Exam 2 Flashcards
(176 cards)
1
Q
What two systems are activated during fight or flight response?
A
1) autonomic nervous system
2) adrenal-cortical system
2
Q
what initiates the autonomic nervous system in the fight or flight response?
A
the hypothalamus
3
Q
what sends a signal in the adrenal-cortical system during the fight or flight response
A
the pituitary gland
4
Q
describe panic disorder
A
recurrent, unexpected panic attacks
5
Q
what course does panic disorder usually take?
A
chronic
6
Q
What is anxiety sensitivity?
A
unfounded belief that bodily symptoms have harmful consequences
7
Q
What is interoceptive awareness?
A
heightened awareness of bodily cues that may indicate an oncoming panic attack
8
Q
What is interoceptive conditioning?
A
how certain bodily cues become a conditioned stimulus and illicit a panic attack as a response
9
Q
what kinds of medications are used to treat panic disorder?
A
medications that affect serotonin and norepinephrine
10
Q
what is the issue with the biological treatment of panic disorder?
A
a relapse after ending medication
11
Q
What are the goals of CBT for panic disorder?
A
- relaxation and breathing exercises
- identify and challeng catastrophizing cognitions
- sytematic desensitization
12
Q
describe GAD
A
- excessive anxiety about ordinary, everyday situations
- anxiety is intrusive, causes distress or functional impairment
13
Q
what are the comorbidities of GAD?
A
80% will have a comorbidity. often MDD
14
Q
what is the course of GAD?
A
chronic
15
Q
Describe the emotional components of GAD
A
- more intense negative emotion
- highly reactive to negative emotion
- emotions are not controllable or manageable
16
Q
Describe the cogitive factors of GAD
A
- maladaptive assumptions
- hypervigilant to posible threats
- overreactions
17
Q
What do the maladaptive assumptions from GAD often reveal?
A
- fear of losing control
- being unable to tolerate uncertainty
18
Q
What are the goals of CBT for GAD?
A
- confronting most worrisome issues
- challenging catastrophizing thoughts
- developing coping strategies
19
Q
what are the drugs used to treat GAD?
A
- benzos
- tricyclic antidepressants
- SSRI
- SNRI
20
Q
are biological or cognitive treatments more effective for GAD?
A
they have equal efficacy
21
Q
What is the main factor that differentiates social anxiety from a general fear?
A
avoiding social situations
22
Q
what is the course of social anxiety?
A
chronic
23
Q
What are the comorbidities with social anxiety?
A
- mood disorders
- other anxiety disorders
24
Q
Describe the genetic factors of social anxiety
A
genetic factors do not specifically lead to social anxiety but do lead to a general predisposition to anxiety disorders
25
Describe the cognitive theory on social anxiety
- excessively high standards for own social perfpormance
- focus on negative aspects of social interaction
- evaluate own behaviors harshly
- note potentially threatening social cues and misinterpret them in self defreating ways
26
what medications are used to treat social anxiety?
- SSRI
- SNRI
27
What are the goals of CBT for social anxiety?
- exposing clients to social situations
- group therapy to see they are not the only one and to prictice social skills
28
how is mindfulness used to treat social anxiety?
used to accept and observe anxiety
29
Describe specific phobias
- unreasonable or irrational fears of specific objects/situations
- fear is disproportionate to actual danger
- will avoid phobia at all costs
30
what are the five catagories of specific phobias?
1) animal type
2) natual environment type
3) situational type
4) blood-injection type
5) other
31
what is special about blood-injection type phobias?
- heart rate drops and person faints
- usually more hereditary
32
Describe agoraphobia
- fear places where they can't escape or get help
- fear they will embarrass themselves if others notice symptoms or escape attempt
33
What is the most common comorbidity with agoraphobia?
50% of people have a history of panic attacks
34
What is the behavioral theory of specific phobias?
- classical conditioning can create the phobia
- negative reinforcement (operant conditioning) can maintain a phobia
35
What is the biological theory of specific phobias?
- 1st degree relatives makes you 3 to 4 times more likely to develop phobia
36
What is the main goal of behavioral treatments of specific phobias?
use exposure to extinguish person's fear
37
What components of behavior therapy are used to treat specific phobias?
- systematic desensitization
- modeling
- flooding
38
what is the applied tension technique and what is it used for?
- increases blood pressure and heart rate
- used for treatment of blood-injection type phobias to keep them from fainting
38
what is used in the biological treatment of specific phobias?
benzodiazapines
39
Describe obsessions and compulsions for OCD
- obsessions: persistent and uncontrollable thoughts, images, ideas, impulses
- compulsions: ritualistic behaviors or mental acts
40
what did the DSM 5 change in regards to OCD?
before the DSM 5, OCD was classified as an anxiety disorder. It has now been determined not everyone experiences anxiety
41
what is the course for OCD?
chronic
42
wha is the major comorbidity of OCD?
