Chapter 5 - Anxiety, Obsessive-Compulsive, and Related Disorders Flashcards
(178 cards)
1
Q
What is fear?
A
The central nervous system’s physiological and emotional response to a serious threat to one’s well-being
2
Q
What is anxiety?
A
The central nervous system’s physiological and emotional response to a vague sense of threat or danger, cannot pinpoint a specific cause for your alarm but expect something unpleasant to happen
3
Q
How are fear and anxiety helpful?
A
Prepare us for actions, our “fight or flight” response when danger threatens, can motivate us to stay on top of our responsibilities
4
Q
What are specific phobias?
A
A persistent and irrational fear of a particular object, activity, or situation
5
Q
What is agoraphobia?
A
Fear of travelling to public places such as stores or movie theatres
6
Q
True or false, people with one anxiety disorder often suffer from a second one as well?
A
True
7
Q
What are panic disorders?
A
Recurrent attacks of terror
8
Q
True or false? many of those who have an anxiety disorder also experience depression?
A
True
9
Q
What is generalized anxiety disorder?
A
A disorder marked by persistent and excessive feelings of anxiety and worry about numerous events and activities
10
Q
Characteristics of generalized anxiety disorder?
A
Experience excessive anxiety under most circumstances and worry about practically anything, often described as free-floating anxiety
11
Q
Symptoms of generalized anxiety disorder?
A
Feel restless, edginess, fatigue, poor concentration, irritability, muscle tensions, and sleep problems. These symptoms lasting at least 6 months
12
Q
Sociocultural perspective of generalized anxiety disorder
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Theory that it is likely to develop in people who are faced with ongoing societal conditions that are dangerous. Societal and multicultural factors such as race and ethnicity
13
Q
What conclusions have been made in the field of sociocultural perspective discovered?
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Studies have found that people in highly threatening environments are more likely to develop general feelings of tension, anxiety, fatigue and sleep disturbances
14
Q
What is one of the most powerful forms of social stress?
A
Poverty, live in communities with higher crime rates, less educational and job opportunities, financial burdens
15
Q
Benefits of the sociocultural perspective?
A
provide sociocultural variables that may help create a climate in which generalized anxiety disorder is more likely to develop
16
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Limitations of the sociocultural perspective?
A
Most people in poor or dangers environments do not develop this disorder, it only provides a broad role does not explain why some people develop it and others do not
17
Q
What is the psychodynamic perspective?
A
Theory developed by Sigmund Freud, as children all experience anxiety and use their ego defence mechanisms to help control such anxiety, Childs whose defence mechanisms are inadequate may develop generalized personality disorder
18
Q
What is Freud’s hypothesis?
A
Early developmental experiences may produce an unusually high level of anxiety in certain children
19
Q
What are the potential ways anxiety is produced in children?
A
The child feels overwhelming anxiety from their various id impulses, or a child’s ego defence mechanisms may be too weak to cope with normal levels of anxiety
20
Q
What are the believes of modern day psychodynamic theorists?
A
Believe that the disorder can be traced to inadequacies in the early relationships between children and their parents.
21
Q
How have researchers tested the psychodynamic explanations?
A
Attempt to demonstrate that people with generalized ancient disorder are particularly likely to use defence mechanisms. BE DEFENSIVE, DENY AND OR AVOID
22
Q
What is another way researchers have tested the psychodynamic explanations?
A
Studied people who as children suffered extreme punishment for id impulses as well as extreme protectiveness. Observed that these people had higher levels of anxiety later in life
23
Q
What are psychodynamic therapies?
A
therapists use the same general techniques to treat all psychological problem which is free association and the therapists interpretations of transference, resistance and dreams
24
Q
How do Freudian psychodynamic therapies use these interpretations (methods)?
A
Use them to help clients with generalized anxiety disorder to become less afraid of their id impulses and more successful in controlling them
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Results of psychodynamic therapies?
