Exam 3 Flashcards

1
Q

OCD Gender and Course

A
  • more female (55-60%)

- chronic; waxes and wanes

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2
Q

Biological Theories of OCD

A
  • Injury or illness: only anxiety disorder that has a link to injury or illness (can develop as a response to these) i.e. PANDAS-strep throat activates OCD in some children; brain tumors; pospartum women
  • frontal lobes increased activity (obsesions): over concern with own thoughts and can’t filter out irrelevant stimuli
  • basal ganglia increased activity: motor behavior, compulsions i.e. tourettes
  • decreased levels of serotonin
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3
Q

Cognitive Theories of OCD

A
  • belief that things are not complete-brain never tells them they’re done now and to move on
  • belief that thinking about something will cause it to occur
  • try thought suppression: makes it worse
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4
Q

Treatment for OCD

A
  • exposure to obsessions and response prevention for compulsions (very behavioral; not allowed to make ritualistic behavior she normally would (i.e. morgan-shows her her mom won’t die if she doesn’t do them)
  • people don’t want to do these things because they’re painful but they really do work
  • all about empirically supported treatment: scientifically evaluate if treatments are working/successful
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5
Q

Treatment of Phobia: Behavioral (Learning)

A
  • desensitization and exposure
  • systematic desensitization
  • substitute response incompatible with anxiety=progressive relaxation (cannot be relaxed and anxious at the same time) ex: can’t eat and digest and be anxious so some people eat during anxious times
  • application of systematic desensitization –> introduce tension into muscles then slowly release it
  • application 2 make hierarchy of anxiety producing situations (kathy fears birds) then relax while imagining the situations and work through the hierarchy moving up when you can imagine one without anxiety
  • in vivo exposure: like systematic desensitization but can actually experience the anxiety provoking stimulus in real life (not always possible)
  • flooding=exposure to most feared object/situation for extended period and not allowed to escape (most effective but people hardly agree to it)
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6
Q

Treatment of Panic Disorder: Behavioral (Learning)

A

-panic control treatment=exposure to own physical symptoms to learn they won’t kill you

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7
Q

Treatment for Anxiety Disorders: Cognitive

A
  • identify automatic negative thoughts
  • catastrophizing: going to worst case scenario and exaggerating importance of things (ex: exams I’m going to fail which means I’ll have no success in life; GAD worries about same things as everyone else but thinks the worst possible thing happened)
  • retrain thinking: identify thought and challenge it; create more adaptive
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8
Q

CBT

A
  • cognitive behavioral therapy
  • very effective
  • challenges negative patterns of thoughts about the self and world to alter unwanted behavior patterns or treat mood or anxiety disorders
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9
Q

Treatment for Anxiety Disorders: Biological

A
  • antidepressants: SSRI (prozac, paxil, lexapro, zoloft) serotonin reuptake inhibitors so serotonin stays in synapse space longer (can be anti-depressive and anti-anxiety)
  • SNRIs (Effexor, celexa) norepinephrine reuptake inhibitors (only anti-anxiety)
  • anxiolytics: Buspirone (Buspar) serotonin-GAD; not sedating; not addictive (takes several weeks to begin to work and need to take it daily)
  • Benzodiazepines: (Xanax, Valium) severe anxiety, panic; act quickly (30 min-1hr); addictive, build up tolerance, go through withdrawals
  • surgery: severe OCD cingulotomy
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10
Q

Morgan

A
  • compulsions: ordering, touches everything to left
  • obsession: that her mother is going to die
  • compulsions don’t have to be logically connected to obsessions
  • good exampel of diathesis stress model: not enough to have stressor, have to have genetic predisposition (diathesis); her friends don’t develop the disorder but when their parents died she did
  • believes she’s pleasing god by doing rituals and that he will keep her mom alive
  • experiencing distress and it interferes with her functioning: sometimes can’t get out of bed because she doesn’t wan to start ritualizing
  • if her mother passed away she would feel responsible and her obsession would probably pass onto another object and she would try even harder to please god
  • treatment: exposure to idea that something bad could happen to her mother and she’ll want to do her compulsions but they won’t let her
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11
Q

