anxiety, obsessive compulsive, and related disorders

Question 1

symptom checklist for anxiety diagnosis

Answer 1

• at least 6 months of persistent, disproportionate, and uncontrollable fear
• symptoms include at least three of following: edginess, fatigue, difficulty concentrating, irritability, muscle tension, sleep problems

Question 2

sociocultural view of anxiety

Answer 2

most likely to develop when ppl faced w frequent threataning situations (like poverty- rate almost twice as high among low income ppl)

Question 3

psychodynamic view of anxiety

Answer 3

Freud: -ego defense mechanisms used to protect against anxiety
-realistic anxiety when faced w real danger
-neurotic anxiety when repeatedly forced not to express id desires
-moral anxiety when punished for expressing id desires
most psychodynamic therapists disagree w freud abt some things, but agree that its bsed on inadequacies in early parent/child relationship

Question 4

what do psychodynamic therapists use to treat anxiety?

Answer 4

free association + interpretation of transference, resistance, and dreams

• freudian use these methods to help clients be less afraid of id impulses + able to control them.
• Only short term psychodynamic therapy seems to be successful for anxiety

Question 5

humanistic view of anxiety

Answer 5

anxiety happens when ppl repeatably deny + dont accept their thoughts, cognitions, and behaviors
-limited support from research

Question 6

cognitive view of anxiety

Answer 6

anxiety caused mainly by maladaptive assumptions - irrational beliefs causing ppl to act in dysfunctional ways

Question 7

what is the metacognitive theory of anxiety

Answer 7

ppl with GAD have both positive and negative views of their worrying (worrying is useful/necessary to avoid bad things, but also worrying is apparently bad and i cant control it)

• then they worry about worrying; meta worries
• leads to GAD

Question 8

what is the intolerance of uncertainty theory

Answer 8

ppl cant handle even tiny chances of a negative event occurring, this causes GAD

Question 9

avoidance theory

Answer 9

ppl w anxiety have higher levels of body arousal, and worrying serves to REDUCE this arousal (maybe by distrsction)
-leads to anxiety

Question 10

what is the rational emotive theory?

Answer 10

therapists poitn out the irrational assumptions, suggest more rational ones, and give hw to practice replacing bad assumptions w good ones

Question 11

what is mindfulness based cognitive therpay

Answer 11

part of acceptance and committment therpay

-clients become aware of their thoughts while they occur and learn to accept them rather than try to eliminate them

Question 12

what is the biological view of anxiety

Answer 12

anxiety caused by bio issues

• benzo receptors normally recieve gamma-aminobutyric acid (GABA); inhibitory NT
• GABA eventually slows/stops the fear response
• when GABA less able to bind to neurons, anxiety increases
• but, other NT may have important roles too, and causal direction unclear (anxiety may lead to GABA probs)

Question 13

what brain circuits are invlved in anxiety reactions?

Answer 13

-prefrontal cortex
-anterior cingulate cortex
-amygdala
this circuit often dysfunctional in anxiety ppl

Question 14

what are the bio treatments for anxiety?

Answer 14

• drugs (benzos and barbiturates, along w some antidepressants and antipsychotics)
• (physical) relaxation training
• biofeedback (therapists use electrical signals from body to train ppl to control phyisological processes, like heart rate. EMG most common; muscle elecricity from tension measurment)

other than drugs, only modest improvement

Question 15

what is agoraphobia?

Answer 15

fear of being in public places, or sitches where escape/help difficult
twice as frequent for women + poor ppl
panic disorder often accompanies

Question 16

what is behavioral model of how phobias occur?

Answer 16

phobias acquired thru

• classical conditioning (strong association btween temporally close events
• modeling (from ppl)

strong support from research

Question 17

stimulus generalization

Answer 17

response from one stimulus begins to be elicited by other similar stimuli (scared of running water, also be scared of milk poured)
-if many phobias, this can make it turn into GAD

Question 18

preparedness

Answer 18

ppl are evolutionarily ‘prepared’ to develop some phobias more than others, like darkness or heights

Question 19

flooding

Answer 19

therapists expose the client to the phobia repeatedly w/o relaxation training or buildup, so they learn that its harmless
actual contact more effective

Question 20

modeling for treating phobias

Answer 20

the therapist confronts it while the client watches

actual contact more effectiv

Question 21

treatment for agoraphobia

Answer 21

home or group based support; gradual emergence into world.

