Psych 405 Exam 2: Lectures 4-6
Match the following words to their definition Words: 1. Fear 2. Anxiety 3. Worry 4. Phobia Definitions: A: an emotional response to immediate danger B: An excessive fear of a specific object or situation that causes immediate distress or impairment C: A state of apprehension often accompanied by mild autonomic arousal D: Thinking about potential problems, often without settling on a solution
1. A 2. C 3. D 4. B
Explain three components of the inverse "U-shaped" curve describing the impact of anxiety on performance
1. Absence of anxiety interferes with performance 2. Moderate levels of anxiety improve performance 3. High levels of anxiety are detrimental to performance
List two reasons that psychological treatment is a better option than medication for anxiety disorders
1. Although the efficacy of psychotherapy and medications is similar, medications have significant side effects 2. Relapse is common once medication use is discontinued
Name and briefly describe describe two etiological factors related to the development of social anxiety disorder
1. Behavioral factors: Conditioning of Social Anxiety 2. Cognitive factors: Too much focus on negative self-evaluations
What are the two main personality factors that are linked to anxiety?
1. Behavioral inhibition 2. Neuroticism
Name and describe side effects of two drugs used to treat anxiety (antixiolytics)
1. Benzodiazepines (e.g., Valium, Xanax): Can be addictive and cause severe withdrawal symptoms; side effects include cognitive and motor difficulties 2. Antidepressants (e.g., Tricyclics, SSRIs, SNRIs): Side effects include jitteriness, weight gain, elevated treatment
Describe Mowrer's two-factor model of fear conditioning
1. Classical conditioning: A person learns to fear a neutral stimulus (CS) that is paired with an intrinsically aversive stimulus (UCS) 2. Operant Conditioning: A person gains relief by avoiding the CS; Avoidance maintained through negative reinforcement
What are the three Dissociative disorders that you should be familiar with?
1. Depersonalization/derealization disorder 2. Dissociative amnesia 3. Dissociative identity disorder
What are six suggestions for treatment of DID?
1. Developing a strong therapeutic relationship with a therapist 2. Administering treatment in a safe therapeutic environment 3. Setting appropriate boundaries with the therapist 4. Working through traumatic material 5. Developing other defenses as opposed to new personalities 6. Integration of the identities into one state of the self
What are three DSM-5 criteria specific to agoraphobia?
1. Disproportionate and marked fear or anxiety about at least 2 situations where is would be difficult to escape or receive help in the event of incapacitation, embarrassing symptoms, or panic-lie symptoms 2. The situations consistently provoke fear or anxiety 3. These situations are avoided, require the presence of a companion, or are endured with intense fear or anxiety
What are the five DSM-5 criteria for Dissociative Identity Disorder (DID). Note, this is a very long answer, but it's super important!
1. Disruption of identity characterized by two or more distinct personality states (alters) or an experience of possession. These disruptions lead to discontinuities in the sense of self or agency, as reflected in altered cognition, behavior, affect, perceptions, consciousness, memories, or sensory-motor functioning. This disruption may be observed by others or reported by the patient 2. Recurrent gaps in memory for events or important personal information that are beyond ordinary forgetting 3. Symptoms are not part of a broadly accepted cultural or religious practice 4. Symptoms are not due to drugs or a medical condition 5. In children, symptoms are not better explained by an imaginary playmate or by fantasy play
What are the three DSM-5 criteria specific to generalized anxiety disorder (GAD)?
1. Excessive anxiety and worry at least 50% of days about a number of events or activities (e.g., family, health, finances, work, school, etc.) 2. The person finds it hard to control the worry 3. The anxiety and worry are associated with at least three (or one in children) of the following: -Restlessness or feeling keyed up or on edge -Easily fatigued -Difficulty concentrating or mind going blank -Irritability -Muscle tension -Sleep disturbance
What are two key components of exposure therapy for treatment of anxiety disorders that must be ensured to help prevent relapse?
1. Exposure should include as many features of the feared object as possible 2. Exposure should be conducted in as many different contexts as possible
What are some common symptoms (name six) of Dissociative Identity disorder (DID) that are unrelated to the symptoms defined by the DSM-5?
