Psych 405 Exam 2: Lectures 7-9

List all DSM-5 criteria for PTSD. Include examples where appropriate

-Exposure to trauma -Symptoms in the following four categories: 1. Intrusion (e.g., recurrent and intrusive memories, dreams, flashback, etc.) 2. Avoidance: Internal and external reminders 3. Negative alterations in cognitions and mood (e.g., persistent negative beliefs and negative emotional states) 4. Arousal and reactivity (e.g., aggressiveness, hypervigilance, exaggerated startle response)

Describe two concerns regarding the diagnosis of acute stress disorder. Provide examples

1. ASD diagnosis could stigmatize very common short-term reactions to serious traumas. For example, more than 90% of women report significant symptoms one month after a rape 2. ASD is not very predictive of who develops PTSD. For example, less than half of people with ASD develop PTSD within two years

List three reasons to consider OCD, BDD, and hoarding disorder as related conditions

1. All share symptoms of uncontrollable and repetitive thoughts and behavior 2. the syndromes often co-occur 3. the genetic vulnerability for these conditions overlaps

In somatic symptom related disorders, what are three factors that may increase the presence/intensity of somatic symptoms?

1. Anxiety 2. Depression 3. Stress hormones

With respect to cognitive behavioral factors influencing the etiology of somatic symptom related disorders, name and describe two behavioral consequences of fear of an impending illness

1. Assuming the sick role, which intensifies poor health 2. Safety behaviors (e.g., help-seeking), which maintain focus on potential health concerns and prevents extinction of the fear)

What are the four DSM-5 criteria for somatic symptom disorder (one of these has three sub-components)?

1. At least one somatic symptom that is distressing or disrupts daily life 2. Duration of at least six months 3. Specify if predominant pain (vs. numbness, soreness, etc.; the purpose of this is to rule out nerve damage and prevent people seeking pain meds) 4. Excessive thought, distress ,and behaviors related to somatic symptom(s) or health concerns, as indicated by at least one of the following: -Health-related anxiety -Disproportionate and persistent concerns about the seriousness of symptoms -Excessive time and energy devoted to health concerns

In the context of the etiology of somatic symptom related disorders, what are two important cognitive variables that are important once a somatic system develops? Name and describe each

1. Attention to bodily sensations: automatic focus on physical health cues 2. Interpretation of those sensations: Overreact with overly negative interpretations

Name 4 treatment options to reduce pain in somatic symptom and related disorders

1. CBT 2. Hypnosis 3. Acceptance and community therapy 4. Low-dose antidepressants

What are five commonalities between the etiology of PTSD and other anxiety disorders?

1. Childhood exposure to trauma increases risk 2. Greater reactivity to signals of threat 3. Mowrer's two-factor model of condition can be applied to both PTSD and anxiety disorders 4. Overlap in genetic risk for PTSD and other anxiety disorders 5. Greater amygdala activation in PTSD and anxiety disorders

What are two criticisms of diagnostic criteria for somatic symptom and related disorders?

1. Conditions are remarkably varied 2. Patients often find these diagnoses stigmatizing (they don't want a mental health diagnosis for what they perceive to be a medical problem)

Name several (at least 6) of the most common obsessions among people with OCD

1. Contamination 2. Responsibility for harm 3. Sex and morality 4. Violence 5. Religion 6. Symmetry/order

The etiology of somatic symptom related disorder has focus largely on neurobiological and cognitive behavioral models to explain these disorders. What two things do both of these models emphasize about somatic symptom related disorders?

1. Excessive attention to somatic symptoms 2. Disproportionate anxiety about one's health

What are two reasons that Exposure and Response Prevention (ERP) works for people with OCD?

1. Exposes the person to the full force of the anxiety provoked by the stimulus 2. Not performing the ritual promotes the extinction of the conditioned response (the anxiety)

What are the four DSM-5 criteria for fictitious disorder?

