Chapter 5: Trauma, Anxiety, Obsessive-complusive

Almost _____ of people with a specific phobia never seek treatment. 20 percent 40 percent 60 percent Correct! 90 percent

90 percent

Which of the following disorders consists of emotional and behavioral symptoms such as depressive symptoms, anxiety symptoms, or antisocial behaviors that occur within three months of the experience of a stressor? Agoraphobia You Answered Generalized anxiety disorder Social phobia Correct Answer Adjustment disorder

Adjustment disorder

Freud's theory of phobias is detailed in a 150-page case history of a little boy named Hans. In his study, little Hans's behavior was representative of which phobia? Correct Answer Animal-type phobias Natural environment type phobias You Answered Social phobia Situational type phobias

Animal-type phobias

Jacob has been diagnosed with panic disorder without agoraphobia. He was taking his medication regularly until recently. Since discontinuing his medication, he is experiencing severe withdrawal symptoms and rebound of anxiety symptoms. Which medication was Jacob most likely taking? SSRIs Tricyclic antidepressants Correct! Benzodiazepines Phenothiazines

Benzodiazepines

Which of the following suppresses the central nervous system and influences functioning in the GABA, norepinephrine, and serotonin neurotransmitter systems? Tricyclic antidepressants Correct! Benzodiazepines MAOIs SSRIs

Benzodiazepines

Which of the following theories have been integrated into a model to explain the factors associated with panic disorders? Correct! Biological and cognitive Cognitive and social Social and biological Biological, psychological, and social

Biological and cognitive

Which of the following phobias is more likely to run in families? Natural environment type phobias Correct Answer Blood-injection-injury type phobias Situational type phobias Animal-type phobias

Blood-injection-injury type phobias

OCD and Related Disorder Biological treatments Cognitive behavioral

Cognitive theories—people who develop OCD are depressed or generally anxious much of the time. They have a tendency toward rigid, moralistic thinking. They appear to believe that they should be able to control all their thoughts. They have trouble accepting that everyone has horrific notions from time to time. And compulsions develop largely through operates conditioning include antidepressants, serotonin enhancing drugs, but can have significant side effects. exposure and response prevention. It exposes the client to the focus of the obsession, preventing compulsive responses to the resulting anxiety, and challenges individual's moralistic thoughts, excessive sense of responsibility and maladaptive cognitions.

_____ are repetitive behaviors or mental acts that an individual feels he or she must perform. Drives Obsessions Correct Answer Compulsions Motives

Compulsions

Which of the following environmental, social, and psychological factors increases an individual's vulnerability to post-traumatic stress disorder (PTSD)? Having a strong support network of friends and family Correct Answer Having experienced the traumatic event first-hand Having adopted a non-avoidant coping strategy to deal with the traumatic event Having experienced no anxiety and depression symptoms before the traumatic event

Having experienced the traumatic event first-hand

Separation Anxiety Disorder Treatments

It is not diagnosed unless symptoms persist for at least 4 weeks and it significantly impairs the child's functioning. cognitive behavioral ones, which teach skills—they teach skills for coping and for challenging cognition that feed anxiety, they teach skills for relaxation exercises to practice for when separated from parents, to learn relaxation exercises to practice when separated from parents, to challenge fears about separation, and use self-talk to calm themselves, and drugs used are antidepressants, antianxiety drugs, stimulants and antihistamines.

PTSD

It is the consequences of experiencing extreme stressors. The diagnostic criteria the DSM-5 requires that individuals directly experience or witness the traumatic event, or learned that the even happened to someone they were close to Symptoms include repeated experiencing of the traumatic event, persistent avoidance of situations, thoughts or memories associated the trauma, negative changes in thought and mood associated with the event, hyper vigilance and chronic arousal.

Which of the following statements about panic disorder is true? People with panic disorder often fear they have life-threatening illnesses, though they are less likely to have a personal or family history of serious chronic illness. Correct Answer Many people with panic disorder feel ashamed of it and try to hide it from others. About 28 percent of people will develop panic disorder at some time, usually between late adolescence and the mid-thirties. You Answered People with panic disorder may become demoralized and depressed but rarely do they become suicidal.