1. Headaches 2. Hallucinations 3. Suicide attempts 4. Self-injurious behaviors 5. Amnesia 6. Depersonalization
Describe the three DMS-5 criteria for Dissociative Amnesia
1. Inability to remember important autobiographical information, usually of a traumatic or stressful nature, that is too extensive to be ordinary forgetfulness 2. The amnesia is not explained by substances, or by other medical or psychological conditions 3. Specify dissociative fugue subtype if amnesia is associated with bewildered or apparently purposeful wandering
What are two reasons that early versions of Mowrer's two-factor model of anxiety disorders is inconsistent with evidence?
1. Many people who have anxiety disorders cannot remember any exposure to a threatening event that triggered their symptoms 2. Many people who do experience serious threats do not develop anxiety disorders
What are three DSM-5 criteria specific to social anxiety disorder?
1. Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny 2. Exposure to the trigger leads to intense anxiety about being evaluated negatively 3. Trigger situations are avoided or else endured with intense anxiety
What are two DSM-5 criteria that are specific to specific phobias?
1. Marked and disproportionate fear consistently triggered by specific objects or situations 2. The object or situation is avoided or else endured with intense anxiety
What are three DSM-5 caveats for diagnosis of depersonalization/derealization disorder?
1. Reality testing remains intact 2. Symptoms are persistent ot recurrent 3. Symptoms are not explained by substances, another dissociative disorder, another psychological disorder, or by a medical condition
What are two DSM-5 criteria specific to panic disorder?
1. Recurrent unexpected panic attacks 2. At least 1 month of concern about the possibility of more attacks occurring or the consequences of an attack, or maladaptive behavioral changes because of attacks
Name and describe two forms of psychological treatment for GAD
1. Relaxation training: Promotes calmness. Studies suggest that relaxation training is more effective than non-direct treatment or no treatment 2. Cognitive behavioral methods: -improve problem solving -Challenge and modify negative thought -Increase ability to tolerate uncertainty -Worry only during "scheduled" times -Focus on present moment
List two reasons why antidepressant medications are preferred to benzodiazepines for the treatment of anxiety disorders
1. Side effects are more severe with benzodiazepines compared with antidepressant medications 2. There is a risk of addiction with benzodiazepines
What are the five categories of anxiety disorder in the DSM-5?
1. Specific phobias 2. Social anxiety disorder 3. Panic disorder 4. Agoraphobia 5. Generalized anxiety disorder
What are four cognitive factors that contribute to the development of anxiety disorders
1. Sustained negative beliefs about the future 2. Belief that one lacks control over their environment 3. Attention to threat 4. Intolerance of uncertainty
What are four DSM-5 criteria that apply to all five anxiety disorders
1. Symptoms interfere with important areas of functioning or cause marked distress 2. Symptoms are not caused by a drug or a medical condition 3. Symptoms persists for at least 6 months or at least 1 month for panic disorder 4. The fears and anxieties are distinct from the symptoms of another anxiety disorder
What are two pieces of evidence that support the sociocognitive model of Dissociative Identity Disorder (DID), which states that DID could be iatrogenic
1. The symptoms of DID can be role-played 2. Some therapists reinforce DID symptoms
According to the Sociocognitive model of Dissociative Identity Disorder, what are four means/pieces of evidence to support the notion that some therapists reenforce symptoms of DID in a clinical setting?
1. The use of hypnosis, urging clients to unremember abuse experiences, and naming alters may support the notion that therapists inadvertently reinforce DID symptoms. 2. Most clients are unaware of having alters before beginning treatment 3. There tends to be a rapid increased in the number of alters once treatment commences. 4. Alters share memories, even when they report amnesia (i.e., implicit memories are transferred between alters)
While many view dissociation as an avoidance response that protects the person from consciously experiencing stressful events, what are two additional causes of dissociation?
1. Trauma 2. Sleep disturbance
What are three etiological explanations for specific phobias? Describe each
1. Two-factor model of behavioral conditioning (discussed in another card) 2. Risk factors act as diatheses: Vulnerabilities influence the development of phobias 3. Prepared learning: Evolutionary preparation to fear certain stimuli (e.g., things that are potentially life threatening like height, snakes, etc.)
What are four possible explanations for the gender differences in anxiety?
