Abnormal Psych Chapter 5- Obsessive-Compulsive and Stressor-Related Disorders

In a therapy session, Gail, who has a phobia of dogs, is asked to stand near a dog. This action reactivates her fear response. The therapist exposes her to dogs repeatedly while giving her support. Gail was never bit or harmed during these sessions. Eventually the fear response was reduced and she was less afraid of dogs. What specific technique is the therapist using?

"extinction of the fear response" in the application of reconsolidation therapy

One of the main differences between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) is

Children with DSED are more outgoing and more likely to talk to strangers than those with RAD. They may have little to no fear of interacting with people they don't know, to the point where they will venture away with them to somewhere new and unfamiliar.

Shania is suffering from PTSD following her experiences of losing a friend in combat while being deployed with the Air Force. Her therapist specializes in memory reconsolidation. What might her therapist do to help Shania reduce the anxiety she feels related to her experiences?

Her therapist might have her explain the experience in detail, then immediately work on techniques to reduce the emotional impact of the memory.

Doris is a shy, eccentric 60-year-old woman living alone following the death of her mother, with whom she had lived for her whole life. At her mother's funeral, her brother Todd and his wife Cynthia try to persuade her to sell the house, especially the possessions that Doris has collected and saved over the years. Most of the items are of no value, except for sentimental reasons they cannot understand. The clutter has become hazardous, as Doris herself can hardly move through the house. There isn't anywhere to sit anymore, but Doris can manage to get to her bed, where she spends most of her time. One day, fed up, Todd and Cynthia arrive with Doris's therapist, planning on decluttering her house, but when Cynthia tries to throw out a pencil, Doris angrily throws them out of her house. Which of the following disorders is Doris likely to have?

Hoarding disorder

Which example below best demonstrates how someone might exhibit symptoms of body dysmorphic disorder?

Kit is 53 years old and works as a nurse in a retirement home. She never married and has always felt that men were turned off because of the shape of her nose, which she considers to be unusually large and crooked. Despite being reassured by friends and family members that her nose looks normal and that she is fairly attractive, she is overly conscious of the shape of her nose and thinks it negatively affects her overall appearance.

For the past 12 years, Ryan has suffered from flashbacks in which he relives the horrors of his nine months of active duty while he was deployed in Iraq. While in Iraq, Ryan witnessed and experienced a number of traumatic incidents. He spoke about fellow soldiers who were killed and injured in service and talked about survivor's guilt. One of his most vivid memories involves a convoy that he witnessed being hit by improvised explosive devices. He has flashbacks that occur unexpectedly in the middle of the day, and Ryan is thrown back into the emotional reality of his war experiences. Ryan has found that alcohol provides the only escape that he needs when he feels distressed about the flashbacks. Ryan has developed which disorder?

PTSD

Audrey was a victim of molestation when she was 18 years old. Her medical evaluation revealed that she possesses two short versions of a gene that regulates the neurotransmitter serotonin. Audrey is at a significantly higher risk of developing

PTSD.

Rasheem is a 31-year-old man who was discharged from the army in 2015 after serving two tours of duty in Iraq. He has been experiencing significant difficulty sleeping and has nightmares. During his second tour, he experienced trauma he has never spoken with anyone about, but he talks about having intrusive memories of the traumatic events. He avoids anything that makes him think of his time in combat and he spends much of his time alone because seeing friends makes him feel irritable, and he doesn't want to snap at anyone. He is easily startled by noise and motion and is unnecessarily hypervigilant. His wife urges him to see a psychologist because he is "not the man that she married." The psychologist most likely diagnosed Rasheem with

PTSD.

Which of the following statements best describe the psychodynamic perspective in regards to OCD?

People with OCD have unconscious conflict that they are trying to cope with, and this conflict comes from a clash between the id (usually a sexual or aggressive urge) and the superego (the desire to do the right thing and follow socially acceptable behavior).

Buddy has been diagnosed with OCD and is always concerned about his lucky numbers. Whenever he looks at dates on a calendar or chooses a day to do a particular activity, he is excessively preoccupied with lucky and unlucky numbers. From the humanistic perspective, how would this behavior be explained?

Ron is attempting to work toward self-actualization, but finds himself stuck and unable to move forward.

Which of the following individuals is most likely to have hoarding disorder based on the description of symptoms alone?

Sheri is a 49-year-old woman who has suffered depression and anxiety. She lives alone and works in a hospital gift shop. She has problems getting organized and has a hard time throwing away business papers, newspapers, and magazines. Her apartment is filled with books, stationery, crafts, plastic packages, cardboard boxes, and all sorts of other things. She has little room to live. Ashamed by the state of her apartment, she has told no one about her behavior and never invites anyone into her apartment. This has gone on for 10 years.

