Ch 10 abnormal, ch 9 abnormal, ch 8 abnormal
graduate exposure
Clients initially confront situations that cause only minor anxiety and gradually progress toward those that cause greater anxiety
Psychological factors affecting medical conditions
Disorder in which clients have a medical disease or symptom that appears to be exacerbated by psychological or behavioral factors. -Depression, stress, denial of a diagnosis, or engaging in poor or even dangerous health related behaviors
Phobia
An irrational fear associated with a particular object or situation.
Traumatic experience
-Disastrous or extremely painful event. -Has lasting adverse effects on the individual's functioning and mental health.
Hoarding disorder
-A compulsion in which people have persistent difficulties discarding things, even if they have little value -They believe these items to have utility, or to have aesthetic or sentimental value, but in reality the items often consist of old newspapers, bags, or leftover food
Separation anxiety disorder
-A disorder characterized by intense and inappropriate anxiety concerning separation from home, caregivers, or someone to whom they are emotionally attached. -Lasting at least 4 weeks -No longer limited to childhood cases -Epidemiologists estimate that 5.3% of individuals experience this disorder at some point in life. -People who develop this disorder are at greater risk of subsequently developing other anxiety disorders and depressive disorders, as well as A D H D and conduct disorder.
Body dysmorphic disorder
-A disorder in which individuals are preoccupied with the idea that a part of their body is ugly or defective. -People with B D D perform compulsive behaviors. -People with B D D may check themselves constantly, groom themselves to an excessive degree, or constantly seek reassurance from others about how they look. -B D D is frequently comorbid with major depressive disorder, social anxiety disorder, obsessive-compulsive disorder, and eating disorders.
Reactive attachment disorder
-A disorder involving a severe disturbance in the ability to relate to others. -The individual is unresponsive to people, is apathetic, and prefers to be alone rather than to interact with friends or family. -These children are emotionally withdrawn and inhibited and show little positive affect and an ability to control their emotions. -When distressed, they do not seek comfort
Panic disorder
-An anxiety disorder in which an individual has panic attacks on a recurrent basis or has constant worry about the possibility of recurring attacks. -Panic disorder is often associated with agoraphobia. Someone can have Panic Disorder, with or without agoraphobia
Dissociative Amnesia
-An inability to remember important personal details and experiences that is associated with traumatic or very stressful events. -What they forget is a traumatic or stressful experience. -This amnesia can be diagnosed with a specifier of dissociative fugue: During which they travel or wander without knowing their identity.
Anorexia nervosa (A N)
-At the heart of A N experience is a core disturbance in an individual's body image. -People with A N believe that their bodies are larger than they really are, which leads them to believe they are unattractive. -Women with the restrictive form of A N appear not to value thinness so much as they are repelled by the idea of being overweight -Lifetime prevalence is 0.9% (women) and 0.3% (men) -People with anorexia nervosa have higher rates of mood, anxiety, impulse-control, and substance use disorders
Social anxiety disorder: theories and treatment
-Biological perspectives -SSRIs and SNRIs -Psychological perspectives -Motivational interviewing -Acceptance and commitment therapy -Mindfulness /meditation
categories of specific phobias
-Insects and animals -Natural environment -Blood-injection-injury -Engaging in activities in particular situations -Variety of miscellaneous stimuli
Effects of bulimia nervosa
-Ipecac syrup has toxic effects -Dental decay -Laxatives, diuretics, and diet pills also have toxic effects over time -Gastrointestinal damage may be permanent
4 major dimensions of O C D:
-Obsessions associated with checking compulsions -Need for symmetry and order -Obsessions about cleanliness associated with washing compulsions -Hoarding-related behaviors
panic attacks
-People with panic disorder experience periods of intense physical discomfort known as panic attacks. -Panic attacks: (not "anxiety attack") -A period of intense fear and physical discomfort accompanied by the feeling that one is being overwhelmed and is about to lose control. -Experience constant apprehension and worry about the possibility of recurring attacks -Occur in 20 percent or more of adult samples
Excoriation (skin-picking) disorder
-Recurrent picking at one's own skin which can be healthy skin, or skin with mild irregularities -When they are not picking their skin, they think about picking it and try to resist their urges to do so -Prevalence is estimated at least 1.4% of adults, three-quarters of whom are female
Compulsion
-Repetitive and seemingly purposeful behavior performed in response to: -Uncontrollable urges or according to a ritualistic or stereotyped set of rules
Psychological treatments and theories for O C D
-The cognitive-behavioral perspective proposes that maladaptive thought patterns contribute to the development and maintenance of O C D symptoms. -Individuals with O C D may be primed to overreact to anxiety-producing events in their environment Behavioral methods to treat O C D : -Exposure with ritual prevention -Thought-stopping -Satiation therapy
Trichotillomania (hair-pulling disorder)
-The compulsive, persistent urge to pull out one's own hair. -Relief, pleasure, or gratification is typically experienced after pulling out their hair. -Estimated prevalence - 0.6% -This may be underreported due to secrecy associated with this disorder.
