Test #1 Lecture Notes Flashcards

Question

Moral model today: are there disorders of choice?

Answer 1

Malingering: some behavior disorders can be construed as instrumental to the individual, they have secondary gains from the disorder. Malingering is the faking of the disease or disorder for some gains. Most of the people on death row actually met criteria for psychosis but within those settings admitting psychosis makes you a target. Factitious disorders: munchausen disorder by proxy, people like attention so they make a problem for it, or by proxy they use another individual's disorder. Interpersonal theories: some models of depression cite secondary gains as a motivating factor behind system persistence. Some depressed people develop a lifestyle to accommodate it and get used to it. Learned helplessness. This model does not work great because it is rare.

Answer 2

Has a bad reputation. Misses a broader picture. Placing sole responsibility on the individual disregards biological, environment, developmental, and sociocultural determinants of behavior. Leads to interventions that minimally lack compassion but can also include mistreatment But, failure to placed any onus of responsibility on the individual is disempowering. Removing personal responsibility from the equation can have problematic implications. Choices are not set equal across individuals, some things make choices harder for some than others. If you swing too far in the other direction you get other issues. “The best perspectives are usually the ones that balance viewpoints… dialectic” Affluenza: not a real thing, was an idea about a disorder that was used in the criminal difference of an uber rich kid who killed people in a car crash. He has not been held responsible for anything, he has no idea of responsibility so we could not hold him accountable to irresponsible behavior.

Answer 3

The very notion of a chemical imbalance goes back to galen who proposed their were four humors, flem and bile ect. tells us what you have, the germ of the idea has been around He offered treatments: different proportions of physical fluids determines your health so we should do things to get those back in order Phrenology: (same time around moral movement) shape of skull was associated with different personality predispositions and behaviors. Not a great science Recommended treatments were tied to the physical realm. There is a clear relationship between physical and mental health. Physical injury can get you fired from work and lead to depression, also, there is a direct relationship in some cases between body and mental states. Exercise intervention and dieting, can help with depression, sleep can help with ocd Psychotropic medication can help

Answer 4

SRI’s help with depression, we do see after several weeks of ssri’s help, your serotonin levels change immediately, but it is not for a few weeks that you feel better, it is unclear of the change in serotonin is directly responsible for depression to begin with. This is affirming the consequent - logical fallacy. Lack of aspirin does not cause headaches. Mixed success of psychotropic medication may or may not prove this. Irvin kirsch: took depressed people, gave one third an SSRI, gave a second group a placebo, and the third group got a decrease in serotonin. Everyone got better. Maybe serotonin does not play the role in depression that we think it does.

Answer 5

Reductionist fallacy: if i can relate some phenomena to some more fundamental analysis then this is better? Analysis is scaffolded on what precedes it - usually a connection down and thus tempting to look down. Problem is that each level you go up phenomena start to be created - emergence, it becomes more than a sum of its parts, you then can’t reduce it. If i were to explain the significance of the Mona Lisa as a piece of art, I couldn't explain it on the quantum level. Our understanding of it must be focused on the level it is at. Lots of reductionist fallacy when it comes to behavior disorders. Depression lights up these areas, non depressed does not so it must be these places cause depression. Correlation is not causation. Biology has gotten a lot of focus, because it seems more fundamental, but that is based on a fallacy. Some disorders are biological, but oftentimes it is not.

Answer 6

As biological sciences advanced so too were there efforts in classification. Many believed biological science had solved classification problems, and that you can use biological taxonomies to classify mental illness. William Cullen (1769) applied the principles of linnaeus to behavior disorders; leading to a com[;ex scheme involving classes, orders, and genera, and species of disorders The field at thou time was a mess Diagnosis ranged from single systems, broad descriptions, or failed attempts to organize disorders based on etiological speculation. Variety of taxonomies and different systems, if the goal is communication and we are all talking different languages it will fail.

Answer 7

only distinguished on the basis of broad symptom presentation (neurotic vs. psychosis) Psychosis: represented a severe mental disorder characterized by a break with reality Neurosis: a milder mental disorder characterized by distortions with reality. Probably better as classified as psychological disorders.

