Unit 2 final review psychopathology Flashcards
Criteria for Specific Phobia
- Afraid of specific object
- Immediatly provokes fear
- Fear is out of porportion
Criteria for Social phobia
- Fear of social situation
- Fear they will be viewed negatively
- Always provoke fear
Difference between Social phobia and Specific phobia
Social phobia has fear of being negatively viewed
Panic Disorder criteria
- Panic attacks lasting longer than one month
- Fear of future attacks
- Avoid trigger
Agoraphobia criteria
- Fear of crowded spaces
- Avoidance
GAD criteria
- Worry about many things majority of time, > 6 mo
- Difficult to control symptoms of worry
Shared features of anxiety disorders and prevelance in genders and comorbitity/ prevelance
- Clinically sig impairment
- Avoidance
- Woman > man, 80% comorbidity, 18% prevelance, 30% lifetime
What is the goal of expsure treatment
- facing situation rather than avoiding
- Generalize to settings and stimuli
- reduce safety behaviors
What is the habituation model vs inhibitory learning model
- Habituation is old, inhibitory learning is new. Used to desentsitize by spending hours in area of fear, now new model is to learn competing association of fear
What ideas does cognitive therepy increase for Axiety disorders
- Increase belief in one’s coping ability
- Challenge unhelpful beliefs
- Debrief to learn
- Increase mindfulness
Medications for Anxiety disorders
Benzos, SSRI/SNRI- Benzos don’t work well and have bad side effects- create dependence and can be deadly
Why is SAD advantageous
- Evolutionarily important
- learn behaivor from traumatic event like bullying
Cognitive factors of SAD
- Unrealistic perception of concsequences
- belief of negativity toward oneself
- upward social comparison
- safety behaviros
Neurobiology behind panic
- Panic circut, early focus on locus cerilious, source of adrenaline. Hippocampus helps learn the anxiety that was produced
- Extra sensitivity of normal body causes fear of harm
Wells cog model vs Borkoveks cog model vs Newmans Contrast avoidance model
- Wells- Believe in function of worry nad harm simultaniously, worry about act of worry
- Borkoveks- worry destracts from neg emotions and images, reinforces itself
- Newmans contrast avoidance model- worry protects from shift of emotions
Heritability of Anxiety
20-50%
Neurobiology of anxiety
- Fear circut, amygdala and hippocampus
- Neurotransmitters (Seratonin, adrenaline, GABA, Corticotropin that decreases HPA axis)
Personality and Temperment of Axiety disorder
- Negative affectivity of personality, behavioral inhibition in childhood (shyness) leads to social anxiety, changes development and cause other disorders
Cognitive model of Anxiety
- Negative feelings of future and percieved lack of control.
- Cognitive biases, information processing focuses on threat.
- Childhood trauma fosters these
Gender and sociocultural factors of Anxiety
- Reporting bias- woman report more
- Men more likely to confront fears
- Woman experiance more childhood trauma
What is Mauers model of phobias
- Classical and operant conditioning combine to cause phobias and fear of objects. Classical ( neg event) paired with Avoidance (operant)
What is the panic circut
The trigger stimulus causes the stimulus to be percieved as harmful, even if its a normal stimulus
Criteria for OCD
- Presence of Obsessions, compulsions, or both, O or C is time consuming
How is OCD similar and different from anxiety disorder?
- Similar- has avoidance and rumination
- Different- has more elaborate behaviors and specificity
Criteria for Body Dysmorphic disorder
-Preoccupation with one’s flaws
- Repetative behaviors like picking, grooming, and checking
-
Criteria for hording disorders
- Difficulty parting with possesions
- Difficulty is due to need to save items and distress with discarding
- Clutter living area
Epidemiology of OCD
- 2-3%
- Equally common
- Themes common across cutlures, but obsessions change
Epedemiology of BDD
- 1-2%
- Equal in Men/Woman, preoccupations differ (bicep vs boobs)
- Many seek medical intervention
-63% consider suicide, 1/4 attempt
Epidemiology of Hoarding
- 3-6%
Biological factors of OCD
- Moderate heratability
- Disregulation of impulses and drives circut- impulses not functioning, come out as obsessions.
