Chapters 4, 5, and 7

What are the two main differences between PTSD and ASD?

1) ASD requires the presence of at least nine symptoms from any of the symptom clusters while PTSD requires that individual to exhibit one or two symptoms from the symptom clusters 2) ASD involves symptoms that persist for at least three days but no longer than one month after the event while with PTSD, symptoms must be present for at lease a one month period.

What factors account for the differential suicide rates among various racial groups?

1) American Indians: increased risk of suicide b/c families deprived of their land, torn apart, and forced to live on reservations. Many became alienated and isolated from their communities and from larger society. 2) African Americans: less risk associated with close family relationships, strong community connections, and religious and personal values that discourage suicide 3) Hispanic: lower because of strong social connections and religiosity

What are the biological treatment options for GAD?

1) Benzodiazepines (however GAD is chronic and this can lead to drug dependence) 2) antidepressants are more preferred

What is the primary cause of bipolar disorder?

1) Biological factors appear to play a much more prominent role in development compared to other factors 2) Also suggested that biochemical pathways associated with (serotonin, norepinephrine) and also disrupted glutamate transmission 3) Functional and anatomical irregularities in brain networks

Describe the characteristics of hypertension.

when the systolic blood pressure equals or exceeds 140 and the diastolic blood pressure is 90 or higher

Describe 4 ways in which social or sociocultural factors contribute to psychophysiological disorders.

1) CHILDHOOD MALTREATMENT: associated with headaches and hypertension and suppressed immune functioning 2) LACK OF SOCIAL SUPPORT: can lead to immune system dysregulation and on flip side having social support can help resistance to disease and increase immune functioning 3) GENDER ROLES: women are more susceptible to stressors because of their role as caregivers for children, partners,and parents. Also social isolation for women known to increase likelihood of CHD. 4) RACISM AND DISCRIMINATION: can heighten stress response and elevate blood pressure leading to hypertension and cardiovascular reactivity

Name three proposed psychological factors that may explain suicidal behavior.

1) Childhood abuse 2) mental illness: many are associated with 3) hopelessness: Psychache

Describe the psychological etiology of phobias.

1) Classical conditioning: fears resulting from an association process 2) Observational learning: develop fears by seeing others portray fear in real life or in the media 3) Negative information perspective: fears induced through negative or threatening information 4) cognitive behavioral: catastrophic thoughts and cognitive distortions

Describe two ways in which biological influences can lead to depression.

1) Dysregulation and overactivity of the hypothalamic-pituitary-adrenal (HPA) axis and overproduction of stress related hormones such as cortisol 2) Circadian rhythm disturbances affecting sleep

Describe the three behavioral treatments used to treat OCD.

1) Exposure therapy: continued actual or imagined exposure to fear-arousing situation which can involve gradual exposure or flooding 2) Response prevention: involves not allowing the individual with OCD to perform the compulsive behavior *usually a combination of exposure and response prevention is used* 3) CBT: focuses on correcting dysfunctional beliefs

Why might PTSD be more prevalent amongst women and ethnic group members?

1) For ethnic group members: may be because of differential exposure to previous trauma or cultural differences in responding to stress 2) For women: may be because of psychological differences or that women have a greater risk of exposure to stressors that can lead to PTSD.

Describe intrusion symptoms in relation to PTSD and ASD.

1) Intrusive thoughts, including distressing recollections, nightmares or flashbacks of the trauma, psychological distress triggered

Give a brief description of the 4 different types of phobias.

1) Living creatures (i.e. spiders, insects, dogs) 2) Environmental conditions (i.e. heights, earthquakes, thunder) 3) Blood/injections or injury (i.e. needles, dental treatment, invasive medical procedures) 4) Situational factors (i.e. enclosed places, flying, driving, being alone, the dark)

What evidence supports a biological explanation for suicide?

1) Low levels of chemical called 5-HIAA which metabolizes serotonin found in those that have died from suicide. 2) genetic and epigentic effects: 3) sleep difficulties 4) alcohol effects: increases emotionality and inhibits strong emotions

Describe the three different types of headaches.

1) Migraine (mild to severe): nausea, sensitivity to light, odors, lasts from hours to 4 days. 2) Tension (mild to moderate): tightness or pressure around neck, head, or shoulders, lasts from hours to days 3) Cluster (excruciating): eye often teary, nose clogged on side of head, pacing and rubbing head, lasts less than an hour

What are some key treatments for bipolar disorder?