1. Fabrication or induction of physical or psychological symptoms, injury, or disease 2. Deceptive behavior is present in the absence of obvious external rewards 3. In factitious disorder imposed on the self, the person presents to others as ill, impaired, or injured 4. In factitious disorder imposed on another, the person fabricates or induces symptoms in another person and then presents that person to others as ill, impaired, or injured

What are three key features of Factitious Disorder?

1. Factitious disorder is when people intentionally produce symptoms to assume the role of a patient 2. People may injure themselves, take damaging medications, or injection themselves with toxins 3. Factitious disorder can be imposed on someone else (i.e., making someone else sick in order to fulfill the role of care taker)

List the 4 major risk factors that contribute specifically to PTSD (as opposed to increasing general risk for anxiety disorders)

1. Greater activation of the hippocampus when completing a wide range of tasks 2. Avoidant coping strategies that prevent processing the trauma, such as dissociation 3. Low cognitive function 4. Poor social support

Name seven cognitive and behavioral strategies that can be implemented to help people with somatic symptom related disorders

1. Learning to identify and change triggering emotions 2. Changing cognitions about symptoms 3. Changing behaviors to improve social interactions 4. Training people to pay less attention to their body 5. Helping people resume healthy activities and rebuilding their lives 6. Involving family members to reduce attention given to somatic symptoms 7. Mindfulness

What are two major obstacles that people with somatic symptom disorder face when seeking care for their conditions? What can help these people be more willing to seek mental health treatment?

1. Most people with somatic-symptom disorders want medical care, not mental health care 2. Referring to mental health care may be viewed as invalidating their symptoms (so as to minimize the use of expensive diagnostic tests and medical interventions) A reminder of the mind-body connection can enhance their willingness to consider psychological treatment

What are the three obsessive-compulsive and related disorders you should know for this exam?

1. Obsessive-compulsive disorder (OCD) 2. Body Dysmorphic disorder (BDD) 3. Hoarding Disorder

What are the three DSM-5 criteria for Conversion Disorder?

1. One or more symptoms affecting voluntary motor or sensory function 2. The symptoms are incompatible with recognized medical disorders 3. Symptoms cause significant distress or functional impairment or warrant medical evaluation

Conversion disorder is characterized by the sudden development of neurological symptoms that are not readily explained by medical disease models. Name (and describe where appropriate) five examples of these sorts of symptoms

1. Partial or complete paralysis of arms or legs 2. Seizures or coordination problems 3. Vision impairment or tunnel vision 4. Anesthesia: Insensitivity to pain 5. Aphonia: Whispered speech

Conversion disorder is more common among people from what two demographics?

1. People from rural areas 2. People of low SES

What are the four DSM-5 criteria for hoarding disorder?

1. Persistent difficulty discarding or parting with possessions, regardless of their actual value 2. Perceived need to save items 3. Distress associated with discarding items 4. The accumulation of a large number of possessions clutters active living spaces to the extent that their intended use is compromised unless others intervene

What are three factors contributing to the etiology of hoarding disorder according to the cognitive behavioral model? Provide examples where appropriate

1. Poor cognitive organizational abilities (e.g., difficulty with attention, categorization, and decision making) 2. Unusual beliefs about possessions (e.g., ability to see potential in each object and extreme emotional attachment to objects) 3. Avoidance behaviors: Many with this disorder find organizing their clutter so overwhelming that they delay tackling the chaos. The avoidance maintains the clutter

What are the five DSM-5 criteria for Illness Anxiety Disorder?

1. Preoccupation with and high level of anxiety about having or acquiring a serious disease 2. Excessive illness behaviors (e.g., checking for signs of illness, seeking reassurance) or maladaptive avoidance (e.g., avoiding medical care) 3. No more than mild somatic symptoms are present 4. Not explained by other psychological disorders 5. Preoccupation lasts at least six months

What four DSM-5 criteria for Body Dysmorphic Disorder (BBD)?

