Abnormal Psychology Exam 2

_______ _______- firing that if they throw something away, they might urgently need it- throwing away items causes distress -three types: animal hoarding, compulsive shopping, object hoarding -results in psychological issues, health issues, and environmental issues -19 million impacted -Symptoms- depression/anxiety, excessive items w/ limited space to store them, hard parting w/ possessions, feel upset someone suggests throwing stuff out -Causes- unknown, risk - family having it, brain injury triggers need to save things, traumatic event -Treatment- CBT, counseling/support groups, medications (for depression/anxiety) -Challenges- hurt intrapersonal relationships, health/fire hazards, family conflict, hard to perform daily tasks

Hoarding Disorder

Concept Check: Diagnose the somatic symptom and related disorders described here by choosing one of the following: (a) illness anxiety disorder, (b) somatic symptom disorder, (c) conversion disorder 1. Emily constantly worries about her health. She has been to numerous doctors for her concerns about cancer and other serious diseases--even though she doesn't report current notable physical symptoms--only to be reassured of her well-being. Emily's anxiousness is exacerbated by each small ailment (for example, mild headaches or stomach pains) that she considers to be indications of a major illness. 2. D. J. arrived at Dr. Blake's office with a folder crammed full of medical records, symptom documentation, and lists of prescribed treatments and drugs. Several doctors are monitoring him for his complaints, ranging from marked chest pain to difficulty swallowing. D. J. recently lost his job for using too many sick days. 3. Sixteen-year-old Chad suddenly lost the use of his arms with no medical cause. The complete paralysis slowly improved to the point that he could slightly raise them. However, Chad cannot drive, pick up objects, or perform most tasks necessary for day-to- day life.

a, b, c

Social Anxiety Disorder (Social Phobia): -Social anxiety disorder is a fear of being around others, particularly in situations that call for some kind of "performance" in front of other people. -Although the causes of social anxiety disorder are similar to those of specific phobias, treatment has a different focus that includes rehearsing or role-playing socially phobic situations. In addition, drug treatments have been elective. PTSD: -Focuses on avoiding thoughts or images of past traumatic experiences -The precipitating cause of PTSD is obvious--a traumatic experience. But mere exposure to trauma is not enough. The intensity of the experience seems to be a factor in whether an individual develops PTSD; biological vulnerabilities, as well as social and cultural factors, appear to play a role as well -Treatment involves reexposing the victim to the trauma and reestablishing a sense of safety to overcome the debilitating effects of PTSD ________ disorders: -Development of anxiety or depression in response to stressful, but not traumatic, life events -Individuals prone to anxiety or depression generally may experience increases during stressful life events

adjustment

OCD: -Focuses on avoiding frightening or repulsive intrusive thoughts (_________) or neutralizing these thoughts through the use of ritualistic behavior (_________). -biological and psychological vulnerabilities seem to be involved in the development -Drug treatment seems to only modestly successful in treating it. the most effective treatment approach is a psychological treatment called exposure and ritual prevention (ERP) BDD: -Person who looks normal is obsessively preoccupied with some imagined defect in appearance (imagined ugliness). The patients typically have more insight into the problem and may seek out plastic surgery as a remedy. Psychological treatment approaches are also similar to those for _____ and are approximately equally successful Hoarding Disorder: -Characterized by excessive acquisition of things, difficulty discarding anything, and living with excessive clutter under conditions best characterized as gross disorganization -Treatment approaches are similar to those for OCD but are less successful

obsessions, compulsions, OCD

Dissociative Disorders: -Characterized by alterations in perceptions: a sense of detach meant from one's own self, from the world, or from memories -Dissociative disorders include depersonalization-derealization disorder, in which the individual's sense of personal reality is temporarily lost (depersonalization), as is the reality of the external world (derealization). In dissociative amnesia, the individual may be unable to remember important personal information. In generalized amnesia, the individual is unable to remember anything; more commonly, the individual is unable to recall specific events that occur during a specific period (localized or selective amnesia). In dissociative fugue, a subtype of dissociative amnesia, memory loss is combined with an unexpected trip (or trips). In the extreme, new identities, or alters, may be formed, as in dissociative identity disorder (DID). The causes of dissociative disorders are not well understood but often seem related to the tendency to escape psychologically from stress or memories of traumatic events. -Treatment of dissociative disorders involves helping the patient reexperience the traumatic events in a controlled therapeutic manner to develop better coping skills. In the case of DID, therapy is often long term. Particularly essential with this disorder is a sense of trust between therapist and patient.

