Chapter 5: Anxiety, Trauma-Related and OCD Pt 2 Flashcards Preview

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Flashcards in Chapter 5: Anxiety, Trauma-Related and OCD Pt 2 Deck (79)
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1
Q

An irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function

A

Specific phobia

2
Q

4 major subtybes of specific phobia

A

Blood-injury-injection phobia: people with this phobia inherit a strong vasovagal response to blood, injury, or the possibility of an injection, all of which cause a drop in blood pressure and a tendency to faint

  • Situational phobias: fear of public transportation or enclosed places
  • Natural environment phobias: sometimes very young people develop fears of situations or events occurring in nature. The major examples are heights, storms, and water.
  • Animal phobias: fears of animals and insects
3
Q

Reports of specific phobia ___ with age (increase/decrease)

A

decline with age

4
Q

the fear, anxiety and avoidance is persistant for at least ____ ____ in order for it to be classified as a specific phobia

A

at least 6 months with this persistent fear

5
Q

illness phobia

A

if you are afraid of contracting a disease and go to excessive and irrational lengths to avoid exposure to that disease.

6
Q

which gender is most affected by specific phobia

A

women. lifetime prevalence rate was about twice as high in women than in men.

7
Q

treatment paradox for specific phobia

A

even though specific phobia is common, treatable, and well understood, people very rarely come for treatment. The only time SP is treated is in very severe cases that prevent a person from living/going to work/school

8
Q

3 methods of causing a phobia

A

1) direct experience
2) watching someone else experience (VICARIOUS)
3) being told about it (informational transmission)
* 4) experiencing a false alarm/ panic attach in a specific situation
- person may have an unexpected panic attack in a specific siutation, related to curernt life stress. A phobia of that situation may then develop.

9
Q

4 things that have to occur for a person to develop a phobia

A

1) traumatic condition (ex/ experiencing, vicariously experiencing, or being told).
2) inherited tendency to fear situations that have always been dangerous to humans
3) we have to be susceptible to developing anxiety by focusing on the possibiltiy that the event will happen again
4) cultural and social factors (ex/ males will supposedly be less likely to develop a phobia).

10
Q

Treatment of specific phobia

A

Exposure based exercises, which leads to the extinction of respondently-conditioned emotional response.
-change brain functioning by modifying neural circuitry in amygdala, insula and cingulate cortex (limbic structures)

  • virtual reality may become a thing too.
11
Q

Exposure based exercises as a treatment for specific phobia leads to the extinction of ____-___ ____ response.

A

Exposure based exercises, which leads to the extinction of respondently-conditioned emotional response

12
Q

Social anxiety disorder is characterized by

A

marked fear or anxiety focused on one ormore social performance situations.
- fear of negative evaluation. Speaking in public, eating in a restaurant, or generally interacting with people

13
Q

SAD is onset when

A

during adolesence.

14
Q

what demographic has most SAD

A

higher among young, less educated single, SES individuals. more common in america that in collaborative cultures.

15
Q

Causes of SAD

A

1) humans may be biologically predisposed or prepared to fear angry, critical, or rejecting people or face

2) pathways to developing social phobia include biological vulnerability, conditioning
- biological vulnerability could include being born to be socially inhibited, or having a predisposition to develop anxiety. there is a genetic component.
- generalized psychological vulnerability could include learned helplessness, or the belief that events cannot be controlled.

3) modellingof socially anxious parent
4) unexpected panic attack in a specific situation may resut in that situation being associated with that panic attack, and the person would be anxious about having a panic attack when they are in that position again.
5) traumatic event in childhood.

16
Q

olfactory reference syndrome

A

a type of SAD that invovles someones anxiety about offending someone because of their body odour

17
Q

T/F people with SAD are more likely to recognize mad faces andthink neutral faces are also mad

A

true. also, being exposed to angry faces results in greater activation of the amygdala.

