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Flashcards in Midterm 2 Deck (136):
1

Is obsessive compulsive disorder under the anxiety category in the DSM5

no

2

What is anxiety

An unpleasant feeling of fear and apprehension

3

What other disorder is anxiety most commonly comorbid with

depression

4

What characteristics indicate that the anxiety one is feeling is problematic (4)

Chronic, relatively intense, associated with role impairment, causing significant distress to self or others.

5

What factor distinguishes chronically anxious people

their propensity to perceive threat and to be worried or concerned when there is no object threat or the situation is ambiguous.

6

What is a phobia

Fear and avoidance of objects or situations that do not present any real danger.

7

Where does the word phobia come from

Phobos (God of fear)

8

How many different factors can fears be grouped into?

5

9

What are the 5 different types of fears

Agoraphobia, fears of heights or water, threat fears, fears of being observed, speaking fears

10

What is agoraphobia

The fear of going out and seeing people

11

What two phobias only begin because of experience

fears of height or water

12

How do we know that the phobia of height has to be learned

we are not born with the ability of depth perception

13

What are some examples of threat fears

Thunder, storms, needles, blood

14

What three things would someone dislike if they had a phobia of being observed

Being evaluated, judged, or watched

15

What 2 higher-order categories can the 5 fears be broken down into

specific fears and social fears

16

Which type of fear tends to be longer lasting and on average how long

specific fears and 20 years

17

What percent of people with a specific phobia will actually receive treatment

8

18

What are the 8 most common specific fears in order

Animals, heights, being in closed spaces, flying, being in or on water, going to the dentist, seeing blood or getting an injection, storms/thunder/lightening.

19

What is nomophobia

A pathological fear of remaining out of touch with technology that is experienced by people who have become overly dependent on their mobile phones.

20

According to the behavioural perspective what causes phobias?

Avoidance learning

21

What are the two stages of avoidance learning

stage 1: neutral stimulus is paired with aversive stimulus. stage 2: negative reinforcement.

22

According to the behavioural perspective how do you treat phobias? (2)

Systematic desensitization or/and exposure therapy

23

What does cognitive behavioural therapy focus on when looking at phobias

On how thought processes can serve as a diathesis and on how thoughts can maintain a phobia

24

According to CBT what 3 things is anxiety related to:

Being more likely to attend to negative stimuli, interpret ambiguous information as threatening, believe that negative events are more likely to occur than positive ones.

25

What are two different behavioural systems?

Behavioural inhibition system and behavioural activation system

26

What side of the brain is the behavioural inhibition system on

right side

27

What side of the brain is the behavioural activation system on

left side

28

Cognitive behavioural models of social phobias link social phobias to which 3 cognitive characteristics?

Attentional bias (more likely to focus on negative social information), Perfectionistic standards for accepted social performances, high degree of public self consciousness

29

What is post-event processing

A form of rumination about previous experiences and responses to these situations, especially experiences involving other people that did not turn out well

30

What are the 5 steps in the cognitive interpretation of a social phobia

Social situation, activation of assumptions, perceived social danger, catastrophic thinking, and behavioural symptoms.

31

According to the cognitive perspective how does anxiety get treated

reducing the perception of threat.

32

What are three different treatments of phobias according to psychoanalytic theory?

Free association, resistance, and transference

33

How do phobias form according to the psychoanalytic perspective

Anxiety is displaced from the feared id impulse and moved onto an object or situation that has some symbolic connection to it.

34

What is panic disorder

The recurrence of panic attacks involving a sudden onset of physiological symptoms, such as dizziness, rapid heart rate, trembling, and accompanied by terror and feelings of impending doom

35

What are the steps of a panic attack in the cognitive perspective (6)

internal/external stimulus, perceive threat, apprehension, body sensations, interpretation of sensation as catastrophic, circular continuation

36

What is generalized anxiety disorder

persistent uncontrollable worry, often about minor things.

37

What is the "learning view" of GAD according to the cognitive perspective

Anxiety is regarded as having been classically conditioned to external stimuli, but with a broader ranged of conditioned stimuli

38

What is the cognitive view of GAD

Looks at control and helplessness believes that people with GAD are highly sensitive to threat cues and worry serves as a form of "control"

39

According to cognitive theory what is the central characteristic of all forms of anxiety?

Perception of not being in control

40

What is separation anxiety

The anxious arousal and worry about losing contact with and proximity to people, typically significant others.

41

What is the obsession component in obsessive compulsive disorder

A thought or an image that keeps intruding into a person's consciousness

42

What is the compulsion component in obsessive compulsive disorder

An action that a person feels compelled to repeat in a stereotyped fashion though e'she may have no conscious desire to dose.

43

How is OCD maintained

negative reinforcement.

