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139 terms

Abnormal Psychology

Chapters 5 and 8
STUDY
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anxiety
apprehension over an anticipated problem
fear
reaction to immediate danger
anxiety disorders
disorders in which fear or tension is overriding and the primary disturbance; include phobic disorders, panic disorder, generalized anxiety disorder, obsessive compulsive disorder, acute stress disorder, and post traumatic stress disorder
phobia
disruptive fear of a particular object or situation that is out of proportion to any danger posed
specific phobia
unwarranted fear caused by the presence of a specific object or situation
panic disorder
characterized by frequent panic attacks that are unrelated to specific situation and by worry about having more panic attacks
panic attacks
sudden attack of intense apprehension, terror, and feelings of impending doom, accompanied by at least four other symptoms (i.e. labored breathing, heart palpitations, nausea, upset stomach, chest pain, feelings of choking and smothering, dizziness, lightheadedness, seating, chills, hot flashes, and trembling)
depersonalization
feeling of being outside ones body during a panic attack
derealization
feeling of the worlds not being real during a panic attack
agoraphobia
defined by anxiety about situations in which it would be embarrassing or difficult to escape if panic symptoms occurred; fear and avoidance of places where they might feel unsafe
generalized anxiety disorder
disorder characterized by anxiety so chronic, persistent, and pervasive that it seems free-floating. individual is jittery and strained, distractible, and worried that something bad is about to happen. pounding heart, fast pulse and breathing, sweating, flushing, muscle aches, a lump in the throat, and an upset gastrointestinal tract are some of the bodily indications.
obsessive compulsive disorder
characterized by persistent and uncontrollable thoughts or urges and by the need to repeat certain acts again and again
obsessions
intrusive and recurring thoughts, images, or impulses that are persistent and uncontrollable
compulsions
repetitive clearly excessive behaviors or mental acts that the person feels driven to perform to reduce the anxiety caused by obsessive thoughts or to prevent some calamity from occuring
posttraumatic stress disorder
entails an extreme response to a severe stressor, including increased anxiety, avoidance of stimuli associated with the trauma and a general numbing of emotional responses
acute stress disorder
short lived anxiety reaction to a traumatic event; if it lasts more than a month, it is diagnosed as post traumatic stress disorder
subthreshold symptoms
symptoms that do not meet full diagnostic criteria
fear circuit
set of brain structures, including the amygdala, that tend to be activated when the individual is feeling anxious or fearful; especially active amount people with anxiety disorders
neuroticism
personality trait defined by the tendency to react to events with greater than average negative affect
behavioral inhibition
tendency to become agitated and cry when faced with novel toys, people, or other stimuli
safety behaviors
behaviors used to avoid experiencing anxiety in feared situations, such as the tendency of people with social phobia to avoid looking at other people (so as to avoid perceiving negative feedback) or the tendency of people to with panic disorder to avoid exercise (so as to avoid somatic arousal that could trigger a panic attack)
Mowrer's two-factor model
theory of avoidance learning according to which (1) fear is attached to a neutral stimulus by pairing it with a noxious unconditioned stimulus, and (2) a person learns to escape the fear elicited by the conditioned stimulus, thereby avoiding the UCS
prepared learning
our fear circuit may have been "prepared" by evolution to learn fear of certain stimuli
locus ceruleus
the brain region in the fear circuit that is especially important in panic disorder; the major source in the brain of norepinephrine, which helps trigger sympathetic nervous system activity
interoceptive conditioning
classical conditioning of panic attacks in response to internal bodily sensations of arousal (as opposed to the external situations that trigger anxiety)
Anxiety Sensitivity Index
measures the extend to which people resound fearfully to their bodily sensations
fear-of-fear hypothesis
suggests that agoraphobia is driven by negative thoughts about the consequences of having a panic attack in public
orbitofrontal cortex
portion of the frontal lobe located just above the eyes; one of three closely related brain regions that are unusually active in individuals with obsessive-compulsive disorder
anterior cingulate