Select the best response regarding the treatment of adjustment disorder.

There has been little systematic research regarding the best way to manage individuals with an adjustment disorder. However, AD sufferers with depressive or anxiety symptoms may benefit from treatments usually used for depressive or anxiety disorders.

In regards to PTSD, what is the cognitive theory approach?

Traumatic events disrupt a person's perspective on life and the world around them, which ultimately creates a negative viewpoint that has lasting damage, resulting in chronic stress symptoms seen in PTSD.

Elijah is a 25-year-old sales clerk in a sporting goods store who was psychologically healthy until two weeks ago when he survived a wildfire that destroyed his apartment building. He was treated and released within several hours from the emergency room. Since the fire, Elijah has been tormented by vivid images of waking to see his apartment filled with smoke. He described himself as having irritable behavior and angry outbursts (with little or no provocation) toward his friends. At other times, he felt as if he were in a daze, seemingly numb. Elijah continued to experience these symptoms for several weeks, after which they gradually subsided. His symptoms suggest that he might have been suffering from

acute stress disorder.

Lashon was violently attacked in a dark parking lot after work a week ago. Her assaulter took her purse and her car and left her for dead. She is constantly re-experiencing the event through images, dreams, thoughts, and flashbacks. She finds herself avoiding situations that might make her think about the trauma, but she is still so anxious that she cannot concentrate or sleep. Lashon is likely suffering from

acute stress disorder.

The anxiety disorder that is similar to PTSD, but describes a disorder that lasts between three days and one month of a traumatic event, is referred to as

acute stress disorder.

Farzad recently moved several states away from home to live on campus as a freshman. He grew up in a tight-knit family in a small, rural community where he had close friends and positive relationships. He'd chosen this university because it hadn't seemed overwhelmingly large but now that he's here, in a new living situation, surrounded by people he doesn't know, he feels overwhelmed anyway. Always a straight-A student, Farzad is halfway through the semester and having difficulty with his courses. He had a panic attack right before a midterm exam and was referred to counseling by his professor. At the counseling center, he talks to a therapist about feelings of sudden depression, anxiety, and the physical symptoms that he can't explain: chest pain, fatigue, and frequent headaches. His therapist explains he is likely experiencing

adjustment disorder.

When Aidymarie feels stressed, she often has an urge to pick, squeeze, or scratch at her face. When she engages in this behavior, she feels a sense of relief. A psychologist might assess whether or not Aidymarie has

excoriation disorder.

Tianna was a sixteen-year-old Hispanic female who was living in a shelter after being removed from her aunt's house by the child welfare agency. She was living in the shelter for three months. During her interview with a counselor, she reported feelings of worry and anxiety and stated she was very sad. She felt sad every day almost all day long, and her sadness got worse after going to the shelter. She also complained of poor concentration and feelings of hopelessness and she said; "I feel like I will be sad for the rest of my life." Tianna may be experiencing

adjustment disorder.

Aliya is overly conscious about a mole on her cheek that she has had since birth. She usually spends several hours during the day before the mirror re-applying make-up on the mole. Even though friends and family reassure her that the mole is barely visible, Aliya wants to have plastic surgery to remove it. Aliya's behavior is most likely to be associated with which of the following disorders?

body dysmorphic disorder.

Marc is 30 years old and thinks that the bald spot on his head makes him look old and unattractive. He is overly conscious of his appearance and spends a lot of time looking in the mirror to see if his bald spot is visible. He has also tried many treatments, such as topical creams and steroid injections, to get his hair to grow back. He has spent a lot of time and money on various remedies, but none have been successful. Now he avoids social gatherings. Marc displays signs of

body dysmorphic disorder.

PTSD learning models suggest that some symptoms are developed and maintained through

classical conditioning.

Isabella is a 5-year-old child who was placed with a foster family after years of abuse and neglect. She has adjusted to her foster family, but her foster parents notice that she tends to engage in overly familiar behavior with people she has never even met—like running toward a neighbor that she has never met and jumping into his/her arms. A psychologist might assess whether Isabella has

disinhibited social engagement disorder.

Which type of attachment is seen most often in kids who have been abused or severely neglected?

disorganized attachment

Sheila, a 26-year-old single female, who lives with her family, was admitted to an outpatient department of psychiatry. Sheila suffered from childhood sexual abuse when she was nine years old. The abuse lasted for four years. She presented complaints of excessive skin scratching of the fingers, forearms, and upper back for the last three years. However, in the past two years, the picking has been a daily routine, which was associated with emotional stress, followed by a feeling of relief after picking. She had been treated by her general practitioner and dermatologist for approximately two years, although none of the therapies provided a complete clinical result. Eventually, Sheila was diagnosed as having

excoriation (skin-picking) disorder.