Most only provide modest help. Short-term psychodynamic therapy has however show in some cases a significant reduction in the levels of anxiety, worry and social difficulty of patients with this disorder
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What is the humanistic perspective?
Humanistic theorists propose that generalized anxiety disorder arises when people stop looking at themselves honestly and acceptingly
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How does the humanistic perspective characterize people with this disorder?
People repeatedly deny their true thoughts, emotions, and behaviour causing them to be anxious and unable to fulfill their potential as human beings
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What theory by Carl Rogers explained the humanistic view of why people develop generalized anxiety disorder?
Rogers believed that children who fail to receive unconditional positive regard from others mat become overly critical of themselves and develop harsh self-standards (conditions of worth). Try to meet these standards by repeatedly distorting and denying their true thoughts and experiences
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What is client-centred therapy (person-entered therapy)?
The humanistic therapy developed by Carl Rogers in which clinicians try to help clients by being accepting, empathized accurately, and conveying genuineness
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What is the goal of client-centred therapy?
To create a atmosphere of genuine acceptance and caring that will help clients feel secure enough to recognize their true needs, thoughts, and emotions, being honest and comfortable with themselves is believed to alleviate their anxiety
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Limitations of client-centred therapy?
Controlled studies have failed to offer strong support for this approach, the approach is only sometime superior to placebo therapy and researchers have found only limited support for Rogers explanation
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What is the Cognitive-Behavioural Perspective?
Suggest that psychological disorders are often caused by problematic behaviours and dysfunctional ways of thinking
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What do cognitive-behavioural therapists focus on?
Explanations and treatments focus on the nature of such behaviours and thoughts, how they are acquired, and how they influence feelings and emotions
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In the case of generalized anxiety disorder, what dimension does cognitive-behavioural therapy focus on?
The cognitive dimension of the disorder
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What are maladaptive assumptions (pessimism)?
Albert Ellis proposed that many people are guided by irrational beliefs that lead them to act and react in inappropriate ways. He called these basic irrational assumptions.
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What are basic irrational assumptions?
The inaccurate and inappropriate beliefs held by people with various psychological problems
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What did theorist Aaron Beck argue people with generalized disorder experience
They hold silent assumptions, "always best to assume the worst"
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What have researchers found about maladaptive assumption?
People with general anxiety disorder do hold these assumptions and typically about dangerousness, and are, in turn, overattentive to potentially threatening stimuli
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What is the metacognitive theory (cognitive behavioural explanation)?
Researcher Adrian Wells suggests that people with generalized anxiety disorder implicitly hold both positive and negative beliefs about worrying
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How is worrying positive, argued by Adrian Wells?
People believe worrying is a useful way of appraising and coping with threats in life, examine all possible signs of danger - that is they worry constantly?
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Adrian Wells argues that people with generalized anxiety disorder also hold negative beliefs about worrying, what were these negative beliefs?
Society teaches them that worrying is bad, they come to believe that their repeated worrying is in fact harmful (mentally and physically) and uncontrollable,
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What is Meta-worries?
Worrying about worrying, metaworrying is a powerful predictor of developing the disorder as well as having both positive and negative beliefs on worrying.
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What is the intolerance of uncertainty theory?
| waiting for a text from your crush the first time
Certain individuals cannot tolerate the knowledge that negative events may occur, even if the possibility of occurrence is small
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How does the intolerance of uncertainty theory characterize people with generalized anxiety disorder?
These people experience the sense of unbearable uncertainty over the possibility of an unacceptable negative outcome
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What does this theory believe people with generalized anxiety disorder do?
They keep worrying and worrying in their efforts to find "correct" solutions for various situations in their lives and to restore certainty to their situations. However, because they can never really be sure that a given solution is a correct one, they are always left to grapple with intolerable levels of uncertainty, triggering new rounds of worrying and new efforts to find correct solutions.
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What does research suggest about the intolerance of uncertainty theory?
It develops in early childhood and can be passed on from parents to children
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What is the avoidance theory?