Trauma- and stressor-related disorders
-These disorders are placed in this category because they are found in children who have experienced an abuse pattern of: -Social neglect, repeated changes of primary caregivers, or rearing in institutions with high child-to-caregiver ratios. -Children with this disorder are significantly impaired in their ability to interact with other children and adults.
Theories and treatment of separation anxiety disorder
A biopsychosocial model seems particularly appropriate for understanding separation anxiety disorder. -Results of twin studies suggest strong genetic support. -However, a recent study suggests that children with anxious parents learn to develop anxiety through modeling
Selective mutism
A disorder originating in childhood in which the individual consciously refuses to talk. -Children with this disorder are capable of using normal language, but they become almost completely silent under certain circumstances. -Anxiety may be at the root of selective mutism given that children most typically show this behavior in school rather than at home.
Depersonalization/derealization disorder
A dissociative disorder in which the individual experiences recurrent and persistent episodes of depersonalization, derealization, or both
anxiety
A future-oriented response which involves a sense of dread about what might happen to you in the future
Post-traumatic stress disorder: theories and treatment
A traumatic experience is an external event that impinges on the individual and hence does not have biological "causality." However, traumatic experiences in part lead to changes in the brain that make it hypersensitive to possible danger in the future.
Acute stress disorder
Acute stress disorder is an anxiety disorder that develops after a traumatic event, and lasts for up to 1 month. -Symptoms: -Intrusion of distressing reminders of the event -Dissociative symptoms -Avoidance of situations that serve as reminders of the event -Hyper-arousal
Bulimia nervosa
Alternation between the extremes of eating large amounts of food in a short time and then compensating for the added calories by: -Vomiting -Laxatives/diuretics -Excessive exercise -Fasting -Other extreme actions to avoid gaining weight Lifetime prevalence is 1.5% (women) and 0.5% (men)
Intermittent explosive disorder
An impulse-control disorder involving an inability to hold back urges to express strong angry feelings and associated violent behaviors. }Angry outbursts, either verbal (temper tantrums, tirades, arguments) or physical, in which individuals: }Become assaultive or destructive in ways that are out of proportion to any stress or provocation are common. }Physical outbursts (on at least three occasions) in a 12-month period, may cause damage to the individual, other people, or property. }Estimated 4 to 7 percent of people in the U.S. population have this disorder }Of these, 70 percent have at least three outbursts per year with an average of 27 on a yearly basis }Faulty cognitions and strong familial component contribute to the development of this disorder. }Treatments include: }S S R I s and Cognitive Behavioral Therapy (C B T)
specific phobia
An irrational and continuous fear of a particular object, activity, or situation. People will go to great lengths to avoid the object situation that is the target of their fear.
Generalized anxiety disorder
Anxiety that is not associated with a particular object, situation, or event -A constant feature of a person's day-to-day existence •Symptoms - General restlessness, sleep disturbances, feelings of being easily fatigued, irritability, muscle tension, and trouble concentrating to the point where their mind goes blank. •Biological perspective - People experience their symptoms due to disturbances in GABA, serotonergic, and noradrenergic systems. •Cognitive-behavioral therapy - Cognitive distortions contribute to generalized anxiety. •Clients learn how to recognize anxious thoughts, to seek more rational alternatives to worrying, and to take action to test these alternatives.
Anorexia nervosa (A N) is characterized by..
Characterized by an inability to maintain normal weight, an intense fear of gaining weight, and distorted body perception. Three basic symptoms: 1.Severely restricted eating, which leads to an abnormally low body weight 2.Intense and unrealistic fear of getting fat or gaining weight 3.Disturbed self-perception of body shape or weight. }Classified as "restricting type" of eating disorder and binge-eating/purging type.
Selective mutism treatments
Children with selective mutism seem to respond well to behavioral therapy. -Contingency management -Shaping plus exposure therapy -Cognitive behavioral therapy (C B T)
Imaginal flooding
Client is immersed through imagination in the feared situation.
Flooding
Client is totally immersed in the sensation of anxiety by being exposed to the feared situation in its entirety.