Answer 8

Detailed observation, careful description, and precise organization of data. Psychiatric diseases are mainly caused by biological and genetic disorders He also went beyond this. The ultimate goal beyond collecting data and even classification. He wanted to be able to classify things in a way that had uti;ity! We are going to need the anatomical pathology: what went wrong in your brain or body that explains these symptoms, he thinks what is causing it is some sort of pathology on the anatomical level. He thought if you iron out these details you will get a good sense of etiology He also then thought we needed a course/ prognosis His attempt at classification was pretty broad, get all this data, collect it, and hope ith all this information it can cover all these grounds we want to achieve in a classification He proposed a 15 categories of disorder He introduced ideas that were not around before hand, schizophrenia, bipolar disorder (at the time manic depressive insanity), and at the time he was the first to corner off the personality disorders. (really now problems in your interpersonal relationships) His program ultimately fils, and he acknowledged that classifying on some kind of pathological anatomy was nearly impossible, most etiological theories which were rooted in biology were largely speculative. But he did do a good job of catogirizng and orgnizing informagtion was good, but the broader goal was a failure

Answer 9

Prior it was strictly biological Freud built and entire psychological system from nothing - He created a system that accounted for psychological functioning - Freud was a physician by training so his psychological training was rooted in biology - He founded it on biology, but another system sits on top of it with emergent qualities - Our biology impulses give rise to cognitive faculties - We’re animals that have animal impulses - We don’t behave like animals because of reason and moral upbringing - Reasons and society bottle up primal impulses and our impulses go somewhere – Freud said they went into behavior disorders - Issues of mental health extended from uniquely psychological processes

Answer 10

Psychiatrists were referred to as alienists, and at the time flocked to Freud's ideas - These were physicians who treated the mentally ill in asylums, but didn’t have proof - Psychiatry was not taken seriously in the profession due to lack of proof of their assumptions, but Freud’s ideas takeoff in context of psychiatry

Answer 11

- 1913 - Noguchi and Moore figured out dementia paralytica - Figured out dementia paralytica was syphilis - Noguchi and Moore isolated syphilitic bacterium in brains of people with syphilis - The was the first psychological disorder where they found a biological basis - This is what Kraepelin was hoping for – a biological basis - Prior to 1913, psychiatry was the laughing stock of the medical community - Using psychotherapy instead of medicalized treatment was what caused the medical community to not take it seriously - However, by 1919 psychiatry becomes 3rd most recognized speciality in medicine after the discovery in 1913 - Major turning point in history of behavior disorders and classification because it was proof of concept - Behavior disorders have a biological root, but this doesn’t mean there is a biological root to every behavior disorder

Answer 12

we are starting to get traction in this idea of behavior disorders or mental illness, what started as biological pricnicple, now we are in the period where people are taking this more seriously as a branch of medicine. The incorporation of behavior disorders into diagnostic manuals for medical problems. The one that is still used everywhere but america was originaly called the bertillon classification of causes of death, now more than jsut death so diferent name. Around 1900 this was adopted as a diagnostic manual for diseases, following world war two this expanded beyond death and put a section for mental illnesses. Renamed the internal classification of diseases.

Answer 13

The dsm 1 and 2 were heavily influenced by freudian theory. They had not biological tech sp they stuck with freud. The dsm one and two were effectively psychological manuals. They were not aligned with the medical model. They differentiated between Disorders caused by or associated with impairment of brain tissue function and Disorders of psychogenic origin or without clearly defined physical causes or structural change in the brain Because they were influenced by the psychodynamic approach the categories reflect reactions to environmental factors then biological or pathological causes. They also did not divide between healthy and unhealthy disorders, it was more of a spectrum, the internal conflicts were a normal part of life that might cause problems, we can help, but does not classify as mentally ill. They are super subjective and open to interpretation Criticisms of Psychiatric classification Diagnostic reloanot;otuy showed highest level of agreement for dsm1 was 42%. This creates problems for clinical practice and generalizability of research findings

Answer 14

- Thomas Szasz claimed mental illness was a myth - Szasz claimed they only benefited psychiatrists - Sociologists and psychologists had issues of labeling and stigmatizing - Diagnosis were shown to be self-fulling prophecies in some cases, these things still happen - If all it’s doing is creating the problem you’re meant to solve, you have a problem - People in society were calling attention to mental illness and questioning validity - People are not agreeing what things are broadly and at granular level

