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Clinical and Abnormal Psychology - BEHL 3032 > Week 3 - OCD and related disorders/trauma and stress related disorders > Flashcards

Week 3 - OCD and related disorders/trauma and stress related disorders Flashcards

1
Q

Anxiety disorder characterised by obsessions and/or compulsions.

A

obsessive-compulsive
disorder (OCD)

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2
Q

Current DSM5 list OCD as part of the anxiety disorders or as a separate disorder?

A

Separate
but adjacent to AD to reflect close relationship with each other.

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3
Q

4 diagnostic criteria of OCD are:

A

1.obsessions and compulsions
2. marked distress (for more than one hour a day, difficulty functioning)
3. symptoms are not
attributable to a substance (drugs, meds)
4. content of obsessions or compulsions cannot
be restricted to another disorder that is present (E.g. excessive concern about appearance in
an individual with body dysmorphic disorder would not warrant the additional diagnosis of OCD)

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4
Q

In addition to 4 main diagnostic criteria, what is the additional criterion required by DSM5?

A

individual’s level of insight:
- ‘Good or fair insight’ is defined as the individual recognising that his/her OCD beliefs
are probably not true. - ‘Poor insight’ is noted in cases where the sufferer argues that his/her OCD
beliefs are probably true. - ‘Absent insight’ (or ‘delusional beliefs’) refers to individuals who appear to be completely convinced that their OCD beliefs are true. It should be noted that the inclusion of
an ‘absent insight’ specifier is somewhat controversial as it makes the distinction between OCD and
psychotic conditions more difficult. Finally, given the frequent experience of tic-related problems in
OCD, a current or past history of tic disorder (e.g., Tourette’s disorder, in which sufferers experience
motor tics such as repeated eye blinking and vocal tics such as repeating one’s own words), should
also be specified in a complete DSM-5 assessment of OCD.

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5
Q

Uncontrollable, persistent thoughts, images, ideas or impulses that an individual feels intrude
upon his/her
consciousness and that cause significant anxiety
or distress.

A

obsessions (to qualify as obsession the person must engage in active attempts to ignore these thought and be recognise they come from his/her own mind)

(are not thoughts
are not simply excessive worries about real-life problems)

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6
Q

Repetitive
behaviours or
mental acts that
an individual
feels s/he must
perform.

A

compulsions

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7
Q

According to APA, separating OCD from the anxiety disorders and grouping it with body dysmorphic disorder, hoarding disorder, reflects the commonalities in the diagnostic features and
treatment approaches. True/False

A

True

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8
Q

Despite a good description of the limits of OCD, the DSM-5 does little to indicate the
breadth of possible presentations of this disorder. True/False

A

True

(more than any other psychiatric condition,
OCD varies considerably from case to case with an endless list of objects to become obsessed about).

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9
Q

In addition to washing/cleaning, compulsive checking is another common feature of OCD. True/False

A

True

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10
Q

OCD is a relatively common disorder, with a prevalence rate in the ___ - ___ per cent range, with an average age of onset for the disorder of _____ years and will usually remain through a life.

A

2-3

10.3

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11
Q

The aetiology of OCD is supported by two strong models: the _____________ and ___________.

A

neuropsychological
cognitive

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12
Q

Neuropsychological model suggests that OCD results from a failure of inhibitory pathways in the_________ ganglia of the brain to stop ‘behavioural macros’ (sets of behaviours
choreographed for specific situations, such as grooming and checking) being triggered in response to internal or external stimuli.

A

basal

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13
Q

Group of large
nuclei in the
forebrain;
involved in the
control of motor
behaviour and
may be relevant
to obsessive/compulsive
disorder.

A

basal ganglia

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14
Q

The _________ model emphasises that OCD results from the misinterpretation of intrusive thoughts.

A

cognitive ( cognitive model of Salkovskis)

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15
Q

Cognitive model of OCD is supported by the effectiveness of cognitive-behavioural approaches to
treatment that are based on the cognitive model. True/False

A

True

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16
Q

Correlational study by the Australian team of Jones and Menzies, found that threat appraisals trigger compulsive washing and the related symptoms of anxiety and avoidance but no causal role of the threat appraisals has been established. True/False

A

True

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17
Q

Common treatments for OCD are:

A
  1. CBT:
    - exposure and response prevention
    - behavioural experiment
    - cognitive restructuring
  2. PHARMACOTHERAPY
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18
Q

Type of psychological
treatment that
combines both
cognitive and
behavioural
concepts and
techniques.