*

Somatic symptom and Related Disorders: -Individuals with somatic symptom and related disorders are pathologically concerned with the functioning of their bodies and bring these concerns to the attention of health professionals, who usually find no identifiable medical basis for the physical complaints. -There are several types of somatic symptom disorders. Somatic symptom disorder is characterized by a focus on one or more physical symptoms accompanied by marked distress focused on the symptom that is disproportionate to the nature or severity of the physical symptoms. This condition may dominate the individual's life and interpersonal relationships. Illness anxiety disorder is a condition in which individuals believe they are seriously ill and become anxious over this possibility, even though they are not experiencing any notable physical symptoms at the time. In conversion disorder, there is physical malfunctioning, such as paralysis, without any apparent physical problems. Distinguishing among conversion reactions, real physical disorders, and outright malingering, or faking, is sometimes difficult. Even more puzzling can be factitious disorder, in which the person's symptoms are feigned and under voluntary control, as with malingering, but for no apparent reason. -The causes of somatic symptom disorder are not well understood. Patients with this disorder are often preoccupied with physical symptoms that significantly distress or interfere with their lives. In the case of illness anxiety disorder (formerly known as hypochondriasis), the person experiences significant anxiety about having or developing a serious medical disease. The latter diagnosis is similar to an anxiety disorder. Treatment of somatic symptom disorders ranges from basic techniques of reassurance and social support to interventions meant to reduce stress and remove any secondary gain for the behavior. Recently, specifically tailored, CBT therapy has proved successful with these conditions

*

______ _______ ______- disorder featuring a disruptive preoccupation w/ some imagined defect in appearance ('imagined ugliness"). now classified among OCD and related disorders; previously grouped w/ DSM-IV somatoform disorders -Clinical Description- involves obsessive focus on a perceived flaw in one's appearance - minor or imagined even though look normal, obsessed w/ perceived flaw in appearance that others can't see or appears minor, strong belief of defect in body, reassurance seeking, comparing w/ others -Stats- equal in men and women, onset: early adolescence through the 20s peak at age 16-17, 50 cases - 33%-50% believed bodily image defect was real and a concern -Causes- little of etiology - no Information if it runs in families and no meaningful information of biological or psychological predisposing factors or vulnerabilities, comes from the pattern of BDD and OCD; abuse or bullying, low self-esteem, fear of being alone or isolated, perfectionism or competing with others, genetics, depression, anxiety or OCD. -Treatment- CBT, medications (SSRIs), use both outlook is good

Body Dysmorphic Disorder

_______ _______ (Functional Neurological Symptom Disorder)- physical malfunctioning, such as blinds or paralysis (sensory-motor areas), suggesting neurological impairment but w/ no organic. pathology to account for it -clinical description- physical malfunctioning (sensory-motor areas [paralysis, blindness, phobia]), lack physical or organic pathology, lack awareness, "la belle indifference" (possible, but not always), intact functioning -What disorders are closely related to conversion? -malingering, factious disorder/Munchausen's Syndrome by Proxy --What is _______- deliberate faking of a physical or psychological disorder motivated by gain - intentionally produced symptoms, clear benefit-attention, nonprecipitating stressful event, impaired function --Define ______ ______/_______ Syndrome by Proxy- nonexistent physical os psychological disorder deliberately faked for no apparent gain except possibly sympathy and attention - intentionally produced symptoms, no obvious benefit (sick role?) --What role do _______ ______ ______ play? - psychopathology, help distinguish between conversion disorders and related conditions -Stats- rare, prevalence depends on setting, female>male, onset is adolescence, chronic intermittent course -causes- Freudian psychodynamic view (trauma, conflict experiences; repression; "conversion" to physical symptoms [______ gain]; attention and support [______ gain]), behavioral (traumatic event must be excepted, avoidance is not an option, social acceptability of illness, negative reinforcement), family/social/cultural (low SES, limited disease knowledge, family history of illness) -treatment- attending to trauma, remove secondary gain, reduce supportive consequences (sick - stay in bed instead sick - keep working), reward positive health behaviors - exercise -special populations- soldiers, children (better prognosis?), cultural considerations (religious experiences, rituals)