1) Mood stabilizing medications such as lithium are foundation for treatment 2) Social rhythm therapy: treatment that teaches participants to avoid disruption of bodily rhythm patterns by developing regular eating, sleeping, and exercise routines 3) family-focused therapy 4) interpersonal therapy 5) CBT

Name 4 symptoms of mania.

1) Mood: unstable and rapidly changing emotions and mood (aka lability) 2) Cognitive: energized, goal-oriented behavior at home, school, or work 3) Behavioral: uninhibited and act impulsively, engaging in uncharacteristic behaviors 4) physiological: high levels of physiological arousal that result in intense activity, extreme restlessness or the need to be constantly "on the go"

Describe the biological treatment options for OCD.

1) SSRIs

Explain how bullying may contribute to suicide among young people.

1) Victims of bullying are 2 to 9 times more likely to consider suicide than those not subjected to bullying 2) 50% of young people who commit suicide have experienced bullying

What do we know about suicide among college students?

1) a large amount of students who die by suicide do not seek help through college counseling services, also almost a majority do not tell anyone 2) Campus prevention and intervention efforts are critically important in identifying risk of suicide 1) educate 2) provide counselors 3) publicize campus community resources

Name the four reasons why the symptoms seen in depressive and bipolar disorder differ from temporary emotional reactions.

1) affect the person's well-being and school, work, or social functioning 2) continue for days, weeks, or months 3) often occur for no apparent reason 4) involve extreme reactions that cannot be explained by what is happening in a person's life

Describe the psychological etiology of panic disorder.

1) anxiety sensitivity or physiological vigilance 2) catastrophic thoughts in reaction to physiological changes 3) conditioning since the amplified body changes result in even more fearful thoughts

Describe the social etiology of panic disorder.

1) anxiety-filled social environment 2) separation or loss 3) peer victimization

Why are baby boomers and older adults at risk for suicide?

1) baby boomers: youth oriented perspective and belief in a limitless future. Economic pressure, dual-caregiver responsibilities, age related changes in health 2) Older adults: illness and diminishing physical strength. Friends and relatives die which leads to social isolation. Hard to live on a fixed income. loss of independence, serious financial and relationship problems-> depression. More at risk for suicide

Name three reasons why it is important for clinicians to gather comprehensive information about mood symptoms before making a diagnosis.

1) brief depressive or hypomanic symptoms also can occur with people that don't have a mood disorder 2) Some symptoms such as irritability occur in both disorders as well as depression occurring in both 3) People often fail to report hypomanic symptoms because they do not seem to cause significant problems or impaired functioning

List 3 similarities between bipolar I and schizophrenia.

1) certain risk alleles that contribute to both ->suggest a genetic component 2) both have similar cognitive deficits: including confused thought processes and poor insight (failure to recognize symptoms of one's own mental illness) 3) also neurocognitive deficits that affect psychosocial competence and daily functioning are present in both

Describe three different treatment options for depression.

1) circadian-related treatments: efforts to reset the circadian clock 2) Behavioral activation therapy: based on principles of operant conditioning, focusing on helping those who are depressed to increase their participation in enjoyable activities and social interactions 3) Interpersonal therapy: focuses on relationship issues

Describe the sociocultural etiology of OCD.

1) cultural differences in obsessions/compulsions (i.e. concern over animals African Americans vs. European Americans)

Describe what actions you would take if your roommate in college expressed suicidal thoughts.

1) determine lethality and recognize risk factors 2) referral for potential counseling 3) provide crisis number

Describe sociocultural etiology of phobias.

1) gender (females more likely) 2) cultural child-rearing patterns/culturally distinct fears (i.e collectivist cultures where an individual's behavior reflects on the whole group) 3) use of shame as a method of control 4) rigid moral codes

Describe sociocultural etiology of panic disorder.

1) gender differences (more common in women) 2) cultural differences in expression

Name some potential clues to suicidal intent.

1) giving away prized possessions 2) suicide ideation or actual plan 3) preoccupation with death 4) recent severe loss 5) previous suicide attempts

Describe the elements of cognitive behavior treatments for panic disorder.

1) helps promote self-efficacy by helping clients develop a sense that they can effectively deal with panic symptoms a) educates client and corrects misconceptions b) identifies and corrects catastrophic thinking c) encourages the client to face the symptoms

Describe the biological etiology of OCD.

1) increased activity in the orbitofrontal cortex 2) reduced availability of serotonin and glutamate

Describe two ways in which psychological factors can contribute to depression.

1) insufficient social reinforcement 2) learned helplessness-a belief that we have little influence over what happens to us

Describe social etiology of GAD.

