Anxiety, Obsessive-Compulsive and Trauma-Related Disorders Flashcards
(129 cards)
1
Q
Explain fight or flight.
A
Physiological changes in the body that occur in response to a perceived threat including elevated heart rate, metabolism, blood pressure, breathing and muscle tension.
2
Q
Describe specific phobia.
A
Marked and persistent fear in response to the presence or anticipation of a specific object or situation.
3
Q
Describe panic disorder.
A
Recurrent or unexpected panic attacks.
4
Q
Describe agoraphobia.
A
Anxiety about being in situations in which escape might be difficult or help may not be available in the event of experiencing panic symptoms.
5
Q
Describe social anxiety disorder (social phobia).
A
Marked fear of social situations where the person is exposed to possible scrutiny by others.
6
Q
Describe generalised anxiety disorder.
A
Excessive anxiety and worry about a number of events or activities.
7
Q
Describe obsessive-compulsive disorder.
A
Recurrent obsessions or compulsions that are time-consuming or cause marked distress or impaired functioning.
8
Q
Describe post-traumatic stress disorder.
A
After exposure to actual or threatened death, serious injury or sexual violence, symptoms or re-experiencing the trauma, avoiding stimuli associated with the trauma, alterations of cognitions and mood and increased arousal.
9
Q
_____ described the fear reaction to danger as the fight or flight response.
A
Cannon.
10
Q
Give three vulnerabilities that increase the sensitivity of the alarm trigger.
A
Biological factors, generalised psychology factors and specific psychological factors.
11
Q
This clustering of emotional disorders around a common genetic vulnerability has been called:
A
General neurotic syndrome.
12
Q
Explain negative reinforcement.
A
Increasing the frequency of a behaviour through the removal of an aversive experience.
13
Q
What is the autonomic nervous system?
A
Part of the peripheral nervous system that regulates involuntary functions like heart rate, digestion, respiration rate, and perspiration.
14
Q
Which systems does the autonomic nervous system include?
A
Sympathetic and parasympathetic.
15
Q
What does positive affectivity involve?
A
Feeling enthusiastic, active and alert.
16
Q
What does negative affectivity involve?
A
Subjective distress involving anxiety, disgust and anger.
17
Q
What four subtypes of phobias does the DSM-5 specify?
A
Animal; natural environment; blood, injection and injury; and situational.
18
Q
When do most specific phobias begin?
A
Childhood and adolescence.
19
Q
What does the greater number of children with phobias than adults suggest?
A
Many phobias remit without treatment.
20
Q
How did Freud think phobias came into being?
A
From unresolved sexual conflict.
21
Q
What did Watson and Raynor manage to classically condition?
A
Fear of a white rat in Little Albert.
22
Q
What kind of basis did Seligman suggest for phobias?
A
Biological evolutionary.
23
Q
Explain prepared classical conditioning.
A
Evolution has prepared people to be easily conditioned to fear objects or situations that were dangerous in prehistoric times.
24
Q
What is the SCR a measure of?
A
Amount of moisture on the hands.
25
Explain exposure therapy.
Behavioural technique in which the client confronts the feared stimuli that they have avoided until their anxiety reduces.
26
Explain in vivo exposure.
A technique of behaviour therapy in which clients confront their feared objects/situations in real life.
27
Explain flooding.
A behavioural technique in which the client is intensively exposed to a feared object until their anxiety diminishes.
28
Which treatment method for phobia is most effective?
In vivo.
29
Explain extinction.
Elimination of a classically conditioned response by removal of the unconditioned stimulus or the elimination of an operantly conditioned response by removal of the reinforcement.
30
Explain self-efficacy.
A person's belief that they have the ability to succeed in a specific situation.
31
Give a behavioural mechanism that may account for the effectiveness of exposure therapy.
Extinction.
32
Describe a panic attack.
An episode where an individual experiences a rapid increase in the physiological and cognitive symptoms of intense fear and discomfort.
33
Give some symptoms of a panic attack.
Pounding or racing heart, sweating, trembling, dizziness or faintness, choking/smothering sensations, shortness of breath, chills or heat sensations, and fears of dying, going crazy or losing control.
34
Give five situations that are used to diagnose agoraphobia.