1. Women may be more likely to report symptoms 2. Men are more likely to be encouraged to face their fear 3. Women are more likely to experience sexual assault, which may interfere with sense of control 4. Women show more biological reactivity to stress
Match the theory to the model of etiology: 1. Panic disorder 2. GAD 3. Specific phobias 4. Agoraphobia 5. Social anxiety disorder A: Anxiety sensitivity B: Prepared learning C: Avoidance of powerful changes in negative emotions D: Too much focus on one's flaw E: Fear of fear
1: A 2: C 3: B 4: E 5: D
Discuss two disorders that are commonly comorbid with anxiety
60% of people with an anxiety disorder also have depression. OCD is also very common among
What is a panic attack? Specify the four other symptoms that must be present
A panic attack is a sudden attack of intense apprehension, terror, and feelings of impending doom. They are accompanied by at least four other symptoms including physical symptoms, depersonalization, derealization, and fears of going crazy, losing control, or dying
How does the Psychodynamic model view causes and treatment of Dissociative Identity Disorder. In your answer, discuss goals of treatment and what treatment looks like
According to the psychodynamic model, DID is believed to arise from traumatic events that the person is trying to block from consciousness. The goal of psychodynamic treatment, then, is to overcome this repression through the use of hypnosis
One extension to Mowrer's two-factor model of anxiety is used to explain why some people with anxiety disorders do not remember any conditioning experience. What does this model assume? Provide three examples
According to this extension, c lassical conditioning can occur in different ways, including : -Direct experience (e.g., getting bit by a dog) -Modeling: Seeing someone else experience feared situation (e.g., seeing a dog bite a man or watch a video of a vicious dog attack) -Verbal instruction (e.g., hearing a parent say dogs are dangerous) In any of these ways, a person could learn to associate a stimulus with fear
Hypnosis is the main method treatment of Dissociative Identity Disorder according to the psychodynamic model. Discuss the use of age-regression therapy in hypnosis and the effectiveness of this treatment
Age regression is a technique utilized in hypnosis used to treat DID, in which a person is encouraged to go back in his or her mind to traumatic events in childhood. Research has shown that this type of hypnosis can actually worsen symptoms
What is agoraphobia, and how does it cause impairment? Include several examples in your answer
Agoraphobia describes anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred (e.g., crowds, stores, malls, churches, trains, bridges, tunnels, etc.). This causes significant impairment, as some people may be unable to leaves the house (or if they do, it is with great distress)
What is the significance of the amygdala in the "fear circuit"?
Amygdala: Involved in the conditioning of fear; responsible for assigning emotional significance to fear
Describe Excoriation disorder including what may precede it. What must occur for a diagnosis
An OCD-related disorder than involves picking (or extreme rubbing) at the skin, often resulting in lesions. It may be preceded by an increased sensation of tension or may lead to gratification. You need to have repeatedly tried and failed at stopping the behavior in order to meet diagnostic criteria
What is the difference between anxiety and fear?
Anxiety describes apprehension over an anticipated problem, whereas fear describes a reaction to immediate danger
Both anxiety and fear involve physiological arousal. How do these two differ in this regard? Provide examples
Anxiety involves moderate arousal (e.g., feeling restless energy or tension). Conversely, fear involves higher levels of arousal (e.g., experiencing an overpowering urge to run)
How are neurotransmitters involved in anxiety disorders? Refer to three specific NTs in your answer
Anxiety is correlated in disruptions of the NTs serotonin and GABA. Anxiety is also associated with increased levels and changes in the sensitivity of receptors for Norepinephrine
The key feature of the fugue subtype of dissociative amnesia is what?
Assumption of a new identity or bewildered wandering
Cognitive factors found to correlate with anxiety disorders include which of the following: -Low self-esteem -Attention to signs of threat -Hopelessness -Lack of perceived control
Attention to signs of threat; Lack of perceived control
One of the three cognitive factors related to the development of anxiety disorders is attention to threat? What is this, and how can it be reduced?
Attention to threat describes the tendency to notice negative environmental cues and to selectively pay attention to signs of threat. Attention training interventions are used to train anxious people to tend more preferentially to positive information over negative information (usually through dot-training exercises). Attention training interventions show promise for reducing anxiety related to attention to threat
A key structure in the fear circuit is the: A: Cerebellum B: Amygdala C: Occipital cortex D: Inferior colliculi
B
The most common foci for obsessions include all of the following EXCEPT: A: Contamination B: Travel C: Sexual or aggressive impulses D: Symmetry or order
B
Why are psychological treatments considered the preferred treatment over medications for most anxiety disorders?