Mood Disorders 2 Distinctions

A
  • Depression: major depressive disorder (like flu; intense symptoms, lasts short time) or dysthymic disorder (like cold; less severe, but lasts longer
  • Mania and Depression (bipolar): bipolar disorder (flu) or cyclothymic disorder (cold)
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12
Q

Depression Major Depressive Episode Criteria (ESSAY)

A
  • symptoms must be present during the same 2 week period and represent a change from previous functioning
  • at least one of the symptoms is depressed mood or loss of interest or pleasure in things you would normally enjoy (anhedonia)
  • other symptoms
  • depressed mood most of the day, nearly every day
  • markedly diminished interest or pleasure in all activities most of the day, nearly every day
  • significant weight loss when not dieting or weight gain (5% of body weight in month) or decrease or increase in appetite every day
  • insomnia or hypersomnia nearly every day
  • psychomotor agitation or retardation nearly every day observable to others (change)
  • fatigue or loss of energy nearly every day
  • feelings of worthlessness or excessive or inappropriate guilt nearly every day
  • diminished ability to think or concentrate, or indecisiveness nearly every day
  • recurrent thoughts of death, recurrent suicidal ideation or suicide attempt or specific plan (fear that if you ask your friend if they feel this way it will put the thought in their head-not really the case, it may actually help them address it and feel like they can talk to you about it)
  • symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning
  • symptoms not due to direct effects of substance use or general medical condition
  • symptoms not better accounted for by bereavement (death of someone important to person) after loss (no longer put a classification on how long bereavement can last, because it often takes a whole year have to experience every yearly milestone without the person)
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13
Q

Bipolar Disorder Manic Episode Criteria

A
  • only need to have one to be considered bipolar
  • considered adult disorder
  • distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week (or any duration if hospitalization is needed)
  • each symptom has to be noticable change from normal behavior
  • inflated self-esteem or grandiosity (Mary=spy for Jesus)
  • decreased need for sleep (so much energy even though she didn’t sleep the night before-can go days without)
  • more talkative than usual or pressure to keep talking (mary asks if she can keep talking–> about outdoors and living under bridge)
  • flight of ideas or racing thoughts (leads to pressure of speech)
  • distractibility (attend to unimportant/irrelevant stimuli)-mary asking if she’s in focus while in the middle of another thought
  • increase in goal-directed activity (social, work, sex) or psychomotor agitation (feels like she could get everything done that she needed to-cheats on husband)
  • excessive involvement in pleasurable activities that have high potential for painful consequences (buying sprees, sexual indiscretions, business investments) Mary cheats on husband
  • mood disturbance severe enough to cause marked impairment (NOT DISTRESS) in occupational functioning or in usual social activities or relationships with others or to necessitate hospitalization to prevent harm to self or others or there are psychotic features
  • not due to substance or medical condition
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14
Q

Hypomanic Episode

A
  • same as Manic Episode but not as intense and differs in 2 ways
  • elevated, expansive, irritable mood lasts at least 4 days
  • episode not severe enough to cause marked impairment in functioning, or to necessitate hospitalization; no psychotic features
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15
Q

Mary Bipolar Depressive Episode

A
  • also having psychotic symptoms that aren’t associated with depression
  • affect: no eye contact, dark clothes, difficulty concentrating
  • psychomotor retardation
  • hearing voices may happen in manic episodes but rarely seen in depressive
  • got in a fight with a lady
  • expresses feelings of worthlessness (feels fat and ugly)
  • self medicating (smokes pot)
  • burns herself with cigarettes because she thinks her husband is cheating on her
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16
Q

Mary Bipolar Manic Episode

A
  • acts over the top
  • feels on top of the world but can also feel irritable as she does toward her husband and she beats him up because he made her mad
  • spy for Jesus
  • says she can control the weather
  • religiosity: so it makes sense her symptoms relate back to her religion
  • asked if she would take out her gum-refused and said she had strong teeth, offered to therapist, then laughed uncontrollably
  • asked what makes her cry, talked about her mom’s death, asked if she was in focus and started laughing
  • can hear pressure of speech when she talks about her mom
  • says she can get drunk off water, coffee, kool aid when in a manic episode
  • says manic episode only feels unpleasant when she can’t sleep but she still feels fully rested
  • cheats on husband-gets her in trouble
  • experiences psychotic symptoms as well though they’re not in mania criteria but hey can happen
  • says she’s a “morphodite” (hermaphrodite) with both organs and that she thinks this is how god is in heaven
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17
Q