Many people with panic disorder feel ashamed of it and try to hide it from others.

Drake has a fear of dogs. As part of his therapy, Drake must first observe his therapist petting a dog and then, when instructed, must do the same. Which behavioral treatment is most likely being used in this situation? Systematic desensitization Correct! Modeling Flooding Applied tension technique

Modeling

Which of the following behavioral theories has been useful in explaining the reinforcement of phobias? Observational learning Correct! Operant conditioning Social-cognitive learning Social learning

Operant conditioning

Which diagnosis is most likely when panic attacks that are not usually provoked by any particular situation become a common occurrence, leading one to begin to worry about having the attacks and change behaviors as a result? Generalized anxiety disorder Correct! Panic disorder Obsessive-compulsive disorder Separation anxiety disorder

Panic disorder

Which of the following is true about the integrated model of panic disorder? Many people who experience panic disorders have recurrent panic attacks because of structural damage to the brain. Correct! Panic disorders seem to develop as a result of a biological vulnerability to a hypersensitive fight-or-flight response. People will not typically develop a panic disorder if they engage in constant catastrophizing cognitions about their physiological symptoms. Avoidance of situations that evoke panic attacks remains isolated to those specific situations, and has no occasion to generalize to other situations.

Panic disorders seem to develop as a result of a biological vulnerability to a hypersensitive fight-or-flight response.

Which of the following disorders is most common among adults over age 65? Panic disorder Obsessive-compulsive disorder Correct Answer Post-traumatic stress disorder Generalized anxiety disorder

Post-traumatic stress disorder

Which of the following statements is true about social phobia? Social phobia is relatively common, with a lifetime prevalence of about 3 percent in the United States. Social phobia tends to develop in either late adolescence or early adulthood. Over 90 percent of adults with social phobia report severe childhood trauma that contributed to their symptoms. Correct Answer Social phobia often co-occurs with mood disorders, other anxiety disorders, and avoidant personality disorder.

Social phobia often co-occurs with mood disorders, other anxiety disorders, and avoidant personality disorder.

_____ may cause memories of the traumatic event to be planted more firmly in memory. Higher levels of cortisol Damage to the amygdala The sluggish reactions of the HPA axis Correct! The overexposure of the brain to neurochemicals

The overexposure of the brain to neurochemicals

hich of the following bodily changes occurs when the hypothalamus activates the sympathetic division of the autonomic nervous system? The liver reduces the amount of glucose it releases to the muscles. You Answered Saliva and mucus dry up, decreasing the size of the air passages to the lungs. Correct Answer The spleen releases more red blood cells to help carry oxygen. The body's metabolism decreases in order to conserve energy for physical action.

The spleen releases more red blood cells to help carry oxygen.

According to cognitive theory, which of the following statements is true about people diagnosed with generalized anxiety disorder (GAD)? They are always anticipating a negative event, and they tend to think it through. Correct! They believe that worrying can help them avoid bad events by motivating them to engage in problem solving. They actively conjure up visual images of what they worry about, as a way of habituating to the negative emotions associated with the event. Their chronic anxiety is the result of having had highly controlled and predictable experiences in their childhood.

They believe that worrying can help them avoid bad events by motivating them to engage in problem solving.

trauma related disorders: acute stress disorder Adjustment disorder

This occurs in response to traumas similar to those involved in PTSD. It is diagnosed when symptoms arise within 1 month of exposure to the stressor and last no longer than 4 weeks. witnessing a death or serious accident is the emotional behavioral symptoms arising within 3 weeks.

Which of the following statements is true of post-traumatic stress disorder (PTSD)? Common events, such as traffic accidents, are rarely associated with PTSD. You Answered About 25 percent of adults will develop PTSD at some time in their lives. Even the mildest symptoms of PTSD prevent normal functioning. Correct Answer Women are at greater risk of developing PTSD than men.

Women are at greater risk of developing PTSD than men.

Susan is deathly afraid of the wind since she and her family survived Hurricane Ike. She gets very worried and panicky when the sky gets dark and the wind begins to blow. Susan is most likely experiencing: a situational type phobia. an animal type phobia. a social phobia. Correct! a natural environment type phobia.

a natural environment type phobia.