A

cognitive
behaviour
therapy (CBT)

(Used in about 75% of OCD cases)

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19
Q

Behavioural technique in which the client
is:
(a) exposed to feared
stimuli (such as
obsessions in obsessive/compulsive
disorder), and
(b) prevented from utilising any responses (such as compulsions
in obsessive/compulsive
disorder) aimed at
escaping from his/her anxiety

A

exposure
and response
prevention

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20
Q

Cognitive
technique in
which the client
participates in a
planned activity
in order to test
the accuracy of
his/her beliefs

A

behavioural
experiment

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21
Q

Cognitive
technique in
which the client
learns to identify,
challenge and
replace his/her
dysfunctional
beliefs with more
realistic or helpful
beliefs.

A

cognitive
restructuring

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22
Q

What is DIRT, developed by Australian team Jones and Menzies:

A

Danger Ideation
Reduction Therapy (DIRT) for compulsive washers
(focuses on psychoeducation about
disease and immune function, and includes a variety of cognitive therapy strategies to lower patients’ risk estimates of illness. The treatment has been
shown to eliminate OCD in individuals who have
failed to benefit from exposure and response prevention and medication. In addition, DIRT can result in rapid recovery, sometimes in as few as eight one-hour sessions The DIRT program has been extended to address compulsive checking

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23
Q

Persistent
difficulty in
discarding
possessions,
with a high
level of distress
associated with
removing the
items

A

hoarding
disorder

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24
Q

The point
prevalence of body dysmorphic disorder disorder is estimated at approximately _______ per cent, with similar numbers of male
and female sufferers.

A

2.5

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25
Q

Condition that
involves recurrent
skin picking (most commonly picked sites are hands, face and arms)

A

excoriation
disorder

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26
Q

Prevalence of hoarding disorder is ___-____ percent with slightly more ______ than males.

A

2-6
females, males

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27
Q

Disorder involving
obsessive
concern
regarding a
part of the body
the individual
believes is
defective.

A

body dysmorphic
disorder

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28
Q

Condition that
involves the
recurrent pulling
out of one’s own
hair.

A

trichotillomania

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29
Q

Evidence suggests that up to _____ per cent of people seeking
cosmetic surgery meet criteria for body dysmorphic disorder

A

15

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30
Q

prevalence of trichotillomania is approximately __-____ percent, with estimates 10:1 between females and males.

A

1-2

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31
Q

Excoriation disorder is often seen as a comorbid condition in those with ______ or _______________.

A

OCD
trichotillomania

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32
Q

The lifetime prevalence of excoriation disorder is approximately _______per cent, with up to 75 per cent of sufferers are female.

A

1.5

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33
Q

This relatively low prevalence figure for excoriation is probably due to the low level of interference in functioning associated with mild cases of the condition. True/False

A

False

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34
Q

Prior to the DSM-5, obsessive-compulsive disorder was conceptualised as an
________ disorder.

A

anxiety

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35
Q

Multiple Choice Question
Researchers have demonstrated obsessive-compulsive disorder to have one of the most __________ presentations between individuals with the same disorder.

diverse
predictable
similar
unusual

A

diverse

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36
Q

It has been suggested that up to _______
% of adult sufferers of OCD recall symptom onset before 18 years years of age.

A

80

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37
Q

According to the neuropsychological model, OCD results from a failure of inhibitory pathways in the ____.

limbic system
basal ganglia
amygdala
prefrontal cortext

A

basal ganglia

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38
Q

The __________ model of OCD remains the only theoretical perspective able to account for the full phenomenology of the disorder.

