Flashcards in Midterm 2 Deck (136):
Is obsessive compulsive disorder under the anxiety category in the DSM5
What is anxiety
An unpleasant feeling of fear and apprehension
What other disorder is anxiety most commonly comorbid with
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.
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.
What is a phobia
Fear and avoidance of objects or situations that do not present any real danger.
Where does the word phobia come from
Phobos (God of fear)
How many different factors can fears be grouped into?
What are the 5 different types of fears
Agoraphobia, fears of heights or water, threat fears, fears of being observed, speaking fears
What is agoraphobia
The fear of going out and seeing people
What two phobias only begin because of experience
fears of height or water
How do we know that the phobia of height has to be learned
we are not born with the ability of depth perception
What are some examples of threat fears
Thunder, storms, needles, blood
What three things would someone dislike if they had a phobia of being observed
Being evaluated, judged, or watched
What 2 higher-order categories can the 5 fears be broken down into
specific fears and social fears
Which type of fear tends to be longer lasting and on average how long
specific fears and 20 years
What percent of people with a specific phobia will actually receive treatment
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.
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.
According to the behavioural perspective what causes phobias?
What are the two stages of avoidance learning
stage 1: neutral stimulus is paired with aversive stimulus. stage 2: negative reinforcement.
According to the behavioural perspective how do you treat phobias? (2)
Systematic desensitization or/and exposure therapy
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
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.
What are two different behavioural systems?
Behavioural inhibition system and behavioural activation system
What side of the brain is the behavioural inhibition system on
What side of the brain is the behavioural activation system on
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
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
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.
According to the cognitive perspective how does anxiety get treated
reducing the perception of threat.
What are three different treatments of phobias according to psychoanalytic theory?
Free association, resistance, and transference
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.
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
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
What is generalized anxiety disorder
persistent uncontrollable worry, often about minor things.
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
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"
According to cognitive theory what is the central characteristic of all forms of anxiety?
Perception of not being in control
What is separation anxiety
The anxious arousal and worry about losing contact with and proximity to people, typically significant others.
What is the obsession component in obsessive compulsive disorder
A thought or an image that keeps intruding into a person's consciousness
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.
How is OCD maintained
What are the two biological causes of OCD
Genetics and brain structure abnormalties
What is the heritability of OCD in first degree relatives
What is the heritability of OCD in control relatives
What are three things that can happen to the brain structure that can cause OCD
Encephalitis, head injuries and brain tumours
Damage to what brain area is most closely linked to OCD and why?
frontal lobe. This is because this area is responsible for inhibition.
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
What two syndromes are associated with low levels of serotonin in the basal ganglia
Tourettes and OCD
What type of medication can be effective for helping people with OCD
What does ERP stand for
Exposure with response prevention
What happens in ERP
The person exposes him/herself to situations that elicit the compulsive act but refrain from performing the accustomed ritual.
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.
What percent of people who stay in their ERP program treat their OCD
According to the psychodynamic perspective where does neuroses stem from?
According to the psychodynamic perspective how can childhood cause anxiety
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
What two biological mechanisms can cause anxiety
Autonomic nervous system overactivity and genetic factors
What genetic factors can cause anxiety
Too little GABA, too much norepinephrine and abnormal levels of serotonin
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
What happens when you give someone yohimbine which is a drug that stimulates activity in the locus ceruleus?
It can cause panic attacks
What happens when you inhibit the locus ceruleus in terms of panic attacks?
What kind of GABA abnormalities do people with panic disorder have
Fewer GABA-receptor binding sites
What is CCK and what can it induce
It is a peptide that can induce anxiety-like symptoms
How can the effects of CCK be blocked
Where is the locus ceruleus located
top of the brainstem
What two physiological issues can illicit panic attacks
Mitral valve prolapse syndrome and inner ear disease
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.
How can inner ear disease cause a panic attack?
Can cause dizziness which illicit a panic attack
What two major classes of drugs can help anxiety disorders
Anxiolytics and antidepressants
What are the two types of anxiolytics
Sedatives and tranquilizers
What type of drug is a benzo
How do benzos work
They increase the efficacy of GABA and inhibit CCK
How is anxiety treated according to the psychodynamic perspective
by gaining insight into the unconscious roots of loss and abandonment
How is anxiety treated according to the behavioural perspective (5)?