1. Preoccupation with one or more perceived defects in appearance 2. Others find the perceived defect(s) as slight or unobservable 3. The person has performed repetitive behaviors or mental acts (e.g., mirror checking, seeking reassurance, or excessive grooming) in response to the appearance concerns 4. Preoccupation is not restricted to concerns about weight or body fat

What are the five major cognitive distortions?

1. Probability overestimation (e.g., all planes crash 100% of the time) 2. Catastrophizing 3. Black or white thinking 4. Intolerance of uncertainty 5. Need for control

In detail, name and describe four unique factors in the etiology of PTSD

1. Severity and type of trauma: For example, more likely to develop PTSD when directly witnessing violence vs. indirect exposure; and trauma caused by humans (more likely to causes PTSD) vs. natural disasters 2. Neurobiological role of the hippocampus: Hippocampus plays a central role in autobiographical memories. The hippocampus shows much greater activation in people with PTSD 3. Presence of Dissociation: a form of avoidance, keeping a person from confronting memories. People who use dissociation to cope are more prone to developing PTSD after a trauma. 4. Protective factors: cognitive abilities (e.g., ability to think rationally) and social support deter the development of PTSD

What three somatic symptom related disorders are included in the DSM-5?

1. Somatic symptom disorder 2. Illness anxiety disorder 3. Conversion disorder

All somatic symptom and related disorders involve excessive concerns about physical symptoms or health, as is characterized by what four components?

1. Tendency to seek frequent medical treatment 2. Often see several physicians for a given health concern 3. May try many different medications 4. Hospitalization and (unnecessary) surgery are common experiences

What are three key features of Hoarding Disorder?

1. The need to acquire possessions is excessive 2. People with this disorder are extremely attached to their possessions 3. People with this disorder are very resistant to efforts to get rid of their possessions

What is deep brain stimulation used to treat and what does it entail? Does it work?

10% of people with OCD do not respond to multiple pharmacological treatments. Deep brain stimulation is indicated for these people. Involves implanting electrodes into the brain. Half of people who endure this therapy attain significant relief within a couple of months

What is imaginal exposure?

A form of exposure treatment for PTSD in which the person deliberately remembers the event

Define malingering, and describe why people may do this THIS IS ALL YOU NEED TO KNOW FOR MALINGERING

A person intentionally fakes a symptom to avoid a responsibility (e.g., work, military duty, criminal sentence). Can be viewed as a help seeking behavior (i.e., people may exaggerate the severity of their condition out of fear that they aren't being taken seriously)

Discuss the symptom, including duration, of acute stress disorder

Acute stress disorder presents with symptoms similar to PTSD, although the duration of symptoms is shorter.Specifically, symptoms are generally present for 3 days to 1 month after the trauma. If symptoms of Acute stress disorder last longer than a month, you would now qualify for PTSD

What class of medication is most recommended for the treatment of obsessive-compulsive and related disorders?

Antidepressants (more specifically, SSRIs)

What classes of medications are most often prescribed for OCD-and related disorders?

Antidepressants are the most common, specifically SSRIs

What is the most common comorbid disorder among people with PTSD?

Anxiety disorders (over two thirds of PTSD sufferers)

How long must the symptoms of somatic symptom disorder persist to meet diagnostic criteria?

At least 6 months

What is the major difference between somatic symptom disorder and illness anxiety disorder?

At least one somatic symptom is present in somatic symptom disorder, but no significant somatic symptoms are present in illness anxiety disorder

What is body dysmorphic disorder (BDD), and how do people with BDD perceive themselves? Are there differences in perception between men and women?

BDD is characterized by a preoccupation with one or more imagined or exaggerated defect in appearance. People with BDD perceive themselves to be ugly or "monstrous". Women tend to focus more on skin, hips, breasts, and legs, whereas men tend to focus on height, penis, size, body hair, and muscularity

How does Exposure and Response Prevention therapy (ERP) work for hoarding disorder?

