Test #2 Lecture Notes Flashcards
OCD falls into what category of disorder
anxiety disorder
obsessions, def, forms/distressing?
intrusive and recurring thoughts, impulses, and images that are irrational and appear uncontrollable to the individual
can take forms of thoughts, images, impulses, doubts ect.
are experienced as distressing: unwanted, threatening, obscene, blasphemous, nonsensical etc
incongruent with individuals belief system
attempts are made to resist obsession
General categories of obsessions
contamination, responsibility for harm (if I don’t warn people that the floor is slippery, it will be my fault they get hurt), incompleteness, uneccapteble thoughts with immoral, sexual, or violent content
compulsions
Is a repetitive behavior or mental act that the person feels driven to perform in
order to reduce the distress caused by obsessive thoughts
* The activity is not realistically connected with its apparent purpose or is clearly excessive
(e.g., hand washing)
they are motivated and intentional behaviors and are performed to reduce distress/obsessional anxiety
commonly reported compulsions
Decontamination:
* Hand washing for 45 minutes after using the bathroom
* Checking:
* Returning home after seeing a fire engine to make sure own house is safe
* Repeating routine activities:
* Going through a doorway over and over to prevent bad luck
* Ordering/arranging:
* Rearranging book on a book shelf in size order
* Mental rituals:
* Cancelling a bad thought by thinking a good thought
* Excessive praying to prevent feared disastrous consequences
hoarding and its relationship to OCD
Hoarding: previously a subtype of OCD, not anymore. Should it be? Dr. Mattson
believes it should be because of the anxiety/reinforcement component.
i. Thoughts are not intrusive, unwanted or distressing in hoarding, they just
want to keep/collect
1. Can be neutral or positive (when looking at the wrong part of the
process - ex: aw so nice he kept his mom’s birthday cards,
convincing justifications, fail to realize that it’s because of the anxiety that is provoked when he goes to throw them out, not
because he’s saving them for memories)
ii. Hard to conceptualize excessive saving as compulsive or realistic
- i.e. does not seem to result in an escape from (or neutralization of)
obsessional anxiety
- A hoarder can have OCD behaviors and also hoard, but both are
manifestations of the same thing
OCD subtypes
Poor insight and overvalued ideation:
*Individuals who view their obsessional fears
and compulsive behavior as reasonable
*More strongly associated with religious obsessions,
fears of mistakes, and aggressive obsessional
impulses
A common underlying factor here is that you can make a case for
why cases like these could be a good thing (like someone who has
a fear of making mistakes - aren’t mistakes unwanted anyway?)
- Perfectionistic tendencies/cleanliness fall into this category:
shouldn’t cleanest be best? But bigger picture shows the
flaws here – cleaning all day brings up negative returns
because of the focus on the singular outcome
- Makes these cases harder to treat – many people do not
realize that their behaviors are disordered, they may not be
ready to fix their problem
Biological models of OCD 2
Serotonin hypothesis:
* OCD arises from abnormalities in the serotonin neurotransmitter system
* Medications that increase brain levels of serotonin are effective in reducing OCD
symptoms
Structural Abnormalities:
* Connects regions of the brain that play roles in information processing
and behavioral responses
* Examination of glucose utilization in OCD and non-OCD brains
evaluation of biological models of OCD
Evaluation: there is no explanation as to why serotonin or structural abnormalities
cause OC behaviors
- OC people feel more responsible for the wellbeing of others, but feeling
responsible is not a marker for OCD
- Repetition may also be thought to be a marker for OCD, but repetition is
practice and can be helpful and good
- The biological model is unable to explain themes and content of OC
behaviors (EX: religion, feelings of anger, sexual thoughts)
- This limits the biological model’s validity
Learning Model of OCD
*Two-factor theory:
* Stimulus that poses no objective threat comes to evoke
obsessional fear
* Avoidance behaviors develop as a means of reducing anxiety
* Superstitious conditioning
*Evaluation:
* Operant conditioning plays a role in maintenance of behaviors
