Exam 2 Flashcards

1
Q

Later Versions of DSM

A
  • not meeting diagnosis criteria=subdiagnosis
  • systematic description
  • no etiology or theoretical orientation in DSM
  • higher reliability and validity
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2
Q

Systematic Description

A
  • a lot of description in order to increase good diagnosis
  • not treatment-just symptoms
  • do not meet criteria yet for disorder but you are treated anyway like you have it
  • the more specific your criteria, the higher reliability of your system
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3
Q

No Etiology

A
  • just a lot of causes-means no psychoanalytics in DSM
  • we do not need to know the cause to know the disease
  • no treatment in DSM-everyone can use it
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4
Q

DSM-V

A
  • 350 disorders
  • arranged by diagnostic criteria
  • high reliability and validity
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5
Q

Number of disorders has tripled-why?

A
  • autism: thought to be caused by cold mothering–>refrigerator mothers
  • advanced technology has improved diagnostics also created disorders
  • more distinction within categories
  • cultural changes: no sex addiction, no internet addiction
  • increased awareness
  • insurance requires a diagnosis which means we need several categories
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6
Q

Symptoms reflect disorders or normal behavior?

A
  • pathologize-take normal behavior and make it an illness
  • 3 examples
  • primary insomnia
  • caffeine intoxication: 2-3 cups of coffee a day, nervous restlessness, diuresis
  • developmental coordination disorder: clumsy/unathletic
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7
Q

Why are some behaviors no longer considered mental disorders?

A

-homosexuality: no impaired or non-normative psychological function

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8
Q

Decision based on?

A
  • are the behaviors impairing your normal cognitive or life function?
  • identity disorder: young adults questioning their goals and relationships
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9
Q

Fear

A
  • innate emotion
  • adaptive (helps us to survive)
  • 4 components: cognitive, emotional, somatic (physical response SNS–>adrenaline), behavioral (fight or flight, freeze or faint)
  • focus on present danger
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10
Q

Anxiety

A
  • derives from fear
  • extreme becomes a disorder (extreme when starts interfering with function)
  • focus on future danger (what if questioning)
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11
Q

GAD

A
  • fear everything

- have insight

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12
Q

Criteria for GAD

A
  • excessive anxiety and worry has to occur for more days than not for at least 6 days
  • difficult to control the worry
  • associated with 3 or more of the following (1 for children)
  • restlessness/keyed up/on edge/hypervigilant (if you’re always waiting for the other shoe to drop it’s easy to handle if something does happen), easily fatigued, difficulty concentrating/mind going blank, irritbility, muscle tension (biggest symptom that separates GAD from other anxiety disorders), sleep disturbance
  • anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning
  • disturbance not attributed to physiological effects of a substance or another medical condition
  • disturbance not better explained by another mental disorder
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13
Q

Separation Anxiety

A
  • kids afraid when they’re away from their caretakers something terrible will happen and they won’t see their caretakers ever again
  • only given to children
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14
Q

Onset, Course, and Comorbidity of GAD

A
  • over half that have it had it as a child
  • chronic; waxes and wanes
  • half also have other disorders; sometimes other anxiety disorders, often depression
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15
Q

Theories of GAD-Biological/Genetic

A
  • characteristics in families: runs in families; sensitivity to risk (risk aversive) everything is a threat; decreased GABA neurotransmitter (inhibits negative emotion)
  • behavioral inhibition (infants): don’t approach/like new things/novelty; don’t see challenges, they see a threat
  • brain areas: limbic system (monkey mind)-emotion in an emergency this system takes over and silences your prefrontal cortex (higher functioning/rational thought) medication calms you down and therapy helps you take control over your monkey mind and allows frontal lobes to take over again; amygdala: fear response-overactive in anxiety disorders
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16
Q

Theories of GAD-Cognitive

A
  • misperceived, exaggerate danger (where it isn’t)

- catastrophize

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17
Q

Specific Phobias Criteria

A
  • marked or persistent fear that is excessive or unreasonable, cued by presence or anticipation of a specific object or situation
  • exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or predisposed panic attack
  • person recognizes that fear is excessive or unreasonable
  • phobic situation is avoided or endured with intense anxiety/distress
  • the avoidance, anxious anticipation, or distress in the feared situation interferes significantly with the person’s normal routine, occupational functioning, or social activities and relationships or there is marked distress about the phobia
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18
Q

Types of Phobias

A
  • animals: dogs
  • natural environment: deep water
  • blood/injection/injury: different from other phobias-often pass out (HR and BP decrease); only one that seems to be genetic; could possibly be adaptive (if you’re bleeding out it will decrease your blood flow)
  • situational: small spaces
  • other types: clowns, dolls, vomiting
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19
Q