When the sufferer experiences marked fear or anxiety while using public transport; being in open spaces; being in enclosed spaces; standing in queues or in a crowd; and being outside of home alone.
35
What is neuroticism?
A personality trait entailing a tendency to experience negative emotional states.
36
Give two internal machinations that can generate a stressful life event.
Generalised psychological vulnerability, like anxiety sensitivity, and generalised biological sensitivity, like neuroticism.
37
What can cause the alarm reaction to be triggered at lower intensities of stress?
Individuals with a generalised biological vulnerability react more strongly to everyday stressors.
38
Explain anxiety sensitivity.
A belief that the bodily symptoms of anxiety have harmful consequences.
39
What did Clark believe regarding individual's misrepresentations of the physical sensations accompanying panic?
Individual's catastrophise the symptoms of panic (I'm having a heart attack, I'm dying) and so elicit the fight or flight response, which generates more sensation
40
What can agoraphobia occur as a complication of?
Panic disorder.
41
Name some effective pharmalogical treatments for panic disorder.
Tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and high-potency benzodiazepines.
42
Give a disadvantage of benzodiazepines.
Dependence.
43
Give a disadvantage of SSRIs.
Sexual dysfunction.
44
Give two disadvantages of tricyclics.
Dry mouth and dizziness.
45
Name two tricyclics.
Imipramine and amitriptyline.
46
Name a SSRI.
Fluoxetine.
47
Name two benzodiazepines.
Valium and Xanaz.
48
What is cognitive behaviour therapy?
A type of psychological treatment that combines both cognitive and behavioural concepts and techniques.
49
How are external phobic avoidances treated?
Graded in vivo response.
50
Explain graded in vivo response.
People confront less fear-provoking situations, until only minimal fear is produced, and then proceed through other phobic situations until they can face the most fear-provoking situation.
51
What is interoceptive exposure?
A behavioural technique that entails exposing the individual to the physical sensations of a panic attack.
52
What does social phobia have a high rate of comorbidity with?
Depression.
53
__/10 individuals with social phobia indicate that the disorder has significantly interfered with their academic, occupational and interpersonal functioning.
9
54
What does the presence of a two- to three-fold increased risk of social phobia among the relatives of people with the disorder point to?
Genetic vulnerability.
55
A ____ of the variability in the familial transmission of social phobia is due to genetic factors.
Third.
56
What may reduce a child's self-confidence?
Excessive parental criticism.
57
How does excessive self focus relate to social phobia?
Attention is disproportionally focused on real or imagined failures of the self during social interactions, which increases anxiety and diverts attention away from engaging in prosocial behaviours necessary for successful social encounters.
58
According to Rapee and Heiberg, what do people with social phobia infer about other people?
That they are inherently critical and likely to form negative opinions of them.
59
What did Spence find about children with social phobia?
They speak less, initiate fewer interactions, interact for shorter durations and are rated by themselves and others as being less socially competent.
60
What is the most common treatment for social phobia?
CBT.
61
How many people achieve improvement in their social phobia in group treatment?
2/3
62
Give some examples of treatment for social phobia.
Psyhoeducation about the factors maintaining social phobia, skills for challenging negative thoughts and images, behavioural experiments designed to directly challenge the negative cognitions, reducing reliance on safety behaviours, video feedback to challenge negative self-images, attention training, and challenging core beliefs about the self.
63
Define safety behaviour.
Subtle avoidance behaviour used in a misguided attempt to prevent a fear from coming true.
64
What is the main feature of generalised anxiety disorder?
Excessive anxiety and worry about a number of activities such as work, health, finances, relationships, or educational performance.
65
Who developed the information processing model of GAD?
Rapee.
66
What is the premise of the information processing model of GAD?
People with GAD are on the look-out for potential threats in the environment, which leads to symptoms of anxiety (like avoidance).
67
Who developed the meta-cognitive model of GAD?
Wells.
68
What does the meta-cognitive model of GAD highlight?
The importance of a number of interacting systems that maintain and promote worry, like the use of worry as a coping strategy, negative appraisals or beliefs about worry, and control strategies aimed at stopping the worry process.
69
Explain Wells' Type 1 worry.
Normal worry about everyday events.
70
Explain Wells' Type 2 worry.
Beliefs about worry itself, called meta-beliefs.