60-80% show partial improvement, less effective than for other phobias tho

Question 22

social anxiety

Answer 22

persistent/severe/irrational anxiety about social/performance sitches where they might be judged. May be narrow (eating in front of others) or broad (general performance anxiety)
-ppl repeatadly judge themselevs to have performed worse than reality

Question 23

cognitive theory of social anxiety

Answer 23

ppl hold a group of socially related beliefs that work against them:

• unrealistically high social self standards
• self image of socially unskilled, and that inept social behaviors will lead to horrible consequences
• think they cant control social anxious feelings

leads to avoidance/safety behaviors exacerbating issue

Question 24

treatment for social anxiety

Answer 24

• antidepressant meds
• exposure therapy
• cognitive therapies

COMBINED w social skills training (modeling, rehearsing, role play, with accompanying feedback + reinforcement), most effective

Question 25

panic attack symptoms

Answer 25

must be at least four of following - heart palpitations - hands/feet tingling - shortness of breath - sweating - hot/cold flashes - trembling - chest pains - choking sensations - faintness - dizziness - feeling of unreality

Question 26

what percent of ppl experience a panic attack at some point in their lives

Answer 26

25%

Question 27

what brain areas and neurotransmitter is associated w panic?

Answer 27

- norepinephrine (which is why antidepressants help w panic; restore proper functioning of this NT) - amygdala (stimulated in fearful sitches, then stimulates following areas) hippocampus, ventromedial nucleus of the hypothalamus, central grey matter, and locus coeruleus

Question 28

cognitive explanation of panic

Answer 28

unexpected bodily sensations are misinterpretaed as medical catastrophe

Question 29

anxiety sensitivy

Answer 29

focus on bodily sensations much of time, view them irrationally, interpret as harmful

Question 30

cognitive treatment of panic

Answer 30

1) educate about panic attakcs, actual nature of bodily sensations, misinterpretations 2) learn to apply interpreting during panic, and how to relax+ distract unclear if drug + therapy is more effective than just therapy

Question 31

Obsessive compulsive disorder

Answer 31

obsessions: persistent thoughts, ideas, impulses, or images that invade mind compulsions: repetitive/rigid behaviors/mental acts that ppl feel they must do to prevent/reduce anxiety usually both, sometimes one

Question 32

forms obsessions take

Answer 32

- wishes (spouse dying), - impulses (urge to yell obscenties at work), - images (dead ppl), - ideas (germs are everywhere), or - doubts (concerns that one has made wrong decision) generally very aware that the thoughts are excessive

Question 33

forms of compulsions

Answer 33

- cleaning - checking - seeking order/balance - touching - verbal - counting

Question 34

psychodynamic view of OCD

Answer 34

-conscious conflict between id impulses and ego control id impulses take form of obsessive thoughts, ego defenses as counterthoughts/compulsive acts little research support for PD view/treatment

Question 35

psychodynamic three ego defense mechanisms most common for OCD

Answer 35

- isolation (disown unwanted thoughts, view them as foreign) - undoing (perform acts to 'cancel out' the impulses) - reaction formation (take on lifestyle that directly opposes impulses)

Question 36

behavioral view of OCD

Answer 36

focus on addressing/treating compulsions, not obsessions | accidental associations form link between reduction of fear and the compulsion

Question 37

behavioral treatment of OCD

Answer 37

exposure and response prevention (exposed to the anxiety thing, can't do the compulsion) pretty effective

Question 38

cognitive view of OCD

Answer 38

- everyone has these unwanted thoughts, but in OCD ppl blame themselves for the thoughts and try to neautralize them by doing things meant to make matters right - when the neutralizing thing makes temporary help, likely to be repeated

Question 39

cognitive treatment

Answer 39

1) educate about how misinterpretaion, excessive sense of responsibility, + neutralziing acts can maintian the OCD 2) guide to identify/challenge/change the obsession

Question 40

biological research of 2 sources of OCD

Answer 40

1) low serotonin activity | 2) abnormal functioning in key brain regions

Question 41

biological treatment of OCD

Answer 41

drugs can increase serotonin levels and produce more normal activity in orbitofrontal cortex + caudate nuclei (which normally act as filters for impulses w only strongest getting thru to thalamus [driven to think more and act on them] but in OCD overactivity makes it happen too much)

Question 42

obsessive-compulsive-related disorders

Answer 42

- hoarding - trichotillomania (hair pulling) - dermatillomania (skin picking) - body dysmorphic obsessions w an accompanying action (body dysmorphic; obsession w nose- checking in mirror)

Question 43

diathesis stress view of disorders

Answer 43

certain individuals have a bio vulnerability to a certain disorder which is then brought out by socio / psych factors