Kenya locks the door ten times after coming inside because she fears an intrusion. She recently started working with a therapist to discuss this fear, evaluate and rank its severity, and practice imagining ways to tolerate the distress she feels when she doesn't check the locks. Eventually Kenya performed exercises where she kept the doors unlocked without going near the door and started learning strategies to cope with the distress. Which type of therapy is the therapist using with Kenya?

exposure and response prevention

Josyel is asked by his therapist to talk about his traumatic experience and as he does, he tries to keep up with her finger as it moves back and forth rapidly. The therapist explained to him that this process will help him reprocess his memories to lessen the fear he has surrounding the traumatic event. What type of therapy is being used here?

eye movement desensitization and reprocessing (EMDR)

The results of family and twin studies suggest that one of the main causes of obsessive-compulsive disorder is/are

genetics.

James is diagnosed with trichotillomania. His therapist, who prefers behavioral treatment, has asked him to start counting numbers from 100 in the reverse order whenever he feels an intense urge to pull out his hair. According to James's therapist, such a therapy would help him to get rid of the undesirable habit by learning a new response. Which of the following is being used in this instance?

habit reversal training

Which form of therapy has the highest rate of success in treating trichotillomania, and other body-focused repetitive behaviors, and involves learning a new response to compete with troublesome behaviors?

habit reversal training (HRT) answer

Kim, a nursing assistant who worked in a nursing home, worked long hours for little pay in a difficult facility. Her supervisor was domineering, unpleasant, and unsupportive; he was disrespectful of Kim's personal time, frequently informing her at the last minute she must work several additional hours after her shift ended or that she must report to work on weekends. Kim did not feel as though her hard work was appreciated, either by supervisory staff or by the residents of the home. She was very unhappy over her low pay, and she felt that many of the residents treated her disrespectfully. After several years, Kim dreaded going to work in the morning, and she gradually developed a callous, hostile attitude toward many of the residents. What Kim experienced is known as

job burnout.

Sam is a 54-year-old man whose wife died recently. Within the same year, he was diagnosed with chronic obstructive pulmonary disease. Six months following, he was dismissed from work as a construction worker because he could keep up with demands of the job. He had to sell his house and move to a different city. Sam became socially isolated and lost his appetite. If Sam were to take the Social Readjustment Rating Scale, the score might indicate that he is at risk for developing

mental health problems.

Excoriation disorder has a high rate of comorbidity with other psychiatric conditions, especially with

mood and anxiety disorders.

Maurice is a 15-year-old high-school student referred for treatment by his health teacher, who became worried by Mark's irrational concern about getting ill and vomiting. The teacher had discussed vomiting as an involuntary response to illness. From that class forward, Maurice would shun anyone who appeared to be sick at school. His friends wondered why he wasn't talking to them. He became so obsessed with getting ill that he also started carrying hand sanitizer everywhere he went and avoided the school restrooms. He would no longer touch food that he thought might be contaminated by germs. What is the probable diagnosis for Maurice?

obsessive-compulsive disorder

Seventeen-year-old Sheri often felt very depressed and hopeless. She had several oddities at home—rearranging cutlery and turning light switches on and off—and these oddities caused annoyance with family members. She had always tried to live up to every standard (academic, religious, familial) that was placed upon her. Before every exam, she lined up her pencils, erasers, and notebooks exactly the same way, each two fingers apart. She felt a strong urge to complete this task because if she didn't, she would fail her exam. At times, the thought of failing and believing that she is a failure and therefore incapable of success made her ill. Her mother took her to see a counselor. What could be Sheri's diagnosis?

obsessive-compulsive disorder

Kyle is always concerned about harming himself or other people. He feels as if he were going crazy because these thoughts are very intrusive. To be sure that he doesn't harm himself or anyone else, he feels compelled to hide or store away sharp objects such as knives and pizza cutters. His symptoms suggests that he might be suffering from a(n)

obsessive-compulsive disorder.

Whenever Tania eats at a restaurant, she thinks about the number of people who may have touched her silverware. When no one is looking, she puts the silverware into her pocket, goes to the ladies room, and washes the silverware in hot water several times, without ever feeling like they are clean. Tania might be suffering from

obsessive-compulsive disorder.

