Exam 2 Flashcards
(85 cards)
1
Q
What are the major psychiatric classification systems?
A
- International Classification of disease system (ICD): most commonly used outside of north america
- Diagnostic and statistical manual of mental disorders (DSM): Most commonly used in north america
2
Q
What classification system includes medical illnesses?
A
ICD 10
3
Q
What approach does the DSM take?
A
Atheoretical approach since DSM 3. Relies on clinical description. Doesn’t take on any theory.
Empirical Approach since DSM 4. Development based heavily on results of research.
Prototypical approach since DSM 5- typically for each disorder a set of criteria is presented, including various symptoms of which a specific number must be present for a diagnosis to be assigned.
4
Q
What approach to classification is predominately used by the DSM 5?
A
Prototypical approach.
5
Q
What was the development of the DSM 5?
A
- Planning began ins 1999
- a task force consisting of 28 members oversaw its development.
- 13 work groups out of those members, each work group was assigned a specific section of the DSM
- Final criteria were voted on by the work group members, than the task force and then the APA board of trustees
6
Q
What were the major changes in the DSM 5?
A
- Reorganization and regrouping of several disorders (PTSD and OCD are no longer classified as anxiety disorder)
- Addition of some new disorders (hoarding disorder, premenstrual dysphoric disorder) and renaming of some old disorders
- Diagnostic criteria for several disorders updated
- Dimensional approach added (disorders exist on a continuum of symptoms- there are different levels of disorders)
- Multiaxial system removed
- Global assessment of functioning scale replaced by WHO disability assessment schedule 2
- Increased attention to cultural factors
7
Q
What are the criticisms of the DSM 5?
A
- Some changes may lead to lover diagnosis and the medicalization of normal distress
- It uses a prototypical/categorical approach
- Questionable improvements in reliability
- A lack of transparency
- Advances in genetics/neuroscience have been over incorporated or under incorporated (depending on who’s complaining)
8
Q
How much of the population is affected by anxiety disorders?
A
18% of the population at some point in their lives
9
Q
How many people with an anxiety disorder seek treatment?
A
Most common category of psychological disorder and the most treatable but only 1/3 of people seek treatment
10
Q
What is anxiety?
A
Involves the anticipation of future threat
11
Q
What is the subjective component of anxiety disorders?
A
sense of unease, worry, dread, sense of being unable to predict or control future threat
12
Q
What is the behavioral component to anxiety disorders?
A
appearing worried, fidgeting, active avoidance
13
Q
What are the physiological component of anxiety disorders?
A
elevated heart rate and muscle tension
14
Q
What is fear?
A
an emotional response to real or perceived imminent threat
15
Q
What is the subjective, behavioral and physiological components to fear?
A
Subjective- thoughts of immediate danger
Behavioral- escape behaviors
Physiological- surge of autonomic arousal (fight or flight)
16
Q
What is a panic disorder as stated by the DSM 5 criteria?
A
Recurrent unexpected panic attacks.
17
Q
What is a panic attack?
A
a panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of the symptoms occur
18
Q
How many symptoms do you need to be diagnosed with panic disorder?
A
4 of the 13 symptoms. Some include: -chest discomfort -chills or heat sensations -sweating -choking feeling -trembling or shaking
19
Q
What other criteria must be met for a diagnosis for a panic disorder besides the symptoms?
A
At least one of the attacks has been followed by 1 month or more of one or both of the following:
- Persistent concern or worry about additional panic attacks or their consequences
- A significant maladaptive change in behavior related to the attacks
The disturbance is not attributable to the physiological effects of a substance or other medical condition
The disturbance is not better accounted for by another mental disorder
20
Q
What is the sex ratio for panic disorder?
A
2:1 (female)
21
Q
What is the one year and lifetime prevalence for panic disorder?
A
One year: 2.7%
Lifetime: 4.7%
22
Q
What is the median age of onset for panic disorder?
A
20-24 years
23
Q
What is the course for panic disorder?
A
Episodic course with years of remission between episodes or continuous severe symptomatology
24
Q
Is there a genetic contribution to panic disorder?
A
Twin and family studies suggest a genetic contribution. If your biological relative has it, youre 8 times more likely to have it as well.
25
How is panic disorder biologically explained?
Overactivity in the noradrenergic system. Diminished GABA receptor binding sites.