Answer 15

E.g., Sent his undergraduate research assistants to inpatient units and have them fake hallucinatory experiences. As soon as they were admitted they acted how they normally would – ultimately they were stuck in the asylum - People within psychiatry can't differentiate between normal and abnormal - What’s happening in the world of behavior disorders requires some degree of scrutiny

Answer 16

the 1 and 2 were wedded with psychoanalisis. tech and meds were on the rise and succesful, psychoanalysis takes a long time and tech does not. psychiatrits were abandoning the psychological model. this gave power to the neo-krapelinians who wanted to revert back to a medical/ biological model

Answer 17

by 1978 mental health providers agreed to give the neo's full control of the dsm3. this resulted in backlash by psychoanalytic and humanistic theorists. the krepes tried to but a definition for behavior disorders in the apendix, the humanists and psychodynamicists lost it and went to go make their own manual with the apa, legal ction was threatened, in the end agreed to make the dsm3 theoretically agnostic

Answer 18

theoretically agnostic, * new hierarchical system, before, psychotic vs nuerotic, organic vs non-organic. now, 17 major headings with a more holisitc approach, multi acial system categorizing patients along 5 dimensions, sumptom picture, personality style, medical conditions etc. this helps contextualize

Answer 19

○ Axis I: ■ Clinical Disorders ● They tend to come and go ○ Axis II: ■ Personality Disorders and Mental Retardation ● These are a part of you ○ Axis III: ■ General Medical Conditions ● General Health Issues ○ Axis IV: ■ Psychosocial and Environmental Problems ● What kind of living situation is this person in? ○ Axis V: ■ Global assessment of functioning ● A rating of how a “pathological” a person is overall ● Not consistent and didn’t provide reliability

Answer 20

○ Adopted diagnostic criteria in contrast to prose description ■ Makes diagnostic process more clear-cut and explicit ■ Provided very specific guidelines in order to be diagnosed with a behavior disorder ● This provided reliability but created questionable validity ○ Do these criteria really encapsulate all depressed people?

Answer 21

essentially the three with some changes, increased the coerage from 265 to 374

Answer 22

conception of mental illness wat explicitly atheoretical but implicitly based on the medialc model - either you are mentally ill or healthy comorbidity: co-occurence of different diagnoses, can result from overlapping diagnostic criteria, dsm made a lot of comorbidity, their categories overlapped a lot, 10% of personality disorder patients meet criteria for 4 or more PDs. Not therapeutically useful: “I agree with for the most part” for a given diagnosis does not imply some specific etiology or necessary form of treatment. Two people can have depression and be treated in opposite manners, can be useful in many ways but trying to treat it just knowing it is depression does little to help somewhat dubios process for defining diagnosis, had panels of experts, a lengthy consultation process, a comprehensive literature review, reanalyzed extant data, extensive field trials, but... poltical and social processes within and between stakeholders influenced the solutions adopted. Influence who gets on the panel in the first place

Answer 23

an open letter to apa ■ The proposal to include new disorders with relatively little empirical support and/or research literature that is relativity recent ● Ex: disruptive mood dysregulation disorder and childhood bipolar ■ The lowering diagnostic thresholds, which may result in diagnostic expansion and various iatrogenic hazards, such as inappropriate treatment and stigmatization of normative life processes ● Resulting in overdiagnosis ■ The development of novel scales (e.g. severity scales) with little psychometric testing rather than utilizing established standards ■ The perplexing personality disorders overhaul, which is an unnecessarily complex and idiosyncratic system that is likely to have little clinical utility in everyday practice ● In addition, we are increasingly concerned about several aspects of the development process. These are: ○ Continuing delays, particularly in the drafting and field testing of the proposals. ○ The substandard results of the first set of field trials ○ The cancellation of the second set of field trials. ○ The lack of formal forensic review also hiring of a pr firm the process of developing the dsm5 is fraught top to bottom