in the subcortical region of the brain, the anterior portion of the cingulate gyrus, stretching about the corpus callosum
thought suppression
key feature of obsessive-compulsive disorder; has the paradoxical effect of inducing preoccupation with the object of thought
dissociation
process by whereby a group of mental processes is split off from the main stream of consciousness, or behavior loses its relationship with the rest of the personality
panic control therapy
cognitive behavior treatment, based on the tendency of individuals with panic disorder to overreact to bodily stimuli, in which sensations are induced physically and coped with under safe conditions
exposure and response prevention
the most widely used and accepted treatment of obsessive compulsive disorder in which the sufferer is prevented from engaging in compulsive ritual activity and instead faces the anxiety provoked by the stimulus, leading eventually to extinction of the conditioned response (anxiety)
imaginal exposure
treatment that involved visualizing trauma related scenes for extended periods of time
anxiolytics
minor tranquilizers benzodiazepines used to treat anxiety disorders
benzodiazepines
any of several drugs commonly used to treat anxiety, such as Valium and Xanax
antidepressants
any drug that alleviates depression; also widely used to treat anxiety disorders
tricyclic antidepressants
group of antidepressants with molecular structures characterized by three fused rings; interfere with the reuptake of norepinephrine and serotonin
selective serotonin reuptake inhibitors
any of various drugs that inhibit the presynaptic reuptake of the neurotransmitter serotonin, thereby prolonging its effects on postsynaptic neurons
beta blockers
any of numerous beta-adrenergic antagonists, competitive inhibitors of a class of receptors for the hormone adrenaline; are approved as cardiovascular drugs but often used to treat social phobia, despite a lack of demonstrated efficacy
mood disorders
disorders, such as depressive disorders or mania, in which there are dialing disturbances in mood
major depressive disorders
symptoms must be present for at least 2 weeks, symptoms include depressed mood or loss of interest and pleasure, plus changes in sleep, appetite, concentration or decision-making, feelings of worthlessness, suicidality, or psychomotor agitation or retardation
episodic disorder
symptoms tend to be present for a period of time and then clear
dysthymic disorder
chronically depressed - more than half of the time for at least two years, they feel blue or derive little pleasure from usual activities and pastimes
mania
state of intense elation or irritability accompanied by other symptoms shown in the diagnostic criteria
flight of ideas
symptom of mania that involves a rapid shift in conversation from one subject to another with only superficial associative connections
mixed episodes
severe symptoms of both mania and depression within the same week
hypomania
less extreme than mania; change in functioning that does not cause serious problems
bipolar I disorder
single episode of mania or a single mixed episode during the course of a person's life
bipolar II disorder
person must have experienced one major depressive episode and at least one episode of hypomania
cyclpthymic disorder
requires symptoms be present for at least two years; frequent but mild symptoms of depression, alternating with mild symptoms of mania
seasonal
episodes happen regularly at a particular time of the year
rapid cycling
person has experienced at least four episodes within the past year
psychotic features
delusions or hallucinations
catatonic features
extreme immobility or excessive peculiar physical movement
postpartum onset
onset within 4 weeks postpartum
melancholic
no pleasure in any activity, does not feel better even temporarily when good things happen, and also experiences at least three other symptoms of depression
tryptophan
amino acid that is the major precursor of serotonin, experimental depletion has found that a lowered serotonin level causes temporary depressive symptoms in people with a personal or family history of depression.
second messengers
adjust postsynaptic receptor sensitivity
g-proteins
play an important role in modulating activity in the postsynaptic cell
reward system
system of brain structures involved in motivation to pursue rewards. believed to be involved in depression, mania, schizophrenia, and substance abuse
cortisol
main stress hormone
Cushing's syndrome
causes over secretion of cortisol, frequently experiences depressive symptoms
expressed emotion
family member's critical or hostile comments toward or emotional over involvement with the person with depression
negative affect
distress and worry
positive affect
happiness and contentment
somatic arousal
sweaty palms, fast heart rate, etc.