18
Q

SAD interpersonal transaction cycle

A

individuals interactions with people in their social environments contribute to and maintain social anxiety.

people with SAD have biaed social perceptions and expectations that lead them to behave in certain maladaptive ways in social interactions. This social behavior in turns elicits negative reactions from others, which confirms the biased perceptions.

ex/ SAD people are less likely to make eye contact and divulge information, and then people around them think they are low energy or less intelligent. This creates a reinforcing bias

19
Q

People with SAD make more ___ comparisons

A

make more upward comparisons (ie/ assessments that someone else is superior to them). This causes them more anxiety and distress.

20
Q

treatment for SAD

A

1) antidepressants have been found to reduce social anxiety, though relapse is comon when medications are discontinued

2) CBT for social phobia includes rehearsal or role play of feared social situations in a group setting. Also includes INTERPERSONAL PSYCHOTHERAPY.
- family based treatment appears to out perform individual treatment when the child’s parents also have an anxiety disorder.

  • CMT and SSRIs are comparable in efficacy, but combinding them was no better than two individual treatments.
21
Q

CBT for social phobia includes ___ or ___ ___of feared social situations in a group setting

A

CBT for social phobia includes rehearsal or role play of feared social situations in a group setting

22
Q

post traumatic stress disorder

A

the emotional disorder tht follows a trauma.

23
Q

PTSD flashback

A

when victims re=experience the even through memories and nightmares. May occur very suddenly and the victims find themselves reliving the event.

24
Q

PTSD can occur from __ or __ exposure

A

direct or vicarious

25
Q

Exposure to a Traumatic Event: A person with PTSD must have been exposed to some event during which he or she feels ___, ___ ,or ___.

A

A person with PTSD must have been exposed to some event during which he or she feels fear, helplessness, or horror.

26
Q

Example of an intrusive symptom of PTSD

A

Continue to re-experience the event through memories, re-enactments, nightmares, or flashbacks

27
Q

Duration of symptoms must be greater than 1 month for someone to be diagnosed with PTSD. What if the symptoms lasted for less than 1 month?

A

less than one month is often diagnosed with Acute Stress Disorder.

28
Q

4 broad categories of symptoms for clinical description of PTSD.

A

INTRUSIVE symptoms: Continue to re-experience the event through memories, re-enactments, nightmares, or flashbacks

DISSOCIATIVE symptoms:altered sense of reality

AVOIDANCE symptoms: Cues that remind the person of the event are AVOIDED and emotional responsiveness is numbed

AROUSAL symptoms: Chronically overaroused, sleep disturbed, easily startled, hypervigilant, and/or quick to anger

29
Q
  • Research suggests approximately ___ of sex workers would meet criteria for PTSD
A
  • Research suggests approximately 70% of sex workers would meet criteria for PTSD
30
Q

___, ___ ___ workers and __ workers are commonly associated with PTSD

A

veterans, first response workers and sex workers are commonly associated with PTSD

31
Q

delayed onset PTSD

A

individuals show few if any symptoms immediately or for months after a trauma, but at least 6 months later, and perhaps years afterwards develop full-blown PTSD

32
Q

In addition to trauma, the greater the __, ht more likely you are to develop PTSD

A

the greater the vulnerability

  • ex/ a family hisotry of anxiety = greater chance of developing PTSD
  • PTSD symptoms are moderately heritavle.
  • basically like diathesis-stress model. These diathesis might actually determine the kind of environment or may actually be responsible for placing the person in the situation that will cause PTSD in the first place. Ex/ children with problems of acting out because of inherited anger tendencies are more likely to encounter trauma such as assults, and later PTSD.
33
Q

explain the specific genetic (diathesis) predisposition that may play a role in the accrual of PTSD

A
  • people with a short SS allele for serotonin transports had a higher chance of developing PTSD. It also increases the probability of become depressed.
34
Q

relationship between genetic disposition to anxiety sensitivity and PTSD

A

anxiety sensitivity is a predisposition/psychological vulnerability that ay elicit worse PTSD symptoms in a response to a stressor.