Answer 24

NIH rejects dsm and akes RDoC. It integrates many levels of information (from genomics to self-report) to better understand basic dimensions of functioning underlying the full range of human behavior from normal to abnormal. ○ Five formal domains: ■ Negative Valence System: Responses to aversive stimuli ■ Positive Valence System: Responses related to appetitive stimuli, incentive systems ■ Cognitive Systems: Thought processes (e.g., working memory) ■ Social Processes: Systems that mediate responses to interpersonal settings ■ Arousal/Regulatory Systems: Systems responsible for generating activation of neural systems, providing appropriate homeostatic regulation ● previously, research was funded by NIMH in accordance with the diagnostic criteria set forth by the DSM ○ By creating RDoC, they are choosing to fund research that will develop new ways of understanding behavior disorders (outside of the DSM) ● In practice it has had some problems- social processes tend to be overlooked (tough to get a grant to look at interpersonal processes .. easier when studying biological processes)

Answer 25

● We need to better define the social, ethical, legal, economic, practical, and philosophical aspects and processes of defining behavior disorders. ○ This is not solely a scientific matter ○ Decisions about the final product predominantly reflect the opinion of a small group of academic psychiatrists and psychologists ● In order to advance we need to abandon the medical model: ○ There is not a clear line between mental health and mental illness (cf., dimensional models). ○ Behavior disorders do not exist on the inside of a person. ■ Behavior disorders are contextually defined ■ Problems seen as not inherent to a behavior (or set of behaviors), but as an interaction between a behavior and the environment. ○ current diagnoses really reflect signs and symptoms of a problem but not the problem itself ■ Depression example: can display symptoms (after effects) but does not help to understand the actual problem ■ a function of a person's behavior in a given context (contextually defined) ● Whether or not your behavior is a problem is defined by the situation not actually the behavior itself ● a very valid way of treating a disorder may be changing the context (ADHD children in classrooms) We need to develop an essentialist account of problems, with particular focus on those stemming from psychological processes Under what circumstances and in what ways do subjective distress, dysfunction, abnormality and impairment relate to actual problems, as well as for whom, and to what extent to these problems require outside intervention targeting psychological (behavioral, cognitive, etc.) processes. If social values are inherent to behavior disorders, what processes will lead us to act on the best values and thus produce the best results What do we mean by best values and or results? Where do we draw the line between society’s responsibility to accommodate differences and an individual’s responsibility to adapt to their context Who gets to decide what is and is not in the best interest of an individual and or society

Answer 26

classical and opperant -opperant avoidance reinforfes, classival initial learning

Answer 27

two factor theory guy only applies to fear/anxiety acquisition i. Whether or not these fears and anxiety are problematic is subjective 1. It must impair a person’s daily life 2. Ask: in the context, does the avoidance behavior make sense? Is it justified? a. Context matters 3. In moderation, some of these anxiety/fear behaviors are not that bad, but in excess they can be problematic

Answer 28

You’re not inheriting the disorder, rather an adaptation i. Ex: learning fear associations faster than others

Answer 29

Hettema, Neale and Kindler (2001): - Showed that anxiety disorders do aggregate in families - Heritability estimates (based on large scale twin studies) were 0.32 for generalized anxiety and 0.43 for panic disorder The genes might predispose you to develop fears but it doesn’t specify what fears it will be - You inherit traits that are characteristic of anxiety disorder, not a fear of spiders - These traits are really adaptive to some circumstances but are really problematic in other disorders - In certain people, there are traits that can both be adaptive and also really harmful - You aren’t inheriting a disorder, you are inheriting broad traits - If your family has anxiety disorders, there is a higher chance that you have it, as well - The ability to form fear associations efficiently is evolutionary sound - People who make those fear associations more quickly in safe environments may be considered abnormal just because of change in context but back in the day was good

Answer 30

On the one hand there really is only one anxiety disorder. Two factor process explain the etiology and maintenance of anxiety Also explains the heterogeneity of anxiety disorders. If it can be experienced, it can become a conditioned stimulus High comorbidity amongst anxiety disorders Stimuli differs response is the same On the other hand some of the differences between the anxiety disorders matter, they have different topographical/descriptive features. Differences result from differences in the signaling stimuli, nature of the conditioned response, ect Differences result from differences in the signaling stimuli, nature of the conditioned response, etc. - EX: avoidance behaviors in OCD vs phobia - OCD includes repetitive behaviors, whereas phobias are strictly avoidant - OCD includes doubt (EX: I can’t see the germs I’m afraid of, so I don’t know if I still have them), whereas phobias are more clear-cut (EX: the dog is not here anymore, and I can see that) - OCD is the only anxiety disorder where the criteria is not that you need to know that your phobia is irrational - EX: low insight in certain manifestations of OCD - EX: chronic hyperarousal in PTSD / GAD - Chronic - all the time - hyperasoul - keyed up