44

What are the two biological causes of OCD

Genetics and brain structure abnormalties

45

What is the heritability of OCD in first degree relatives

10.3%

46

What is the heritability of OCD in control relatives

1.9%

47

What are three things that can happen to the brain structure that can cause OCD

Encephalitis, head injuries and brain tumours

48

Damage to what brain area is most closely linked to OCD and why?

frontal lobe. This is because this area is responsible for inhibition.

49

What brain structure is associated with OCD and why does this make sense

The basal ganglia. This makes sense people this area is linked to the control of motor behaviour

50

What two syndromes are associated with low levels of serotonin in the basal ganglia

Tourettes and OCD

51

What type of medication can be effective for helping people with OCD

SSRI's

52

What does ERP stand for

Exposure with response prevention

53

What happens in ERP

The person exposes him/herself to situations that elicit the compulsive act but refrain from performing the accustomed ritual.

54

What is the assumption of ERP

Preventing the person from performing the ritual will expose him or her to the anxiety provoking stimulus thereby allowing the anxiety to be extinguished. Not allowing for negative reinforcement.

55

What percent of people who stay in their ERP program treat their OCD

75%

56

According to the psychodynamic perspective where does neuroses stem from?

Inner conflicts

57

According to the psychodynamic perspective how can childhood cause anxiety

Faulty attachments

58

What did Alfred Adler believe the cause of OCD was

A result of feelings of incompetence due to an inferiority complex. Parents not letting children have control so the child may later engage in compulsive rituals to carve out a domain in which they can exert control

59

What two biological mechanisms can cause anxiety

Autonomic nervous system overactivity and genetic factors

60

What genetic factors can cause anxiety

Too little GABA, too much norepinephrine and abnormal levels of serotonin

61

What is the Noradrenergic activity theory of panic disorder

Assumes that panic is caused by overactivity in the noradrenergic system. More specifically the locus ceruleus

62

What happens when you give someone yohimbine which is a drug that stimulates activity in the locus ceruleus?

It can cause panic attacks

63

What happens when you inhibit the locus ceruleus in terms of panic attacks?

nothing

64

What kind of GABA abnormalities do people with panic disorder have

Fewer GABA-receptor binding sites

65

What is CCK and what can it induce

It is a peptide that can induce anxiety-like symptoms

66

How can the effects of CCK be blocked

benzos

67

Where is the locus ceruleus located

top of the brainstem

68

What two physiological issues can illicit panic attacks

Mitral valve prolapse syndrome and inner ear disease

69

How can mitral valve prolapse syndrome cause panic attacks

In this syndrome the heart can have palpitations from not closing properly. Which could feel like a heart attack and then illicit a panic attack.

70

How can inner ear disease cause a panic attack?

Can cause dizziness which illicit a panic attack

71

What two major classes of drugs can help anxiety disorders

Anxiolytics and antidepressants

72

What are the two types of anxiolytics

Sedatives and tranquilizers

73

What type of drug is a benzo

Minor tranquilizers

74

How do benzos work

They increase the efficacy of GABA and inhibit CCK

75

How is anxiety treated according to the psychodynamic perspective

by gaining insight into the unconscious roots of loss and abandonment

76

How is anxiety treated according to the behavioural perspective (5)?

Therapeutic intervention to change behaviour by exposure therapy, systematic desensitization, flooding, modelling, response prevention.

77

How is anxiety treated according to the cognitive perspective (4)?

Changing maladaptive thoughts by cognitive restructuring, thought stopping, cognitive reattribution therapy and cognitive rehearsal

78

What is an example of cognitive restructuring (as a therapeutic treatment for anxiety)

Asking yourself what is the worst thing that could happen

79

What is thought stopping as a therapeutic treatment for anxiety

Wearing an elastic band around your wrist and every time you have the thought you snap it.

80

What does cognitive rehearsal as a means of therapeutic treatment for anxiety entail?

Doing the things you're scared of doing

81

What is the treatment for anxiety according to the neurological perspective

Anti-anxiety medication

82

What are the 9 possible symptoms of major depression? Which 2 are mandatory?

Sadness, anhedonia, disturbance of appetite, sleep disturbance, psychomotor retardation or agitation, loss of energy, feelings of worthlessness or guilt, reduced ability to think or concentrate, recurrent thoughts of death. Sadness and anhedonia must be present

83

What is the diagnostic criteria of MDD in terms of how many symptoms over what period of time

At least 5 of the major symptoms (2 must be anhedonia and sadness) for at least 2 weeks.

84

What percent of people who have MDD have more than one episode

80%

85

What is the average amount of depressive episodes and how long for the average person with MDD

4 episodes of 3-5 months in length

86

What does the kindling hypothesis posit?

Once a depression has already been experienced, it takes less stress to induce a subsequent episode

87

Describe the demographics of MDD

2x more common in women than men. This difference appears in adolescence and is maintained across the lifespan. After age 65 rates of depression drop sharply for both sexes.