66% of people will have depression
43
describe hoarding disorder
- uncontrollable urges to keep items with no utility or value
- feelings of anxiety when someone tries to throw something out
44
what are the comorbidities of hoarding disorder?
- depression
- social anxiety
- GAD
45
what is the course of hoarding disorder?
increases with age
46
describe trichotillomania
- unconcious, repeatedly pulling out hairs
47
describe body dysmorphia
excessive concern with part of the body they see as defective, but others see as normal
48
describe excoriation
repeated picking of the skin
49
What is the biological theory of OCD?
- dysfunction of circuit involved in motor, behavior, cognition, and emotion
- HPA axis
- dysregulation of serotonin
- genetic heritability
50
What are the cognitive theories of OCD?
- chronic depression/anxiety invoke intrusive thoughts
- tendency toward rigid, moralistic thinking
- believe they should be in total control over their thoughts
- compulsions possibly caused by operant conditioning
51
What kinds of medications are used to treat OCD?
serotonin enhancing drugs reduce compulsions
52
What is the goal of CBT for OCD?
- exposure and response prevention
- challenge maladaptive cognitions
53
what is exposure and response prevention?
1) exposure to triggering thing
2) prevention from committing compulsion
54
what are the criteria for a PTSD diagnosis?
- must be the result of a traumatic experience
- symptoms must be present for at least a month
55
what does the DSM constitute as experienceing trauma?
- direct experience of trauma
- learn about trauma that happened to a loved one
- repeated or extreme exposure to details of trauma
56
What does the DSM count as a traumatic experience?
expopsure to actual or threat of death, serious injury, or sexual violation
57
what are the symptoms of PTSD?
- repeated experiencing of trauma
- avoidance of anything related to trauma
- negative changes in thoughts and mood
- hypervigilence or chronic arousal
- depersonalization or derealization
58
What is different about acute stress disorder?
the symptoms only last for a most 4 weeks
59
What is different about adjustment disorder
- the stressor does not have to be traumatic
- arises within 3 months of stressor
60
What are the 4 catagories of traumatic events?
1) natural disasters
2) human made disasters
3) traumatic events
4) sexual assaut
61
What are the environmental/social factors of PTSD?
- severity, duration, procimity to trauma (experienced vs witness, who did it to you, etc)
- amount of social support
62
what are the psychological factors of PTSD?
- pre-existing anxiety or depression
- coping strategies
63
what are good and bad coping strategies for PTSD?
good: meaning making
bad: substance abuse
64
What are the biological factors of PTSD?
- brain more ractive to emotional stimulus
- lw resting cortisol
- exaggerated physiological response to stress
- extreme/chronic stress during childhood
- genetic predisposition
65
What is the goal of CBT and stress management for PTSD?
- systematic desensitization
- stress inoculation therapy
66
what is stress inoculation therapy?
- used if a client can't think about traumatic event
- focuses on other stress in client's life
67
what medications are used to treat PTSD?
- SSRI
- benzodiazapines
68
What are the symptoms of separation anxiety disorder?
- extreme anxiety when separated from caregivers
- may refuse to leave home
- worried something may happen to caregiver
69
what are the criteria for separation anxiety disorder?
- excessive fear that is developmentally inapropriate
- symptoms for at least 4 weeks
- significantly impairs functioning
70
what are the 5 types of somatic disorders in the DSM?
1) somatic symptom disorder
2) illness anxiety disorder
3) functional neurologcal symptom disorder
4) factitious disorder
5) psychological factors affecting other medical conditions
71
What are the criteria of somatic symptom disorder?
- one or more distressing physical symptoms
AT LEAST ONE OF THE FOLLOWING:
1) disproportionate and persostent thoughts about seriousness of symptoms
2) persistently high level of anxietty about health or symptoms
3) excessive time and energy devoted to symptoms
72
What is the main difference between illness anxiety disorder and SSD?
in IAD there are no physical symptoms (or only mild ones)
73
what are the symptoms of IAD?
- high anxiety about having/developing a serious ilness
- excessive health related behavior
74
how long do symptoms of IAD have to be present for a diagnosis?
6 months
75
what are the 2 types of IAD patients?
1) care seeking
2) care avoidant
76
what are the cognitive factors of SSD and IAD?
- dysfunctional beliefs about illness
- feel bodily sensations more intensly
77
what are the psychological factors of SSD and IAD?
- PTSD increases risk
- stressful events
78
what is the goal for cognitive therapy for SSD and IAD?
- help people interpret their symptoms appropriately
- avoid catastrophizing
79
what is the goal of CBT for SSD and IAD?
- challenging illness beliefs and misinterpretations
- expose clients to triggers
80
What are the symptoms of FNSD?