Answer 31

uncertainty is an abstract stimuli and potentially threatening. - Any deviation from the norm can trigger an anxiety response → potentially everywhere and can happen at any time - Anxiety is related to having feelings of uncertainty but if there is uncertainty everywhere

Answer 32

Proximity of the signal to the threat is major contributor in shaping the topography/descriptive characteristics of the anxiety response - EX: the closer a test is, the more anxious a person may become - There are qualitative differences in animal defensive behavior depending on the imminence of threat (fanselow & lester, 1995, blanchard, 1977) - Fight or flight: proximal, but avoidable threat - I can still maneuver in a way - Worry: problem solving to mitigate distal threat - The threat is not here, so I can still come up with a plan - Panic: imminent threat - Increased oxygen intake to get more energy - Bracing for impact

Answer 33

- The DSM-5 criteria for a specific phobia is - - A marked out of proportion fear within an environmental or situational context to the presence or anticipation of a specific object or situation - Are you getting nervous if you are in the presence of, or will be in the presence of a scary stimulus - The phobic situation is avoided purposely or endured with intense anxiety or distress - The distress/anxious anticipation of the feared situation interferes greatly with a person's regular routine, or there is clear distress about having the phobia

Answer 34

- CS (dog) - UCS (pain) → CR (recoil) - CS (dog) → (FEAR) → CR (avoidance) → (RELIEF) - Exposure to the phobic stimulus provokes an immediate anxiety response, may take the form of a situationally bound or situationally predisposed panic attack - Recognizing that the fear is out of proportion, but can’t help the response - The phobic situation is avoided or else endured with anxiety or distress - The avoidance, anticipation, or distress in the feared situations interferes with the person's normal routine - Once it becomes a problem, it can begin to be considered a disorder

Answer 35

1. Direct conditioning 2. Modeling (ie, vicarious conditioning) a. Observation of the aversive stimulus being harmful to others, associated b. Eg: most people haven’t had any direct experience with guns, but everyone tenses up when they see one 3. Instructional transference a. Don’t really see this in primates because they lack language quality i. I can tell people that haven’t experience something that they’re dangerous, this is how parents give their children function (sometimes not functional) anxiety b. We don’t remember these because we usually remember high salience events, less small conditioned stimuli memories

Answer 36

How come I can’t remember the fear being conditioned? - Infantile amnesia: We can’t really remember the first few years of life, although we did learn and experience things. Generally not understood. Inorder to have memories you need to have a general understanding to hang them on. Haven’t made a mental framework for themselves yet. - Insidious acquisition: in line with the notion of multiple ways of fear acquisition. The process is insidious (gradually and unnoticed by us), slow, unaware yet although the amygdala is recording the associations. Low magnitude multiple experiences, unaware that you’re being conditioned. - Fear responses need no verbal mediation (thought): Just because you cannot remember it happening, does not mean it is not happening. Don’t need to be aware that fear acquisition is taking place for it to be taking place, most fears are developed insidiously, mental knowledge is unnecessary for fears to be learned.

Answer 37

often offered as an additional theory of fear acquisition with an evolutionary advance, makes a lot of evolutionary assumptions (whereas two-factor theory does not) - Individuals are predisposed to fear certain things over others due to evolutionary pressures there is an evolutionary reason for these phobias Individuals are predisposed to fear certain things due to evolutionary pressures, spider and snake phobias because they are potentially dangerous, somewhere in our evolutionary past this seemed relevant and we have the gene for spider phobia. certain stimuli are more often tied to phobias, If I were to try and condition someone to have a spider phobia, it is a lot easier than to condition to someone to have a pillow phobia, same goes for dropping that pillow phobia or snake phobia