Conversion, malingering, factitious disorder, Munchausen's, unconscious mental processes play, primary, secondary

__________-________ _______- dissociative disorder in which feelings of depersonalization are so severe they dominate the client's life and prevent normal functioning --________- distortion in perception of reality; lose sense of own reality; like a dream --_______- losing a sense of the external world; feel separated or isolated -Clinical description- feelings of unreality and detachment, severe/frightening, depersonalization, derealization, significant impairment -stats- 0.8%, female:male = 1:1, high comorbidities (anxiety/mood disorders), onset is age 16, lifelong chronic course -causes- cognitive deficits (attention, short-term memory, spatial reasoning, daily distracted, decreased emotional response) -treatment- psychological treatments are unstudied, prozac appears ineffective

Depersonalization, Derealization, Depersonalization, Derealization

True or False: 1. _____ Panic disorder is a disorder in which an individual experiences anxiety and panic triggered by being in an "unsafe" situation. 2. _____ About 40% of the population meets the criteria for panic disorder at some point in life. 3. _____ Some individuals with panic disorder are suicidal, have nocturnal panic, and/or are agoraphobic. 4. _____ Psychological treatments like PCT or CBT are highly effect for treating panic disorder Identify the following phobia: (a) blood-injection-injury, (b) acrophobia, (c) animal, (d) social, (e) natural environment, and (f) other. 1. Mark had no friends at school and hid in the boys' bathroom during both lunch and recess. _____ 2. Dennis fears and strenuously avoids storms. Not surprisingly, on his first oceangoing cruise, he found that deep water terrified him, too. _____ 3. Rita was comfortable at the zoo until the old terror gripped her at the insect display. _____ 4. Armando would love to eat fish with his fishing buddies, but he experiences an inordinate fear of choking on a bone. _____ 5. John had to give up his dream of becoming a surgeon because he faints at the sight of blood. _____ 6. Rachel turned down several lucrative job offers that involved public speaking and took a low-paying desk job instead. _____ 7. Farrah can't visit her rural friends because of her fear of snakes. _____

F (panic attacks occur unexpectedly in panic disorder, even in "safe" situations"), F (3.5%), T, T d, e, c, f, a, d, c

______ ______ _______ (__________)- somatic symptom disorder (was somatoform disorder) involving severe anxiety over belief in having a disease process w/o any evident physical cause -clinical description- anxiety or fear of having a daises, high comorbidity w/ anxiety/mood disorders, focus on bodily symptoms (normal, mild, vague), little benefit from medical reassurance, strong disease conviction (misperceptions of symptoms) -stats- 1%-5%, female:male = 1:1, onset any age but peaks in adolescence, middle age, elderly; chronic course, worldwide -causes- disorder of cognition or perception (physical signs and perceptions), familial history of illness (genetics - modeling/learning), other factors (stressful life events, high family disease incidence, "benefits" of illness) -treatment- psychodynamic (uncover unconscious conflict, limited efficacy data) emotional and supportive (ongoing and sensitive, detailed and repeated Information, beneficial for mild cases), cognitive behavior (identify and challenge misperceptions, stress reduction) -Illness Anxiety and _____ Disorder --Similarities ---focus on bodily symptoms --Differences in illness anxiety disorders ---focus on long-term process of illness, constant concern, constant medical/treatment seeking, wider range of symptoms

Illness anxiety disorder, hypochondriasis, Panic

_______-_______ _______- involving unwanted, persistent, intrusive thoughts and impulses, as well as repetitive action intended to suppress them -clinical description- _______ (intrusive and nonsensical; thoughts, images, or urges; attempts to resist or eliminate; 60% multiple obsessions - contamination, aggressive imposes, sexual content, somatic conferences, need for symmetry); _________ (thoughts or actions, suppress obsessions, provide relief; Four major categories - checking, ordering, arranging, washing/cleaning; association w/ obsessions, tic disorder, hoarding) -Stats- 1.6% (life), 1% (year), female>male - reversed in childhood, chronic, onset = depends - males: 13-15 and females: 20-24 -Causes- similar generalized biological vulnerability, specific psychological vulnerability (early life experiences and learning, thoughts are dangerous/unacceptable, thought action functions), distraction temporarily reduces anxiety (increase frequency of thought) -Treatment- Medications (SSRIs - 60% benefit), psychosurgery (cingulotonomy - 30% - high relapse when discontinued), CBT (exposure, response, prevention, reality testing, highly effective - 86% benefit)