Researcher Thomas Borkovec, suggests that people worry repeatedly in order to reduce or avoid uncomfortable states of bodily arousal
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Example of avoidance theory?
People implicitly choose to worry about losing their job or losing a friend rather than having to stew in a state of intense negative arousal
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What research supports this?
Research behind this suggests that people with generalized anxiety disorder experience particularly fast and intense bodily reactions, find such reactions overwhelming, worry more than other people upon becoming aroused, and successfully reduce their arousal whenever they worry
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What cognitive-behavioural therapies approaches are used in cases of generalized anxiety disorder?
Therapists help clients change the maladaptive assumptions that characterize their disorder
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What is the other cognitive-behavioural therapies approach used in cases of generalized anxiety disorder?
Help clients to understand the special role that worrying may play in their disorder, modify their views about worrying, and change their behavioural reactions to such unnerving concerns, the goal is to make the client aware of their misguided efforts to control their lives by worrying, recognize their triggers and misconceptions about worrying
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What is rational-emotive therapy?
A cognitive therapy developed by Albert Ellis and Beck that helps clients identify and change the irrational assumptions and thinking that help cause their psychological disorder, studies shown this brings at least modest relief
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What is mindfulness-based cognitive-behavioural therapy?
Therapist help clients to become aware of their streams of thoughts, worries as they are occurring and to accept such thoughts as mere events of the mind
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What is the goal of mindfulness-based cognitive behavioural therapy?
By accepting their worries rather than trying to eliminate them, the clients are expected to be less upset by them and less influenced by them in their behaviours and life decisions
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The biological perspective, what is family pedigree study?
A research design in which investigators determine how many and which relatives of a person with a disorder have the same disorder
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What is the logic behind the biological perspective?
If biological tendencies toward generalized anxiety disorder are inherited then people who are biologically related should have similar probabilities of developing this disorder
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How did researchers determine that generalized anxiety disorder is related to biological factors?
Researchers discovered that benzodiazepines reduce anxiety. They are now the most common group of anti anxiety medication which includes Valium (diazepam) and Xanax (alprazolam), Ativan (lorazepam)
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Why do benzodiazepines reduce anxiety?
Certain neutrons have receptors that receive the benzodiazepines
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What are these benzodiazepine receptors?
They ordinarily receive GABA, a common neurotransmitter in the brain. GABA carries inhibitory messages causing the neutron to stop firing causing excitability in the neurons to stop (anxiety produces excitability in the neutrons) inside the amygdala
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What are brain circuits?
Networks of brain structures that work together, triggering each other into action
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The circuit in the brain that helps produce anxiety reactions includes what structures? known as the "fear circuit"
The amygdala, prefrontal cortex, anterior cingulate cortex, and insula
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What do studies reveal about the fear circuit?
The fear circuit is excessively active in people with generalized anxiety disorder, producing experiences of fear and worry that are excessive in number and duration
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How is GABA involved in the fear circuit?
Low GABA activity helps produce circuit hyperactivity because it is not inhibiting the receptors, other neurotransmitters can also contribute to generalized anxiety disorder by leading to circuit hyperactivity
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What is BSNT?
Bed nucleus of the stria terminalis may play a large role in the fear circuit
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What are recent claims about the fear circuit?
that there is actually two circuits, one circuit that produces the physical and behavioural reactions associated with fear and the other circuit that produces the cognitive processes that often accompany fear, such as worrying
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What does LeDoux claim?
the circuit that deals with the cognitive processes is what may be more responsible for the development of generalized anxiety disorder
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What are Sedative-Hypnotic Drugs?
Drugs that calm people at lower doses and help them to fall asleep at higher doses, benzodiazepines were marketed as these
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How do benzodiazepines reduce anxiety?
They bind to these neuron receptor sites in the amygdala, they increase the ability of GABA itself to bind to the sites and to stop neurons from firing
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What are the problems with benzodiazepines?