Tracy is being treated for depression and post-traumatic stress disorder (PTSD). Her therapist has asked her to recall a recent happy experience. Tracy answers, "When I was visiting my friends last weekend," but then she is unable to recall or describe any particular events or interactions during that visit that were enjoyable or rewarding. The memory distress that Tracy is showing is called

overgeneralized autobiographical memory (OGM).

A 5-year-old boy loses his beloved uncle suddenly to an accident. Six months later, he developed problems sleeping and bedwetting. He complained of stomach aches. He always felt nervous and watchful (on guard), as if something bad were going to happen to him or his family. He began to worry about dying at a young age. He lost interest in the things he used to enjoy, like playing with friends or video gaming. To his parents, he seemed to be more aggressive than before, even violent at times. This behavior was unusual for him. He refused categorically to ride in a car, and going out in public with family became an ordeal. These symptoms seem to suggest which of the following disorders?

post-traumatic stress disorder

Connie was a victim of domestic violence for 10 years. She decided to do exposure therapy when she started having flashbacks of the trauma she had experienced. Her husband had severely abused her and she had had several hospitalizations as a result of kicks to her abdomen, stab wounds, and burns. One day, two years after leaving the abusive relationship, she recalled "feeling the pain of her broken arm" that had already healed. Connie was being treated for which disorder?

post-traumatic stress disorder

Jizaya, a victim of rape, is being treated by her psychologist through a technique called eye movement desensitization reprocessing (EMDR), followed by virtually exposing her to her most feared and hated situation. These methods of psychological treatment are most effective for

post-traumatic stress disorders.

Jake is a 4-year-old adopted boy who at the age of two years and four months was brought by his adoptive mother to a child psychiatrist with symptoms of irritability, fearfulness, emotional dysregulation, and attachment issues. The child would rarely or minimally seek comfort when distressed, nor did he respond to comfort from the adoptive mother when distressed. Little is known about Jake's early history. There is suspicion that his mother was neglectful with feeding and frequently left him crying, unattended, or with strangers. He was taken away from his mother's care at seven months due to neglect and placed with his aunt, who after two months decided she was unable to take care of him. Given the abuse pattern of neglect and repeated changes of primary caregivers in Jake's early years, the psychiatrist diagnosed him with

reactive attachment disorder.

Which type of attachment is thought to be the result of a caregiver's inconsistent level of response to their child?

resistant attachment

In which type of attachment is the attachment figure used as a secure base to explore the environment and sought out in times of stress?

secure attachment

There are four types of attachment styles, according to attachment theory. These are

secure attachment, avoidant attachment, resistant attachment, and disorganized attachment.

Which of the following elevates the risk for developing PTSD?

severity of the trauma

Which psychological perspective best matches with the following statement? The meanings linked to PTSD show cultural variations: in individualistic cultures, appraisals about a vulnerable or inadequate self are common; in collectivistic cultures, appraisals about social functioning or evaluation by others are common.

sociocultural perspective

Some stressors involve traumatic events or situations in which a person is exposed to actual or threatened death or serious injury. Stressors in this category include which of the following?

terrorist attacks

For PTSD, and other stress-related disorders, researchers have found that both genetics and environment play important roles in one's risk for developing PTSD due to trauma. But, genes may not be the only thing affecting the risk factor for PTSD. Recent studies have shown

that smaller hippocampal volume has been correlated with PTSD.

The cognitive model of OCD, as proposed by Paul Salkovskis, proposes that everyone will experience intrusive thoughts from time to time, but those with OCD falsely assume that

thinking about an action is the same as doing it.

Jesse is diagnosed with obsessive-compulsive disorder. He acknowledges that he pulls his hair when he feels anxiety. He sees his broken hairs when he looks in the mirror. His psychologist, who prefers habit reversal therapy, has asked him to start counting numbers from 100 in the reverse order whenever he felt an intense urge to act on the impulse to pull out his hair. Which of the following comorbid disorders is being treated in this instance?

trichotillomania

Madison is a nine-year-old girl who often pulls out her own hair one hair at a time, and these hair-pulling episodes can last for hours at a time. She is unable to stop pulling out her hair, despite the development of several bald patches on her head. Which of the following impulse-control disorders is Madison most likely to have?

trichotillomania

Kadir is being treated for PTSD. He begins therapy by making a script of his traumatic memories, and then undergoes six sessions of viewing a computerized combat or war scene on a visor screen. The computerized scenes closely resemble the real combat environment that he experienced during deployment. During the sessions, he is able to converse with the therapist while actively re-experiencing his memories. What type of therapy is being used here?

virtual reality therapy (VRT)