Major Depressive Disorder

A
  • episodic: symptoms are present for a period of time, then clear
  • episodes tend to recur
  • untreated episode: may last 5 months or longer
  • never had manic or hypomanic episode (the minute you do it’s becomes bipolar diagnosis)
  • clinical vs. subclinical depression: number of symptoms (less than 5) and length of episode (less than 2 weeks)
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18
Q

Disruptive Mood Dysregulation Disorder

A
  • for children because they cannot be included in bipolar disorder-start to include children, you’ll pick up a lot more cases because kids are typically irritable
  • issue: stigma and medication (very strong for bipolar disorder and could majorly affect developing brain)
  • in DSM-V new diagnosis to try to get to the kids who are abnormally irritable (gets to point where it interferes with functioning)
  • severe and recurrent temper outbursts that are way out of proportion
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19
Q

Specific Symptoms Kay Experienced While Manic

A
  • decreased sleep (both a symptom and a cause of mania)
  • felt as if she were being charming , bubbly, seductive and assured
  • pressure of speech (talks to chairman forever)
  • took on lots of responsibilities (felt like she could accomplish everything-tracking down articles, co teaching courses, volunteering at animal behavior studies at the zoo)
  • psychiatrist said she was less conservative in dress and how she did her makeup and she was frenetic
  • racing thoughts
  • restless, irritable, craved excitement
  • moved out, bought all new decor, many spending sprees (watches, snakebite kits, precious stones, books)
  • awareness/experiences of sounds dramatically increased (poignant)
  • psychotic symptoms: visual hallucinations
  • agitated, paranoid, physically violent
  • increased energy levels
20
Q

Cognitive Treatment of Depression (Reading)

A

-depression causes people to take negative view of themselves, the world, and the future

21
Q

Hopelessness

A
  • one of most debilitating aspects
  • perception that the problems are huge, numerous, and insurmountable and will never get better
  • fueled by negative cognitions that accompany depression
  • not DSM symptom
22
Q

Disputing Depressive Thinking

A
  • trying to think positively is less effective than identifying and challenging negative distorted aspects of thinking
  • faulty thinking patterns play a role in maintenance of depression (i.e. more depressed we feel, more distorted cognitions–>generates sens of global pessimism
  • typical cognitions: I’m worthless, life is meaningless, nothing is going to get better, life isn’t worth living, everything is my fault, I’m inferior
  • have to identify errors in thinking: Am I assuming the worst? Am I ignoring strengths and focusing on weaknesses? Am I blaming myself for things that aren’t my fault? Am I overreacting about something that’s not that bad?
23
Q

Two-Column Technique

A
  • left column has negative cognitions and type of faulty thinking patterns that underlie them
  • right column disputing statements/rational cognitions that challenge the faulty thinking
  • then set steps to take control of life
24
Q

Socratic Questioning

A
  • what are the facts and what are my subjective perceptions?
  • what evidence supports my perceptions?
  • what evidence contradicts my perceptions?
  • am I making any thinking errors?
  • what is an alternative, more balanced view of this situation?
25
Q

PMDD

A
  • premenstrual dysphoric disorder
  • new depressive disorder
  • females impaired by 5/11 symptoms a week before menstruation
  • depressed/hopeless feelings; tense/anxious feelings; marked mood changes; frequent irritability or anger and increased interpersonal conflicts; decreased interest in usual activities; poor concentration; lack of energy; changes in appetite; insomnia or sleepliness; sense of being overwhelmed or out of control; and physical symptoms (swollen breasts, headaches, muscle pain, bloatedness, weight gain)
  • would pathologize severe cases of PMS (which is normal and common) and might cause women’s behavior in general to be attributed to raging hormones; argued that it lacked data for inclusion of this new category
  • is now in DSM-V
26
Q