- Stronger neurological response to making errors
- Serotonin, glutamate, GABA, dopamine
Behavioral processes in OCD
- Prone to habit formation
- difficulty un-learning bahits
- Reduced anxiety and fear reinforces compulsions
- Avoidance- difficult not ton continue to perform even if action stops being assocated
Cognitive processes in OCD
- Thoughts embedded with catastrophic meaning
- Thought-action fusion- thoughts morlaly equivelent to actions
- -Disporportionate attention to stimuli or blocking out distracting information
What is Rachman’s theory of OCD
- Thoughts are equivelent to actions morally, guilt leads to self blame and shame, so nutralize thoughts to seak reassurance
Why is checking consistantly done?
- Low confidence in memories
- Yedasentience- internal feeling that you’ve done enough- is problematic- never feel as if they’ve done enough
Etiology of BDD
- History of being bullied by apperance
- Strong value of apperance- I am nothing if I have defect
- Biased attention to features
- Attention to Details
Etiology of Hoarding, including beleifs of self/others/items
- Evolutionary roots- stockpiling resources
- High rates of trauma
- Cog factors like difficulty organizing, believe self is unlovable, others cant be relied upon, possessions are irreplacable
What is ERP for OCD
- Exposure to situations, Response Prevention from engagement in behaviors ( 50-70% effective
Cognitive component of OCD treatment
- Challenge unhelpful beliefs about excessive sense of responsibility, post-exposure processing- review what they learned from exercise
What is the biological treatment for OCD
- SSRI/SNRI- Higher doses, 50-60% effective.
- DBT for OCD- 50% relief
What are the 2 types of stress
Chronic and accute
Why is the timing of stressors important
- Childhood is senstive, greater plasticity, less control and autonomy, fewer coping skills.
- Loss of spouse 30 v 90
- Stressors compound- incidental vs causal (loss of job leads to loss of house)
What is Diamond and Alley’s argument
Social safety- reliable social inclusion and protection, is deficient in excess stress and imperilesd by queerphobia
What are the criteria for the Adjustment disorder
- Development of symptoms in response to stress
- symptoms are clinically significant and impair functioning
How does stress impact biologically?
- Pupils dialate, muscles tense, lungs dialate, increase sweating, HR accelerates
Describe Alostasis and Allostatic load
- Alostasis is like homeostasis, sometimes deviate to survive in long term- get out of it to return later,
Alostatic load is when there is a new set point, we overload the system and can’t return
Physological impacts of chronic stress
- Negative affect
- difficulty concentrating
- beliefs about self others and world
Behavioral impacts of chronic stress
- Sleep
- substance abuse
- social withdrawl
- diet
Biological impacts of chronic stress
- Brain structure and fucntion
- inflammation
- immune suppression
- metabolic function
What are some ways that healing slows with stress
- AIDS disease outcomes
- Heart disease
- Decreased cancer survival
-Slower wound healing - Greater percent of colds with more stress
Why is subjective stress > Stress exposure
- Subjective stress ratings are a combination of expsure and individual differences, and stress exposure is objective
Why is stress linked to disease
- Direct biological, indirect behavioral and psycholigical, but stress may not cause illness but rather exascerabate pathogenic processes
Factors associated with resilience
- Access to resources. (physhological, interpersonal, financial), Genetic
What is the definition that is commonly agreed upon for Trauma
-Subject of enormous deabte. No obvious definition we all agree upon. DSM says its the exposure to actual or threatened violent death, serious injury, or sexual violence
Pros/Cons of a broader and more narrow deinition of PTSD
- Term ceases to have meaning if every experiance counts.
- Discounts some events that were traumatic
What is the new addition to DSM for trauma?
Traumatic Stress Spectrum- trauma and stressor related disorder.
- Some PTS symptoms
Why was inclusion of PTSD in the DSM originally opposed
- PTSD has explicit cause (trauma) , violates rule we don’t talk about causal role of event
Criteria for PTSD
- Exposure to trauma, one or more intrusion symptoms (flashback, nightmare), avoidance, changes in cognition, alteration in reactivity, > 1 mo
Prevelance of PTSD
- 7-9%
Which gender is PTSD greater in
Woman> Men
What covers the 1 month gap between start of PTSD
- Acute stress disorder
- Symptoms similar to PTSD, can only be diagnosed immediatly following trauma
- Half cases of Acute stress disorder develop to PTSD
What is Judith Herman’s theory of cPTSD
- Compled, focuses on Woman. Serial traumatization with no escape can give rise to PTSD
- Focus on emotion regulation, interpersonal problems
What is the theory of moral injury with PTSD
- Having moral injury combined with PTSD emphisizes psycholiglcal aspects of truama.