Onset and Course of Phobias

A
  • onset as a child, adults 20’s

- only 20% fully remit (without treatment) most avoid treatment, never learn they won’t die

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20
Q

Theories of Phobias-Biological

A
  • genetic: autonomic lability (labile=easily changed), SNS easily turned on–>emergencies
  • biological preparedness: “built into us” as a species–>fears; evolution-adaptive; cars vs. spiders
21
Q

Theories of Phobias-Behavioral (learning)

A
  • classical conditioning: how phobia develops UCS cat scratch–>UCR fear *has to happen to you personally; CS any cat–>CR fear
  • operant conditioning: reinforces and maintains phobia; avoidance learning–>avoid small spaces takes away fear, taking away don’t like=negative reinforcement
  • observational learning: indirect; happens to someone else–>Marvin; hear about it; experiencing someone else’s anxiety
22
Q

Social Phobia Criteria

A
  • same as specific phobia except for “marked or persistent fear that is excessive or unreasonable, cued by presence or anticipation of a specific object or situation”
  • marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others; fears that s/he will act in an embarrassing way
23
Q

Gender, Onset, and Course of Social Phobia

A
  • equally male and female
  • teenage years (hormones, you care very strongly about what other people think of you-egocentric time-imaginary audience)
  • lifelong without treatment
24
Q

Theories of Social Phobia-Biological

A
  • temperment: shyness, behavioral inhibition-don’t like new–>seen as threats (like GAD)
  • sensitivity to others anger or rejection (people may come to you with their issues because you’re highly interpersonally sensitive, makes you feel like you’re in charge of fixing their problems and also makes you think that people are angry because of you
25
Q

Theories of Social Phobia-Cognitive

A
  • unrealistic negative beliefs about performance-if they wipe out it will ruin them
  • performance anxiety: professionals choke because they stop relying on muscle memory and start thinking like amateurs
  • increased self-monitoring=see how other people are behaving and you change your behavior to match
26
Q

Theories of Social Phobia-Behavioral

A
  • social skills deficits: close talkers, no eye contact could lead other people to respond in a rejecting manner because they’re uncomfortable
  • classical conditioning UCS get sick at dance–>UCR embarrassed; CS dance–>CR embarrassed
  • operant conditioning
27
Q

Panic Attack

A

-not individual diagnosis but can be central component of other disorders

28
Q

Panic Attack Criteria

A
  • period of intense fear or discomfort in which 4 or more of the following symptoms develop abruptly and reach a peak in 10 minutes (fight or flight symptoms)
  • palpitations/pounding heart, sweating, trembling or shaking, sensations of shortness of breath of smothering, feeling of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy/unsteady/faint, derealization (feelings of unreality) or depersonalization (detached from self), fear of losing control or going crazy, fear of dying, numbness/tingling, chills or hot flushes
  • can be expected or unexpected
  • one panic attack doesn’t mean you have a panic disorder; have to have recurrent unexpected panic attacks and you have to be concerned that you’re going to have another one
29
Q

Agoraphobia

A
  • person is afraid they’re going to have a panic attack in a public place
  • fear of the marketplace
30
Q

Agoraphobia Criteria

A
  • anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms
  • agoraphobic fears typically involve a cluster of situations (driving, classroom, mall)
  • the situations are avoided or else endured with marked distress or with anxiety about having a panic attack or panic-like symptoms or require the presence of a companion
31
Q

Diagnosis of Panic Disorder Without Agoraphobia

A
  • recurrent unexpected panic attacks
  • at least 1 attack followed by 1 month or more of the following
  • persistent concern about additional attacks, worry about implications of attack or its consequences, significant change in behavior related to the attacks
  • absence of agoraphobia
32
Q

Diagnosis of Panic Disorder with Agoraphobia

A

-same as without but have agoraphobia

33
Q

Agoraphobia Without History of Panic Disorder

A

-agoraphobia with fear of developing panic symptoms, but never met criteria for pani

34
Q

Gender, Onset and Course of Panic Disorder

A
  • more female
  • without agoraphobia 2:1
  • with agoraphobia 3:1
  • why more women? more likely culturally to stay home not considered as suspect; women in general tend to face more environmental stressors than men-world is a little more dangerous for women; women allowed to show fear/emote more in general; women play role of caretaker more-anxiety may in part be due to being responsible for their health and wellbeing
  • late adolescence to mid 30’s
  • chronic, waxes and wanes (like all anxiety disorders)
35
Q

Theories of Panic Disorder-biological

A
  • limbic system: responsible for emotion; activates norepinephrine that triggers onset of SNS
  • anxiety oversensitivity: overly sensitive to own physiological symptoms
  • cognitive: mislabel symptoms–>increases anxiety–>causes panic
  • treatment: panic control treatment=exposure to physical symptoms (make dizzy, make HR go up)
  • hormones: women affected by hormones more often (goes up and down with menstrual cycle and in menopause)
36
Q