Begin with exposure to situations that elicit obsessions (e.g., getting rid of possessions). Next, they are prevented from engaging in compulsive behaviors (e.g., counting or sorting possessions). ERP for hoarding disorder also involves the use of motivational strategies to facilitate insight into problems caused by symptoms, and provides tools and strategies to help organize and remove clutter (e.g., in-home visits for in vivo de-cluttering exercises)

A strictly behavioral therapist treating Steve for contamination fear due to OCD would use which of the following interventions: A: Have Steve meditate daily B: Have Steve challenge the idea that it is necessary to be clean C: Have Steve Purposely get dirty D: Have Steve say "stop" to himself quietly when he feels he must wash

C

Describe the most typical course of obsessive-compulsive and related disorders over time

Chronic course

What is the main focus of cognitive therapy for OCD and related disorders? How do treatment outcomes compare to ERP

Cognitive therapy is designed to challenge beliefs about anticipated consequences of not engaging in compulsions (usually also involves exposure); treatment outcomes are comparable to ERP

What is the DSM-5 criteria/definition of compulsions (3 parts)?

Compulsions are defined by: 1. Repetitive behaviors or thought that the person feels compelled to perform to prevent distress or a dreaded event 2. The person feels driven to perform the repetitive behaviors or thoughts in response to obsessions or according to rigid rules 3. The acts are excessive or unlikely to prevent the dreaded situation

Define compulsions, including what they may involve

Compulsions are repetitive, clearly excessive behaviors or mental acts to reduce anxiety. It is extremely difficult to resist the impulse to perform these behaviors, and people with OCD may carry out elaborate behavioral rituals to reduce anxiety

Determine the disorder present in the following case study: Thomas's ophthalmologist referred him for psychological treatment. Thomas reported that 2 weeks before, he had sudden developed tunnel vision. Medical tests failed to reveal any reason for his tunnel vision, and there was no sign he was faking symptoms

Conversion disorder

How is dissociative coping implicated in PTSD? Discuss this specifier in the DSM-5

Dissociation may allow the person to avoid confronting memories of the trauma. People who show symptoms of dissociation are much more likely to develop PTSD following a trauma than those who do not dissociate. The DSM-5 now includes a dissociative symptom specifier to denote when persistent or recurrent symptoms of dissociation are present for those with PTSD. About 15% of people meet the criteria for this specifier

How does Exposure and Response Prevention therapy (ERP) work for BDD? Are symptoms alleviated by this therapy? Explain

ERP for BDD involves exposure to situations that elicit obsessions (e.g., interacting with people who are critical of their looks). They are then prevented from engaging in compulsive behaviors (e.g., avoiding activities used to reassure themselves about their appearance). Many people continue to experience at least mild symptoms after treatment

One of the treatment methods for OCD is exposure and response prevention (ERP). What does this therapy involve and how does it work?

ERP is a therapy in which a person with OCD is exposed to situations that elicit their obsessions (exposes person to full force of anxiety). The exposure hierarchy begins with tackling less threatening stimuli and progresses to more threatening stimuli. This therapy also involves prevention from engaging in compulsive behavior, which promotes extinction of the conditioned response

True or false: If shape and weight concerns are the only focuses of concern, the symptoms are better explained by an _______ _________ than BDD

Eating disorder

True or false: Conversion disorder is highly heritable

False

True or false: Acute Stress Disorder is a good predictor of who develops PTSD. Explain

False: ASD in not very predictive of who develops PTSD. In fact, less than half of people with acute stress disorder develop PTSD within 2 years

True or false: CBT is less efficacious in reducing health concerns, depression, and anxiety than standard medical care or psychodynamic treatment of somatic symptom-related disorders

False: CBT is MORE efficacious in reducing health concerns, depression, and anxiety than standard medical care or psychodynamic treatment of somatic symptom-related disorders