26
What are the social contributions to panic disorder?
Stress. It can also be learned (modeling).
27
What are psychological contributions to panic disorder?
Conditioning, dysfunctional beliefs (belief that physical sensations mean something terrible is going to happen), heightened interoceptive awareness (increased awareness of internal sensations)
28
What is the panic cycle?
Individuals experience anxiety about the prospect of having more attacks, this anxiety produces more physical sensations, they have an increased awareness of these sensations and that creates more anxiety, which results in more symptoms, creating a vicious cycle
29
What kind of medications are given to people with panic disorder?
SSRI's (Prozac)
Tricyclic antidepressants
Benzodiazepines
30
What kind of treatment is available to those with panic disorder?
Expose based treatment (gradual exposure exercises that are sometimes combined with anxiety reducing coping strategies)
Panic control treatment (focuses on exposing clients to interceptive sensations associated with an attack to teach them that these sensations are normal and not dangerous and that they are in control of them)
31
What is a comorbid diagnosis?
When a person has a diagnosis for more than one disorder
32
What is agoraphobia?
anxiety about being in places or situations from which escape might be difficult in the event of panic symptoms or other unpleasant physical symptoms.
Agoraphobia was listed under panic disorder in the DSM 4 but in the DSM 5 they are two separate things.
33
What is generalized anxiety disorder defined as in the DSM 5?
Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities.
The individual finds it difficult to control the worry
The anxiety and worry are associated with three or more of the following six symptoms
- restlessness
- being easily fatigued
- difficulty concentrating
- irritability
- muscle tention
- sleep disturbance
The anxiety, worry or physical symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning
The disturbance is not attributable to the physiological effects of a substance or another medical condition
The disturbance is not better accounted for by another mental disorder
34
What is the sex ratio for generalized anxiety disorder?
2:1 (female)
35
What is the live time and one year prevalence of generalized anxiety disorder?
Lifetime: 5.7%
| One year: 3.1%
36
What is the onset of generalized anxiety disorder?
median age of onset is 30 years of age
37
What is the course for generalized anxiety disorder?
chronic course with waxing and waning symptoms (waxing especially during times of stress)
38
What are the biological contributions to generalized anxiety disorder?
Family and twin studies show that there is a genetic contribution.
There is a possible functional deficiency in GABA
39
What are the psychological contributions to generalized anxiety disorder?
History of experiencing unpredictable and uncontrollable stress.
Dysfunctional beliefs
Perceived lack of control
Attentional bias toward perceived threats
40
What medications are given to people with generalized anxiety disorder?
Benzodiazepines (Valium)
| Antidepressants (Paxil)
41
What neurotransmitter system do benzo's most directly effect?
GABA
42
What kind of treatment is given to people with generalized anxiety disorder?
Cognitive behavioral therapy (focuses on helping clients to identify, challenge and correct beliefs about worry, to diminish intolerance of uncertainty and to intervene with relaxation techniques when worry begins
43
What is the DSM 5 definition for a specific phobia?
Marked fear or anxiety about a specific object or situation.
- Provokes immediate fear
- Object is actively avoided
- Fear is out of proportion to the actual danger
- Lasts 6 months or more
- causes clinically significant distress in functioning
- Not better explained by another disorder
44
What is a specifier?
additional standardized tags or add ons that can be applied to a primary diagnosis in oder to better characterize the specific manifestation of the disorder
45
What are some specific phobia specifiers?
- Situational- fears of specific situations
- Natural enviroment- fears of objects in the natural enviroment
- Blood injection-injury- fears of blood or injury or receiving an injection or other medical procedure. Associated with strong vasovagal response.
- Animal- fears of animals or insects
- Other
46
What is the sex ratio for specific phobias?
2:1 female
47
What is the lifetime and one year prevalence of specific phobias?
Lifetime: 7-11%
| One year: 7-9%
48
What is the onset for specific phobias?
median age of onset is between 7 and 11 years of age
49
What is the course for specific phobias?
chronic if left untreated
50
What are the biological contributions to specific phobias?
Phobias can run in families. Blood-injury-injection is a type that is specifically inheritable.
51
What are the psychological contributions to specific phobias?
Experience!
- Direct experience: traumatic experience with object or situation, including panic attacks
- Vicarious experience: witnessing the experience
- Prepared learning: a biological preparedness to fear certain objects that is shaped evolutionary by natural selection
52
What is the treatment for specific phobias?