71
What do meta-beliefs focus on?
Negative appraisals or interpretations of the worry process that focus on the idea that one's worry is dangerous.
72
What effect do positive meta-beliefs have on worry?
They maintain the worry process by promoting worry as a seemingly helpful coping strategy.
73
Who proposed the avoidance theory of worry or GAD? (3)
Borkovec, Alcaine and Behar.
74
What do Borkovec, Alcaine, and Behar argue about excessive worry?
It is a strategy used by individuals to avoid the anxiety associated with distressing images and underlying fear or concerns.
75
`Who proposed the intolerance of uncertainty model of GAD?
Ladouceur, Talbert, and Dugas.
76
How is anxiety triggered according to the intolerance of uncertainty model?
Situations and events that involve uncertain outcomes trigger negative emotional , cognitive, and behavioural responses in people with GAD.
77
Intolerance of uncertainty is argued to interact with three other key processes to maintain GAD symptoms, the first of which is:
Positive beliefs about the use of worry as a coping strategy.
78
What is habituation?
Lessening of an organism's response with repetition of the stimulus.
79
What is the second key process of maintaining GAD symptoms in intolerance of uncertainty?
People with GAD possess a poor problem orientation, meaning that they selectively focus on the uncertain aspects of problems have low levels of confidence regarding their ability to solve problems.
80
What is the third key process of maintaining GAD symptoms in intolerance of uncertainty?
Worry is a process that functions as a means of inhibiting distressing images.
81
Give some pharmalogical treatments for GAD.
Benzodiazepines, azapirones, tricyclic antidepressants, and SSRIs.
82
What are azapirones?
A class of drugs that may be used in the treatment of a generalised anxiety disorder.
83
Give an example of a azapirone.
Buspirone.
84
What is interpersonal psychotherapy?
Short-term psychological treatment originally developed to treat depression by addressing the client's interpersonal problems as a way of improving their psychological symptoms.
85
Who developed interpersonal psychotherapy?
Gerald Klerman, Myrna Weissman and their colleagues.
86
Give the DSM-5's four criterion for OCD.
Presence of obsessions and/or compulsions; cause subjective distress, be time-consuming, or significantly interfere with the sufferer's occupational or social functioning; the symptoms are not attributable to substance or another medical condition; and the content of obsessions or compulsions cannot be restricted to another disorder that is present.
87
Define obsessions.
Uncontrollable, persistent thoughts, images, ideas or impulses that an individual feels intrude upon their consciousness and that cause significant anxiety or distress.
88
Define compulsions.
Repetitive behaviours or mental acts that an individual feels they must perform.
89
What is body dysmorphic disorder?
A disorder involving obsessive concern regarding a part of the body the individual believes is defective.
90
Define clinically significant.
This disorder causes substantial impairment in social, occupational or other areas of functioning.
91
Who proposed the neurophysical model of OCD?
Baxter.
92
What does the neurophysical model of OCD suggest?
OCD results from a failure of inhibitory pathways in the basal ganglia of the brain to stop behavioural macros being triggered in response to internal or external stimuli.
93
What are behavioural macros?
Complex sets of behaviours choreographed for specific situations.
94
What is the basal ganglia?
A group of large nuclei in the forebrain involved in the control of motor behaviour and may be relevant for obsessive-compulsive disorder.
95
Why does the cognitive model disagree with the neurophysical model?
Salkovski pointed out that most of the observed differences in brain function could be a consequence of OCD and not a cause of it.
96
What does the cognitive model of OCD believe it results from?
The misrepresentation of intrusive thoughts.
97
Explain primary obsessive slowness.
A form of OCD where the individual carries out everyday activities in a precise, slow and unvarying sequence.
98
How does the DSM-5 define hoarding disorder?
A persistent difficulty in discarding possessions, with a high level of distress associated with discarding the items.
99
Which CBT procedure has received the strongest support for OCD?
Exposure and response prevention.
100
Describe exposure and response prevention.
A behavioural technique in which the client is exposed to feared stimuli and prevented form utilising any responses aimed at escaping their anxiety.
101
Describe cognitive restructuring.
A cognitive technique in which the client learns to identify, challenge and replace their dysfunctional beliefs with more realistic or helpful beliefs.
102
What is cognitive restructuring used to treat?
