns (job, family, chores, appointments)
- accompanied by symptoms such as sleep disturbance and irritability
- leads to behaviors like procrastination, overpreparation

A

Generalized Anxiety Disorder (GAD)

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13
Q

How is Generalized Anxiety Disorder different in children and the elderly?

A
  • Children: need only one physical symptom, worry about academic, social, and athletic performance
  • Elderly: worry about health, use minor tranquilizer: for medical or sleep problems, increase risk of falls and cognitive impairments
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14
Q

What causes GAD?

A
  • inherited tendency to become anxious
  • neuroticism (tendency for more intense negative affect w/ avoidant coping)
  • less responsiveness: autonomic restrictors
  • threat sensitivity
  • Frontal lobe activation
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15
Q

What are the pharmacological treatments for GAD?

A

Benzodiazepines (most often)
- Ativan
- fast-acting, short-term
- cognitive & motor impairment
- physical & psychological dependance
Antidepressants (SSRI)
- Paxil, Effexor

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16
Q

What are the psychological treatments for GAD?

A
  • Cognitive-behavioral treatments
    – exposure to worry processes
    – confronting anxiety-provoking images
    – coping strategies
  • Acceptance
  • Meditation
    *Similar benefits to drugs and better long-term results
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17
Q

What disorder is described as
- Unexpected panic attacks
- Anxiety, worry, or fear of another attack
- Persists for 1 month or more

A

Panic Disorder

Female:Male 2:1

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18
Q

What disorder is described as
- Fear or avoidance of situations/events
- Concern about being unable to escape or get help in the event of panic symptoms or other unpleasant physical symptoms (incontinence, vomiting, falling)
- Avoidance can be persistent
- Use and abuse of drugs and alcohol
- Interoceptive avoidance (physical sensations)

A

Agoraphobia

Female:Male 2:1

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19
Q

What is unique about children and elderly for PD and agoraphobia?

A

Children:
- Hyperventilation is a common symptoms
- Earlier cognitive development means fewer cognitive symptoms
Elderly:
- Health focus is more common
- Changes in prevalence - decreases with age

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20
Q

What is the Latin American disorder similar to PD characterized by sweating, increased heart-rate and insomnia but not anxiety or fear, even though severe fright is the cause

A

Susto

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21
Q

What is the Hispanic American disorder similar to PD characterized by panic attack-like symptoms with shouting

A

Ataque de nervios

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22
Q

What is the Cambodian (Khmer) and Vietnamese refugees disorder similar to PD and characterized by a
- panic attack with orthostatic dizziness and sore neck
0 Khmer concept - “wind overload” - too much wind or gas in the body which may cause blood vessels to burst

A

Kyol goeu

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23
Q

What are the aspects of nocturnal panic?

A
  • Nocturnal attacks:
    – occur in non-REM sleep, during delta/slow wave sleep
    – deep relaxation (letting go)
  • Sleep terrors; kids, blood curdling scream remembering nothing next morning
  • Isolated sleep paralysis: unable to move from sleep to wakes accompanied by surge of terror and occasional hallucination
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24
Q

What are the causes of PD and agoraphobia?

A
  • Generalized biological vulnerability: alarm reactions to stress
  • Cues get associated with situations: conditioning occurs
  • Generalized psychological vulnerability: anxiety about future attacks, hypervigilance, increase interoceptive awareness
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25
Q

What are the medications for PD and agoraphobia? Affects, result and use?

A
  • Benzodiazepines (Ativan)
  • SSRIs (Prozac and Paxil)
  • Affects: serotonergic, noradrenergic, GABA
  • Results: high relapse rates after discontinuation
  • Use: Can be very necessary and helpful for many people
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26
Q

What is the psychological treatment for PD and agoraphobia?

A
  • Exposure based
  • Reality testing: testing their hypothesis that they cannot handle an anxiety-provoking situation by entering the situation and discovering that it is survivable
  • Relaxation and breathing skills

Ex: Panic control treatment (PCT)
- exposure to interoceptive cues, cognitive therapy, relaxation/breathing

*High degree of efficacy - better than drugs long term, combination no better

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27
Q

What is the disorder described as
- Extreme and irrational fear of a specific object or situation
- Feared situation almost always provokes anxiety
- Significant impairment or distress

A

Specific phobias

Female:Male 4:1

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28
Q

What is unique about blood-injection-injury phobia?

A
  • Decreased heart rate and blood pressure when seeing blood, injection or injury
  • Fainting
  • Inherited vasovagal response
  • Onset = usually in childhood
29
Q

What is unique about situational phobia?