A

cognitive

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39
Q

In addition to obsessions and compulsions, the other key criteria for obsessive-compulsive disorder relate to:

Multiple select question.

comorbid anxiety disorders

medication effectiveness

distress

negative impacts on functioning

A

distress

negative impacts on functioning

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40
Q

The treatment of choice for OCD is:

cognitive behaviour therapy

danger ideation reduction therapy

cognitive therapy

psychodynamic therapy

A

cognitive behaviour therapy

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41
Q

Two of the most common compulsions experienced by individuals with obsessive-compulsive disorder are _________
and __________.

A

checking
washing

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42
Q

Brian has ongoing difficulties with getting rid of possessions, even those that are damaged and useless. His house is overflowing with items, but he cannot cope with the idea of decluttering. Brian would likely be diagnosed with ________ disorder.

anxiety
hoarding
delusional
obsessive-compulsive

A

hoarding

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43
Q

It has been suggested by authors of the Epidemiology Catchment Study that OCD is the _______ most common psychiatric condition across the world:

second
fifth
fourth
third

A

fourth

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44
Q

Behavioural
_________ are complex sets of behaviours choreographed for specific situations, such as checking.

A

macros

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45
Q

The media extensively documented Michael Jackson’s seeming obsession with changing his appearance. If this behaviour was due to perceived defects in appearance, it is possible he was suffering from which disorder?

obsessive-compulsive
social anxiety
body dysmorphic
delusional

A

body dysmorphic

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46
Q

Cognitive theorists suggest that __________ may mediate some compulsive behaviours.

trauma history
insight
fear of death
fear of fear

A

fear of death

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47
Q

It is suggested that the prevalence of clinically significant hoarding is approximately ___%.

4–8
3–7
2–6
1–5

A

2–6

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48
Q

The medication shown to have the greatest effectiveness in managing OCD is:

clozapine
valium
clomipramine
diazepam

A

clomipramine

(only 40–60 per cent of sufferers seem to benefit from medication)

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49
Q

It is suggested that OCD is a relatively common disorder, with prevalence rates of approximately:

2–3%
10–11%
5–6%
8–9%

A

2–3%

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50
Q

Males with body dysmorphic disorder are likely to experience distressing thoughts regarding their:

Multiple select question.

general build
weight
nose
body hair

A

general build
body hair

51
Q

__________ disorder is often seen as a comorbid condition in those with OCD or trichotillomania.

A

Excoriation

52
Q

To meet criteria for trichotillomania, the individual must have:

experienced the disorder before the age of 18

removed virtually all hair from the affected area

tried to reduce his/her hair pulling

sought treatment

A

tried to reduce his/her hair pulling

53
Q

Psychological treatments for OCD-related disorders generally include:

Multiple select question.

cognitive restructuring
exposure
avoidance
safety behaviours

A

cognitive restructuring
exposure

54
Q

It is estimated that up to
_______ % of excoriation disorder sufferers are female.

A

75

55
Q

Females with body dysmorphic disorder are likely to experience unhelpful thoughts about their:

Multiple select question.

body hair
genitals
nose
weight

A

nose
weight

56
Q

The most common regions targeted by sufferers of trichotillomania are:

Multiple select question.

leg hair
eyelashes
head hair
pubic hair

A

eyelashes
head hair

57
Q

Medications that increase the availability of the neurotransmitter ________ are widely used in the treatment of OCD-related disorders.

serotonin
norepinephrine
GABA
dopamine

A

serotonin

58
Q

Leo has a pattern of picking his skin until it bleeds and scars. He continues to do this despite distress, and observable lesions. Leo would likely be diagnosed with:

body dysmorphic disorder

trichotillomania

excoriation disorder

obsessive compulsive disorder

A

excoriation disorder

59
Q

Anxiety disorder that may develop after a traumatic experience.

A

posttraumatic
stress disorder
(PTSD)

60
Q

_________ is characterised by:
(a) repeated
re-experiencing
of the traumatic event;

(b) avoidance of stimuli associated with the trauma or emotional
numbing;

(c) negative changes in
cognitions and mood; and

(d) increased arousal

A

PTSD

61
Q

DSM5 classifies PTSD among ‘Trauma- and Stressor-Related Disorders. True/False

A

True

62
Q

There is strong evidence of a relationship
between the greater likelihood of PTSD development as the severity of ___________ increases. Common examples of traumatic events associated with PTSD include war, natural disasters, rape, assault, car accidents and terrorism.