Obsessive-Compulsive Disorder, obsessions, compulsions

_______- enduring, distressing emotional disorder that follows exposure to severe helplessness or a fear-inducing threat. the victim reexperiences the trauma, avoids stimuli associated w/ it, and develops a numbing of responsiveness and increased vigilance and arousal -Clinical description- exposure to a traumatic event during which an individual experiences or witnesses death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation; feeling upset by things that remind you of it, nightmares, vivid memories, flashbacks, feeling irritated, having angry outbursts, troubles sleeping, avoidance, substance abuse, self-harm, harming others, isolation, avoidance -Stats- 6.8% (life), 3.5% (year), 3.9% (year - adolescents) -Causes- traumatic experience (combat, witnessing event, SA, accidents) -Treatment- CBT, prolonged exposure therapy, EMDR, art therapy, group counseling, medication (SSRIs)

PTSD

______ ______ w/ and w/o _______- recurrent unexpected panic attacks accompanied by concern about future attacks and/or lifestyle change to avoid future attacks -Clinical Description- unexpected panic attacks; anxiety, worry, or fear of another attack; persists fro 1 month or more; agoraphobia - fear or avoidance of situation/events; avoidance can be persistence; use and abuse of drugs and alcohol (coping); _________ avoidance - avoidance of situations or activities that produce sensations of physical arousal similar to this occurring during a panic attack or intense fear response -Stats- 2.7% (year), 4.7% (life), female:male = 2:1, acute onset (sudden/rapid/unanticipated) ages 20-24, special problems are children (hyperventilation, cognitive development) and elderly (health focus, changes in prevalence) -Cultural Influences- social/gender roles, 75% of those w/ agoraphobia are female, similar prevalence rates, variable symptom expression - somatic symptoms -Causes- generalized biological vulnerability (alarm reaction to stress), cues get associated w/ situations (conditioning occurs), generalized psychological vulnerability (anxiety about future attacks, hypervigilance and increase interoceptive awareness) -________ panics- 60% w/ panic disorder experience this (non-REM sleep, delta wave), caused by deep relaxation (sensation of "letting go"), sleep terrors, isolated sleep paralysis -Treatment- medications (multiple systems, SSRIs [prozac and Paxil], high relapse rates), psychological (exposure-based, reality testing, relaxation, breathing), panic control treatment (exposure to interoceptive cues, cognitive therapy, relaxation/breathing, high degree of efficacy) --combined medication/psychological - no better than individual and CBT is better long term

Panic Disorder, Agoraphobia, interoceptive, Nocturnal

______ ______ (Social Anxiety Disorder)- extreme, enduring, irrational fear and avoidance of social or performance situations -Clinical description- extreme and irrational fear/shyness, social/performance situations, significant impairment, avoidance or distressed endurance, generalized subtype -Stats- 6.8% (year), 12.1% (life), female:male = 1.4:1.0, onset = adolescent w/ peak @ 15 -Causes- inherited vulnerability (biological and evolutionary), traumatic exposure (social) (direct conditioning), observational learning, information transmission, family influence -Treatment- medications (beta blockers, tricyclic antidepressants, SSRI - Paxil, high relapse rates when discontinued, psychological (CBT - exposure, rehearsal, role-play, group settings) - highly effective

Social Phobia

_____ ______- unreasonable fear of a specific object or situation that markedly interferes w/ daily life functioning; fear - emotion of an immediate alarm reaction to present danger or life-threatening emergencies -1 on the most common disorders in the world -clinical description- extreme and irrational fear of a specific object or situation, significant, impairment, recognizes fear as unreasonable, avoidance --Blood-injection- injury phobia, decreased heart rate and blood pressure, fainting, inherited vasovagal response, onset = 9 --Situational- fear of specific situations (transportation, small places), no uncued panic attacks, onset = early to mid 20s --Natural Environment- heights, storm, water; may cluster together; associated w/ real danger; onset = 7 --Animal- dogs, mice, snakes, may be associated w/ real danger, onset = 7 --Other- illness, choking, separation anxiety disorder, school phobia -Stats- 12.5% population fear qualify as phobia, 8.7% (year), 15.8% (year - adolescents), female:male = 4:1 -Causes- inherited vulnerability (biological and evolutionary), traumatic exposure (direct conditioning), observational learning, information transmission, social and gender roles (guys don't show it to act tough, girls show fear) -Direct experience, experiencing a false alarm (panic attack) in a specific situation, observing someone else experiencing severe fear (vicarious experience), and or being told about danger under the right circumstances -Treatment- CBT (exposure [graduated, structured, consistent], relaxation) -> like systematic desensitization (1) learn relaxation, (2) anxiety hierarchy, (3) desensitization