True or false: People with Body dysmorphic disorder (BDD) do not find it difficult to stop thinking about their concerns. Explain

False: People with BDD spend, on average, 3-8 hours per day thinking about their concerns related to their appearance

True or false: Treatment of PTSD with antidepressants is more effective than psychological treatments

False: Psychological treatments are more powerful than antidepressants

True or false: PTSD can only result when a trauma happens to the person who develops PTSD. Explain

False: The PTSD can result from a trauma that is directly experienced, one that is witnessed, or hearing about the trauma from someone who has experienced it (e.g., a loved one). Note however, that watching traumatic events on TV or the internet will not qualify you for a PTSD diagnosis until watching this material is part of your job description (e.g., a detective who has to watch a video of rape)

In one sentence, describe fictitious disorder

Fictitious disorder describes falsification of psychological or physical symptoms, without evidence of gains from those symptoms

Discuss the effectiveness of ERP for hoarding disorder

Finds of randomized controlled trials provide support for individual and group versions of ERP for hoarding disorder. However, about 2/3 of patients continue to exhibit at least some hoarding symptoms after treatment (hoarding disorder is incredibly difficult to treat)

Name one goal and an example of cognitive therapy for PTSD

Goal is to reduce overly negative interpretations about trauma and its means. An example is cognitive processing therapy.

Name and describe the neurobiological factors in the etiology of somatic symptom-related disorders. In your answer, name three factors that can increase the experience of pain and somatic symptoms

Heightened activity in specific regions of the brain is related to greater propensity for somatic symptoms and more intense pain rating in response to standardized stimulus. You should also be aware of the fact that pain and somatic symptoms can be increased by anxiety, depression, and stress hormones. This is important because people with somatic symptom-related disorders show elevated rates of trauma, anxiety, and depression YOU DO NOT NEED TO KNOW THE NAMES OF THESE REGIONS

How is the hippocampus implicated in PTSD?

Hippocampus plays a central role in autobiographical memories. People with PTSD show greater activation in the hippocampus during cognitive tasks than do those without PTSD. Changes in the function of the hippocampus might increase the risk that a person with PTSD will experience fear when reminded of the trauma, even in a safe context

Determine the disorder present in the following case study: Paula, a 24 year old librarian, sough psychological help on the advice of her sister because of her deeps fears about her health. In daily phone calls with her sister, she would describe worries that she had cancer or a brain tumor. She had no somatic symptoms or signs of disease, but every time she saw an Internet report, a TV program, or a newspaper article on some new serious condition, she became worried she might have it. She had seen doctors frequently for years, but when identified with no disease, she became annoyed with them, criticized the intensity of the medical tests, and sought a new consultant

Illness Anxiety Disorder

Discuss the distress related to somatic symptom disorder, and whether the symptoms are actually present (and if they can be medically explained)

In Somatic Symptom Disorder, distress revolves around a somatic symptom that actually exists. That being said, it can be diagnosed regardless of whether or not the symptoms can be explained medically

What is the difference between malingering and factitious disorder?

In malingering, a person intentionally fakes a symptom to avoid a responsibility, such as work or military duty, or to achieve some reward, such as an insurance settlement. This contrasts with factitious disorder, where the sole goal is to adopt the patient/sick role

What are the key features of hoarding disorder?

Key features include acquisition of an excessive number of objects coupled with an inability to part with those objects

What are the key features of Body Dysmorphic Disorder (BDD)?

Key features of BDD include preoccupation with imagined flaws in one's appearance, as well as excessive repetitive behaviors or acts regarding appearance (e.g., checking appearance, seeking reassurance)

In one sentence, describe malingering

Malingering refers to intentionally faking psychological or somatic symptoms to gain from those symptoms

When SSRIs are used to treat OCD-and related disorders, how does the dosage and symptom alleviation compare to people taking SSRIs for depression

May require more time (up to 12 weeks) and higher doses compared to treating depression. Most people with OCD continue to experience mild symptoms when taking an SSRI

What is one common form of trauma for men and women that precedes PTSD?