A

trauma

63
Q

PTSD comprises four major clusters of symptoms:

A
  1. re-experiencing symptoms,
  2. avoidance symptoms,
  3. negative changes in cognitions and mood,
  4. marked alterations in arousal
64
Q

The intrusive memories, flashbacks and
nightmares related to the traumatic event and distress when exposed to reminders of the trauma are part of the _____________ symptoms cluster.

A

re-experiencing

65
Q

Avoidance of thoughts and reminders of the trauma are part of the ________ _________ symptoms cluster.

A

active avoidance

66
Q

Emotional numbing, inability to recall an important aspect of the trauma, exaggerated
negative expectations about oneself or the world, excessive blaming of the self or others, and pervasive negative affective states (e.g., fear, anger, guilt and shame) are part of the ________ __________ in cognition and mood.

A

negative alterations

67
Q

Exaggerated startle response (i.e., being very jumpy or reactive to stimuli),
hypervigilance (i.e., being on the lookout for possible sources of threat), sleeping and concentration
difficulties, reckless or self-destructive behaviour and anger outbursts, are part of the __________ __________ symptoms cluster.

A

increased arousal

68
Q

To qualify for a diagnosis of PTSD, symptoms must have been present for at least _______ month/months.

A

one

69
Q

PTSD is strongly associated with a range of other psychiatric disorders such as _______ and _______.

A

major depressive disorder

GAD

70
Q

PTSD tends not to be static but rather shifts over time, people shifting from having PTSD to having
subsyndromal PTSD, and even no PTSD. True/False

A

True

(e.g. 94 per cent of rape victims display sufficient symptoms two weeks after the trauma to meet the criteria for PTSD (excluding
the one-month time requirement), this rate dropped to 47 per cent 11 weeks later)

71
Q

Shifting states of
PTSD have been tested using _______ modelling statistics to map the different trajectories
that people follow after trauma, which can be achieved when people are repeatedly assessed.

A

growth

72
Q

_________ __________ statistics found people tend to be either
(a) resilient,
(b) initially distressed but then gradually
recovering,
(c) worsening over time or (d) chronically distressed.

A

Growth modeling

(These patterns have been shown repeatedly in survivors of traumatic injury and SARS infection women diagnosed with breast cancer, those who have experienced disasters or terrorist
attacks and in military personnel).

73
Q

Despite the overall comparability between children’s and adults’ reactions, there are suggestions that PTSD can be manifested differently across different stages of childhood (preschool children can display fewer cognitive symptoms and little avoidance compared to older children. True/False

A

True

74
Q

_________ development is associated with a history of psychological disturbance predating the trauma such as prior traumatic experience, lower intelligence levels, female gender, more severe traumatic
exposure, low social support after the traumatic experience, interpersonal trauma, and ongoing stressors in the aftermath of the trauma.

A

PTSD

75
Q

In addition to factors such as a history of psychological
disturbance, _________, __________ and __________factors are believed to be involved in the causation of PTSD.

A

cognitive
learning
biological

76
Q

According to ____________ models of PTSD, maladaptive appraisals or interpretations of the traumatic event (e.g., ‘I was weak because I did not stop the rape’), the individual’s responses to it (e.g., ‘I am worthless because I am not coping better with the assault’) and the environment after the trauma (e.g.,
‘I can never feel safe again after the assault’) are pivotal in terms of perpetuating the individual’s sense of threat.

A

cognitive

(There is much evidence that maladaptive thoughts about the trauma predict the development of the disorder)

77
Q

______________ accounts of PTSD involve the application of classical conditioning principles to trauma. Specifically, when a traumatic event (US) occurs, people typically respond with fear (UR). It is argued that the strong fear elicited by the trauma will lead to strong associative conditioning between the fear and the events surrounding
the trauma. As
reminders of the trauma occur (CS), people then respond with fear
reactions (CR).

A

Learning

78
Q

__________ accounts highlight the role of arousal in strengthening the fear-conditioning process.

A

Biological

79
Q

Process that involves
pairing a fear response with factors present at the time of experiencing
the fear, such that subsequent exposure to
these factors triggers a fear reaction.