Therapeutic intervention to change behaviour by exposure therapy, systematic desensitization, flooding, modelling, response prevention.
How is anxiety treated according to the cognitive perspective (4)?
Changing maladaptive thoughts by cognitive restructuring, thought stopping, cognitive reattribution therapy and cognitive rehearsal
What is an example of cognitive restructuring (as a therapeutic treatment for anxiety)
Asking yourself what is the worst thing that could happen
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.
What does cognitive rehearsal as a means of therapeutic treatment for anxiety entail?
Doing the things you're scared of doing
What is the treatment for anxiety according to the neurological perspective
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
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.
What percent of people who have MDD have more than one episode
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
What does the kindling hypothesis posit?
Once a depression has already been experienced, it takes less stress to induce a subsequent episode
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.
What does the continuity hypothesis post
Depression occurs on a continuum, it is an exaggerated form of "normal" sadness
Qualitative approaches to depression are categorical or dimensional
Quantitative approaches to depression are categorical or dimensional
What is endogenous depression
depression that occurs from within from a diathesis
What is reactive depression
depression that occurs due to something in the environment
Which of the two types of depression has an earlier onset
What is the diagnostic criteria for bipolar 1
Elevated or irritable mood and increased activity level plus three additional symptoms
What 8 possible symptoms of manic depression
elevated/expansive/irritable mood, inflated self esteem, sleeplessness, talkativeness, flight of ideas, distractibility, hyperactivity, reckless behaviour
According to PET scans is there more brain activity during manic or depressed state in bipolar patients
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.
What are the two types of psychodynamic approaches to therapy for major depression
Insight therapy and interpersonal therapy
What is the goal of insight therapy
To open up the wound of the main cause of ones depression to give a cathartic release.
What is the goal of interpersonal therapy
Tries to cure the effect major depression has on the here and now
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.
What are the four principle cognitive biases of those with major depression?
Arbitrary inference, selective abstraction, overgeneralization, and magnification/minimization.
first degree relatives of someone with MDD are what times more likely to also have MDD
first degree relatives of someone with bipolar are what times more likely to have bipolar
What mental illness has no demographic?
Twin studies for bipolar disorder show a ___% concordance rate for MZ twins and a ___% rate for DZ twins
85% and 15%
what gene has bipolar disorder been linked to
the dominant gene on the 11th chromosome
What gene has been implicated in depression
serotonin transporter gene linked promotor region (5-HTT)
What percent of individuals with one short version of the 5-HTT gene have depression
What percent of individuals with two short versions of the 5-HTT gene have depression
Low levels of which two neurotransmitters lead to depression and high levels lead to mania
dopamine and norepinephrine
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
Do G-protein regulators effect activity in the pre or post synaptic cells
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
Where in the brain is ect administered
frontal lobe to avoid memory loss
How is lithium believed to work
effects G-Proteins on the post synaptic side
What are the 5 kinds of delusions seen in schizophrenia
Nihilistic, controlled, grandeur, reference, and hypochondriacal
What are the three common beliefs in delusions of control
thought inserting, thought withdrawal and thought broadcasting
What are the 5 ways that speech is affected in people with schizophrenia
Poverty of content, loose associations, word salad, clanging, and neologisms.
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
What are the three ways that schizophrenia can effect affect
blunted affect, flat affect, and inappropriate affect.
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
What are the three phases of schizophrenia
Prodromal, active, residual
What are the three types of schizophrenia
catatonic, disorganized, and paranoid
What are the four negative behavioural symptoms of schizophrenia
avolition, alogia, anhedonia, Asociality
What does avolition mean
Lack of energy
What does alogia
Poverty of speech, disorganized speech
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
Negative symptoms of schizophrenia come from which part of the brain
What is the dopamine hypothesis
Schizophrenia occurs from excess dopamine in the mesolimbic pathway
What receptors do neuroleptics work on
blocking the D2 receptors
What are three pieces of support for the dopamine hypothesis
Medication that block dopamine work, parkinson's patients, amphetamines
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
What is one huge region why people with schizophrenia stop taking their medication
What are two environmental/interpersonal circumstances that could make relapse more common or symptoms worse
ee environments and communication deviance