Specific Phobias

Match the correct preliminary diagnosis with the cases below: (a) PTSD, (b) acute stress disorder, (c) delayed onset PTSD 1. Judy witnessed a horrific tornado level her farm 3 weeks ago. Since, then, she's had many flashbacks of the incident, trouble sleeping, and a fear of going outside in storms. _____ 2. Jack was involved in a car accident 6 weeks ago in which the driver of the other car war killed. Since then, Jack has been unable to get into a car because it brings back the horrible scene he witnessed. Nightmares of the incident haunt him and interfere with his sleep. He is irritable and has lost interest in his work and hobbies. _____ 3. Patricia was raped at the age of 17, 30 years ago. Just recently, she has been having flashbacks of the event, difficulty sleeping, and fear of sexual contact with her husband. _____ Fill in the blanks to form facts about OCD: 1. __________ are intrusive and nonsensical thoughts, images, or urges an individual ties to eliminate or suppress. 2. The practice of washing, counting, and checking to suppress obsessions and provide relief are called __________. 3. The lifetime prevalence of OCD is approximately __________, or even lower. 4. __________ is a radical treatment for OCD involving a surgical lesion to the cingulate bundle.

b, a, c obsessions, compulsions, 1.6%, psychosurgery

Concept Check: Complete the following statements about anxiety and it causes with the following terms: (a) comorbidity, (b) panic attack, (c) expected, (d) neurotransmitter, (e) brain circuits, and (f) stressful 1. A _________ is an abrupt experience of intense fear or acute discomfort accompanied by physical symptoms, such as chest pain and shortness of breath. 2. An _______ panic attack often occurs in certain situations but not anywhere else. 3. Anxiety is associated with specific _________ (for example, behavior inhibition system of flight/fight system) and ________ systems (for example, nonadrenergic). 4. The rates of ________ among anxiety and related disorders are high because they share the common features of anxiety and panic. 5. _______ life events can trigger biological and psychological vulnerabilities to anxiety. True or False: 1. _____ GAD is characterized by muscle tension, mental agitation, irritability, sleeping difficulties, and susceptibility to fatigue. 2. _____ Most studies show that in the majority of cases of GAD, onset is early in adulthood as an immediate response to a life stressor. 3. _____ GAD is prevalent in the elderly and in females in our society. 4. _____ GAD has no genetic basis. 5. _____ Cognitive-behavioral treatment and other psychological treatments for GAD are probably better than drug therapies in the long run

b, c, e/d, a, f T, F (more gradual), T, F, T

Diagnose the dissociative disorders described here by choosing one of the following: (a) dissociative fugue, (b) depersonalization-derealization disorder, (c) generalized amnesia, (d) dissociative identity disorder, and (e) localized amnesia. 1. Ann was found wandering the streets, unable to recall any important personal information. After searching her purse and finding an address, doctors were able to contact her mother. They learned that Ann had just been in a terrible accident and was the only survivor. Ann could not remember her mother or any details of the accident. She was distressed. 2. Karl was brought to a clinic by his mother. She was concerned because at times his behavior was strange. His speech and his way of relating to people and situations would change dramatically, almost as if he were a different person. What bothered her and Karl most was that he could not recall anything he did during these periods. 3. Terry complained about feeling out of control. She said she felt sometimes as if she were floating under the ceiling and just watching things happen to her. She also experienced tunnel vision and felt uninvolved in the things that went on in the room around her. This always caused her to panic and perspire. 4. Henry is 64 and recently arrived in town. He does not know where he is from or how he got here. His driver's license proves his name, but he is unconvinced it is his. He is in good health and not taking any medication. 5. Rosita cannot remember what happened last weekend. On Monday she was admitted to a hospital, suffering from cuts, bruises, and contusions. It also appeared that she had been sexually assaulted.