The effects of the medications are short-lived. When they are stopped, anxiety returns as strong as ever. In large doses, people can become dependent on them, symptoms of the drugs include drowsiness, lack of coordination, memory loss, depression and aggressive behaviour, drugs mix badly with certain other drugs or substances such as alcohol
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What are antidepressants?
More commonly used than benzodiazepines now, antidepressants lift the moods of depressed persons
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What do antidepressants do?
Increase the activity of the neurotransmitters serotonin and norepinephrine. Both prominent in the fear circuit, particularly in the prefrontal cortex and the amygdala. Help relieve anxiety by improving the functioning of the fear circuit in these areas of the brain
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What are antipsychotic medications?
Drugs commonly given to people with schizophrenia and other forms of psychosis, may help relieve anxiety by altering the activity of dopamine (another important neurotransmitter in the fear circuit)
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What is a Phobia?
A persistent and unreasonable fear of a particular object, activity, or situation
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What are specific phobias?
The DSM-5's label for a severe and persistent fear of a specific object or situation.
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Checklist for Specific Phobia?
1. Marked, persistent, and disproportionate fear of a particular object or situation; usually lasting at least 6 months
2. Exposure to the object produces immediate fear
3. Avoidance of the feared situation
4. Significant distress or impairment
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What is agoraphobia?
A broader kind of phobia, an anxiety disorder in which a person is afraid to be in public situations from which escape might be difficult or help unavailable if panic-like or embarrassing symptoms were to occur.
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What causes phobias cognitive-behavioural perspective?
Believe that people first learn to fear certain objects, situations, or events through conditioning
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What is classical conditioning?
A process of learning in which two events that repeatedly occur close together in time come tied together in a person's mind and so produce the same response
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How is classical conditioning applied to phobias
If one event triggers a fear respond, the other may also (look at photo for explanation)
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What is modeling? observing and imitating
Another way to acquire fear, a process of learning in which a person observes and then imitates others. Also, a therapy approach based on the same principle
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Limitation of the classical conditioning and modelling theory?
Although it appears that a phobia can be acquired by classical conditions or modelling, researchers have not established that the disorder is ordinarily acquired in this way
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What is the behavioural-evolutionary explanation behind phobias?
Theory that humans have a predisposition to develop certain fears. Referred to as preparedness
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What is preparedness?
A predisposition to develop certain fears
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Where does this "preparedness" come from?
Theorists suggest that the predispositions have been transmitted genetically through an evolutionary process. Ancestors were afraid of the dark, heights and animals which has prevailed to now
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How does the cognitive-behavioural approach treat phobias? particularly specific phobias
Exposure treatment
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What is exposure treatment?
Treatments in which persons are exposed to the objects or situations they dread
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What are the three most common exposure techniques?
Systematic desensitization, flooding and modeling
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What is systematic desensitization?
An exposure treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations they dread, learn to relax while gradually facing the objects or situations they fear.
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What is in vivo desensitization?
Actual confrontation, tends to be more effective
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What is covert desensitization?
Confrontation is imagined
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What is flooding?
An exposure treatment for phobias in which clients are exposed repeatedly and intensively to a fear object and made to see that it is actually harmless. Flooding can be both in vivo and covert desensitization.
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What do flooding therapists do?
They guide the clients in imagining the fear, often exaggerating the description so that the clients experience intense emotional arousal
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What is modeling as an exposure therapy technique?
The therapist who confronts the feared object or situation while the fearful person observes
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What is participant modeling?
the client is actively encouraged to join in with the therapist
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How does the cognitive-behavioural approach treat phobias? particularly agoraphobia phobias
Therapists typically help clients to venture farther from their homes and to gradually enter outside places, using support, reasoning and coaxing
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What is the support group approach?
A smack number of people with agoraphobia go out together for exposure sessions that last for several hours
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What is the home-based self-help programs?