Eating disorders
Diagnosis for people who experience persistent disturbances of eating or eating-related behavior that result in changes in how they eat or retain their food. -These disorders go beyond dieting or occasional overeating, significantly impairing the individual's physical and psychosocial functioning.
Disinhibited social engagement disorder
Diagnosis given to children who engage in culturally inappropriate, overly familiar behavior with people who are relative strangers.
Conditions related to somatic symptom disorders
Factitious disorder imposed on self, factitious disorder imposed on another, Malingering- no longer in DSM
Dissociative identity disorder:
Formerly called multiple personality disorder -An individual develops more than one self or identity -Lots of skepticism if the diagnosis is real or faked. There isn't any debate on disassociation or depersonalization, but personalities are not concrete structures-
Treatment of dissociative disorders
Goal: -Integrate alters Methods: -Hypnotherapy -Cognitive behavioral techniques. Treatment of dissociative disorders often involves not only these disorders themselves, but also associated disorders of mood, anxiety, and post-traumatic stress.
Post-traumatic stress disorder (P T S D)
Individual experiences several distressing symptoms for more than a month following a traumatic event. -Symptoms fall into categories: -Intrusions -Dissociation -Avoidance The difference between Acute Stress Disorder and PTSD is the amount of time the symptoms persist
thought stopping
Individual learns to stop anxiety-provoking thoughts.
Conduct Disorder
Individuals with conduct disorder violate the rights of others and society's norms or laws. }Their delinquent behaviors include: }Aggression to people and animals (such as bullying and acts of animal cruelty) }Destruction of property }Deceitfulness or theft }Serious violations of rules (such as school truancy or running away from home) }Around the world, rates of conduct disorder are estimated at 3.2 percent, with remarkable consistency across countries
Agoraphobia
Intense anxiety triggered by the real or anticipated exposure to situations in which they may be unable to get help should they become incapacitated. (The symptom can be not leaving the house because of the anxiety about being in a place they can not escape.) -Fear or anxiety about two of the following five: -Using public transportation -Being in an enclosed space (such as a theater) -Being in an open space (such as a parking lot) -Being outside of the home alone -Standing in line or being in a crowd -Their anxiety is out of proportion to the actual danger involved in the situation
Obsession:
Persistent and intrusive idea, thought, impulse, or image.
Obsessive-compulsive disorder (O C D)
Recurrent obsessions that are inordinately time-consuming or that cause significant distress or impairment.
Disorder category: Hypersomnolence disorder
Recurrent periods of sleep or lapses into sleep during the day, prolonged main sleep episodes, or difficulty being fully awake after abruptly awakening.
Effects of anorexia nervosa
Results in a series of serious health changes that can even be life threatening: -Bones, muscles, hair, and nails become weak and brittle -Develop low blood pressure, slowed breathing and pulse -Lethargic, sluggish, and fatigued -Infertility and disturbed sexual function -Gastrointestinal system functions abnormally -Heart and brain damage -Multiple organ failure
Items from the S C I D-D-R
Scale/items Amnesia: Have you ever felt as if there were large gaps in your memory? Depersonalization: Have you ever felt that you were watching yourself from a point outside of your body, as if you were seeing yourself from a distance (or watching a movie of yourself)? Have you ever felt as if a part of your body or your whole being was foreign to you? Have you ever felt as if you were two different people, one going through the motions of life and the other part observing quietly? Derealization: Have you ever felt as if familiar surroundings or people you knew seemed unfamiliar or unreal? Have you ever felt puzzled as to what is real and what's unreal in your surroundings? Have you ever felt as if your surroundings or other people were fading away? Identity confusion: Have you ever felt as if there was a struggle going on inside of you? Have you ever felt confused as to who you are? Identity Alteration: Have you ever acted as if you were a completely different person? Have you ever been told by others that you seem like a different person? Have you ever found things in your possession (for instance, shoes) that belong to you, but you could not remember how you got them?
treatment of eating disorders
Sociocultural -Family component for clients -Maudsley model: Families enter treatment for 10 to 20 sessions over a 6- to 12-month period. }Biological - Serotonin and dopamine receptor genes }SSRIs }Psychological }Cognitive-behavioral therapy: Clinicians attempt to change what are selective biases in people with eating disorders that lead them to focus on the parts of their bodies they dislike. }Exposure therapy: clients view their own bodies, clinicians attempt to reduce the negative emotions that they would ordinarily experience. }Holistically viewing their bodies in front of a mirror
Somatoform disorders
Somatic symptoms involving physical problems and/or concerns about medical symptoms. -The term "somatic" comes from the Greek word "soma," meaning body.