Because most people relapse once they stop taking their medications
What is behavioral inhibition and how is it related to anxiety?
Behavioral inhibition is a temperament that is linked to anxiety disorders. It is characterized by a tendency to become agitated, distress, and cry in unfamiliar or novel settings (can be observed in infants as young as four months old and may be inherited). Behavioral inhibition predicts social anxiety in adolescence
What do both the sociocognitive and post-traumatic model of DID suggest as the cause?
Both theories suggest that severe physical or sexual abuse during childhood sets the stage for DID, as is evidenced by the fact that nearly all patients in therapy for DID report severe child abuse
Which of the following is an obsession: A: Repeatedly checking to make sure the water is turned off B: Humming a tune over and over C: Having a recurring fear than one is giving others illnesses when they are actually not D: Having excessive worry over finances
C
Discuss the use of CBT for panic disorder as well as the efficaciousness of this treatment
CBT for panic disorder focuses on exposure. The therapist uses exposure techniques that elicit the somatic sensations the person associates with an impending panic attack. When these sensations arise, the person practices coping techniques for dealing with the somatic symptoms, and the person eventually learns to stop seeing these somatic symptoms as signals of loss of control and to see them instead as intrinsically harmless and controllable sensations. This treatment has been shown to work well in many studies.
Name and briefly describe three treatment options for social anxiety disorder
CBT for social anxiety: Involves a graded hierarchy of exposure and role playing or practicing with a small group Social skills training: Provides extensive modeling of behaviors and reduces use of safety behaviors (e.g., poor eye contact). Clarks' cognitive therapy for social anxiety: The therapist helps people learn not to focus their attention internally. The therapist also helps them combat their very negative images of how others will react to them
Name and describe one treatment option for agoraphobia
CBT involving exposure is the main treatment for agoraphobia . It involves systematic exposure to feared situations. Patients are coached to gradually leave home and engage in community activities for short periods of time. This form of therapy is enhanced by involving the patient's partner
Define antixiolytics
Class of drugs that reduce anxiety
People with anxiety disorders acquire fears more readily through ____________ conditioning
Classical
The first step in Mowrer's two-factor model includes ________ conditioning, and the second step involves ___________ conditioning
Classical; operant
Name and describe one cognitive factor that is implicated in the etiology of panic disorder
Cognitive perspectives on panic disorder focus on catastrophic misinterpretations of somatic changes. According to this model, panic attacks develop when a person interprets bodily sensations as signs of impending doom (e.g., "I must be having a heart attack because my HR is increased). Obviously, such thoughts will increase the person's anxiety, which produces more physical sensations, creating a vicious cycle
Provide a brief (one sentence) description of dissociative identity disorder
DID involves at least two distinct personalities that act independently of each other
Discuss sex differences in the prevalence of Dissociative Identity Disorder (DID)
DID is more common in women than in men
When is Dissociative Identity Disorder (DID) typically diagnosed? What is important to note about this?
DID is rarely diagnosed until adulthood. However, symptoms may date back to childhood
Discuss the presence/nature of delusions in DID vs. schizophrenia
Delusions are relatively absent in DID, with the only delusion present being the delusion of other personalities. In schizophrenia, delusion are present, and may include bizarre and/or paranoid delusions
Describe the onset of depersonalization/Derealization disorder, including what symptoms are generally triggered by, as well as the typical age of onset
Depersonalization/Derealization disorder has symptoms that are usually trigged by stress. Onset is usually in adolescence
Describe Depersonalization/Derealization disorder. In your answer, define the terms depersonalization and derealization, providing examples where appropriate
Depersonalization/Derealization disorder involves a disconcerting and disruptive sense of detachment from one's self and surroundings. Depersonalization describes experiences of detachment from one's mental processes or body, as though one is in a dream (e.g., being an observer outside one's body), whereas derealization describes experiences of unreality of surroundings
Define Dissociation
Dissociation refers to some aspect of emotion, memory, or experience being consciously inaccessible
According to psychodynamic theory, dissociative amnesia is the result of traumatic memories that have been repressed. What is some evidence against this theory? With this in mind, how has this theory been adapted
During times of severe stress (i.e., trauma), hormones like NE, which heighten arousal, are shown to enhance rather than impair consolidation and retrieval of memory. With this in mind, the theory has been adapted to say that chronic stress, rather than acute stressors may have more to do with dissociative amnesia, as chronically high levels of stress hormones interferes with memory formation
Provide a brief (one sentence) description of depersonalization/derealization disorder
Experience of detachment from the self and reality
Effective psychological treatments for anxiety disorders share a common focus: exposure. What does this entail in a CBT context, and how effective is it? How is this therapy viewed in the context of the behavioral view and the cognitive view?