* Little evidence that classical conditioning can account for onset
of fear
* Verbal transmission and modeling may account for development
Cog behavioral model of OCD
*Unpleasant mental intrusions are a normal and universal
experience
*Cognition in OCD individuals:
* Cannot tolerate or dismiss mental intrusions:
* Appraise the mental intrusion as posing a threat
* Believe specific thoughts are indicative of abnormality
* Attempt to inhibit thoughts have paradoxical effects
* E.g., white bear phenomenon
*Behavioral component:
* Compulsive behaviors persist because they are immediately
reinforced by reducing anxiety
Psychodynamic model of OCD
Psychodynamic Model
*OC behaviors represent unconscious conflicts between the
id and the superego
* Accounts for general themes in obsessive thoughts
* e.g., contamination, sex, aggression
* Aligns with general organization of the brain
makes sense that you have animalistic obsessions and you can’t control them because they come from the back of our brain and were can’t control them with our forebrain
Depression prevalence rate
depression seems to be more prevalent and the age o onset of the first depressive episode is decreasing
how many times are women more likely to develop depression
2X
The rates of depression in girls and boys don’t differ until about age 13 whereat:
- Girls rates increase sharply and are twice those for men by late
adolescents
- Lower age at onset predicts a worse course of the disorder ONLY
for females
Boys rates remain low and may even decrease over time, staying at a
stable rate while girls rate rises over time
You must have one of two of these for depression
anhedonia, down mood
Is depression and adaptation according to Nesse (2000)
There are benefits to regulating investment strategies as a function of
changes in anticipated levels of payoffs
❧ In certain situations, down regulation of effort and risk taking is an
advantage
Wender & Klien (1982, p. 204)
biologically based self-esteem – and mood in general – seems to us to
have evolutionary utility…If one is subject to a series of defeats, it pays to
adopt a conservative game plan of sitting back and waiting and letting
others take the risks. Such waiting would be fostered by a pessimistic
outlook.”
● In a situation where an activity is unlikely to succeed, having a
pessimistic outlook may be adaptive
Incentive-disengagement theory of depression
The role of depression was to disengage motivation for an
unreachable goa
Control theory of depression
Low mood prompts the consideration of alternative strategies
● E.g. low mood elicited by a mismatch between achievement and
expectations
● If you don’t succeed, try something else
Behavior model of depression
Low rates of response contingent reinforcement (RCPR)
● For aversive stimuli (Things you don’t like):
○ Responses aimed at reducing aversive stimuli are not
negatively reinforced
● For appetitive stimuli (Thing you like):
○ Responses aimed at producing rewards are not positively
reinforced (may also be punished)
● Ultimately, behavior that is not reinforced (or is punished) will
extinguish
○ If nothing seems to be working, you stop the behavior
completely
○ Ex: you are looking for a job and nothing seems to work so
you stop looking
make sure to ask someone the practical difference between incentive disengagement theory and behavioral model of depression
I believe in you Elias
Lewinsohn’s integrative model
■ Decrease in rewards (or increase in costs) in the environment lead to lower
response-contingent reinforcement, which increase depressive symptoms
● Person does not engage in activities that provide reinforcement
○ Ex: you want to date but you don’t go out and meet people,
you’re not on dating apps, and you sit in your room all day
● The environment does not provide opportunities for reinforcement
○ Ex: a person on a deserted island who wants a partner but is
all alone may begin to feel isolated or depressed
● Inability to access available rewards (skills deficits)
● Environmental changes (ex: loss)
Lewinsohn’s Integrative Model (continued):
❧ Depressed mood creates cognitive vulnerabilities (e.g., pessimism) and
behavioral consequences (e.g., social withdrawal)
❧ Information processing shifts to become more negative:
❧ Negative information more accessible and efficiently processed
❧ Change toward more negative self-schema
If response depression is adaptive, why is depression a disorder?