When June was 7 years old, she and her mother were stuck in an elevator. Several other people were in the elevator as well. The elevator became hot and stuffy, and breathing became difficult. June remembers experiencing shortness of breath, palpitations, and dizziness. Now June refuses to ride elevators. When she is with other people, she makes excuses to use the stairs. June is probably suffering from _____. Correct! a situational type phobia an animal-type phobia social phobia a natural environment type phobia

a situational type phobia

Systematic desensitization 系统脱敏

a treatment for phobias in which the patient is exposed to progressively more anxiety-provoking stimuli and taught relaxation techniques.

In Watson's experiment with Little Albert, the conditioned stimulus was _____. Correct Answer a white rat Little Albert a loud noise a startle and fear response

a white rat

Two months ago, Mark's mother passed away unexpectedly. Since her death, he has been unable to function at school, has lost interest in extracurricular activities, and gets agitated easily. Mark may be exhibiting the symptoms of _____. Correct! adjustment disorder acute stress disorder post-traumatic stress disorder bereavement disorder

adjustment disorder

Ruth is afraid of being in large open spaces. She is especially worried that she will not be able to leave the area if she begins to panic. Ruth is most likely experiencing _____. social phobia Correct! agoraphobia acute distress disorder claustrophobia

agoraphobia

Social Anxiety Disorder: (more common in women) Treatments

anxious in social situations and are afraid of being rejected, judged, or humiliated in public, and focus on avoiding such events. It develops either in the early preschool years or in adolescence. Theories of this disorder is a genetic basis, as it does run in families. include the SSRI's—Selective Serotonin Reuptake Inhibitors—also Serotonin Norepinephrine Reuptake Inhibitors—SNRI's, and cognitive behavioral therapy which identifies negative cognitions that people have, and learn to dispute these cognitions, as well as mindfulness based interventions.

People diagnosed with generalized anxiety disorder (GAD): know their anxiety is provoked by uncontrollable circumstances. Correct! are often excessively worried about almost all situations. only worry about the safety and security of their family members. see their anxiety and worry as part of their personality.

are often excessively worried about almost all situations.

Panic Disorder Treatment:

are short but intense periods during which people experience many symptoms of anxiety People begin to worry about having these attacks, and change their behaviors as a result of this worry. Inheritability is 43% to 48%. People show dysregulation of the norepinephrine systems too. Biological treatments include ：medication affecting serotonin and norepinephrine systems and medication including ：benzodiazepines. And most people experience a relapse of symptoms when drug therapies are discontinued, though. Cognitive behavioral therapy includes： relaxation and breathing exercises, identifying a catastrophic cognition, relaxation and breathing exercises while experiencing symptoms during the session, challenging catastrophic thinking, and systematic desensitization therapy.

Generalized Anxiety Disorder Treatment

being anxious all the time, worrying about life, common in women more than men. cognitive behavioral, focusing on helping people with generalized anxiety disorder why confronting the issues they worry about most, challenging negative catastrophic thinking, developing coping strategies. Biological treatments include: benzodiazepines, and tricyclic antidepressants and the Selective Serotonin Reuptake Inhibitors.

In _____, individuals can practice their feared behaviors in front of others while the therapist coaches them in the use of relaxation techniques. psychodynamic therapy Correct Answer cognitive-behavioral therapy in a group setting You Answered behavioral therapy cognitive-biological therapy in an experimental setting

cognitive-behavioral therapy in a group setting

The hypothalamus activates the adrenal-cortical system by releasing _____, which signals the pituitary gland to secrete _____, the body's "major stress hormone." You Answered cortisol; adrenaline corticotropin-release factor; adrenaline cortisol; adrenocorticotropic hormone Correct Answer corticotropin-release factor; adrenocorticotropic hormone

corticotropin-release factor; adrenocorticotropic hormone

Janie's house was broken into and the perpetrator brutally attacked her. Since the attack, she has been overly cautious and watchful. The smallest noise startles her. If someone looks at her "strangely," she becomes very anxious. Janie is most likely: experiencing emotional numbness and detachment. Correct Answer exhibiting hypervigilance and chronic arousal. reexperiencing the trauma. demonstrating deluded thinking.

exhibiting hypervigilance警觉过度 and chronic arousal激励.