Men: military trauma Women: rape

Discuss the effectiveness of Exposure and Response Prevention for BDD

Multiple trials have shown that ERP produces a major decrease in BDD symptoms compared with control conditions, and that effects are maintained in the months after treatment ends. However, many people continue to experience at least mild symptoms after treatment

How is PTSD different from all other major diagnoses in the DSM-5?

No other major diagnoses, except for PTSD, place evidence squarely on the cause of the symptoms (e.g., the trauma)

Are behaviors like compulsive gambling and eating considered to be compulsions with regard to OCD? Why or why not?

No, these are not considered compulsions because they are often pleasurable. Conversely, compulsions are motivated by the feeling that something dire will happen if the act is not performed

Define obsessions, including how they are experienced

Obsessions are intrusive and persistent thoughts, images, or impulses that are uncontrollable, and are often experienced as irrational

When is the typical onset of conversion disorder? Describe the speed of onset

Onset of conversion disorder is typically in adolescence or early adulthood. Onset is usually rapid, with symptoms developing in less than one day

Discuss sex differences in PTSD and how this relates to sex differences in other anxiety. What is this thought to be related to?

PTSD is 1.5 to 2 times more likely to occur in women. This is consistent with the gender ratio in other anxiety disorders and may be related to different life circumstances of women

What is PTSD and what are four associated symptoms?

PTSD is an extreme response to a severe stressor (a trauma). It involves: 1. Recurrent memories of trauma 2. Avoidance of stimuli associated with trauma 3. Negative emotions and thoughts (including depressive symptoms and guilt) 4. Increased arousal (hyperarousal)

What is complex PTSD?

PTSD that results not from a single specific trauma, but from prolonged exposure to multiple traumatic events during childhood, including invasive and interpersonal traumas (e.g., growing up in an abusive household). This can cause children to form unhealthy trust-mistrust relationships with caregivers. There is a wide range of long term effects including dissociation. Note that complex PTSD is not listed as a specifier in the DSM, as research indicates that, while prolonged trauma can lead to more severe PTSD symptoms, it does not result in a distinct subtype with unique symptomatology

With respect to the etiology of BDD, how do people with this disorder differ from healthy people in their attention to detail?

People with BDD are usually detail oriented, which influences how they look at features. Instead of look at the whole, they examine one feature at a time

How do people with BDD view attractiveness with respect to other qualities of the self?

People with BDD consider attractiveness to be more important than other factors, and believe that self-worth is exclusively dependent on appearance

What sort of behaviors do people with Body Dysmorphic Disorder (BDD) feel compelled to perform? Provide an example

People with BDD feel compelled to engage in certain behaviors to reduce distress over their appearance. For example, frequently checking appearance in the mirror

One component of the cognitive model of obsessions that focuses on thought suppression is thought-action fusion. What is this, and how does it relate to thought suppression and the etiology of OCD?

People with OCD tend to believe that (1) thinking about something is as morally wrong as engaging in the action, or (2) thinking about an event can make it more likely to occur. These types of beliefs have been labeled as thought-action fusion. Because those with OCD tend to have these dysfunctional beliefs about their obsessions, the initial though is intrusive and distressing. Thus, to rid themselves of these uncomfortable thoughts, people with OCD engage in thought suppression, which lead to the paradoxical effect of actually thinking about the unwanted thought even more (e.g., don't think about white bears experiment)

Describe the types of dissociation that are most relevant to PTSD

People with PTSD often report feeling removed from one's body or emotions or being unable to remember the traumatic event, either at the time of the trauma or after the trauma

Discuss the association between PTSD and rates of medical illness. Discuss prolonged exposure in your answer. What is this phenomenon called, and what is believed to cause it?