extraversion
personality trait associated with frequent experiences of positive affect
negative triad
negative views of the self, the world, and the future
schemata
mental structure for organizing information about the world
cognitive biases
tendencies to process information in certain negative ways
learned helplessness theory
theory of depression etiology that individuals, through unpleasant experiences and traumas against which their efforts were ineffective, acquire passivity and a sense of being unable to act and to control their lives
attributions
explanations a person forms about why a stressor has occurred 3 dimensions - 1. internal (personal) vs. external (environmental) causes 2. stable versus unstable causes 3. global vs. specific causes
attributional style
person's relatively consistent approach to attribution, for example, the consistent attribution of negative life events to internal, stable, and global causes is thought to dispose to depression
hopelessness theory
cognitive theory of depression that began with learned helplessness theory, was modified to incorporate attributions, and has been modified again to emphasize hopelessness - an expectation that desirable outcomes will not occur and that no available responses can change the situation
interpersonal psychotherapy
short term, here and now focused psychological treatment initially developed for depression and influenced by the psychodynamic emphasis on relationships
cognitive therapy
any behavior therapy procedure that attempts to alter the manner in chick a client thinks about life so that he or she changes overt behavior and emotions
mindfulness based cognitive therapy
focuses on relapse prevention after successful treatment for recurrent episodes of major depression
behavioral activation
people are given activity assignments to provide them with successful experiences and to allow them to think well of themselves
behavioral couples therapy
researcher work with both members of a couple to improve communication and relationship satisfaction
psychoeducational approaches
help people learn about the symptoms of the disorder, the expected time course of symptoms, the biological and psychological triggers for symptoms, and treatment strategies
family-focused treatment
aims to educate the family about the illness, enhance family communication, and develop problem solving skills
electroconvulsive therapy
deliberately inducing a momentary seizure and unconsciousness by passing a 70-130 volt current through the patients brain
egoistic suicide
committed by people who have few ties to family, society, or community
altruistic suicide
committed because the person believes it will be for the good of society
anomic suicide
triggered by a sudden change in a person's relation to society (serious economic and cultural changes)
situationally bound panic attacks
occur in situations you are aware of and only those situations (w/specific phobias or social phobias)
unexpected (uncued) panic attacks
no clue when an attack will come on, associated with panic disorder
situationally predisposed panic attacks
more likely to have a panic attack in a situation when you've had one before, not guaranteed you will, also under panic disorder
polygenic
many genes contribute
increase anxiety
decrease GABA functioning in relation to anxiety
increase panic attacks
high levels of NE in relation to panic attacks
Behavioral inhibition system
activated by signals descending from cortex or ascending from brainstem ( brainstem - amygdala - mPFC (medial prefrontal cortex) )
behavioral inhibition
tendecy to become agitated and cry in novel settings
external cues provoking fear response
similar places or situaitons
internal cues provoking fear response
increases in HR and respiration associated with initial attack (even if due to normal events)
unconscious cues provoking fear response
cues/triggers may travel from eyes directly to amygdala
cognitive risk factors for anxiety
percieved control (history of childhood trauma or punitive parenting), inadequate coping strategies, attention to threat tendency to notice negative environmental cues
social risk factors for anxiety
negative life events - negative cognition can be a consequence, response to stressors runs in families
triple vulnerability threat
biological vulnerability, generalized psychological vulnerability, specific psychological vulnerability
etiology of GAD
GABA system deficits, do not respond as strongly to stressors as people w prominent panic do, autonomic restrictors (less physiological responsiveness, chronically tense muscle tension)
cognitive factors of GAD
less able to identify their own neg feelings, allocate attention to sources of threat more readily, borkovec's cognitive model
Borkovec's Cognitive model
worry negatively reinforcing (removes neg thought processes), allows avoidance of more disturbing emotions, avoidance prevents extinctionh
typical places avoided by agoraphobics
shopping malls, subways, wide streets, tunnels, restaurants, theaters, elevators, being far from home, staying home alone, supermarkets/stores, crowds, planes, escalators
interoceptive avoidance
avoidance of internal physical sensations i.e. running, aerobics, dancing, hiking, drinking caffeinated beverages, etc.