88

What does the continuity hypothesis post

Depression occurs on a continuum, it is an exaggerated form of "normal" sadness

89

Qualitative approaches to depression are categorical or dimensional

categorical

90

Quantitative approaches to depression are categorical or dimensional

dimensional

91

What is endogenous depression

depression that occurs from within from a diathesis

92

What is reactive depression

depression that occurs due to something in the environment

93

Which of the two types of depression has an earlier onset

endogenous

94

What is the diagnostic criteria for bipolar 1

Elevated or irritable mood and increased activity level plus three additional symptoms

95

What 8 possible symptoms of manic depression

elevated/expansive/irritable mood, inflated self esteem, sleeplessness, talkativeness, flight of ideas, distractibility, hyperactivity, reckless behaviour

96

According to PET scans is there more brain activity during manic or depressed state in bipolar patients

Manic

97

According to the psychodynamic perspective how does an oral fixation cause depression

people have a maladaptive attachment style which leads to neediness which pushes people away.

98

What are the two types of psychodynamic approaches to therapy for major depression

Insight therapy and interpersonal therapy

99

What is the goal of insight therapy

To open up the wound of the main cause of ones depression to give a cathartic release.

100

What is the goal of interpersonal therapy

Tries to cure the effect major depression has on the here and now

101

What are two causes of depression according to the behavioural perspective

Extinction (a loss of positive reinforcers), aversive social behaviour which causes shallow responses from others which is hard on needy people.

102

What are the four principle cognitive biases of those with major depression?

Arbitrary inference, selective abstraction, overgeneralization, and magnification/minimization.

103

first degree relatives of someone with MDD are what times more likely to also have MDD

3X

104

first degree relatives of someone with bipolar are what times more likely to have bipolar

10x

105

What mental illness has no demographic?

Bipolar

106

Twin studies for bipolar disorder show a ___% concordance rate for MZ twins and a ___% rate for DZ twins

85% and 15%

107

what gene has bipolar disorder been linked to

the dominant gene on the 11th chromosome

108

What gene has been implicated in depression

serotonin transporter gene linked promotor region (5-HTT)

109

What percent of individuals with one short version of the 5-HTT gene have depression

17%

110

What percent of individuals with two short versions of the 5-HTT gene have depression

43%

111

Low levels of which two neurotransmitters lead to depression and high levels lead to mania

dopamine and norepinephrine

112

What is one possible reason anti-depressants can take up to thirty days to work

G-Proteins on the post-synaptic membrane may be changing the receptors sensitivity to neurotransmitters

113

Do G-protein regulators effect activity in the pre or post synaptic cells

post synaptic

114

What is the DST test and what happens in depressed people

it is a chemical that suppresses cortisol.. in depressed people it doesn't effect them

115

Where in the brain is ect administered

frontal lobe to avoid memory loss

116

How is lithium believed to work

effects G-Proteins on the post synaptic side

117

What are the 5 kinds of delusions seen in schizophrenia

Nihilistic, controlled, grandeur, reference, and hypochondriacal

118

What are the three common beliefs in delusions of control

thought inserting, thought withdrawal and thought broadcasting

119

What are the 5 ways that speech is affected in people with schizophrenia

Poverty of content, loose associations, word salad, clanging, and neologisms.

120

What is one physiological explanation as to why someone may have auditory hallucinations

Abnormalities in their battery loop which makes it hard for them to distinguish internal thoughts from external auditory stimuli

121

What are the three ways that schizophrenia can effect affect

blunted affect, flat affect, and inappropriate affect.

122

What are the demographics of schizophrenia

more common in males than females, has an onset later in life and occurs earlier in the life span in males

123

What are the three phases of schizophrenia

Prodromal, active, residual

124

What are the three types of schizophrenia

catatonic, disorganized, and paranoid

125

What are the four negative behavioural symptoms of schizophrenia

avolition, alogia, anhedonia, Asociality

126

What does avolition mean

Lack of energy

127

What does alogia

Poverty of speech, disorganized speech

128

Name the four differences between type 1 and type 2 schizophrenia

cause of onset, quality in promodal phase, positive versus negative symptoms, paranoid versus nonparanoid

129

Negative symptoms of schizophrenia come from which part of the brain

frontal lobe

130

What is the dopamine hypothesis

Schizophrenia occurs from excess dopamine in the mesolimbic pathway

131

What receptors do neuroleptics work on

blocking the D2 receptors

132

What are three pieces of support for the dopamine hypothesis

Medication that block dopamine work, parkinson's patients, amphetamines

133

Increase of what serotonin in the frontal lobe can help with negative symptoms of schizophrenia but what is the problem with it

Serotonin, these medication cause low immune functioning

134

What is one huge region why people with schizophrenia stop taking their medication

Tardive dsykenisea

135

What are two environmental/interpersonal circumstances that could make relapse more common or symptoms worse

ee environments and communication deviance

136

What two behavioural therapies can be used for people with schizpophrenia

token enviornments and relearning appropriate social behaviour