Exposure therapy involves facing the situation or object that triggers anxiety (e.g., CBT involves creating of an exposure hierarchy--graded exposure to a list of triggers). It is effective for 70-90% of clients. The effects of CBT endure when follow-up assessments are conducted 6 months after treatment, but in the years after treatment, many people experience some return of their anxiety symptoms The behavioral view posits that this therapy works because newly learned associations inhibit fear.
What is the most common strategy used in CBT for anxiety disorders?
Exposure, sometime supplemented with cognitive approaches
True or false: Fear often involves moderate arousal, whereas anxiety involves higher arousal
False
True or false: The Sociocogntive model of Dissociative Identity Disorder view DID as a form of conscious deception
False
True or false: The effects of agoraphobia on quality of life are not as severe as those observed for other anxiety disorders
False
True or false: GAD does not tend to be chronic. Explain
False: About half of people with GAD experience ongoing symptoms for upwards of ten years.
True or false: anxiety disorders are fairly rare compared to other, more common, disorders. Explain
False: Anxiety disorders are the most common type of psychological disorders
True or false: panic attacks are consistently related to specific situations. Explain
False: Panic attacks triggered by specific situations (e.g., phobia) should not be considered in diagnosing panic disorder, as this would better meet the criteria for specific phobia
True or false: All types of dissociations are rare. Explain using an example
False: Some types of dissociations, like losing track of time, are common
True or false: There is low comorbidity with specific phobias
False: There is high comorbidity among specific phobias
True or false: With respect to exposure therapy for treatment of anxiety disorders, virtual reality is less effective than in vivo (real life) exposure therapy
False: They are equally effective
True or false: There is plentiful experimental evidence to support the sociocogntive model of DID. Explain
False: We will never have experiment evidence for the sociocogntive model, since it would be unethical to intentionally reinforce dissociative symptoms
True or false: DID involves many more psychotic symptoms than schizophrenia
False: schizophrenia involves many more psychotic symptoms than DID
Define depersonalization
Feeling of being outside one's body
Define derealization
Feeling of the world not being real
What is generalized anxiety disorder? In your answer, define the term worry, common worries, as well as other disabilities that accompany this disorder
GAD describes excessive, uncontrollable worry (central feature of GAD), and long-lasting worry about minor things. Worry is the cognitive tendency to "chew on" a problem and to be unable to let go of it. Common worries include relationships, health, finances, and daily hassles
Describe Dissociative Identity Disorder (DID), including several characteristics of the alters.
In DID, a person has at least 2 separate personalities, referred to as alters. Each alter has different modes of being, thinking, feeling, and acting. The alters exist independently of one another and emerge at different times
Discuss the presence/nature of Auditory hallucinations in DID vs. schizophrenia
In DID, auditory hallucinations are present, representing the the dialogues between alters. These voices are generally perceived as being internally generated. Conversely, while auditory hallucinations are also present in schizophrenia, they are not solely the voices of personalities, but also noises of animals and other noises perceived as being externally generated
Discuss the severity/duration of dissociative symptoms in DID vs. Schizophrenia
In DID, dissociative symptoms are recurrent or persistent. In schizophrenia, dissociative symptoms are only sometimes present, and tend to be mild if they are present
Discuss the prevalence/nature of functional impairment in DID vs. schizophrenia
In DID, functional impairment is temporary and fluctuating. Conversely, in schizophrenia, functional impairment is pervasive and persistent (it is the main component of schizophrenia)
Discuss the presence or absence of symptoms involving reality testing in DID vs. schizophrenia
In DID, reality testing symptoms are intact, "as if" statements of dissociative symptoms. Reality testing symptoms are absent in Schizophrenia
Discuss the severity/persistence of symptoms of DID vs. schizophrenia
In DID, symptoms tend to be severe and intermittent. Conversely, symptoms of schizophrenia tend to be severe and persistent
In Dissociative Identity Disorder, which alter typically seeks treatment?