35
Q

relationship between PTSD and social factors

A
  • family disturbances may predispose a child to PTSD later in life
  • supportive group of people decreases the likelihood of PTDF
36
Q

Neurobiological system that is involved in PTSD

A

elevated corticotropin releasing hormone, which indicates greater HPA axis activity.

  • compromised hippocampal regions in people with PTSD. May account for repression or dissociation or inability to remember certain events.
37
Q

in PTSD, the initial alarm is the :

if the alarm is severe enough, we may develop a ___ ___ reaction to stimuli that remind us of the trauma.

A

initial alarm: real danger that is experienced

if severe enough, we may develop a LEARNED ALARM REACTION to stimuli that remind us of the original initial alarm/real danger.

38
Q

treatment for PTSD

A

1) re-exposure so it therapeutic rather than traumatic
- having the person gradually re-experience aspects of the traumatic event within a supportive context to develop effective coping procedures and to produce corrective emotional learning

Exposure, coping skills, cognitive therapy.

39
Q

effects of the exposure therapies for PTSD may be strengthened by asking pts to take a nap soon after an exposure. Why?

A

because extinction learning appears to take place during slow-wave sleep and because sleep quality reduces anxiety.

40
Q

T/F preventative psychological appraoches seem more effective than medications

A

true.

41
Q

Donald Meichenbaum’s CBT treatment for PTSD

A

Constructivist-narrative approach. Therapist assists the client in reconstructing his/her story about the traumatic experience to help the client develop adaptive coping strategies and sense of survivorship.

42
Q

what is EMDR

A

eye-movement desensitization and reprocessing.
-while thinking about the traumatic experience, the client is asked to follow the therapists moving fingers with her eyes, all while keeping the image of the trauma in mind.

facilitates rapid reprocessing of the traumatic event.

43
Q

common drug used to help with PTSD

A

SSRIs.

44
Q

Adjustment disorders

A

anxious or depressive reactions to life stress that are generally MILDER than PTSD/acute stress disorder, but are never the less impairing.

  • prominent in adolescence when the situations are not necessarily traumatic, but are uncomfortable and the person is unable to cope with the demands of the situation.
45
Q

WJP journal

A

World Journal of Psychiatry

46
Q

when would an adjustment disorder be considered chronic?

A
  • if the symptoms persist for more than 6 months after the removal of the stress or its consequences.
47
Q

Obsessive- Compulsive and related disorders include

A

1) driven repetitive behaviours
2) hoarding disorder
3) trichotillomania
4) excoriation

48
Q

Obsessions

A

intrusive and nonrational thoughts, images, or urges that one tries to resist or elimina

49
Q

Compulsions

A

thoughts or actions designed to suppress the thoughts and provide relief. Compulsions may be behavioural (e.g., hand washing, checking) or cognitive (e.g., counti

50
Q

Compulsions may be ___ or -__

A

behavioural or cognitive

51
Q

the person with OCD engage in ritualistic behaviours in order to;

A

in order to prevent or reduce distress.

52
Q

3 main types of obsessions and compulsions

A

1) symmetry
2) forbidden thoughts or actions
3) cleaning/contamination

53
Q

___ ___ involves involuntary movements that tend to co-occur with OCD. Movements may not be tics, but may still be compulsions

A

tic disorder/ Tourette’s disorder

54
Q

PANS

A

pediatric autoimmune neuropsychiatric syndrome (PANS) or PANDAs.
- OCD symptoms and tics that tend to occur with a bout of strep throat.

55
Q

male to female ratio of OCDs

A

1;1

56
Q

OCD is a ___ disease

A

chronic.