Artifact Theory

A
  • women and men are equally prone to depression but clinicians fail to detect in men
  • less socially acceptable for men to express emotions
  • women express more emotional symptoms
  • not supported
27
Q

Hormone Explanation

A
  • hormone changes trigger depression in many women

- not supported

28
Q

Life Stress Theory

A
  • females in our society are subject to more stress than men
  • more poverty, more menial jobs, less adequate housing, more discrimination, disproportionate share of responsibilities in household
29
Q

Bodily Dissatisfaction Explanation

A
  • women in western society taught to see low body weight and slender shape
  • unreasonable, unhealthy and unattainable goals
30
Q

Lack of Control Theory

A
  • learned helplessness, women feel less control over own lives
  • victimization also plays a role–>promotes sense of helplessness
  • often victims of rape and burglary
31
Q

Rumination Theory

A
  • tend to keep focusing on one’s feelings when depressed

- women are more likely than men to ruminate when mood darkens

32
Q

Dysthymic Disorder Criteria

A
  • depressed mood for most of the day, for more days than not as indicated either by subjective account or observation of others, for at least 2 years
  • pretty much the same symptoms as major depression but less intense
  • during 2 year period, person has never been without the symptoms for more than 2 months at a time
  • no major depressive episode during the first 2 years of the disturbance
  • never been manic or hypomanic
33
Q

Why is depression twice as likely in women?

A
  • tend to ruminate while men tend to distract
  • ruminating does not lead to problem solving and it makes you feel worse
  • tends to maintain depression
34
Q

Course of Depression

A
  • average age of onset is mid 20’s
  • short or long periods of remission
  • the greater the number of episodes, the greater the number of future episodes (increases probability each time you have one)
35
Q

Theories of Depression: Biological

A
  • genetic; variance=40%; greater the severity of the episode, the greater the genetic component
  • neurotransmitters: receptors less sensitive to; serotonin-SSRI’s SNRI’s (all we can do is have more available in synapse), Norepinephrine (SNRI) serotonin + norepinephrine, dopamine: pleasure/reward system (wellbutrin-dopamine + norepinephrine)
  • endocrine system: increased stress hormones (cortisol) not sure if cortisol causes depression or if it’s released because the depression makes you stressed
  • brain structure: increased activity in amygdala (fear response and emotion) and decreased activity in prefrontal cortex (thinking, decision making) and hippocampus (memory)
36
Q

Theories of Depression: Psychological

A

-broken down into stressful life events or behavioral

37
Q

Stressful Life Events Theory of Depression

A
  • perception of event: have to see event as stressful
  • related to onset
  • offset by social support
  • tangible support: material things
  • emotional support
  • when you get both it’s called enacted support
  • perception of support is better than enacted support (knowing it’s there if you need it)
38
Q

Behavioral Theory of Depression

A
  • lake of reinforcement in environment (especially in terms of reward)
  • lack of social skills–>people withdraw from you
  • lack of pleasant events
  • lack of control (in environment) ex: deadline after deadline in college
  • depressive behavior=reinforced (depression gets you out of things that are aversive; friend says they’ll do something with you because you’re sad and then they don’t)
39
Q

Cognitive Distortions

A
  • all or nothing thinking (black and white thinking)
  • overgeneralization
  • mislabeling (labeling)
  • mental filter
  • mind reading
  • catastrophizing
40
Q

All-or-Nothing Thinking

A
  • you see things in black and white categories

- if something is less than perfect you see it as a failure

41
Q

Overgeneralization

A

-you think of a single negative event as a never-ending pattern

42
Q

Mislabeling

A
  • extreme form of overgeneralization

- instead of describing your error, you attach a negative label to yourself (I’m a loser)

43
Q

Mental Filter

A

-you dwell on a single negative detail, and ignore any positive things that may occur

44
Q

Mind Reading

A

-you arbitrarily conclude that someone is reacting negatively to you and you don’t bother to check this out with them

45
Q

Catastrophizing

A

-you exaggerate the importance of things, and believe the worst case scenario will happen