1) lack of social network 2) separation or loss 3) anxious or non-responsive parents 4) peer conflicts and victimization

Describe the psychological etiology of OCD.

1) lack of trust on own performance 2) impulse control conflicts 3) anxiety reduction

Describe psychological etiology of GAD.

1) lower threshold for uncertainty 2) anxiety evoking schemes aka lenses (i.e. "I am incompetent") 3) use worry as coping mechanism

Describe the biological etiology of phobias.

1) moderate genetic contribution (about 31%) 2) innate tendency to be anxious and have strong emotional responses 2) exaggerated responsiveness of the amygdala and other areas of the brain associated with fear

Describe the biological etiology of panic disorder.

1) modest heritability (32%) 2) fewer serotonin receptors and GABA 3) amygdala and fear circuitry reactivity

Describe the characteristics of OCD and related disorders?

1) obsessions: persistent, anxiety-producing thoughts or images 2) compulsions: involve an overwhelming need to engage in activities or mental acts to counteract anxiety or prevent the occurrence of a dreaded event *These obsessions and compulsions consume at least one hour of time per day and cause significant distress or impairment in life activities*

Describe biological etiology of GAD.

1) overreactive fear network 2) abnormalities in GABA receptors

Describe the social etiology of phobias.

1) parental modeling: overprotection and lack of support for children's independence 2) negative family interaction patterns 3) peer victimization

Describe the social etiology of OCD.

1) social vulnerabilities: divorce separation, unemployment, controlling or critical parenting

Describe sociocultural etiology of GAD.

1) stressful or poor living conditions 2) prejudice and discrimination

Give an example of how genetic factors interact with environmental factors to produce depression.

1) those that are carriers of the short allele of the 5-HTTLPR gene, who experience maltreatment in childhood, are more likely to release cortisol (stress hormone) and produce depressive symptoms

Describe three ways how biological stress responses influence different psychophysiological disorders.

1. Chronic activation of the sympathetic nervous system, which releases cortisol which has been linked to coronary artery calcification, a contributor to coronary heart disease 2. Stress triggers excessive mucus secretion combined with spasms and swelling of airways in asthma 3. Tension headaches produced when stress creates prolonged contraction of the scalp and neck muscles, resulting in vascular constriction and steady pain

What are the four different cognitive-behavioral treatments for phobias?

1. Exposure therapy: involves gradual and increasingly difficult encounters with a feared situation . 2. Systematic desensitization: uses muscle relaxation to reduce the anxiety associated with phobias. 3. Cognitive restructuring: unrealistic thoughts believed to be responsible for phobias are altered. 4. Modeling therapy: the individual with the phobia observes a model (either on screen or in-person) coping with or responding appropriately to the fear-production situation.

Describe the four ways in which psychological factors are involved in coronary heart disease, hypertension, headaches, and asthma.

1. POSITIVE AFFECT: can help regulate heart rate, blood pressure, and other physiological stress reactions. 2. CONTROL AND PERCEPTION OF CONTROL over the environment: Those that believe that they have limited influence over life circumstances have an increased risk mortality from CHD 3. POSITIVE EMOTIONS: may increase heart health and decrease likelihood of cardiovascular illness 4. NEGATIVE EMOTIONAL STATES: are related to airway constriction in individuals with asthma.

Compare 3 different treatments for psychophysiological disorders.

1. Relaxation training: therapeutic technique in which a person acquires the ability to relax the muscles of the body under almost any circumstance 2. Biofeedback training: self-regulation technique where therapist teaches you to voluntarily control a physiological function such as heart rate and you receive feedback presented visually 3. CBT: designed to enhance coping skills and stress management. Have opportunity to express emotions and process beliefs about an illness and develop adaptive strategies that can help improve feelings of well-being

Name this trauma related disorder: direct or indirect exposure to a traumatic stressor involving actual or threatened death, serious injury, or violence, nine or more symptoms involving: intrusive memories, negative thoughts or emotions, heightened arousal, disturbance persists from 3 days to 1 month after exposure, over half will later receive PTSD diagnosis

Acute Stress Disorder

Name this trauma related disorder: exposure to stressors of any type or severity, symptoms begin within 3 months of exposure to a stressor, last less than 6 months, emotional distress and behavior symptoms are out of proportion to severity of stressor

Adjustment Disorder

Name this anxiety disorder: anxiety or panic in situations where escape is difficult or embarrassing, more prevalent in females

Agoraphobia

Describe avoidance symptoms in relation to PTSD and ASD.