A

fear-conditioning

80
Q

Sympathetic arousal at the time of a traumatic event may result in the
release of stress neurochemicals (including noradrenaline and adrenaline) into the cortex, resulting in strong conditioning of fear responses with the associated memories. True/False

A

True

(When individuals with PTSD are asked to recall past traumatic events, they consistently produce larger psychophysiological responses, including heart rate and skin conductance,
compared to individuals with a similar trauma history without PTSD)

81
Q

Activation of the sympathetic nervous
system that is responsible for increased heart rate,
respiration rate and blood flow to the organs, allowing people
to respond to threats.

A

sympathetic
arousal

82
Q
A

According to cognitive models, this is because avoidance prevents
people from having the opportunity to access corrective information that the perceived threats are no longer realistically dangerous. According to learning processes with their biological bases,
avoidance serves to impede the extinction of classically conditioned fear. The combination of predisposing, cognitive, learning and biological factors that are theorised to result in the development of PTSD are
shown in Figure 4.1.

83
Q

Selective ________ ___________ inhibitors (SSRIs) are an effective class of medications for patients with PTSD.

A

serotonin reuptake

84
Q

Class of
antidepressant
drugs (such
as fluoxetine)
that inhibit the
reuptake of
serotonin.

A

selective
serotonin
reuptake
inhibitor (SSRI)

85
Q

CBT for PTSD usually consists of:

A
  1. Psychoeducation - educating patient on disorder and symptoms
  2. Anxiety management - teaching coping skills
  3. Cognitive restructuring - challenge beliefs.
  4. Prolonged imaginal exposure - encouraging patient to engage in vivid imagining of trauma (lasts for at least 30 minutes).
86
Q

Most exposure treatments for PTSD supplement imaginal exposure with in vivo exposure that involves graded exposure to trauma-related stimuli in real life. True/False

A

True

87
Q

The duration of CBT for PTSD is typically __-___ sessions.

A

9-12

88
Q

Individuals diagnosed with acute stress disorder are at higher risk for developing PTSD later. True/False

A

True

89
Q

Across most trials of treating PTSD, nearly _____ percent of patients either drop out of treatment or do not respond.

A

50

90
Q

Behavioural technique in which the client
confronts the feared stimuli that s/he has avoided until his/her
anxiety reduces; there are various types of exposure such as in vivo
versus imaginal.

A

exposure therapy

(found beneficial for child sexual abuse and adults following civilian trauma)

91
Q

The process of extinction involves neural plasticity in the basolateral nucleus of the amygdala, and it is strongly reliant on
NMDA receptors, which are a type of glutamate receptor. True/False

A

True

92
Q

Chris’s daughter nearly
died at birth, and had to undergo multiple surgeries to survive. Ever since then, Chris has avoided hospitals even when sick himself. Chris is demonstrating which symptoms associated with PTSD?

re-experiencing
avoidance
negative mood and cognition
alterations in arousal

A

avoidance

93
Q

Researchers suggest that _________ are more likely to be exposed to trauma than ________.

males; females
children; women
females; males
children; men

A

males; females

94
Q

It has been reported that up to ______% of individuals with PTSD will also meet criteria for major depression.

43
31
25
59

A

59

95
Q

The higher rates of PTSD in women have led to the suggestion that being __________
is a risk for the development of PTSD.

A

female

96
Q

Ever since his car accident, Philip has been emotionally numb—not just to reminders of the accident. Philip is demonstrating which feature of PTSD?

negative changes in mood

altered arousal levels

re-experiencing symptoms

avoidance

A

negative changes in mood

96
Q

According to cognitive models of PTSD, which of the following is pivotal in perpetuating a sense of threat?

positive self-talk
negative appraisals
self-efficacy
access to support

A

negative appraisals

97
Q

Despite the frequency of exposure to potentially traumatising events, few people:

remember the traumatic event

report distress

develop PTSD

are able to cope without intervention

A

develop PTSD

98
Q

When people with PTSD recall past traumatic events, they demonstrate higher _________ and ___________ compared to individuals with a similar trauma history who have not developed PTSD.