People with PTSD tend to have high rates of medical illness. Prolonged exposure to trauma may lead to a broader range of somatic symptoms including stomach pains, headaches, etc. This is referred to as complex PTSD

Discuss the effectiveness of Exposure and Response Prevention for OCD compared to antidepressants, as well as control conditions such as anxiety management and relaxation treatment

Research has shown that ERP is more powerful than control conditions such as anxiety management and relaxation training, and as powerful as antidepressants in the treatment of OCD

Why are SSRIs recommended as the first line treatment for OCD-and related disorders?

SSRIs are recommended as a first line treatment due to less severe side effect profile over other antidepressants like SNRIs or tricyclics or MAOIs

Describe a general timeline of prolonged exposure therapy for PTSD

Session 1: Psychoeducation Session 2: Create fear hierarchy Session 3+: Assign in vivo homework of tape and behavioral exposures (begins with imaginal exposure recording which takes about 1 hour of the session. Clinicians point out discrepancies, utilize socratic questioning, and assigning more homework. Anxiety ratings are assigned throughout the reliving of the trauma, and the clinicians works to locate hot spots that are particularly triggering

Determine the disorder present in the following case study: John's surgeon referred him for psychological treatment because he seemed excessively nervous about his health In the past five years, John, now 35 years old, had sought a stunning array of medical treatments and tests for stomach distress, itching, frequent urination, and any number of other complaints. He had received 10 MRIs and too many X-rays to count, and he had seen 15 different specialists. Each test had been negative. He genuinely seemed to experience physical symptoms, and there was no indication that he stood to gain from a medical diagnosis

Somatic Symptom Disorder

With respect to somatic symptom related disorders, why are safety behaviors believe to be counterproductive for people with health anxiety?

Some may come to believe that they have warded off serious health problems only because they engaged in safety behaviors. Safety behaviors also prevent focused exposure to the initial somatic symptom and, as such, prevent the person from extinguishing their fear of that symptom. At the same time, safety behaviors may keep the person focused on potential health problems

How do the symptoms of Body Dysmorphic Disorder vary by culture?

Symptoms and outcomes of BDD tend to be similar across cultures, although the body part of focus may differ by culture

Discuss the timeline of symptom onset and duration for PTSD.

Symptoms may develop soon after the trauma. However, symptoms some do not develop for years. Symptoms can be chronic

Somatic Symptom and Related Disorders tend to co-occur with what three classes of psychological disorders?

Tend to co-occur with: 1. Anxiety Disorders 2. Mood disorders 3. Personality Disorders

What is the DSM-5 criteria/definition of obsessions?

The DSM-5 states that obsessions are defined by recurrent, intrusive, persistent unwanted thought, urges, or images. Additionally, the person must have tried to ignore, suppress, or neutralize the thought, urges, or images

In detail, discuss the goals and practice of exposure treatment for PTSD

The goal of exposure treatment is to extinguish the fear response and challenge the belief that the person with PTSD cannot cope. Exposure treatment can be direct (in vivo), imaginal, or in virtual reality. It involves creating an exposure hierarchy focusing on memories and reminders of the trauma. Typically involves 8-15 90-minute sessions

What are the key features of obsessive-compulsive disorder (OCD)?

The key features of OCD include repetitive, intrusive, uncontrollable thoughts or urges (obsessions), as well as repetitive behaviors or mental acts that a person feels compelled to perform (compulsions)

What medications are used to treat PTSD? Discuss relapse in your answer

The most commonly used medications to treat PTSD are SSRIs and SNRIs. Relapse is common if medication use is stopped

Discuss the etiology of conversion disorder from a neuroscience perspective. Provide an example

The neuroscience perspective on somatic symptom related disorders asserts that much of out perceptual processing may operate outside of out conscious awareness, which is why somatic symptoms appear. Take, for example, the case of unexplained blindness. The vision system relies on a set of brain regions. If these regions are not coordinated in an overarching conscious fashion, the brain may process some visual input such that the person can do well on certain visual tests, yet still lacks a conscious sense of "seeing" certain types of stimuli.