Answer 38

- Uneven distribution of fears within the human population: certain stimuli are more often tied to phobias (e.g. more snake and spider phobias than pillow phobias, snakes and spiders could kill you, pillows cannot) - Prepared/primed/conditioned to fear “scary” things just by living and experiencing the world - Rapid acquisition and resistance to extinction: fear of stimuli that is “dangerous” is harder to get rid of than fear of non-deadly things - Easier to acquire a fear of deadly things than a fear of non-deadly things → suggests some type of evolutionary basis - There are conditioning experiences that have already been had just by being exposed everyday things (EX: scary movies) - Eg: lots of people are afraid of heights (preparedness theory says that it’s because if you aren’t, you fall and die) - Anxiety is formed based on our experiences, but there could be differences between people’s acquisition

Answer 39

recurrent and unexpected panic attacks. PANIC ATTACKS ARE CHARACTERIZED BY AN ABRUPT SURGE OF INTENSE FEAR OR PHYSICAL DISCOMFORT, REACHING A PEAK WITHIN A FEW MINUTES, IN WHICH AT LEAST 4 OF THE FOLLOWING SYMPTOMS ARE PRESENT RECURRENT AND UNEXPECTED (“OUT OF THE BLUE”) PANIC ATTACKS* * AT LEAST ONE OF THE ATTACKS HAS BEEN FOLLOWED BY 1 MONTH (OR MORE) OF 1 (OR MORE) OF THE FOLLOWING: * PERSISTENT CONCERN ABOUT HAVING ADDITIONAL ATTACKS * WORRY ABOUT THE IMPLICATIONS OF THE ATTACK OR ITS CONSEQUENCES (E.G., LOSING CONTROL, “GOING CRAZY”) * A SIGNIFICANT CHANGE IN BEHAVIOR RELATED TO THE ATTACKS These are the formal symptoms in DSM: - Palpitations, pounding heart, tachycardia - Sweating - Muscle trembling, shaking - Shortness of breath, sensations of smothering - Choking sensations - Chest pain or discomfort - Nausea, abdominal distress (r/o - felt very sick) r/o refers to rule out - Dizzy, lightheaded, instability, feeling faint - Derealization, depersonalization (r/o - blurred vision) - Fears of losing control or going crazy (r/o terrified, apprehensive) - Fear of dying (r/o - terrified, apprehensive) - Numbness, tingling sensations (r/o - felt weak) - Chills, hot flushes - Derealization/depersonalization - Dissociative experiences - Conscious experience becomes unchained from other elements of physical being - Derealization - Dreamlike - Depersonalization - Looking at self from outside

Answer 40

Usually they are very anxious about having another attack and the anxiety of having another attack leads to attacks. That is why there is a link to agoraphobia, having a panic attack while out is very scary, it is a lot better at home, and I am less likely to experience an attack because I am less likely to have one

Answer 41

If you can identify why you have had a panic attack you are less likely to have another Barlows alarm theory: if the panic attack is a true alarm, then the recurrence of panic attack is less likely. If the person cannot identify the source of the threat that induced panic (a false alarm), the recurrence of a panic attack becomes more likely. Panic disorder is fear of having another one

Answer 42

Factor 1: (panic disorder) stimuli, events or situations s are paired with the physiological sensations corresponding to a panic attack the cs may trigger the panic and anxiety when encountered again. Out of the blue onset potentially results from subtle and non-perceptible changes in the physical state or Goldstein and chambless (1978): interoceptive conditioning, fear of fear, low levels of bodily sensations (arousal, anxiety) may become the cs associated with higher levels of anxiety General apprehension toward panic paradoxically increases focus on bodily sensations Cognitive misappraisal of physical symptoms or low levels of anxiety Lead to increased anxiety Factor 2: agoraphobia (behavioral response to factor 1): what do you do if you have out of the blue uncontrollable panic in uncontrolled places Conceptualized as a fear of being in places in which escape might be difficult/ help unavailable in case of a panic attack; or symptom development that might be incapacitating or embarrassing Marked anxiety in two or more Public transportation Open spaces Enclosed spaces Standing in line or being crowded Being outside of the home Agoraphobia is a behavioral response (avoidance) to the anticipation of panic attacks (or other anxiety disorder)