OCD Criteria

A
  • either obsessions or compulsions
  • common obsessions: germs, aggression, sexual, symmetry
  • common compulsions: cleaning, checking, ordering
  • at some point the person has recognized that the obsession or compulsions are excessive or unreasonable
  • cause marked distress, are time consuming, or significantly interfere with normal routine, occupational function or social activities or relationships
37
Q

Obsessions Criteria

A
  • recurrent and persistent thoughts, impulses (afraid you might his someone-something you think you may do-rarely act) or images that are experienced, at some time, as intrusive and inappropriate and that cause marked anxiety or distress
  • thoughts/impulses/images are not simply excessive worries about real-life problems
  • person attempts to ignore or suppress such thoughts/impulses/images or to neutralize them with some other thought or action (when you do this all you end up doing is thinking about them)
38
Q

Compulsions Criteria

A
  • repetitive behaviors (hand washing, ordering, checking) or mental acts (praying, counting, repeating words) that the person feels driven to perform in response that the person feels driven to perform in response to an obsession according to rigidly applied rules (ritualistically(
  • the behaviors/mental acts are aimed at preventing or reducing distress or preventing some dreaded event/situation; however, the behaviors/mental acts either are not connected, in realistic way, with what they are designed to neutralize/prevent or are clearly excessive
39
Q

What percentage of men and women live through a traumatic event

A
  • 60% men

- 50% women

40
Q

What is adjustment disorder?

A

-a response to a stressful life event that is not life threatening

41
Q

Symptoms of PTSD and Criteria

A
  • being exposed to threatened or real death, severe injury, or sexual assault in at least one of the following ways
  • living throughout a traumatic event; seeing the event in person as it happens to others; learning the traumatic event happened to a family member or close friend, the event must be violent or due to accident; being exposed to horrible details of taruma again and again, watching events via computer, TV, movies, or pictures does not apply unless it’s work related
  • having at least one of the following symptoms of intrusion for 1 month or more after the event
  • memories of the trauma recur without warning and cause distress; nightmares that reflect details or feelings during the trauma; flashbacks that cause the person to feel or act as though the trauma is happening again; intense or lasting distress when exposed to thoughts memories, or other reminders that reflect aspects of the trauma; physical responses to thoughts/memories or other reminders that reflect aspects of the trauma
  • frequent avoidance of any reminder of the event for 1 month or more shown by avoiding or trying to avoid memories/thoughts/feelings of event or settings/tasks that are reminders of event
  • showing at least 2 major changes in arousal and response for 1 month or more which began or became worse after the trauma: irritable or angry outbursts (often physical or verbal anger toward people or objects), reckless/self destructive behavior, hypervigilance, greatly startled by loud noises or surprise, problems staying focused in thoughts or attention, trouble sleeping
42
Q

Medication and Treatment for PTSD

A
  • SSRI antidepressants (paroxetine and sertraline)–>treat symptoms like nightmares and flashbacks
  • alpha-adrenergic antagonists (minipress)–>decrease nightmares and improve sleep
  • benzodiazepines (clorazepam or lorazepam) decrease anxiety
  • CBT: psychotherapy focuses on chaning painful patterns aof behavior and intrusive thoughts by teaching relaxation techniques; pinpoints reviews and challenges thoughts causing problem
  • exposure therapy: careful, repeated, detailed reliving of trauma to trigger symptoms in a safe controlled context; helps face and gain control-sometimes can face all at once (flooding) sometimes best to work up to it (desensitization)
43
Q

What’s the difference between acute stress disorder and PTSD?

A

-acute stress disorder has symptoms that last for a shorter time than PTSD

44
Q

How many americans meet criteria for SAD and what’s the average age of onset?

A
  • more than 5 million

- 12

45
Q

What is the most anxiety producing social anxiety?

A

-public speaking

46
Q

What is happening in the brain during a public speaking performance of a person with SAD vs. an average person?

A
  • SAD: PET scans show decreased blood flow to cerebral cortex and increasing blood flow to amygdala
  • normal: increased cortical blood flow
47
Q

What percentage of YA identify themselves as shy?

A

-between 40% and 50%

48
Q

What are the differences between shyness and SAD? How is it considered along a spectrum?

A
  • shy people usually tend to muddle through the anxiety causing social event
  • SAD sufferers don’t muddle through well and go to great lengths to avoid social events
  • if events can’t be avoided, intense anxiety reaction may erupt
  • shyness and SAD are on the same spectrum; shyness is common and not a disorder and SAD represents an extreme
49
Q

How did those two who had been labeled as shy as two year olds differ in brain response to novelty?

A

-one of them showed more brain activity in the amygdala during a fMRI scan