Avoidance of thoughts, feelings, or physical reminders associated with the trauma. Also could be objects or places

Why is premenstrual dysphoric disorder a controversial diagnostic category?

Because physical and emotional symptoms are similar to premenstrual syndrome ; however PMDD produces much greater distress and interferes with social, interpersonal, academic, or occupational functioning

What are the biological modes of treating phobias?

Benzodiazepines, although symptoms can recur when medication is discontinued

Given the following description, identify which bipolar disorder this is: At least one weeklong manic episode, impairment in functioning, mixed features of depressive episodes are common but not required for diagnosis

Bipolar I

Which type of bipolar disorder is this: At least one major depressive episode, at least one hypomanic episode, no history of mania

Bipolar II

Name this disorder: Distressing and impairing preoccupation with imagined or slight defects in appearance

Body Dysmorphic Disorder

What is the psychological treatment option for GAD?

CBT: identify worrisome thoughts, develop self-control skills and challenge irrational thoughts

Describe this bipolar disorder: periods involving milder hypomanic symptoms alternative with milder depression for at least 2 years (with no more than 2 months symptom free), symptoms have never met the criteria for hypomanic, manic or major depressive episode

Cyclothymic disorder

Describe negative alterations in mood or cognition in relation to symptoms of ASD and PTSD.

Difficulty remembering details of the event, persistent negative views about oneself or the world, distorted cognitions leading to self-blame or blaming others

Name this disorder: repeated picking of skin resulting in lesions

Excoriation (Skin-Picking) Disorder

How do suicide crisis centers and suicide hotlines work?

For those considering suicide or friends, family or coworker of someone that is showing signs of wanting to commit suicide. Operate 24 hrs a day, 7 days a week. Crisis lines have health professionals on line that are trained in crisis intervention techniques. Crisis centers: goal to resolve feelings of hopelessness and concerns about immediate life crisis. "No harm" agreement.

Name this anxiety disorder: Excessive anxiety and worry over life circumstances (i.e. money, school, family), difficulty controlling worry

Generalized Anxiety Disorder

Name this disorder: Repeated pulling out of hair resulting in hair loss

Hair Pulling Disorder

Name this disorder: difficulty discarding items because of perceived need, resulting in cluttered or unsafe areas

Hoarding disorder

Describe the characteristics of coronary heart disease.

Involves the narrowing of cardiac arteries due to atherosclerosis (plaque buildup within the arterial walls) resulting in complete or partial blockage of the flow of blood and oxygen to the heart. Can lead to chest pain or even heart attack

Name 4 symptoms of depression.

Mood: hopelessness Cognitive: pessimism Behavioral: social withdrawal Physiological: appetite and weight change

Name this disorder: repeated disturbing and intrusive thoughts or impulses, inability to control or suppress the thoughts or behaviors

Obsessive Compulsive Disorder

Name this anxiety disorder: recurrent and unexpected intense attacks of fear or terror, worry about future panic attacks

Panic Disorder

Why does lack os social connectedness increase suicide risk?

People feel alienated and that they do not belong leads to feelings of hopelessness.

Describe the characteristics of Generalized Anxiety Disorder.

Persistent, high levels of anxiety and excessive difficult-to-control worry over life circumstances, accompanied by physical symptoms such as feeling restless or tense.

Name this traumatic disorder: direct or indirect exposure to a traumatic stressor involving actual or threatened death, serious injury, or violence, one or two symptoms involving: intrusive memories, negative thoughts or emotions, heightened arousal, symptoms are present for at least 1 month

Post Traumatic Stress Disorder

Describe symptoms of panic disorder.

Recurrent unexpected panic attacks in combination with a) apprehension over having another attack or worry about the consequences of an attack or b) changes in behavior or activities designed to avoid another panic attack. *must be prevalent for one month or more*

Name this anxiety disorder: Excessive fear of being watched or judged by others, extreme self consciousness in social situations, twice as common in females

Social Anxiety Disorder

Name this anxiety disorder: Excessive fear of specific objects or situations, intense fear or panic attacks produced by exposure

Specific Phobia

Describe the characteristics of asthma.

chronic inflammatory disease of the lungs, stress or other triggers cause excessive mucus secretion combined with spasms and swelling of the airways, which reduces the amount of air that can be inhaled. Symptoms range from wheezing or coughing to severe respiratory distress.

Describe arousal and changes in reactivity in relation to symptoms of ASD and PTSD.

feelings of irritability that may result in verbal or physical aggression, hyper vigilance involving constantly remaining alert for danger