More likely to cause suicidality
What are ACEs and what are their repercussions
- Adverse Childhood Experiances
- Linked to health- effects on gene expression, brain development, immune systems, increase lifetime risk for problems
What are other factors that potentially contribute to PTSD
- HPA axis with higher reactivity
- Stress circut, reduced hippocampal volume
- apprasal of stress system- think weakness
- anticipation of rauma
What is the first line of treatment for PTSD
- Trauma focused psychotherepy
- Prolonged expsure and Cognitive processing therepy (both have exposure)
What are some nisconceptions about trauma focused psychotherepy
- Not suitable for complex traumas
- Most people with trauma are too fragile for it
- Exposure therepy is harmful because it increases distress
Medication to treat PTSD
- SSRIs ( effective for depression symptoms)
- See management for symtoms, not problem, ex perscription for nightmares
- Benzos perscribed frequently, not helpful
What is the idea behind trauma informed care
- Change narrative from whats wrong with you to you to what happened to you
What is the chriteria for schizophrenia
- Two or more symptoms for 2 month (like delusions, hallucinations, disorganized speach),
- Level of function is below when onset occured
- Disturbance persist 6 months with 1 month of symptoms
What are 3 clusters of symptoms for schizophrenia
- Positive (have something most people don’t have)
- Negative (don’t have something people do have, like speach or emotions)
- Disorganization ( Speach, cognition, behavior)
Describe positive sumptom of delusion
- Bizzare beliefs not aligned with reality, not disconfermable
- Ideas of reference, persecutory (paranoya), grandiose (have power like flight, talk to god), Somatic (tracker in my body), feelings controlled by external forse (Alien forces me to act)
Describe the positive symptom of hallucinations
- Experiances that don’t correspond to external stimuli
Most common positive symptom of hallucinations
Auditory, then visual
Who is more likely to act on hallucinations
- People who consider themselves to be socially inferior
Types of negative symptoms in schizophrenia
- Avolition (lack of motivation)
-Asociality (lack of soical interaciton) - Anhedonia (lack of anticipating pleasure)
- Alogia (reduction of speach)
What are disorganized symptoms in schizophrenia
- Catatonia (repeated gestures, ex. head banging)
- Disorganized speach, difficutly organizing behaviors
What is Schizophreniform disorder
- Same symptoms as schizophrenia, but for 1 month, not 6mo
What is schizoaffective disorder
- Have psychotic and mood episodes, happens when mood interacts with disorder too
What is delusional disorder
- Persistant delusions without other schizophrenia symptoms
Epidemiology of Schizophrenia
- 1% lifetime prevalance
- Men > Woman
- More frequent in black americans than white
Describe prototypical course of schizophrenia
- Premorbid, predromal, onset, residual relapsing
What is behavioral genetics behind Schizophrenia
- 80% heritable, genetic vulnerability, negative symptoms have stronger component
What is the dopamine hypothesis for schizophrenia
- Caused by excess dopamine
- Effacacy in treating psychosis
- Too much dopamine causes too much salience- something we need to pay attention to
What is the brain structure and function behind Schizophrenia
- Enlarged ventricles, not seen in everyone. Correlated with worse functioning, worse response to meds, worse performance
Prefrontal cortex and schizophrenia functioning
- Speach, decision making, goal directed behavior in prefrontal cortex.
- Reduction in grey matter- reduce prefrontal cortex
Temporal cortex and schizophrenia functioning
reduced hippocampal volume, related to disrupted HPA axis, stress is neurotoxic so could be more about that
Connectivity in brain and schizophrenia
- Loss of dendrites in Prefrontal cotex, less connectivity of white matter, difficulty in disengaging default mode- what brain does when not engaged in task
Neurodevelopmental disorder and schixophrenia
- Low oxygen giving birth, presence of toxic chemicals during birth, early malnutrition, maternal stress
What was walkers study of home movies
- Evidence of subtle differences in motor skills, expression of emotions, attention in small kids early on
What is the default mode network
- What our brain does when we are not engaged on a particular task- mind wandering
- Difficulty disengaging= schizophrenia maybe