Clinicians give clients and their families detailed instructions for caring out exposure treatments themselves
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What is Social anxiety disorder?
A severe, persistent, irrational fear of social or performance situations in which embarrassment may occur
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What do cognitive-behavioural theorists propose is behind social anxiety disorder?
Interplay between both cognitive and behavioural factors. Contend that people with this disorder hold a group of dysfunctional beliefs and expectations regarding the social realm and are constantly anticipating the social disasters to occur
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What have theorists discovered about social anxiety disorder?
Sufferers have overwhelming social fears and they often lack skill at starting conversations, communicating their needs, or meeting the needs of other
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What is treatment for social anxiety disorder?
Try to reduce the social fears and provide training in social skills, they reduce social fears by medication (benzodiazepines or antidepressant drugs) and cognitive-behavioural therapy
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How is social anxiety disorder similar to generalized anxiety disorder?
The brain's fear circuit tends to be hyperactive for people with social anxiety disorder
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How does cognitive-behavioural therapy help social anxiety disorder?
combine both behaviour and cognitive techniques, on the behavioural side they use exposure therapy, on the cognitive side, clinicians and clients have systematic therapy discussions where the client re-examines and challenges their maladaptive beliefs and expectations
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What are social skills training?
A therapy approach that helps people learn or improve social skills and assertiveness through role playing and rehearsing of desirable behaviours. There is also social skills training groups and assertiveness training groups
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What are panic attacks?
Periodic, short bouts of panic that occur suddenly, reach a peak within minute and gradually pass, people can lose control of their behaviour and can be unaware of what they are doing
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Signs of having a panic attacks?
heart palpitations, tingling in the hands or feet, shortness of breath, sweating, hot and cold flashes, trembling, chest pains, choking sensations, faintness, dizziness, and a feeling of unreality
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What is a panic disorder?
An anxiety disorder marked by recurrent and unpredictable panic attacks that can have no apparent reason
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What are people described as when characterized with a panic disorder?
People experience dysfunctional changes in their thinking or behaviour as a result of the attacks
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How is panic disorder and agoraphobia related?
Often panic disorder can lead to developing agoraphobia, become fearful of having attacks in public places
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What is the biological perspective on panic disorder?
May be caused by abnormal norepinephrine activity. Evidence that norepinephrine activity is indeed irregular in people who suffer from panic attacks
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Treatment for panic disorders?
Can be alleviated by antidepressant drugs, specifically those that increase the activity of the neurotransmitter norepinephrine
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What is the locus coeruleus?
A small area of the brain that seems to be active in the regulation of emotions. Many of its neutrons use norepinephrine, research suggests that panic attacks may be caused by abnormal activity of norepinephrine in the locus coeruleus
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What brain circuit is involved in panic attacks? IMPORTANT THIS IS DIFFERENT FROM THE FEAR CIRCUIT
Amygdala, hippocampus, ventromedial nucleus of the hypothalamus, central grey matter, and locus coeruleus. Amygdala is first stimulated, tends to be hyperactive in people with panic disorder
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Similarities and differences between the fear circuit and the panic circuit
Similarities is that both involve the amygdala, differences is the panic circuit seems to be more extensive than the fear circuit
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Theories on why people have hyperactive panic circuits and are prone to panic disorders?
Predisposition to develop such abnormalities is inherited. Possible genetic factor
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What are drug therapies for panic disorders?
Antidepressants drugs appear to prevent or reduce panic attacks by increasing the activity of neurotransmitters serotonin and norepinephrine in the locus coeruleus, corrects the hyperactivity
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The Cognitive-Behavioural Perspective
Theorists argue that full panic reactions are experienced only be people who further misinterpret the physiological events that are talking place within their bodies
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Cognitive-behavioural explanation for panic disorders?
Panic prone people may be very sensitive to certain bodily sensations; when they unexpectedly experience such sensations, they misinterpret them as signs of a medical catastrophe, grow upset about losing control, fear the worst, lose all perspective, and rapidly plunge into panic
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Example of cognitive-behavioural explanation?