Short term feelings of sadness are not inherently bad
■ But getting stuck in a state like this leads it becoming an issue
■ It becomes a viscous feedback loop for anhedonia and pessimism
cones 1987 model
Similar to Lewinsohn’s model but more focused on how the
social environment responds to the depressed individual.
❧ An initial event or situation elicits depressive symptoms and
support-and reassurance-seeking.
❧ An initially positive social response over time becomes hostile ore
resentful to the continued support- and reassurance-seeking.
❧ Individuals either find excuses to create social distance with the
depressed person or provide only insincere support or
reassurance
❧ The depressed person may accurately interpret these as rejection or
platitudes and in any case feel socially isolated, furthering
depression
diathesis and precipitating
[M]ost models recognize that suicide risk is a result of the interplay between
predisposing (also known as distal or diathesis) and precipitating (also
known as proximal, triggering or stress) factors, with some models also
specifying a role for developmental factors.” (Turecki et al., 2019)
- Precipitating - “The things leading up to a suicide attempt”
- The decision is usually impulsive, makes it difficult to develop
preventative measures
predispositions and triggers
addictive behavior definition
Any compulsive habit in which an individual seeks a state of immediate
gratification despite longer-term costs associated with the habit
What separated addictive behaviors from compulsions in OCD/avoidance of
anxiety?
A lot of the same features that we see in other disorders will be
present in the concept of addiction
- The motivation for compulsions in OCD is to decrease distress
brought on by unwanted obsessions; in substance addiction, the
initial compulsion is due to the need for IMMEDIATE gratification
Addictive behaviors encompass
Excessive use of psychoactive substances:
- E.g., CNS Depressants: Alcohol, depressant drugs (e.g., Valium)
- E.g., Stimulants: Cocaine, amphetamines (e.g., speed), tobacco
- E.g., Opiates: Morphine, heroin (generate feelings of euphoria)
- E.g., Psychedelics: LSD (aka, acid), psilocybin (aka, mushrooms)
- Tend to not be as addictive as other drugs on this list
substance use disorder
maladaptive pattern of use leading to significant impairment or distress (it’s a
problem), as manifested by 2 or more of the following over a 12-month period:
- substance taken in large amounts or for a longer period than intended
- inability to cut down or control use
- time and resources spent in obtaining, using, or recovering from substance use
- cravings (what drives the addiction)
- failure to fulfill major role obligations
- social, occupational, recreational activities reduced because of addiction
- recurrent substance in situations in which it is physically hazardous
- continued use despite having persistent or recurrent social/interpersonal problems caused or exacerbated by the effects of the substance
biological models of addiction
genetic risk: predisposition to find effects of psychoactive substances reinforcing.
impulsivity
behavioral models of addiction
a critical aspect underlying all forms of addictive behavior is the inability to regulate some behavior despite consequent problems resulting from the behavior
the immediate consequences are pleasurable and the larger future consequences cease to regulate behavior
cravings
Body learns cues related to substance intake (classical
conditioning)
Process B initiated when cue is present
◦ Process B produces withdrawal effects prior to substance intake (craving)
◦ User initiates Process A to reduce craving (Process B)
expectancy theory in addiction
people are going to go along with what they expect to happen. if people expect alcohol consumption to lead to positive outcomes, they will be more inclined to drink
tension reduction theory
people believe it will reduce tension
(alcohol increases stress levels but expectancy theory comes into play and you believe it is making you less stressed)
some have a genetic predisposition to the stress-alleviating effect of alcohol
social learning theory
situational factors can function as triggers through associative learning
incorporates expectancies. and social situations that are triggers
emphasizes coping skills: the patients ability to cope with stressful events without reverting to the use of alcohol
abstinence self efficacy: the patient’s belief in his or her ability to refrain from drinking
dual system theory in video game addiction
behavioral excess results from an imbalance between
hyperactivity of the reward system
hyperactivity of the inhibition system
Moderator
factor that changes the relationship of two variables