A
  • Fear of specific situations (Flying/driving)
  • No uncued panic attacks
  • Fear centers around the risks of the situation, not having a panic attack
  • Onset = early to mid 20s
30
Q

What is unique about natural environment phobias?

A
  • Heights, storms, water
  • May cluster together
  • Associated with real danger
  • Onset = usually in childhood
31
Q

What is unique about animal phobia?

A
  • Dogs, snakes, mice, insects
  • May be associated with real dangers
  • Onset = usually in childhood
32
Q

What can cause a specific phobia?

A
  • Direct experience
  • Vicarious experience - seeing someone else encounter a feared object
  • Information transmission - learning about a situation/object being dangerous
  • “Preparedness” - theory that says through natural selection we are prepared to fear certain things more than others
33
Q

What are the treatments for specific phobias?

A

Cognitive-behavior therapy
- Exposure: graduated/structured
- Relaxation - used to be practived more, now often not a part of empirically supported treatment

34
Q

What disorder is characterized by unrealistic and persistent worry that something will happen to self or loved ones when apart (kidnapping, accident) as well as anxiety about leaving loved ones

A

Separation Anxiety Disorder
(4.1% children, 6.6% adults)

35
Q

What disorder is characterized by
- extreme/irrational concern about being negatively evaluated by other people
- sometimes (not always) manifests as shyness
- leads to significant impairment and/or distress
- avoidance of feared situation, or endurance with extreme distress
What is the subtype?

A

Social phobia/ social anxiety disorder

  • Subtype: performance only: anxiety only in performance situations
36
Q

What are statistics about social anxiety disorder?

A
  • Men = Women
  • Onset: adolescence
  • more common when young, undereducated, single, low socioeconomic class
37
Q

What is the disorder characterized by
- fear of offending others or making them uncomfortable
- concern about aspects of personal appearance (stuttering, blushing, body odor)

A

Taijin Kyofusho
(Japan)
- more common in males

38
Q

What are the causes of social anxiety disorder?

A
  • Generalized psychological vulnerability (believe threatening events are uncontrollable)
  • Generalized biological vulnerability (propensity toward anxiety)
39
Q

What is the medication treatment for social anxiety disorder?

A
  • Beta blockers (stage fright)
  • Benzodiazepines (performance only)
  • SSRI (Paxil, Zoloft, Effexor - Generalized)
  • D-cycloserine (antibiotic) - cognitive enhancer when someone is engaged in extinction learning with exposure therapy
40
Q

What is the psychological treatment for social anxiety disorder?

A

CBT:
- challenging of anxious thoughts about the consequences of social judgement
- exposure to anxiety-provoking situations
- rehearsal
- role-play
Highly effective!

41
Q

What is the comparison of Agoraphobics and Social Phobics?
***

A

Agoraphobics
- Fear of actual symptoms of anxiety
- Seek others for comfort
Social Phobics
- Fear of the social context
- Avoid others for comfort

42
Q

What is the disorder described as
- rare childhood disorder characterized by a lack of speech
- must occur for more than one month and cannot be limited to the first month of school

What is the comorbidity and treatment?

A

Selective Mutism
- HIGH comorbidity with SAD
- Treatment: CBT most efficacious, similar to treatment for SAD

43
Q

What disorder is described as
- Trauma exposure
- Continued re-experiencing (memories, nightmares, flashbacks)
- Avoidance (situation, talking about it)
- Emotional numbing
- Reckless or self-destructive behavior
- Interpersonal problems
- Refers to problems that persists for more than one month after the trauma

A

Posttraumatic stress disorder

44
Q

What disorder is described as post-traumatic stress symptoms lasting less than one month?

A

Acute stress disorder

45
Q

What made the Vietnam War particularly problematic for PTSD?

A
  • no group identity - shipped as massive recruits
  • soldiers felt there was no purpose because Americans were in opposition to the war
  • lack of an all-out attempt to win the war
  • removal from combat was abrupt
46
Q

What are aspects that causes the prevalence of PTSD to vary?

A
  • Most people who undergo traumatic events do not develop PTSD
  • Type of Trauma
  • Proximity: more likely if closer
47
Q

What are factors that affect the likelihood of PTSD: Trauma
***

A

Features of the Trauma
1) Intensity of exposure to the trauma
2) Duration of exposure to trauma
3) Extent of threat posed by trauma
4) Nature of the trauma
- humans
- natural disaster

48
Q

What are factors that affect the likelihood of PTSD: Person
***

A

Features of the Person
1) Pre-trauma psychological adjustment
2) Family history of psychopathology
3) Cognitive and coping styles
4) Feeling of guilt

49
Q

What causes PTSD?