disorder category: parasomnia
Specific disorder: Non-rapid Eye Movement Sleep Arousal Disorder. Symptoms: Recurrent episodes of incomplete awakening from sleep accompanied by either sleepwalking or sleep terrors, and not associated with rapid eye movements (R E M s). Specific disorder: Nightmare Disorder. Symptoms: Repeated occurrences of extended, dysphoric, and well-remembered dreams that typically Involve threats to one's life. Specific disorder: Rapid Eye Movement Sleep Behavior Disorder. Symptoms: Frequent episodes of arousal during sleep associated with speaking and/or motor behaviors occurring during REM sleep. Specific disorder: Restless Legs Syndrome (R L S). Symptoms: An urge to move the legs along with uncomfortable and unpleasant sensations in the legs, urges that begin or worsen during periods of rest or inactivity that are partially or totally relieved by movement, and are worse or only occur in the evening or night.
secondary gain
Sympathy and attention they receive from other people when they are ill. Clients with factitious disorder deliberately feign or exaggerate symptoms for secondary gain
primary gain:
The direct benefits of occupying the sick role (time-off, insurance payments, tangible rewards)
nature of anxiety disorders
The essential feature of anxiety disorders is the experience of a chronic and intense feeling of anxiety.
Binge-eating disorder
The ingestion of large amounts of food during a short period of time, even after reaching a point of feeling full, and a lack of control over what or how much is -Binges occur at least twice a week for 6 months. -Feeling self-disgust or guilt after overeating. -Significant weight gain can occur since there are no compensatory behaviors.
Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale (B D D-Y O C S)
This modification of the Yale-Brown Obsessive-Compulsive Scale uses the following criteria to determine the severity of the client's symptoms regarding the presumed body defect or defects: 1.Time occupied by thoughts about body defect 2.Interference due to thoughts about body defect 3.Distress associated with thoughts about body defect 4.Resistance against thoughts about body defect 5.Degree of control over thoughts about body defect 6.Time spent in activities related to body defect such as mirror checking, grooming, excessive exercise, camouflaging, picking at skin, asking others about defect 7.Interference due to activities related to body defect. 8.Distress associated with activities related to body defect 9.Resistance against compulsions 10.Degree of control over compulsive behavior 11.Insight into the nature of excessive concern over defect 12.Avoidance of activities due to concern over defect.
factitious disorder imposed on another
a condition in which one person induces illness symptoms in someone else. Munchausen's syndrome by proxy
Derealization
a condition in which people feel a sense of unreality or detachment from their surroundings
Illness anxiety disorder
a somatic symptom disorder characterized by the misinterpretation of normal bodily functions as signs of serious illness. -People with this disorder fear or mistakenly believe that normal bodily reactions represent the symptoms of a serious illness. -Formerly called hypochondriasis
systematic desensitization
a variant of counterconditioning that involves presenting the client with progressively more anxiety-provoking images while in a relaxed state
Rumination Disorder
eating disorder in which the infant or child regurgitates food after it has been swallowed and then either spits it out or re-swallows it. }Five common disturbances include: 1.delayed or absent development of feeding and eating skills, 2.difficulty managing or tolerating food or drink 3.reluctance to eat food based on taste, texture, and other sensory factors, 4.lack of appetite or interest in food 5.the use of feeding behaviors to comfort, self-soothe, or self-stimulate.
malingering
fabrication of physical or psychological symptoms for some ulterior motive. -Clinicians assume that clients engage in malingering in order to get a direct benefit or primary gain
fear
innate alarm response to a dangerous or life-threatening situation
Conversion disorder (functional neurological symptom disorder)
involves an individual experiencing a change in a bodily function not due to an underlying medical condition. Clients with conversion disorder show a wide range of physical ailments: -Pseudoseizures -Disorders of movement -Paralysis -Weakness -Disturbances of speech -Blindness and other sensory disorders -Cognitive impairment
Somatic symptom disorder
involves physical symptoms that may or may not be accountable by a medical condition. -Maladaptive thoughts, feelings, and behaviors are also present. -People with this disorder think to a disproportionate degree about the seriousness of their symptoms. They feel extremely anxious about them, and spend a great deal of time and energy on the symptoms or their concerns about their health
Social anxiety disorder
is characterized by intense, fear of anxiety of social situations in which the individual may be scrutinized by others. -The anxiety the person experiences is centered on a desire to avoid humiliation or embarrassment
Factitious disorder imposed on self
people fake symptoms or disorders, not for the purpose of any particular external gain but because of an inner need to maintain a sick role.