- loss of neurological functioning in part of the body with no medical cause
- can be sensory or motor
81
what is the psychodynamic theory of FNSD?
- transfer of psychic energy attached to repressed emotions or memories to physical symptoms
- primary and secondary gain
82
what is primary and secondary gain?
primary: reducing anxiety
secondary: people getting attention from others and being relieved of obligation
83
what is the behavioral theory of FNSD?
- learned behaviors that allowed people to escape responsibility or situations
- La Belle Indifference
- childhood trauma
84
what is Le Belle Indifference?
soldiers became paralyzeand couldn't return to battle
85
what is the neurological theory of FNSD?
sensory or motor areas of brain affected by anxiety
86
what is the goal of psychoanalytic therapy for FNSD?
helps express painful memories/emotions that are linked to symptoms
87
what are the golas of CBT for FNSD?
- systematic desensitization
- relieve anxiety
- relieving any benefits client is receiving from having symptoms
88
what is factitious disorder?
faking an illness to gain medical attention
89
what is malingering?
faking a symptom or disorder to gain something
90
what is dissociation?
when parts on one's self, memories, or consciousness become disconnected from one another
91
what is the name for the different identities presented in DID?
alters
92
what is a host alter?
the main personality that determines when the others get to present themselves
93
when is the onset for DID?
childhood
94
what is the course for DID?
chronic
95
what is often comorbid with DID?
- depression
- PTSD
- substance abuse
- BPD
96
what is the main theory of DID?
result of coping with intolerable illness
97
what is the main form of treatment for DID?
3-Phase trauma focused therapy
98
what is 3 phase trauma focused therapy
1) establish strong, trusting relationship and stabilize symptoms
2) processing, grieving, resolving trauma
3) integrate dissociated selves
99
what happens in phase three of DID therapy?
- give voice to each alter to see their purpose
- allow each alter to grieve
100
what are the symptoms of dissociative amnesia?
- inability to recall autobiographical info
- due to stress
101
what is psychogenic amnesia?
- amnesia from pschological causes
- retrograde amnesia about personal info
102
describe dissociative fugue states
- a person travels to a new place and assumes new identity
- no memory of previous identity
- caused by stressor
103
what is the theory of dissociative amnesia?
- defense against intolerable memories
- arousal impacts memory encoding
104
what is the main form of treatment for dissociative amnesia and fugues? What is its goal?
psychotherapy aims to identify the stressors and learn coping skills
105
describe depersonalization/derealization disorder
frequent episodes of feeling detatched from one's own mental processes or body
106
what is depersonalization?
losing sense of own reality
107
what is derealization?
losing sense of reality of outside world
108
what are causes for depersonalization/derealization disorder?
- stress, sleep deprivation, durgs
- childhood abuse
109
what is the definition of a mood disorder?
severe alterations in mood for long periods of time with severe disruptions
110
what is a state of depression?
extraordinary feelings of sadness
111
what is a state of mania?
intense/unrealistic feelings of excitement/euphoria
112
what are the 2 mood states?
1) depression
2) mania
113
what are the cognitive symptoms in depression?
- anhedonia
- worthlessness, guilt, hopelessness
114
what is anhedonia?
- no interest in activities
- stop engaging in thins they enjoy
115
what are the physical symptoms of depression?
- changes in appetite, sleep, activity
- psychomotor retardation or agitation
116
what are severe symptoms of depression?
- delusions
- hallucinations
- suicide
117
what are the 2 types of MDD?
1) single episode
2) recurrent episode
118
how long must symptoms be present for MDD diagnosis?
2 weeks
119
how many symptoms are needed for an MDD diagnosis?
5 of 9
120
what constitutes recuurent episode MDD?
episodes must be separated by 2 months
121
what cannot be diagnosed as MDD?
grief unless atypical behaviors are present
122
what are the 8 specifiers for MDD?
1) anxious distress
2) mixed features
3) melancholic features
4) psychotic features
5) catatonic features
6) atypical features
7) seasonal pattern
8) peripartum onset
123
what is the anxious distress specifier?
prominent anxiety symptoms
124
what is the mixed features specifier?
- 3 or more manic symptoms with depression
- not enough to be a manic episode
125
what is the melancholic features specifier?
prominent physiological symptoms
126
what is the psychotic features specifier?
dellusions/hallucinations
127
what is the catatonic features modifier?
strange physical behaviors
- lack of movement
- excited aggitation
128
what is the atypical features specifier?
- odd assortment of symptoms
- does not mean rare
129
what is the peripartum onset specifier?
onset during pregnancy or within 4 weeks of birth
130
what are the criteria for persistent depressive disorder?
- symptoms for most of the day for at least 2 years
- 2 of 5 symptoms
131
what are the comorbidities for persistent depressive disorder?