A
  • Trauma intensity: PTSD more likely with severe trauma
  • Generalized biological vulnerability (twin studies, gene-environment interactions)
  • Generalized psychological vulnerability (beliefs about uncontrollability and unpredictability of threatening situations)
  • Poor social support
  • Neurobiological model
50
Q

What is the neurobiological model of causes of PTSD?

A
  • Threatening cues activate CRF system
  • CRF system activates fear and anxiety areas (amygdala)
  • Increased HPA axis activation –> cortisol and CRF
51
Q

What is the psychological treatment of PTSD?

A

CBT
- Imaginal exposure to memories of event
- Graduated or massed
- Increase positive coping skills
- increase social support
- Highly effective !
Psychoanalytic therapy: catharsis = reliving emotional trauma to relieve suffering

52
Q

What is the medication treatment of PTSD?

A

SSRIs can be helpful - relieve heightened anxiety and panic attacks

53
Q

What disorder is characterized as
- anxious or depressive reactions to life stress
- milder than PTSD/acute stress disorder
- occur in reaction to life stressors like moving, new job, divorce, etc
- clinically significant distress or impairment

A

Adjustment disorder

54
Q

What disorder is characterized as
- disturbed and developmentally inappropriate behaviors in children
- child is unable or unwilling to form normal attachment relationships with caregiving adults
- occurs as a result of inadequate or neglectful care in early childhood

A

Attachment disorder

55
Q

What disorder is characterized by
- abnormally withdrawn and inhibited behavior
- less receptive to support from caregivers
- the child will very seldom seek out a caregiver for protection, support, and nurturance and will seldom respond to offers from caregivers to provide this kind of care

A

Reactive attachment disorder

56
Q

What disorder is characterized by
- A pattern of abnormally low inhibition in children

A

Disinhibited social engagement disorder
(approaching unfamiliar adults without fear)

57
Q

What are obsessions? What are the four types?

A
  • intrusive & nonsensical
  • thoughts, images, or urges
  • attempts to resist or eliminate

Types
1) symmetry
2) forbidden thoughts or actions
3) cleaning and contamination
4) hording

58
Q

What are compulsions? What are the four major categories?

A
  • thoughts or actions
  • provide relief from obsessive thoughts

Categories:
1) Checking
2) Ordering
3) Arranging
4) Washing/cleanings

59
Q

What is characterized by
- involuntary movements

A

Tic disorder
- Often co-occurs in patients with OCD
- Sometimes used as compulsions

60
Q

What is Tourette syndrome?

A
  • Two or more motor tics
  • One vocal tic
  • More than one year
    (either or is just tic disorder)
61
Q

What are statistics on OCD?

A
  • Female = male
  • chronic
  • Onset: childhood - 30s
62
Q

What causes OCD?

A
  • Generalized biological vulnerability: similar to general anxiety
  • Specific psychological vulnerability:
    – Early life experiences
    — learning Thoughts are dangerous/unacceptable
    – Thought-action fusion
  • Distraction temporarily reduces anxiety
63
Q

What are medication treatments for OCD?

A
  • SSRIS: 60% benefit, high relapse when discontinued
  • Psychosurgery: cingulotomy, 35% benefit
64
Q

What are psychological treatments for OCD?

A

CBT
- Exposure and Ritual Prevention: exposure to cues that trigger obsessions, with prevention of compensatory compulsions
- Highly effective: 86%
- No added benefit from combined treatment with drugs

65
Q

What disorder is characterized by
- Preoccupation with some imagined defect in appearance
- OR actual defect is slight to others

What is the comorbidity, course, onset, and treatments?

A

Body Dysmorphia Disorder

  • Comorbid: OCD 10%
  • Course: lifelong
  • Onset: early adolescent - 20a
  • Treatments: SSRIs, exposure and response prevention
    – Plastic surgery: 76.4% sought this, 66% received
    (8-25% patients requesting plastic surgery may have BDD)
66
Q

What disorder is characterized by
Excessively collecting and keeping items with minimal value, leading to cluttering and disruption of living space

Statistics?

A

Hoarding disorder
- 2-5% population
- men = women
-

67
Q

What is the difference between hoarding disorder and OCD?

A

OCD tends to wax and wane
Hoarding behavior can begin early in life and get worse with each passing decade

68
Q

What is the disorder characterized by
- the urge to pull out one’s own hair from anywhere on the body
- leads to noticeable hair loss on scalp, eyebrows, arms etc

A

Trichotillomania

69
Q

What is the disorder characterized by
- repetitive and compulsive picking of the skin leading to tissue damage

Treatment?

A

Excoriation
- Often face
1-5% prevalence rate
- behavioral habit reversal treatment is most effective treatment

CU: Abnormal Psychology (7 decks)

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