Discuss the etiology of conversion disorder from a psychodynamic perspective

The psychodynamic perspective on somatic symptom related disorders asserts that physical symptoms are a response to an unconscious psychological conflict

What does the DSM-5 specify about duration of symptoms for PTSD

The symptoms began or worsened after the trauma(s) and continued for at least one month

In conversion disorder, the symptoms suggest an illness related to what? What is an important caveat of this?

The symptoms of conversion disorder suggest an illness related to neurological damage. However, medical tests on people with conversion disorder indicate that the bodily organs and nervous system are fine

Discuss the etiology (specifically heritability) of somatic symptom related disorders

These disorders do not appear to be heritable. In fact, little is known about the etiology of the DSM-5 somatic symptom related disorder

What appears to be the motivation of parents with Factitious Disorder Imposed on Another

These parents will often try to make their children sick because they feel the need to be regarded as an excellent parent who is tireless in attending to their child's needs

Describes the lengths that people with factitious disorder will go to make themselves ill

They may injure themselves, take damaging medications, or inject themselves with toxins

In detail, discuss cognitive processing therapy for PTSD

This is a CBT-focused therapy. The therapy is based on the assumption that we grow up with schemas about how the world should work (i.e., good things should happen to good people), and that trauma distorts these schemas. Part of CTP is writing an impact statement about how the trauma changed who you are in your sense of power and control, trust, esteem, intimacy, safety, etc. The goal is to identify "stuck points" through a log of cognitive distortions. Worksheets are then made to challenge these maladaptive thoughts (e.g., are you focusing on non-important details, and are you including all relevant information)

One cognitive model of obsessions focuses on thought suppression. What is the main assertion of this model?

This model suggests that people with OCD may try harder to suppress obsessions than other people do and, in the process, make the situation worse (paradoxical effect)

How does BDD impact social functioning?

To cope with the intense shame they feel about their appearance, people with BDD may avoid contact with others. This can interfere greatly with the ability to work or even leave the house

True or false: Exposure is the primary psychological treatment for PTSD

True

True or false: In studies that control for history of sexual abuse and assault, men and women have comparable rates of PTSD

True

True or false: Most people with OCD experience both obsessions and compulsions

True

True or false: Once present, OCD, BDD, and hoarding disorder tend to be chronic

True

True or false: People who cope with a trauma by trying to avoid thinking about it are more likely than others to develop PTSD

True

True or false: Somatic symptom disorder can be diagnosed regardless of whether symptoms can be explained medically

True

True or false: While some people with BDD spend several hours a day checking their appearance, others try to avoid reminders of their perceived flaws by avoiding mirrors, reflective surfaces, or bright lights

True

True: Some (but not all) people with conversion disorder seem to be motivated to appear ill

True

True or false: Exposure treatment is by far the most effective psychological treatment for PTSD

True, it even appears more effective than cognitive restructuring in preventing the development of PTSD

True or false: Many people with conversion disorder show no signs that they are amplifying their symptoms

True. Additionally, when people do amplify their symptoms, this may be outside their conscious awareness

True or false: Short-term treatment of ASD may prevent PTSD

True: Benefits can last for years after the traumatic event

True or false: With respect to somatic symptom related disorder, a growing body of experimental research shows how negative thoughts might even trigger the onset of some somatic symptoms. Why is this important?

True: These findings are important because they illustrate that worrying about possible symptoms can make them more likely to occur, and the effect of those worries may be particularly strong for those who are already anxious

What diagnosis may be more appropriate than Somatic Symptom Disorder when psychological factors are the sole cause of symptoms?

When psychological factors are the cause of symptoms, an alternative DSM diagnosis like "Psychological Factors Affecting Other Medical Conditions" may be appropriately considered

Diagnosis for Obsessive-Compulsive Disorders are based on the presence of ______________ or ___________

obsessions; compulsions