In DID, the primary alter typically seeks treatment
What is the difference between the dissociative disorders and the somatic symptom-related disorders?
In the dissociative disorders, the person experiences disruptions of consciousness--he or she losses track of self-awareness, memory, and identity. In the somatic symptom-related disorders, the person complains of bodily symptoms that suggests a physical defect or dysfunction, sometimes dramatic in nature.
Briefly describe dissociative amnesia
Inability to recall important personal information, usually about a traumatic experience
One of the behavioral factors of panic disorder is interoceptive conditioning. Describe this process
Interoceptive conditioning is classical conditioning of panic in response to internal bodily sensations. First, a person experiences somatic signs of anxiety. Next a panic attack occurs. The panic attacks become a conditioned response to somatic changes. See page 37 of Anxiety Disorder PPT for diagram
One of the three cognitive factors related to the development of anxiety disorders is sustained negative beliefs about the future. What does this include, and what type of behavior does it foster?
Involves the belief that bad things are likely to occur in the future. People who experience this often engage in safety behaviors, which maintain negative cognitions
Provide a brief description of dissociative amnesia. Discuss the fugue subtype in your answer
Lack of conscious access to memory, typically of a stressful experience. The fugue subtype involves traveling or wandering coupled with loss of memory of one's identity or past
One of the two etiological factors for social anxiety disorder is behavioral factors? How does the behavioral perspective view social anxiety disorder? Provide examples
Like specific phobias, the behavioral perspective on social anxiety disorder is based on the two-factor model of conditioning. That is, a person could have a negative social experience (directly, through modeling, or through verbal instruction) and become classically conditioned to fear similar situations, which the person avoids. This avoidance of the situation manifests as safety behaviors, which include avoiding eye contact, disengaging from conversation, and standing apart from others. These safety behaviors maintain and intensify social difficulties
How many alters are typically identified in Dissociative Identity Disorder?
Most commonly 2-4 alters are identified when a person is diagnosed with DID
What is a neutral predictable unpredictable (NPU) threat task, and what are the three components?
NPU tasks are used to assess differences in physiological responses based on whether a threat is anticipated. There are three conditions in an NPU threat task: 1. a neutral condition in which they do not experience an aversive stimulus 2. a predictable condition in which they experience sn sversive stimulus and receive a warning beforehand 3. An unpredictable condition in which they experience an aversive stimulus without prior warning
____________ is a personality trait characterized by a tendency to experience frequent and intense negative affect
Neuroticism
What is neuroticism and how is it linked to the development of anxiety (and depression) disorders?
Neuroticism describes the tendency to experience frequent or intense negative affect. Neuroticism predicts the onset of anxiety disorder and depression. People with high levels of neuroticism are twice as likely to develop anxiety disorders compared to those with low levels of neuroticism
According to cognitive theory, how does the nature of attention and memory change during periods of intense stress?
People under stress tend to focus on the central features of the threatening situation and to stop paying attention to the peripheral features. As a consequence, people tend to remember emotionally relevant material more than the neutral details surrounding an event
How is intolerance of uncertainty related to the development of anxiety disorders?
People who have a hard time accepting ambiguity, that is, who find it intolerable to thing that something bad might happen in the future are more likely to develop anxiety disorders. This intolerance of uncertainty can predict increases in worry over time
Despite being highly comorbid with other anxiety disorders, GAD differs from the other anxiety disorders in a few important ways. Discuss one example of this and why it is significant
People who meet diagnostic criteria for GAD are much more likely to experience episodes of MDD than those with other anxiety disorders are. This suggests that some of the risk factors involved in MDD are also likely to be important in GAD
How do people with anxiety disorders differ from healthy people with respect to attention to threat? Provide some examples
People with anxiety disorders pay more attention to negative cues in their environment than do people with anxiety disorders. For example, people with social anxiety disorder have been found to selectively attend to negative faces. Once a threatening object captures their attention, anxious people have a difficult time pulling their attention away fro that object; they tend to stay focused on a threatening object longer than other do
What does it mean to say that people with anxiety disorders are sensitive to unpredictable threats
People with anxiety disorders show high physiological arousal to unpredictable threat conditions compared to healthy controls, as evidence by performance on Neutral predictable-unpredictable (NPU) threat task
How does activity in the amygdala differ between people with and without anxiety disorders when faced with a threat?