Many people with panic disorder seem to "overbreathe", or hyperventilate, in stressful situations. The abnormal breathing makes them think that they are in dance of suffocation, so they panic. They further develop the belief that these and other "dangers" sensations may return at any time and so set themselves up for future panic attacks
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What is the biological challenge test?
A procedure used to produce panic in participants by having them exercise vigorously, hyperventilate, perform some other potentially panic-inducing tasks or administer drugs to create a biological sensation in the presence of a therapist and then have the client apply the newly learnt interpretations and skills
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One theory for why an individual may be more prone to such misinterpretations of being in danger or out of control (cognitive-behavioural)
Suggest that panic-prone individuals experience more frequent or intense bodily sensations that other people do
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What kinds of sensations are often most misinterpreted in panic disorders?
Carbon dioxide increases in the blood, shifts in blood pressure, and rises in heart rate, bodily events that are controlled in part by the brain's panic circuit (overactive in people with panic disorder)
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Another theory for why an individual may be more prone to such misinterpretations of being in danger or out of control (cognitive-behavioural)
Suggest that panic-prone people have had more trauma-filled events over the course of their lives than other persons, leading to higher expectations of catastrophe
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What is anxiety sensitivity?
A tendency to focus on one's bodily sensations, assess them illogically, and interpret them as harmful
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Cognitive-behavioural treatment for panic disorders
To correct people's misinterpretations of their bodily sensations, therapists educate clients about the general nature of panic attacks, the actual causes of bodily sensations, and the tendency of the clients to misinterpret their sensations, teach them to apply more accurate interpretations and how to cope better with anxiety
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What is Obsessive-Compulsive disorder?
A disorder in which a person has recurrent obsessions, compulsions or both that feel excessive or unreasonable, cause great distress, take up much time and interfere with daily functions.
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What is an obsession?
A persistent thought, idea, impulse, or image that is experienced repeatedly, feels intrusive, and causes anxiety
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What is a compulsion?
A repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent or reduce anxiety
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Does DSM-5 classify obsessive-compulsive disorder as an anxiety disorder?
No, although anxiety does play a major role
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How does anxiety play a major role in obsessive-compulsive disorder?
Obsession causes intense anxiety, the compulsions are aimed at preventing or reducing anxiety. Anxiety rises if a person tries to resist their obsessions or compulsions
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Obsessive-compulsive disorders stats?
Unlike more other disorders where its more common in women than men, Obsessive compulsive disorder is equally common in men and women and across race and ethnic groups
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What are the features of obsessions?
Obsessive thoughts feel both intrusive and foreign, attempts to ignore or resist these thoughts may arouse even more anxiety
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What are the features of compulsions?
Although technically under voluntary control, the people who feel they must do them have little sense of choice in the matter. Most recognize their behaviour is unreasonable but believe at the same time something terrible will happen if they don't perform the compulsions.
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What are the features of compulsions?
Detailed rituals, follow ritualistic rules and often repeated multiple times
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Relationship between obsessions and compulsions?
Compulsive acts are often a response to obsessive thoughts, sometimes can serve to help control obsessions.
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What is the psychodynamic perspective on obsessive-compulsive disorder?
The battle between anxiety provoking id impulses and anxiety reducing defence mechanisms is played out in overt thoughts and actions
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What are the id impulses?
The obsessive thoughts
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What are the ego defences?
Counter thoughts or compulsive actions
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What did Sigmund freud propose about obsessive-compulsive disorder?
Traced it the the anal stage of development, at this stage children experience intense rage and shame as result of negative toilet-training experiences
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What have other psychodynamic theorists proposed about obsessive-compulsive disorder?
The early rage reactions are rooted in feelings of insecurity, the child feels the need to express their strong aggressive id impulses knowing they should try to restrain/control the impulses. If the conflict between the id and ego continues it may develop into obsessive compulsive disorder
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What has research said about the psychodynamic explanation?