etiology of panic disorder (neurobiological )
locus ceruleus- increase activity produces more norepinephrine causing more anxiety (only those susceptible to panic attacks)
etiology of panic disorder (conditioning)
interoceptive conditioning - classical condition of panic in response to bodily sensations (external and internal cues present for initial attack)
etiology of panic disorder (cognitive)
develop anxiety over possibility of another panic attack, tendency to misinterpret somatic symptoms triggers panic attack
etiology of specific phobias
direct experience - true alarm, experiencing a false alarm (panic attack), being told about danger (info transmission)
etiology of specific phobias (social factors)
more likely to see in females because they are more lily to say they fear something than males because of societies views
problems with mower's two factor model
many people never experience aversive interaction with phobic object, people w phobias tend to fear only certain types of objects (prepared learning), even phobias linked to modeling influenced by prepared learning
etiology of social phobia (cognitive factors)
negative self evaluation - high standards, fear of negative evaluation by others, excessive attention/monitoring internal cues
social phobial 3 possible pathways
1. inherited tendency to be socially inhibited combined with generalized and specific psychological vulnerabilities 2. conditioned through a panic attack 3. real social trauma (true alarm) 92% of adults experience teasing as a child
etiology of OCD (neurobiological)
hyperactive regions of the brain - orbitofrontal cortex, caudate nucleus, anterior cingulate
etiology of OCD (cognitive/behavioral)
operant reinforcement (engage in behaviors take away anxiety), lack of satiety signal, attempts to suppress intrusive thoughts (the more likely you are to do it)
etiology of PTSD
severity and type of trauma, smaller hippocampal volume, increased sensitivity to cortisol, higher levels of CRF, two factor model, perception of control, avoidance coping, dissociation
exposure
face the situation or object that triggers anxiety (face your fears) w/ as many triggers and settings as possible
systematic desensitization
relaxation plus imaginal exposure (70-90% effective), spontaneous recovery possible
cognitive behavioral therapy
increase patients awareness of thoughts due to interoceptive conditioning
panic control therapy
exposure to somatic sensations associated with panic attack in a safe setting, use of coping strategies to control symptoms
panic disorder meds
SSRI's, Xanax (benzodiazapines), relapse high if discontinued
social anxiety meds
beta blockers, tricyclics and MAO inhibitors (last resort because of side effects), SSRIs
Clarks cognitive therapy
learn not to focus attention internally, address beliefs of how others will respond (social phobia treatment)
psych treatment of GAD
meditational approaches to teach patients to be more accepting of their distressing thoughts, relaxation training - promote calmness
cognitive behavioral methods GAD
challence and modify neg thoughts, increase ability to tolerate uncertainty, worry only during scheduled times, focus on present moment
GAD meds
benzos-therapeutic effects modest (less alert more drug dependencies, associated w falls in elderly) paxil and venlafaxine better choices
psych treatment of OCD
exposure plus response (ritual) prevention - intense, reduce not eradicate symptoms
cognitive treatment of OCD
challenge beliefs about anticipated consequences of not engaging in compulsions
OCD meds/surgery
clomipramine (tricyclic), SSRIs, psychosurgery (lesion to cingulate - 30% benefit)
PTSD cognitive therapy
enhanced beliefs about coping abilities, learn not to self blame, CT+exposure - guilt but not symptom reduction
psych treatment of PTSD
exposure to memories and reminders of the original trauma (direct, imaginal, or virtual reality), may initially increase symptoms, more effective ethan meds
MDD neurobiological factors
low levels of NE, DA, and 5-HT
Mania neurobiological factors
high levels of NE, DA, low levels of 5-HT
higher activity
activity in amygdala in MDD and BP
decrease activity
hippocampus activity MDD
overly active
anterior cingulate activity MDD, anhedonia/coping
arbitrary inference
individual does not take into account other possibilities, automatically attribute to themselves
overgeneralization
1 failing signifies that they are a complete failure
vagus nerve stimulation
implanted stimulator that sends impulse to left vagus nerve in the next, sends electrical impulses