People with anxiety disorders show increased amygdala activity compared to people without anxiety disorders
Discuss the recovery of memory in people with the dissociative fugue subtype of dissociative amnesia
People with this subtype usually achieve complete recovery of memories. However, while people are able to remember details of their lives, they are generally unable to remember the events that took place during the fugue state
Both anxiety and fear involve what?
Physiological arousal
How is procedural memory affected by dissociative amnesia?
Procedural memory remains intact (is unaffected)
What does psychodynamic theory view as the cause of dissociative amnesia?
Psychodynamic theory argues that dissociative amnesia is brought on by repression of traumatic events
Discuss the etiology of agoraphobia. Discuss the fear-of-fear hypothesis in your answer
Risk of agoraphobia is related to genetic vulnerability and life events. The principal cognitive model for the etiology of agoraphobia is the fear of fear hypothesis, which states that people with agoraphobia have negative thoughts about the consequences of experiencing anxiety in public. They have catastrophic beliefs that anxiety will lead to socially unacceptable consequences
When does social anxiety disorder tends to begin?
Social anxiety disorder generally begins during adolescence, when peer relationships become particularly important (although, it can also start in childhood.
What is social anxiety disorder and what are some common fears among people with this disorder?
Social anxiety disorder is characterized by of persistent, unrealistically intense fear of social situations that might involve being scrutinized by or exposed to unfamiliar people. Common fears among people with social anxiety disorder include fears of public speaking, meeting new people, and talking to people in positions of authority
What are specific phobias? Is the person aware of the fact that their anxiety is excessive? What will people with this disorder do to keep their anxiety in check?
Specific phobias describe a disproportionate fear cause by a specific object or situation. People with specific phobias are generally aware that their fear is excessive, and great lengths are taken to avoid the feared object or situation
Describe the duration of symptoms in panic attacks
Symptoms come on rapidly and peak in intensity within 10 minutes
What is needed with respect to the duration of the symptoms in Depersonalization/Derealization Disorder in order to meet diagnostic criteria?
Symptoms must be persistent or recurrent
What is the Anxiety Sensitivity Index, and what is it used for?
The ASI measures the extent to which people respond fearfully to their bodily sensations. High scores are used to predict the onset of panic attacks and anxiety disorders
What is one way in which the DSM-5 differs from the DSM-4 with respect to OCD and trauma-related disorders?
The DSM-5 made OCD and trauma-related disorders their own category
Discuss why CBT involving exposure therapy for anxiety disorders works, in the context of the behavioral and cognitive perspectives
The behavioral view posits that this therapy works because newly learned associations help to extinguish the fear response (note that extinction is the result of newly learned associations, NOT forgetting). The cognitive view posits that exposure therapy works because it helps people correct their mistaken beliefs that they are unable to cope with the stimulus. in this view, exposure relieves symptoms by allowing people to realize that they can tolerate feared situations without a loss of control
One of the two etiological factors for social anxiety disorder is cognitive factors? How does the cognitive perspective view social anxiety disorder? (2 parts)
The cognitive perspective posits that, first, people with social anxiety disorders appear to have unrealistically harsh views of their social behaviors and overly negative beliefs about the consequences of their social behaviors. Second, they attend more to how they are doing in social situations and their own internal sensations more than other people do. Too much thinking about inner feelings can foster social awkwardness, and the resultant anxiety interferes with their ability to perform well in social setting, creating a vicious cycle
Discuss the etiology of Generalized Anxiety Disorder in the context of the Contrast Avoidance Model
The contrast avoidance model states that people with GAD find it highly aversive to experience shifts in emotions. To avoid shifts, they prefer a constant state of worry, which helps them feels as if they are preparing for the worst (e.g., a worrier confronted with a stressor has less room for a large shift in mood and psychophysiological arousal than does a non-worrier . Worry can help a person keep a more stable emotional, albeit, uncomfortable, state
Discuss the severity of the Dissociate Fugue Subtype of Dissociative amnesia and discuss what can occur in people with this subtype
The dissociative fugue subtype of dissociative amnesia is the most severe subtype, characterized by extensive memory loss. A person with the dissociative fugue subtype typically disappears from home or work. They may even assume a new identity, including a new name, job, and personality characteristics
How is fear related to anxiety disorders?
The fear system seems to "misfire" in some anxiety disorders
How is the physiological responses during a panic attack indicative of the fact that the fear system is misfiring?