57
Q

behavioural vulnerabilities that can trigger OCD

A

predisposition to anxiety can trigger OCD

- brain circuit problems

58
Q

specific psychological vulnerabilities that trigger OCD

A
  • thoughts that are believed to be dangeous and unacceptable.
  • attitudes of excessive responsibility and resulting guilt developed during childhood.
  • religious people often have psychological vulnerabilities that include thought-action fusion. (ex/ being afraid of constantly thinking about gay thoughts because it might make you gay)
59
Q

drug treatment method for ocd

A

SSRIS: seen to benefit up to 60% of pts with OCD. However, relapse is common when medications are discontinued

60
Q

most effective psychological treatment is ___ and ___ ____. What does this entail?

A

exposure and response prevention.

process by which rituals are actively prevented and pt is systematically and gradually exposed to the feared thoughts or situations.

hopefully, the pts will realize that no harm will result whether he carries out the rituals or not.

61
Q

CBT therapy for OCD

A

focuses on the overestimation of the threat. Tries to rewire the pts understanding of the importance ( or lack of) of threat. Also addresses the inflated responsibiilty present in pts with OCD who think they alone may by responsible for preventing a catastrophe.

62
Q

surgical/neuropsychological treatments for OCD

A
  • lesioning to cingulate bundle.

- deep brain stimulation

63
Q

effect of combining drug therapy and CBT/ERP as a treatment for OCD

A

ERP produced superior results both alone and with the dug, compared to just the drug.

  • possible reason why drugs are not as good as CBT id because these drugs dampen the symptoms but they do not correct the dysregulated neural circuits.
64
Q

OCD often co-occurs with __ __ __, which is the preoccupation with some imagined defect in appearance by someone who looks normal.

A

Body dysmorphic disoder. People with BDD complain of persistent, intrusive, and horrible thoughts about their appearance, and they engage in such compulsive behaviours (ie/ grooming, looking at mirrors).

65
Q

people with __ or ___, which means that they think everything that goes on in their world somehow is related to them.

A

ideas of reference.

66
Q

sex differences of BDD

A

males and females are equally affected, but men tend to focus on body build, genitals, thinning hair, and tend to have more severe BDD. Women focus on more varied body areas and are more liekly to also have an eating disorder.

67
Q

Clinical description of BDD

A

5–7 body areas of concern to BDD people

  • Checking and compensating rituals
  • Excessive grooming, skin picking
  • Mirror-checking
  • Suicidal: attempt and ideation
68
Q

Age of onset of BDD

A

typically adolesence.

69
Q

2 most common plastic surgery procedures with people with BDD

A

1) nose
2) lips
anything habing to do with skin treatments.

70
Q

2 treatments for BDD

A

there are only two treatments for BDD that are effective:

1) SSRIS
2) cognitive-behavioural therapy (ERP –> exposure and response prevention)

71
Q

2 disorders also related to BDD

A

1) OCD
2) social anxiety. People may avoid a social situation because they are worried about how they might look or how they are perceived.

72
Q

When is hoarding disorder typically onset

A

starts early in life and then gets worse.

73
Q

when do people with hoarding disorder often seek treatment?

A

usually after 50

74
Q

3 major characteristics of hoarding

A

1) excessive acquisition of items
2) difficulty discarding anything
3) living in excessive clutter and gross disorganziation

75
Q

treatment for hoarding disorder

A

cognitive behavioural therapy. Assigning value to all hoarded objects and then throwing out objects with less value.

76
Q

Trichotillomania

A

hair pulling disorder.

77
Q

What gender is affected by trichotillomania more?

A

femaes/

78
Q

excoriation

A

skin picking disorder. characterized by repetitive and compulsive picking of the skin, leading to tissue damage. Mainly also affects females.

79
Q

treatment for both trichotillomania and excoriation

A

habit reversal training. Paying attention to the bad behaviour and then every time you do the behvaior, you try and do something else instead such as applying lotion of chewing gum.

there is some evidence that SSRI’s will work with people with trichotillomania.