- anxiety
- subtance use
131
how do symptoms of persistent depression differ from MDD?
they are longer lasting but less severe
132
what are the required symptoms for premenstrual dysphoric disorder?
- irritability
- depressed mood
- uncontrolled emotion
133
what are the criteria fo premenstural dysphoric disorder?
- symptoms arise within a week of cycle
- distress or impairment
134
what are the comorbidities for PMDD?
- GAD
- agoraphobia
- Bipolar
- PTSD
- MDD
135
what are the symptoms of mood dysregulation disorder?
- severe and chronic irritability
- persistently negative mood
- severe temper outbursts
136
what are the criteria for disruptive mood dysregulation disorder?
- only ages 6-18
- tantrums must be disproportionate to cause
- behavior must be age inappropriate
137
what is the course of depressive disorders?
long lasting and recurrent
138
what are the comorbidities of disruptive mood dysregulation disorder?
-ODD
- coduct disorder
- ADHD
- depression
139
how do MDD symptoms usually present in adolescents?
irritability
140
what are the comorbidities of adolescent MDD?
- ADHD
- anxiety disorders
- disruptive disorder
- substance use
- enureses (peeing yourself)
141
describe a manic episode
abnormally, persistently elevated or irritable mood with goal directed activity or energy
142
what is required for a manic episode?
symptoms last at least a week
143
what are the cognitive/behavioral symptoms of mania?
- impulsive behavior, rapid speech, racing thoughts
- "flight of ideas" mind racing but can't keep up verbally
- grandiosity: inflated self-esteem
144
what are the physical symptoms of mania?
- increased energy
- decreased sleep and appetite
145
what are the severe symptoms of mania?
dellusions and hallucinations
146
what is not needed for a manic episode diagnosis?
distress
147
what are the symptoms of bipolar I?
- elevated, expansive, or irritable mood
- manic episode for more than a week
- possible depressive episodes
- possible dellusions/hallucinatinos
148
what are the symptoms of bipolar II?
- severe depression
- hypomania
149
what are the criteria for bipolar II?
- NO dellusions/hallucinatinos
- mania only needs to be present for 4 days
150
what is not required for a bipolar I diagnosis?
depressive episodes
151
what is the defining feature of cyclothymic disorder?
episodes not frequent, severe, or long enough for bipolar diagnosis
152
what are the criteria for cyclothymic disorder?
- episodes for at least 2 years
153
what is the criteria for rapid cyling bipolar disorder?
4 or more episodes within a year
154
what is the course of bipolar disorder?
recurrent
155
explain the genetic theory of depression
- there is a strong genetic component
- polygenic
- serotonin transport gene
156
explain the neurotransmitter theory of depression
dysregulation of serotonin and norepinephrine
157
explain the brain abnormalities theory of depression
- less gray matter in prefrontal cortex
- anterior singulate: stress/social behaviors and attention
- smaller hippocampus
- enlargement and overreactivity of amygdala
158
explain the neuroendocrine theory of depression
- elevated cortisol levels
- chronic hyperactivity of HPA axis
159
explain the behavioral theory of depression
- stressors reduce positive reinforcers in a person's life
- learned helplessness
160
161
explain the cognitive theories of depression
- negative cognitive triad: negative view of self, world, future
- reformulated learned helplessness: focuses on attributions of stressors
- ruminative response cycle: focus on process of thinking over content
162
explain the interpersonal theory of depression
- often from strained reationships
- rejection sensitivity
163
explain the sociocultural theories of depression
- cohort effect
- gender and race differences
164
explain the genetic factor of bipolar disorder
5-10 times more likely
165
explain the brain abnormality theory of bipolar disorder
- altered structure and functioning of amygdala and prefrontal cortex
- basal ganlgia: abnormal response to environmental rewards
166
explain the neurotransmitter theory of bipolar disorder
dysregulation of the dopamine system
167
what brain structure is linked to manic episodes
basal ganglia
168
what are the psychological factors for bipolar disorder
- greater sensitivity to rewards
- increased stress
- disruptions in routine
169
what are the biological treatments of mood disorders?
- medication
- ECT
- brain stimulation
- light therapy
170
what are the goals of behavioral therapy for mood disorders?
- 6-12 weeks
- teach skills to change negative circumstances
- change how people interact
171
whatare the goals of CBT for mood disorders?
- designed to be brief
- identify negative automatic thought
- recognize basic beliefs/assumptions
- learn new coping skills
172
what are the four types of problems that intrpersonal therapy deals with?
1) grief/loss
2) role dispute
3) role transition
4) interpersonal skill deficits
173
what is interpersonal and social rhythm therapy (ISRT) and what are its goals when treating mood disorders?
- combo of interpersonal and behavioral therapies
- help people maintain regular routines and realtionships
174
what kind of therapy is least likely to hace a relapse for mood disorders?
psychotherapy