- Exposure therapy
- Systematic desensitization- involves controlled gradual exposure to the feared object while relaxation techniques are used
- Participant modeling- therapist calmly models interacting with the phobic stimulus
53
What is the difference between exposure therapy and systematic desensitization?
Systematic desensitization involves relaxation techniques
54
What does the DSM 5 define social anxiety disorder is?
Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
- fears that they will act in a way that will be negatively evaluated
- social situations provoke fear
- social situations are avoided
- fear is out of proportion to the actual threat
- lasts for 6 months or more
- causes clinically significant distress
- cannot be explained by another medical condition or medical disorder (if a medical condition is present it is clearly unrelated)
55
What are the criteria for Body dysmorphic disorder in the DSM 5?
- Preoccupation with one or more perceived defects or flaws in appearance that are not observable or appear slight to others
- Individual has, at some point in the course of the disorder, has performed repetitive behaviors
- Not better explained by concerns with body fat or weight
56
What are the criteria for OCD in the DSM 5?
- Presence of obsessions, compulsions or both.
| - Obsession/compulsion is time consuming or causes stress
57
What is a specifier?
A tag on that can be applied to a diagnosis to better characterize the specific manifestation of the disorder
58
What are the specifiers for OCD?
- With good or fair insight- the individual recognizes that OCD beliefs are definitely or probably not true or that they may or may not be true
- With poor insight- the individual thinks OCD beliefs are probably true
- With absent insight/delusional beliefs- the individual is completely convinced that OCD beliefs are true
CAN ALSO BE APPLIED TO BODY DYSMORPHIC DISORDER
59
What is the sex ratio for OCD?
1:1 in adults
60
What is the prevalence for OCD?
Lifetime: 2.5%
| One year: 1.2%
61
What is the onset for OCD?
mean age of onset is 19.5 years. Onset is typically insidious but acute onset is also possible
62
What is the course for OCD?
Chronic but waxing and waning
63
What are the biological factors to OCD?
- Family and twin studies suggest a genetic contribution
- Neuroimaging studies suggest functional brain abnormalities in the frontal regions and basal ganglia
- occasionally develops after a brain injury
64
What are the psychological factors that contribute to OCD?
Stressful events, memory and attention biases, thought action fusion
65
What is the treatment for OCD?
Medication: SRI's
Psychosurgery
Deep brain stimulation
Therapy: Exposure and response therapy or traditional cognitive behavioral therapy
66
what is the sex ratio for body dysmorphic disorder?
1:1
67
What is the prevalence of body dysmorphic disorder?
point: 2.4%
68
What is the onset for body dysmorphic disorder?
the mean age of onset is 16-17 years of age.
69
What is the course for body dysmorphic disorder?
chronic with a few symptom free intervals (but intensity may wax and wane)
70
What are the biological contributing factors for body dysmorphic disorder?
The same as OCD
71
What are the psychological factors of body dysmorphic disorder?
childhood neglect and abuse, more likely to be teased about their appearance
72
What is the treatment for body dysmorphic disorder?
Medication: SRI's
Therapy: exposure and respinse prevention therapy
73
How many criteria need to be pr esent in order to diagnose an individual with a specific phobia?
All 7 of the 7 criteria
74
What approach to classification provides essential characteristics while still allowing for variation
Prototypical
75
What does ANT stand for?
Automatic negative thought
76
What neurotransmitters contributes to panic disorder?
GABA and Noradrenaline
77
Sensorium involves...
The awareness of our surroundings (who what where)
78
What is an example of a natural enviroment phobia?
Storms and heights
79
If an individual believes their house will definitely burn down if they dont check it every 30 minutes is what kind of insight?
Absent insight
80
What kind of scans can be used to identify abnormalities in the brain?
CAT and MRI
81
What is trichotillomania disorder?
Hair pulling obsession
82
What is excoriation disorder?
Skin picking obsession
83
How long must a person be getting panic attacks/worry about future panic attacks to be diagnosed with panic disorder?
1 month
84
What kind of treatment was used in the video we watched in class on the snake phobia?
Exposure therapy
85
Sara is avoiding scary movies because it creates physiological symptoms of panic disorder. What is this called?
Interoceptive avoidance