Treatments for PTSD

exposing clients to what they fear in order to extinguish that fear, challenging distorted cognitions that contribute to symptoms, helping clients reduce stress in their lives cognitive behavioral therapy and stress management is used These include systematic desensitization, stress inoculation预防接种 therapy; therapists teach clients skills for overcoming problems that increase stress and result in PTSD. Biological therapies include medication managements like the: SSRI's, Selective Serotonin Reuptake Inhibitors, and benzodiazepines.

In exposure and response prevention therapy, repeated exposure to the content of the obsession: stabilizes the client's anxiety about the obsession. Correct Answer extinguishes the client's anxiety about the obsession. reinforces the client's anxiety about the obsession. You Answered builds up the client's anxiety about the obsession.

extinguishes the client's anxiety about the obsession.

claustrophobia

extreme or irrational fear of confined places.

Virginia is very aware of her bodily cues that signal a panic attack. This heightened awareness is known as _____. You Answered conditioned avoidance response introjective awareness Correct Answer interoceptive awareness anxiety sensitivity

interoceptive awareness

fight or flight response

is a set of physical and psychological responses that help us fight a threat or flee from it.

People with panic disorder show dysregulation of norepinephrine systems in an area of the brainstem called the: basal tencephalon. Correct! locus ceruleus. nucleus prepositus hypoglossi. reticular formation.

locus ceruleus.

When they are not exposed to trauma reminders, post-traumatic stress disorder (PTSD) sufferers tend to have resting levels of cortisol that are: somewhat higher than those of people without PTSD. You Answered much higher than those of people without PTSD. Correct Answer lower than those of people without PTSD. similar to those of people without PTSD.

lower than those of people without PTSD.

The most significant problem with the behavioral theory of phobias is that: You Answered most phobias do not have an evolutionary basis and are not part of our collective unconscious. phobias should disappear once the conditioned stimulus is no longer paired with the unconditioned stimulus. Correct Answer many people with phobias cannot identify traumatic events that triggered them. observational learning helps in the maintenance of phobias more than operant conditioning.

many people with phobias cannot identify traumatic events that triggered them.

A study of adults in rural Mexico found that among underprivileged Latino communities, particularly women, _____ expresses the anger and frustration of "being at the bottom" and provides temporary release from the everyday burdens of life. "amok"; Correct! "nervios" "susto" "mal de ojo"

nervios

OSD

obsessions: which are thoughts, images, ideas or impulses that are persistent—they are uncontrollable, they intrude upon consciousness, they cause significant anxiety or distress. Compulsions: are repetitive behaviors or mental acts that and individual feels he or she must perform. It is different from other stress related diseases, and it begins at a young age. A common type are: thoughts and images associated with aggression, sexuality, and/or religion. Symmetry and ordering, contamination and a cleaning compulsion. Hoarding积蓄并储藏（某物） Hair-pulling disorder: resulting in noticeable hair loss called trichotillomania Skin picking disorder: recurrently picking scabs or places on the skin and creating significant lesions that often become infected and cause scars. Body dysmorphic disorder: people are excessively preoccupied with a part of their body that they believe is defective, but that others see as normal or only slightly illusion. Biological theories: focus on a circuit in the brain involved in motor, behavior, cognition, and emotion. Response to drugs is good. Genes also help determine who is vulnerable to obsessive-compulsive disorder.

According to cognitive-behavioral theories of obsessive-compulsive disorder (OCD), compulsions develop largely through _____. interoceptive conditioning observational learning classical conditioning Correct! operant conditioning

operant conditioning

The idea that people learn to fear or avoid selected objects or situations that are vestiges of evolutionary history, and individuals are biologically prepared to quickly associate fear responses with certain objects is called _____. traditional classical conditioning evolutionary classical conditioning biological classical conditioning Correct! prepared classical conditioning

prepared classical conditioning

Cognitive theorists suggest that people who experience panic attacks engage in all of the following behaviors EXCEPT: paying close attention to their bodily sensations. Correct Answer reasoning that the attack is only a temporary response. misinterpreting bodily sensations in a negative way. engaging in snowballing catastrophic thinking.

reasoning that the attack is only a temporary response.