Answer 43

GAD with Panic for Dennis

Answer 44

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance) Individuals find it difficult to control the worry, attempts to distract or move away lead them back to chronic worry Associated with three or more of the following six symptoms (they all feed into each other) Restlessness or feeling keyed up or on edge Being easily fatigues Difficulty concentrating or mind going blank Irritability Muscle tension Sleep disturbance

Answer 45

Key feature of GAD is that the individual experiences chronic and uncontrollable worry that is excessive (in response to a minor event) and unrealistic (unfounded concerns) Worry “descriptively, worry involves a predominance of negative valenced verbal activity”

Answer 46

Problem solving: attention to potential threats or challenges and prompting individuals to generate solutions or strategies to address them Motivation: prompting individuals to take action or engage in behaviors aimed at preventing or resolving perceived threats or difficulties Emotional processing: allows individuals to process and regulate their emotions in response to stressful or uncertain situations

Answer 47

Two factor theory (after initial learning experiences that conditioned stimulus elicits fear which is aversive physiological arousal, whether that results in fff response depends on other factors): it potentially originated from a learning history in which negative events were likely to occur and that they were uncontrollable or unpredictable Early traumatic experiences: death of a parent, injury and illness, physical and sexual abuse Early attachment problems: evidence suggests GAD patients had unpleasant, negative, alienating and rejecting family environments the cs is often times situational ambiguity or uncertainty which provokes physiological arousal

Answer 48

For both anxious and nonanxious individuals, worry is an adaptive mechanism underlying problem-solving A cognitive attempt to avoid future aversive events Problem solving provides short term relief of fear: research suggests that induced worry (when we induce worry people start to show a decrease in arousal, takes the anxiety away, when we try to shock them their response is already buffered for they are expecting something bad and they are ready for it so we see less reactivity, when you worry it makes you feel less stressed out and when bad things happen you are more prepared) reduces fear responses (at the physiological level) and buffers physiological reactivity to fear-eliciting images Alleviating the fear response reinforces the behavior (ie increases probability of future use given the cs)

Answer 49

A marked fear or anxiety about one or more social or performance situations in which the person is exposed to possible scrutiny by others (such as social interactions, performing) ■ Individuals fears acting in embarrassing or humiliating ways (showing symptoms of anxiety) ■ Exposure to feared social situation almost invariable provokes anxiety ■ Feared social or performance situations are avoided or endured with intense anxiety or distress ■ The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context ■ Fear causes significant distress or impairment in the person’s normal routine, occupation, social activities/relationships, or there is marked distress about phobia ■ Fear, anxiety, or avoidance is persistent (typically lasting for 6 months or more)

Answer 50

Median age of onset is 13 years, with onset occurring between 8 and 15 for about 75% of cases ● Late onset trends tend to be rare, but can happen following a stressful or humiliating event or after life changes that require new social roles ● Clients report suffering from shyness/fear of evaluation for most of their lives

Answer 51

extrovert vs introvert, people are born to varying degrees in terms of these personality characteristics or general temperament. Individuals that are prone to develop sad or have developed sad present early on with a shy temperament, they may be preexposed to developing sad. Infants with an inhibited temperament more frequently develop into children and adolescents who avoid novel or unfamiliar people, objects, and situations Some infants are excited about novel stimuli, others were immediately apprehensive or fearful, those with a more inhibited temperament carried through to other encounters in their life they were more prone to avoid novel or unfamiliar things throughout life Adults characterized as inhibited early in life showed greater fmri signal response within the amygdala when presented with novel versus familiar faces. Even after multiple exposures we can still see apprehension. Inhibited temperament does not nec, mean to dev sad Are these considered disorders, no? Fear of novelty can be adaptive. Thus it is in the gene pool One of the offshoots of this is that it makes these individuals more likely to develop sad

Answer 52

Attachment style: children develop working models of self and other through earliest interactions with caregivers. We have a evolutionarily determined system to gravitate toward our parents and vice versa, gives us an expectation of how we will be treated Secure attachment: template for others as accepting and dependable; template for self. Securely attached children have caregivers who are attentive, responsive, and consistent Insecure attachment: template for others as critical and unreliable; template for self. Characterized by parents who are harshly critical, conditional, unpredictable, rejecting These set the schema for life and bad schemas with people can lead to sad from a young age

Answer 53

dyscontrolled maladaptivity

Answer 54

interoceptive conditioning