OCD.
103
Give some common examples of traumatic events associated with PTSD.
War, natural disasters, rape, assault, car accidents, and terrorism.
104
Name the four major symptom clusters of PTSD.
Re-experiencing symptoms, avoidance symptoms, negative changes in cognitions and mood, and marked alterations in arousal.
105
What does re-experiencing symptoms involve?
Intrusive memories, flashbacks and nightmares related to the traumatic event, and distress when exposed to reminders of the trauma.
106
What do avoidance symptoms involve?
Avoidance of thoughts and reminders of the trauma.
107
What do negative changes in cognitions and mood involve?
Emotional numbing, being unable to recall an important aspect of the trauma, exaggerated negative expectations about oneself or the world, excessive blaming of the self and others, and pervasive negative affective states.
108
What do marked alterations in arousal involve?
An exaggerated startle response, hypervigilance, sleeping and concentration difficulties, reckless or self-destructive behaviour and anger outbursts.
109
What is PTSD development associated with a history of?
Psychological disturbance predating the trauma, prior traumatic experience, lower intelligence levels, female gender, more severe traumatic exposure, low social support after the trauma, and ongoing stressors in the aftermath of the trauma.
110
Explain the cognitive models of PTSD.
Maladaptive appraisals or interpretations of the traumatic event, the individual's responses to it, and the environment after the trauma are pivotal in terms of perpetuating the individual's sense of threat.
111
Explain learning accounts of PTSD.
The application of classical conditioning principles to trauma.
112
What do biological accounts of PTSD highlight?
The role of arousal in strengthening the fear-conditioning process.
113
Explain the biological causation of PTSD.
Extreme sympathetic arousal at the time of the traumatic event may result in the release of stress neurotransmitters (norepinephrine and epinephrine) into the cortex, resulting in strong conditioning of fear responses with the associated memories.
114
What support is there for the biological account of PTSD?
People who eventually develop PTSD display elevated resting heart rates in the initial week after the trauma, and individuals with PTSD asked to recall traumatic events, they produce larger psychophysiological responses.
115
There is evidence that avoidance of trauma reminders ____ PTSD.
Maintains.
116
How does avoidance maintain PTSD according to the cognitive model?
It prevents people from having the opportunity to access corrective information that the perceived threats are no longer realistically dangerous.
117
According to the biological model of PTSD, how does avoidance maintain it?
It impedes the extinction of classically conditioned fear.
118
Give the pharmalogical treatment for PTSD.
SSRIs
119
What CBT treatments are most common for PTSD?
Psychoeducation, anxiety management, cognitive restructuring, imaginal and in vivo exposure, and relapse prevention.
120
What does psychoeducation involve?
Providing information about common symptoms following a traumatic event, legitimising the trauma reactions as an understandable response given the event, and establishing a rationale for treatment by describing the cognitive factors believed to be driving the symptoms.
121
What is the purpose of anxiety management techniques?
To provide individuals with coping skills to assist them in gaining a sense of mastery over their fear, to reduce arousal levels and to assist the individual when engaging in exposure to the traumatic memories.
122
Explain cognitive restrucuring.
Based on the premise that maladaptive appraisals underpin the maintenance of PTSD, and involves teaching patients to identify and evaluate the evidence for their beliefs about the trauma, the self, and the environment.
123
What does prolonged imaginal exposure involve?
The individual to vividly involve the trauma for extended periods of time
124
What is a wait-list control group?
In a treatment outcome study, the group of participants that functions as a non-treatment control group while the experimental group receives the intervention but then receives the treatment after the results from the experimental group have been collected.
125
How have researchers attempted to prevent PTSD?
By applying CBT to high-risk survivors shortly after trauma exposure.
126
What is the difference between psychological debriefing and CBT?
In psychological briefing the individual expresses their responses to the trauma on a single occasion within days of the event, while CBT requires repeated systematic exposure for prolonged periods and this intervention does not commence until at least two weeks after trauma exposure.
127
What does the process of extinction involve?
Neural plasticity in the basolateral nucleus of the amydgala, where it is strongly reliant on NMDA-receptors.
128
What does D-cycloserine enhance?
Extinction.
129
D-cycloserine facilitates CBT for:
Specific phobia, social phobia, and OCD.