Does not support it much
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The psychodynamic treatment for obsessive-compulsive disorder?
Treatment involves helping individuals uncover and overcome their underlying conflicts and defences, using free association and therapist interpretation as well as short-term psychodynamic therapies. Research have offered little evidence that this treatment actually helps
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The cognitive-behavioural perspective on obsessive-compulsive disorder?
All people have intrusive, repetitive and unwanted thoughts but those who develop this disorder blame themselves for such thoughts and expect that somehow terrible things will happen.
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What is neutralizing?
A person's attempt to eliminate unwanted thoughts by thinking or behaving in ways that put matters right internal, making up for unacceptable thoughts. Neutralize thoughts
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What does neutralizing lead to?
The neutralizing thought or act is used so often that it becomes an obsession or compulsive, at the same time, the individual becomes more and more convinced that his or her unpleasant intrusive thoughts are dangerous which too become obsessive.
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Support for this explanation?
Studies have found that people with obsessive-compulsive disorder have intrusive thoughts more often than other people, resort to more elaborated neutralizing strategies, and experience reductions in anxiety after using neutralizing techniques
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Why do individuals with obsessive-compulsive disorder find such normal thoughts so disturbing to begin with?
Researchers have found that this population tends to have exceptionally high standards of conduct and morality, thought-action fusion, to believe that they should have perfect control over all their thoughts and behaviours
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What is thought-action fusion?
To believe that intrusive negative thoughts are equivalent to actions and capable of causing harm
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How do cognitive-behavioural theorists treat obsessive compulsive disorder?
Treatment includes educating clients, pointing out how misinterpretations of unwanted thoughts, an excessive sense of responsibility, and neutralizing acts have helped to produce and maintain the symptoms.
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What is the second step in treatment for obsessive compulsive disorder (cognitive-behavioural)
Therapists guide the clients to identify and challenge their distorted cognitions, clients come to appreciate that their obsessive thoughts are inaccurate occurrences rather than valid and dangers cognitions for which they are responsible and recognize their compulsive acts as unnecessary
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What is the third step in treatment for obsessive compulsive disorder (cognitive-behavioural)
Exposure and response prevention (exposure and ritual prevention), a treatment that exposes a client to anxiety-arousing thoughts or situations that produce obsessive fears and would incite compulsive behaviours but then prevents the client from performing their compulsive acts
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How do therapists use videoconferencing?
They conduct exposure and response prevention using videoconferencing to clients direct in their home settings where compulsions cause the most problems or assign homework instructing them not to engage in compulsive acts
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What is the biological perspective on obsessive compulsive disorder?
Initially reasoned that the disorder must be caused primarily by low serotonin activity throughout the brain. Now, researchers conclude instead that the drugs bring improvement by increasing the activity of serotonin within the cortico-striato-thalamo-cortical circuit, thus helping to correct the circuit's tendency to be hyperactive
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What studies support the biological perspective on obsessive compulsive disorder
Family pedigree studies provide the earliest clues that obsessive compulsive may be linked in part to biological factors, may be partly as a result of genetic inheritance
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What other studies support the biological perspective on obsessive compulsive disorder
Genetic studies have identified clusters of gene abnormalities, as well, using brain scan procedures, researchers have identified a brain circuit that helps regulate our primitive impulses called the Cortico-striato-thalamo-cortical circuit is hyperactive in people with obsessive compulsive disorder which makes it difficult for them to turn off or dismiss their various impulses, needs, and related thoughts
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What is the Cortico-striato-thalamo-cortical circuit?
Brings impulses to our attention and leads us to act on or disregard them
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What brain structures are included in the Cortico-striato-thalamo-cortical circuit?
Orbitofrontal cortex, cingulate cortex, striatum (including the caudate nucleus and putamen) and thalamus.
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What happens when an impulse reaches the thalamus?