c, d, b, a, e

________ _______- dissociative disorder featuring the inability to recall personal information, usually of a stressful or traumatic nature -patterns of memory loss: generalized and localized/selective --Generalized amnesia- loss of memory of all personal information, including identity --localized or selective amnesia- memory loss limited to specific times and events, particularly traumatic events (type more common) -subtype of dissociative amnesia is dissociative _______- type of dissociative amnesia featuring sudden, unexpected travel away form home, along w/ inability to recall the past, sometimes w/ assumption of a new identity; fugue = flight/travel, memory loss ("how's" or "why's" or travel), ends abruptly -characteristics and causes- generalized (lifeline or 6 months to year, forget everything), specialized (specific events forgotten); hardly before adolescence and usually occurs in adult hood, may continue into old age; can come from stress or trauma -stats- 1.8%-7.3% (most prevalent of all dissociative disorders), rare to occur for 1st time after age 50 -Cultural examples- Amok (male, trancelike state, brutally assault and sometimes kill people or animals, will not recall episode), see it as a trance or possession -treatment- psychotherapy, comes back with time

dissociative amnesia, fugue

Chapter 6 Dissociative Disorders: -______ ______- disorder in which individuals feel detached form themselves or their surroundings and reality, experience, and identity may disintegrate --severe alterations/detachments - normal perceptual experiences --significant impairment - identity, memory, consciousness --depersonalization --derealization ---go hand in hand

dissociative disorders

________ ______ ______- (multiple personality disorder) a disorder in which as many as 100 personalities or fragments of personalities coexist within one body and mind; amnesia dissociation of personality; adopt several new identities or alters (2-100, average 15, unique characteristics for each) -clinical description- gaps in recall of everyday events, traumatic events, forgetting important information; distress or impairment in social, occupation, and other areas of functions; substance abused; depression, suicidal/self-harm -What are hosts and alters and how do they interact? --______- person who becomes patient and asks for treatment; usually attempt to hold various fragments of identity together but end up being overwhelmed --______- shorthand term for alter egos, the different personalities, or identities in DID ---alters usually protect the host from past trauma -Can DID be faked? - real vs. false memories, suggestibility - open to it, hypnosis studies, stimulated amnesia, demand characteristics, physiological measures - eye movement, GSR, EEG -symptoms- physical changes (posture, physical disabilities, facial expressions), memory loss, detachment from self and emotions, blurry vision of self and identity, distorted perception of others and the world -stats- female:male = 9:1, onset childhood as young as 4, 7 years after to be identified, rare to develop, 1.5% (year), high comorbidity rates (Axis I, Axis II) -Causes- trauma (emotional, sexual, physical abuse; combat; natural disasters; loss), biological and psychological factors (reactivity, hippocampus and amygdala), high suggestibility (autohypnotic model) -treatment- therapy (find cues,/triggers, help w/ trauma - make past the past), medication (anti-depressant), hypnosis

dissociative identity disorder, hosts, alters

Chapter 5 Anxiety Disorders: -______- immediate, present-oriented, sympathetic nervous system activation -_______- a negative mood (affect) state characterized by bodily symptoms of physical tension and by apprehension about the future. Feelings that one cannot predict or control upcoming events -______ _____- an abrupt experience of intense fear or acute discomfort accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and dizziness --fear occurring at an inappropriate time --3 types: situationally-bound/cued, unexpected/uncued, situationally predisposed --expected (specific phobias or social anxiety disorder) and unexpected (panic disorder) Causes of Anxiety Disorders: -biological - heritability -psychological - different theories -social - life events; social and interpersonal -______ _______ _______- development of anxiety comes from three vulnerabilities from inheritability, beliefs/perceptions, and learning/modeling --_______ vulnerability- (diathesis) heritable contribution to negative affect; glass is half empty, irritable driven --_______ _______ vulnerability- (beliefs/perceptions) sense that events are uncontrollable/unpredictable - tendency toward lack of self-confidence, low self-esteem, inability to cope --________ _______ vulnerability- (learning/modeling) physical sensations are potentially dangerous - anxiety about health, nonclinical panic

fear, anxiety, panic attack, Triple Vulnerability Theory, biological, generalized psychological, specific psychological