Eating disorders associated with childhood
pica, rumination disorder, elimination disorders
Disorder category: Insomnia disorder
predominant symptom: Difficulty initiating or maintaining sleep, along with early-morning awakening.
Disorder category: Orcadian Rhythm Sleep-Wake Disorders
predominant symptom: Persistent patterns of sleep disruption due primarily to altered circadian rhythm or misalignment between the Individual's internal circadian rhythm and the sleep-wake schedule required by the person's environment, or work or social schedule. Includes delayed sleep phase type (delay in timing of major sleep period), advanced sleep phase type (sleep-wake cycles that are several hours earlier or conventional), irregular sleep-wake type, non-24-hour sleep-wake type, and shift work type.
Disorder category: Narcolepsy
predominant symptom: Recurrent periods of an irrepressible need to sleep, lapsing into sleep, or napping within the same day. Diagnosis also requires either episodes of jaw-opening or losing facial muscle tone while laughing or showing abnormal CSF or sleep disturbances on polysomnography.
disorder category: Breathing Sleep-related disorders
specific disorder: Obstructive sleep apnea hypopnea: symptoms- Frequent episodes of apnea and hypopnea while sleeping as indicated on polysomnography along with either snoring, snorting/gasping, or breathing pauses during sleep and daytime sleepiness, fatigue, or unrefreshing sleep. Specific: Central sleep apnea. Symptoms- frequent episodes of apnea while sleeping. Specific: Sleep-related hypoventilation. Symptoms: Episodes of decreased breathing (ventilation) while asleep.
Depersonalization
the condition in which people feel they are detached from their own body.
Anxiety disorders are...
the most highly prevalent of all psychological disorders with the exception of substance use disorders.
Pica
}A condition in which a person eats inedible substances, such as dirt or feces. }Significant medical consequences occur to due to lead poisoning or injury to the gastrointestinal tract. }Pica is the most serious cause of self-injury to occur in people with intellectual developmental disabilities
Oppositional defiant disorder
}A disorder characterized by angry or irritable mood, argumentative or defiant behavior, and vindictiveness that results in significant family or school problems. }Oppositional defiant disorder typically becomes evident between ages 8 and 12. }Oppositional defiant disorder often progresses to conduct disorder.
Eating disorders characteristics
}Eating disorders reflect a complex set of interactions among an individual's: }Genetic vulnerability }Experiences with eating, body image, and exposure to sociocultural influences. }Researchers are particularly interested in the role of dopamine, which is involved in feelings of reward and pleasure including those related to eating.
Pyromania
}Impulse-control disorder involving the persistent and compelling urge to start fires. }To be diagnosed with pyromania, the individual must not set fires for monetary reasons or have other medical or psychiatric conditions }Reflect abnormalities in dopamine functioning. }Treatment }Cognitive-behavioral therapy
Kleptomania
}Impulse-control disorder that involves the persistent urge to steal. }Don't actually wish to have the object, or the money that it's worth. Instead, they seek excitement from the act of stealing. }Researchers believe that these features of kleptomania also bear similarities to substance dependence.
Avoidant/restrictive food intake disorder
}Individuals show an apparent lack of interest in eating or food because they are concerned about the aversive consequences. }Food may be avoided based on its sensory characteristics: }Color, smell, texture, temperature, or taste. }As a result, significant weight loss occurs and psychosocial function is disturbed. }People may develop this disorder as the result of a conditioned negative response.
Impulse-control disorders
}People with impulse-control disorders repeatedly engage in behaviors, often ones that are harmful, that they feel they cannot control. }After acting on their impulses, they experience a sense of pleasure or gratification, although later they may regret that they engaged in the behavior.
Sleep-wake disorders
}Researchers and clinicians in sleep medicine typically take a biopsychosocial approach, examining: }Genetic and neurophysiological contributions }Psychological interactions }Social and cultural factors that impinge on the individual's sleep quality and quantity. }Clinician's need to perform a thorough evaluation when clients present with sleep-related disturbance. }Polysomnography is a sleep study that records brain waves, blood oxygen levels, heart rate, breathing, eye movements, and leg movements.
Elimination Disorders
}characterized by age-inappropriate incontinence and are generally diagnosed in childhood. }Enuresis: bed wetting or urination in their clothing after the age when they should be toilet trained }Encopresis: child who is at least 4 years old repeatedly has bowel movements either in its clothes or in another inappropriate place.