The person is driven to think further about them and perhaps to act
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What neurotransmitters are involved in the cortico-straito-thalamo-cortical circuit?
Serotonin, glutamate, and dopamine
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What is biological treatment for obsessive-compulsive disorder?
Antidepressant drugs, specifically ones that increase activity of Serotonin. A common antidepressant named clomipramine. Does not fully cure but often provides partial improvement, also must be continued indefinitely to prevent relapse
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DSM-5 has created a group called Obsessive-compulsive-related disorders, what does this include?
Hoarding disorder, trichotillomania )hair pulling disorder), excoriation (skin-picking) disorder, and body dysmorphic disordered, collectively these 4 disorders are displayed by at least 5 percent of all people
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What Obsessive-compulsive-related disorders?
Disorders in which obsessive-like concerns drive people to repeatedly and excessively perform certain abnormal patterns of behaviour. People perform particular patterns of repetitive and excessive behaviour that greatly disrupt their lives
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What is hoarding disorder?
A disorder in which individuals feel compelled to save items and become very distressed if they try to discard them, resulting in an excessive accumulation of items
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What is trichotillomania disorder?
A disorder in which people repeatedly pull out hair from their scalp, eyebrows, eyelashes, or other parts of the body. (hair-pulling disorder). Typically pull one hair at a time, often enters around just one or two of these body sites.
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What is excoriation disorder? (skin-picking disorder)
A disorder in which people repeatedly pick at their skin, resulting in significant sores or wounds. They often try to reduce or stop the behaviour. The behaviour is typically triggered or accompanied by anxiety or stress. Often focus on one area, most often the face
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What is body dysmorphic disorder?
A disorder in which individuals become preoccupied with the belief that they have certain defects or flaws in their physical appearance. Such defects or flaws are imagined or greatly exaggerated. Causes them to take extreme measures to conceal their "defects"
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What is the effect of plastic surgery on people with body dysmorphic disorder?
They often feel even worse after
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Treatment for body dysmorphic disorder?
Treatment usually involves both antidepressant drug and cognitive behavioural therapy
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What is the developmental psychopathology perspective?
This perspective focuses on the intersection and context of important factors at key pints in time throughout an individual's lifespan
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How is the developmental psychopathology perspective applied to anxiety-related disorders? Biological model
Drawing from the biological model, they are interested in the growing number of studies that link particular genetic variations to hyperactive fear circuits, and in turn, to inhibited (fearful) temperaments in certain infants and toddlers
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What is behavioural inhibition?
Children show a withdrawn isolated and cautious pattern, they are wary of new objects, people, and environments and always seem on guard against potential threats
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How is the developmental psychopathology perspective applied to anxiety-related disorders? Cognitive-Behavioural model and psychodynamic model
Developmental psychopathologists are interested in research findings that highlight the role of parenting styles in detaining weather a child's early temperament will actually become a lifelong posture of worrying, etc.
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Effect of overprotective parenting on anxiety-related disorders?
As children grow, overprotective parenting denies them opportunities to learn how to manage distress by themselves and to build a strong sense of self-confidence
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What is parental accommodations of child anxiety?
A common form of overprotective parenting, parents repeatedly allow their anxious children to avoid social engagements, and other things causing their anxiety and provide them with excessive reassurances
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How is the developmental psychopathology perspective applied to anxiety-related disorders? Sociocultural model
Interested in research showing that life stress, poverty, school difficulties, family disharmony, peer pressure, and community danger can increase the likelihood of developing an anxiety-related disorder
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Overall the developmental psychopathology perspective takes into account?
Biological vulnerability, inhibited temperament, overprotective parenting, social/life factors
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What does the developmental psychopathology perspective highlight about other models
The other models in relative isolation have not addressed important questions about the development of these disorders. How and when do the variables from each of the models interact to produce the disorders?
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What does research suggest about the developmental psychopathology perspective
Relationships between variables are two-directional and that various factors may have greater or lesser impact at different points of development