The Complexity of Anxiety Disorders: -Anxiety is a ______-oriented state characterized by negative affect in which a person focuses on the possibility of uncontrollable danger or misfortune: in contrast, fear is a ______-oriented state characterized by strong escapist tendencies and a surge in the sympathetic branch of the autonomic nervous system in response to current danger. -A panic attack represents the alarm response of real fear, but there no actual danger. -Panic attacks may be (1) unexpected (without warning), or (2) expected (always occurring in a specific situation). Panic and anxiety combine to create different anxiety and related disorders. Several disorders are grouped under the heading Anxiety Disorders. Generalized Anxiety Disorder: -In generalized anxiety disorder (GAD), anxiety focuses on minor everyday events and not on one major worry or concern. -Both genetic and psychological vulnerabilities seem to contribute to the development of GAD. -Although drug and psychological treatments may be elective in the short term, drug treatments are no more elective in the long term than placebo treatments. Successful treatment may help individuals with GAD focus on what is really threatening to them in their ives

future, present

Anxiety Disorder Syndromes: -Generalized Anxiety Disorder, Panic Disorder w/ & w/o Agoraphobia, Specific Phobias, Social Phobia, PTSD, OCD, & BDD _______ _______ ______- anxiety disorder characterized by intense, uncontrollable, unfocused, chronic, and continuous worry that is distressing and unproductive, accompanied by physical symptoms of tenseness, irritability, and restlessness -Clinical Description- excessive apprehension and worry, uncontrollable, strong persistent anxiety, somatic/physical symptoms (muscle tension, fatigue, mental agitation, 6 months or more, shift from possible crisis to crisis, worry about minor everyday concerns (job, family, chores, appointments), problem sleeping --in children need only 1 physical symptom, worry = academic, social, athletic performance -Stats: 3.1% (year), 5.7% (lifetime), similar rates worldwide, female:male = 2:1, insidious onset (gradual, very slow onset) in early adulthood; in elderly worry about their failing health and loss, up to 7% prevalence, use of minor tranquilizers 17-50%, medical problems, sleeping problems, falls, cognitive impairments -Causes- inherited tendency to be anxious, "neuroticism"? - trait disposition to experience negative affects (anger, anxiety, irritability), less responsiveness (autonomic restrictors like lower heart rate, blood pressure, skin conductance, and respiration rate), threat sensitivity, frontal local activation - left v.s right -Treatment- pharmacological (benzodiazepines [risk vs. benefits] and antidepressants) and psychological (CBT [exposure to work process, confronting anxiety - provoking images, coping strategies], acceptance, meditation, similar benefits, better long-term results

generalized anxiety disorder

Panic Disorder and Agoraphobia: -In panic disorder, which may or may not be accompanied by agoraphobia (a fear and avoidance of situations considered to be "unsafe"), anxiety is focused on the next panic attack. For some people, agoraphobia develops in the absence of panic attacks or panic-like symptoms. -We all have some ______ vulnerability to stress, and many of us have had a neurobiological overreaction to some stressful event--that is, a panic attack. Individuals who develop panic disorder and then develop anxiety over the possibility of having another panic attack. -Both drug and psychological treatments have proved successful in the treatment of panic disorder. One psychological method, panic control treatment, concentrates on exposing patients to clusters of sensations that remind them of their panic attacks. For agoraphobia, therapeutically supervised exposure to feared situations is most effective. Specific Phobia: -In phobia disorders, the individual avoids situations that produce severe anxiety, panic, or both. In specific phobia, the fear is focused on a particular object or situation. -Phobias can be acquired by experiencing some traumatic event; they can also be learned vicariously or even be taught -Treatment of phobias is rather straightforward, with a focus on structured and consistent exposure-based exercises

genetic

Chapter 6 Somatic Disorders: -______ ______- soma=body; preoccupation w/ health or appearance, physical complaints, no identifiable medical condition; was somatoform disorder; disorder involving extreme and long-lasting focus on multiple physical symptoms for which no medical cause is evident; psychological/behavioral factors (anxiety and stress) compound the severity of physical symptoms; pain is real whether or not there are physical reasons What is meant by psychological factors affecting medical condition? -related somatic symptom disorder -essential feature of this disorders is the presence of a diagnosed medical condition like asthma, diabetes, or severe pain clearly caused by a known medical condition such as cancer that is adversely affected (increased frequency or severity) by one or more psychological or behavioral factors -behavioral or psychological factors would have a direct influence on the course or perhaps the treatment of the medical condition

somatic disorders