Multiple select question.

accuracy of recall

skin conductance

processing of information

skin conductance

A

skin conductance
skin conductance

98
Q

According to learning accounts of the aetiology of PTSD, fear is the:

unconditioned stimulus
unconditioned response
conditioned stimulus
conditioned response

A

unconditioned response

98
Q

According to learning accounts of PTSD, reminders of the trauma act as:

conditioned responses
conditioned stimuli
unconditioned stimuli
unconditioned responses

A

conditioned stimuli

98
Q

Which of the following disorders is most likely to be comorbidly diagnosed with PTSD?

drug use disorder
alcohol use disorder
Major depression
panic disorder

A

Major depression

99
Q

Which of the following factors have been associated with an increased risk of developing PTSD following trauma?

Multiple select question.

being female

prior trauma exposure

minimal post-trauma stressors

higher intelligence

A

being female

prior trauma exposure

99
Q

There is substantial evidence that ______ about the trauma predict the development of PTSD

adaptive behaviours
maladaptive actions
adaptive processing
maladaptive thoughts

A

maladaptive thoughts

100
Q

Avoidance impedes the
___________ of classically conditioned fear.

A

extinction

101
Q

Which of the following features of CBT for PTSD comprises providing information about the nature of the disorder, and validating distress in response to trauma?

cognitive restructuring
psychoeducation
in vivo exposure
relapse prevention

A

psychoeducation

102
Q

Overactivation of which bodily system has been implicated in the development of PTSD?

parasympathetic nervous system

sympathetic nervous system

central nervous system

endocrine system

A

sympathetic nervous system

103
Q

It is estimated that individuals with PTSD are almost ____ times more likely to develop major depression that those without PTSD.

2
10
5
7

A

10

104
Q

There is a positive correlation between the experience of acute stress disorder and the later development of
_______.

A

PTSD

105
Q

Previous __________
increases the risk of developing PTSD in response to trauma exposure.

A

psychopathology

106
Q

Avoidance prevents access to corrective information that ____________ threats are no longer realistically dangerous.

A

percived

107
Q

CBT for PTSD is also referred to as ________
- ___________ CBT.

A

trauma
focused

108
Q

Which stress neurochemicals are released into the cortex during extreme sympathetic arousal?

Multiple select question.

adrenaline
noradrenaline
GABA
dopamine

A

adrenaline
noradrenaline

109
Q

A key difference between the use of debriefing and CBT to treat PTSD is:

Multiple select question.

the degree to which exposure is used to overcome symptoms

debriefing is an early-intervention approach, whereas CBT is not

CBT can be implemented only by clinical psychologists, whereas debriefing can be implemented by other professionals

the amount of time elapsed before
commencing intervention

A

the degree to which exposure is used to overcome symptoms

the amount of time elapsed before commencing intervention

110
Q

_________ tolerance skills can assist in retaining participants in the exposure component of trauma-focused CBT.

A

Distress

111
Q

The role of avoidance in maintaining PTSD is recognised within which models describing the aetiology of the disorder?

Multiple select question.

biological
social
learning
cognitive

A

biological
learning
cognitive

112
Q

It is proposed that the release of stress neurochemicals into the cortex results in strong fear ____________
in people with PTSD.

A

conditioning

113
Q

CBT-based interventions for PTSD typically span _________ sessions.

6–10
9–12
12–15
15–18

A

9–12

114
Q

The process of extinction is highly reliant on ______
receptors.

A

NDMA

115
Q

Due to questions regarding the generalisability of results from clinical trials, the efficacy of CBT for PTSD in ___________
settings remains
unclear.

A

community

116
Q

Extinction involves neural plasticity of structures in the:

caudate
pre-frontal cortex
amygdala
hippocampus

A

amygdala

117
Q

NDMA agonists have been shown to enhance __________ when administered to PTSD sufferers prior to CBT sessions.

A

extinction

118
Q

One of the biggest challenges in assessing the efficacy of treatments for PTSD is:

the high drop-out rate of participants

comparing the efficacy of markedly different treatment approaches

the difficulty in obtaining ethics approval to conduct research with this population

finding sufficient numbers of people who are suffering from the disorder

A

the high drop-out rate of participants

Clinical and Abnormal Psychology - BEHL 3032 (10 decks)

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