Biological theories of obsessive-compulsive disorder have focused on a circuit in the brain involved in: activating moral behaviors. You Answered regulating thoughts and emotions. Correct Answer regulating primitive urges. filtering incoming stimuli.

regulating primitive原始的 urges.

People with obsessive-compulsive disorder (OCD) often get some relief from their symptoms when they take drugs that better regulate the neurotransmitter _____. GABA epinephrine norepinephrine Correct! serotonin

serotonin

Anna is terrified of speaking in public. She always finds an excuse to avoid public speaking or gets someone to speak for her. Once Anna had a full-blown panic attack when her boss called on her unexpectedly to speak at a meeting. Anna is most likely exhibiting symptoms of: a situational type phobia. an animal-type phobia. Correct! social anxiety disorder. a natural environment type phobia.

social anxiety disorder.

Theories of phobias: Behavioral theory

suggests that negative reinforcement is a factor. The reduction of anxiety is reinforced by the avoidance of the feared object. Prepared classical conditioning: the conditioning of fear to certain objects or situations. And Biological: Related people share phobias.

Post-traumatic stress disorder (PTSD) sufferers may report _____ about having lived through a traumatic event. dehumanization Correct! survivor guilt hysteria cognitive bias

survivor guilt

In exposure and response prevention therapy, by preventing a person from engaging in compulsive behavior: the client's "magical thinking" is reinforced. the client's compulsive behavior is strengthened. You Answered the client's anxiety about the compulsive behavior builds up. Correct Answer the client learns that not engaging in the compulsive behavior does not lead to a terrible result.

the client learns that not engaging in the compulsive behavior does not lead to a terrible result.

Children with a genetic predisposition toward anxiety or who are behaviorally inhibited may not develop a specific phobia, unless: they experience some traumatic event. You Answered their behavior is positively reinforced by the environment. Correct Answer the parenting they receive worsens their anxiety. the performance of the behavior reduces their anxiety.

the parenting they receive worsens their anxiety.

According to cognitive-behavioral theories of obsessive-compulsive disorder (OCD), all of the following are true about people diagnosed with OCD EXCEPT: they may be depressed or generally anxious much of the time, so even minor negative events are more likely to invoke intrusive, negative thoughts. they judge their negative, intrusive thoughts as more unacceptable than most people would and become more anxious and guilty about having them. they appear to believe that they should be able to control all thoughts, and have trouble accepting that everyone has horrific notions from time to time. Correct! they believe that having intrusive thoughts means they are going crazy, but they do not equate having the thoughts with actually engaging in the behaviors.

they believe that having intrusive thoughts means they are going crazy, but they do not equate having the thoughts with actually engaging in the behaviors.

Obsessive thoughts

typically deal with unwanted and intrusive thoughts by trying to suppress them. Research by Daniel Wegner in 1989 indicates that this strategy may backfire. The more people attempt to suppress their obsessive thoughts, the more likely they are to become preoccupied with them.

Cognitive theorists maintain that people with generalized anxiety disorder (GAD) focus on threats at both the _____ levels. Correct Answer unconscious and conscious You Answered conscious and preconscious preconscious and subconscious subconscious and unconscious

unconscious and conscious

According to Freudian theory, phobias develop when: the ego is unable to meet the needs of the id. Correct Answer unconscious anxiety is displaced onto a neutral or symbolic object. the preconscious state of mind becomes tied to the conscious state of mind. sexual urges and drives are retarded or suppressed.

unconscious anxiety is displaced onto a neutral or symbolic object.

Specific phobias

unreasonable or irrational fears or specific objects or situations. One example is agoraphobia: people fear places where they might have trouble escaping or getting help if they become anxious; that they will embarrass themselves if other notice their symptoms or efforts to escape. In extreme cases, individuals do no leave their homes alone.

Treatment of the phobias: Behavioral treatments

use exposure to extinguish the person's fear of an object or situation. It includes systematic desensitization, modeling, or flooding. An applied tensions technique increases blood pressure and heart rate, keeping people from fainting when confronted with the feared object. And biological treatments, many medication, benzodiazepines