The physiological response in panic attacks is similar to what most people experience when faced with an immediate threat (i.e. when experiencing fear)
What does the post-traumatic model of dissociative disorders identify as their cause? What are two pieces of evidence used to support this
The post-traumatic model proposes that some people are particularly likely to use dissociation to cope with trauma. This is based on two pieces of evidence: 1. Children who are abused are at risk for developing dissociative symptoms 2. Children who dissociate are more likely to develop psychological symptoms after trauma
When did the prevalence of dissociative disorders begin to significantly increase? What is this thought to be the result of, and what did it ultimately lead to?
The prevalence of dissociative disorders has increased significantly since the 1970s. This is largely thought to be the result of appearances/portrayals of DID in popular culture like books and movies. The increased prevalence of DID in the 1970s ultimately led to the DSM-III (1980) defining DID for the first time.
Describe the primary alters awareness of the others alters in Dissociative Identity Disorder
The primary alter may be unaware of the existence of the other alters. Additionally, the primary alter may have no memory of what other alters do
Discuss the availability of treatments and/or medication for Dissociative Identity Disorder
There are currently no well-validated treatments available for DID. Additionally, there are no randomized controlled trials that have assessed psychological treatment. Lastly, medications have not been shown to relieve DID symptoms
People who experience panic attacks when exposed to panic-inducing conditions in the laboratory seem to differ from those who do not develop panic attacks by only one characteristic. What is this?
They differ in the extent to which they are frightened by bodily changes (i.e., people who have panic attacks are more frightened by somatic changes)
What have psychodynamic and behavioral theorists identified as the cause of dissociation?
They view dissociation as an avoidance response that protects the person from consciously experiencing stressful events
Fear is said to be "immediate," whereas anxiety is said to be "anticipated". What does this mean?
This means that fear tends to be about a threat that is happening now, whereas anxiety tends to be about a future threat
The Sociocogntive model of Dissociative identity disorder (DID) suggests that DID could be iatrogenic. What does this mean and how does it occur?
This means that the formation of DID could be created within the treatment setting. This is thought to be accomplished by reinforcement of identified alters and suggestive techniques that might promote symptoms in vulnerable people
Review: What is the name for an OCD disorder associated with hair pulling?
Trichotillomania
What is trichotillomania and what must it include? What is it explicitly NOT triggered by?
Trichotillomania is an OCD-related hair-pulling disorder which MUST include repeated attempts to stop or decrease the behavior. it is NOT triggered necessarily by obsessions, but by anxiety or boredom
True or false: Antidepressants are preferred over benzodiazepines in treatment of anxiety disorders because they are less addictive and have a less severe symptom profile
True
True or false: Anxiety and fear are usually adaptive
True
True or false: As many as a quarter of people with panic disorder experience periods of unemployment longer than five years
True
True or false: DID is more severe and extensive than the other dissociative disorders
True
True or false: Depersonalization/Derealization disorder does NOT involve disturbance of memory
True
True or false: GAD is more strongly related to marital distress than any other anxiety disorder
True
True or false: Medications are generally not recommended as the first line of defense against anxiety disorders
True
True or false: Most people who experience depersonalization also experience derealization, and the course of symptoms is similar for both
True
True or false: The symptoms of dissociative amnesia are generally considered to be too extensive to be perceived as ordinary forgetfulness
True
True or false: Without treatment social anxiety disorder tends to be chronic
True
True or false: with respect to dissociative amnesia, behaviors unrelated to memory loss tend to be unremarkable
True
True or false: People with social anxiety disorders tend to pay more attention to internal cues (e.g. heart rate) than external cues (e.g., social cues). Explain within the context of an experiment
True. In one study researchers, gave participants a chance to view their own heart rate or to view a panel of threatening faces. People with social anxiety disorder attend more closely to their own heart rate than did people without social anxiety. Hence, rather than keeping an eye on potential external threats, people with this disorder tend to be busy monitoring their own anxiety levels
When does dissociative amnesia typically occur, how long does it last, and how long does it take to disappear?
Typically occurs after severe stress. May last several hours to several years. Dissociative Amnesia usually disappears as suddenly as it began, with complete recovery of memory and only a small chance of recurrence.
Discuss the presence or absence of sex differences in anxiety disorders
Women are twice as likely as men to have an anxiety disorder and experience greater functional impairment