2. Generalized anxiety disorder is characterized by a difficulty turning off or controlling the worry process, physical symptoms, muscle tension, sleeplessness compared to autonomic symptoms. Those with GAD do not respond strongly to outside stressors. Panic disorder and agoraphobia are often co-morbidities. Panic disorder differs between cultures and genders. Specific phobias characterized by fear of specific object or situation, often with the recognition that level of fear is disproportionate. Phobias can be learned vicariously.
Depression: genes associated with depression, maltreated during childhood
Alc. Example: two college students drinking, one has the addictive genes
PTSD: where a fam history of anxiety suggests a generalized biological vulnerability of PTSD, and a traumatic experience, the stressing factor which can be shooting/military/etc, will lead to PTSD
Discuss the role of neurotransmitters and negative cognitions in the etiology and treatment of depression.
Using the assigned readings and/or lecture slides, describe one of the recent pharmacological interventions being used with success for Major Depressive Disorder.
recent files? psilocybin/ketamine
Summarize the findings demonstrating their potential in treating individuals with Major Depressive Disorder for whom existing medications are ineffective.
Toxicology screening in the emergency room was negative, as were other medical tests. Physical examination revealed an extremely healthy, athletic young man who was largely mute and held his body in a rigid posture. The hospital chart noted one previous psychiatric admission a year before. The diagnosis was "Atypical Psychosis, rule out some kind of organic or drug psychosis." Thomas had been in the hospital only four days, during which time he was observed to be talking to himself and indicating that he was communicating directly with God.
During the first days of the current hospitalization, Thomas was observed to alternate between "rigid posturing" -as if in a trance- and "mild hyperactivity." He would spontaneously become "unstuck" as if coming out of his trance state and began pacing actively around the unit, talking about his new-found faith in religion to "anyone he could corral" and compel to listen.
-Severe and long-lasting disturbance, with highs that involve not sleeping and becoming sexually demanding of his girlfriend, manic episode characterized by decreased need for sleep
-Severe lows where with excessive sleeping and ceasing of social interaction, hospitalized for intensity, delusions account for mood congruency
-Mood congruent because he is having grandiose delusions during manic episodes of talking to god (psychotic feature during mania)
-Catatonic (aligns with rigid body structure)
Ms. Hancock's academic and vocational history has been erratic. She has a masters degree in psychology and worked as a counselor for a while, but found that too upsetting. She then began a Ph.D. program in sociology, completed her coursework, but interrupted this to train in physical therapy. She has never worked in one job more than a few years and has spent much of her adult life as a student. Her current romance is the longest she has sustained. She lived with a man once previously, but this was a brief and tumultuous relationship. Boyfriends described her as 'needy and clinging' and it appears her current boyfriend fears her neediness.
Although Ms. Hancock reports chronic depression, when she is asked about 'high' periods, she describes many episodes of abnormally elevated mood that have lasted several months. During these times she would function on 5 hours sleep a night, run up huge telephone bills, and .
Ms. Hancock is indeed an unhappy-looking woman and describes being unhappy through much of her life, with no long periods of feeling really good. Her father had a history of alcohol problems, and there was always a great deal of strife in her parents' marriage. She denies sexual or physical abuse, but she feels her parents were "emotionally abusive" to her. She was first referred for treatment after a suicide attempt at age 14, and there have been many times over the years during which her usual low-level depression has been considerably worse,but she sought no treatment.
Two years ago, when she had been seeing her current boyfriend for about 4 years, it finally became clear that he was unwilling to marry her or live with her. She began to get more depressed and to experience acute panic attacks, and it was at that time that she entered psychotherapy. In the month before this current evaluation she says she was depressed most of the time. She had gained 10 pounds because she was constantly nibbling on chips or cookies or making herself peanut butter sandwiches. She often awakened in the middle of the night, was unable to get back to sleep for hours, and overslept the following day, often sleeping up to 18 hours. She says she feels like dead weight, her legs and arms are heavy, and she is always tired. She ruminates about her own failures and cannot concentrate on any serious reading. Although she often wishes to be dead, she has not made any recent suicide attempts.
Ms. Hancock's mood is clearly reactive to favorable events. Small attentions from her therapist or her boyfriend can cause her to feel really good for hours at a time. She has an equally extreme reaction to any sort of rejection. If a friend does not return a call, or if someone appears to be romantically interested and withdraws, she feelsm devastated tfeel her thoughts were racing. She was able to get a lot done, but her friends were obviously concerned about the change in her behavior, urging her to slow down and calm down. She has never gotten into any real trouble during these episodes.
On further questioning, Lorraine reveals that she cannot even remember feeling comfortable socially. Even before kindergarten, if she was asked to speak in front of a group of family friends, her mind would "go blank." she felt overwhelming anxiety at children's social functions, such as birthday parties, which she either avoided or, if she went, attended in total silence. She could answer questions in class only if she wrote down the answers in advance; even then, she frequently mumbled and couldn't get the answer out. She met new children with her eyes lowered, fearing their scrutiny, expecting to feel humiliated and embarrassed. She was convinced that everyone around her thought she was "dumb" or "a loser."
As she grew up, Lorraine had a couple of neighborhood playmates, but she never had a "best friend." her school grades were good, but suffered when oral classroom participation was expected. As a teenager, she was terrified of boys, and to this day has never gone on a date or even accepted a boy for a date. This bothers her, although she is so often depressed that she feels she has little energy or interest in dating.
Lorraine attended college and did well for a while, then dropped out as her grades slipped. She remained very self-conscious and "terrified" of meeting strangers. She had trouble finding a job because she was unable to answer questions in interviews. She worked at a few jobs for which only a written test was required. She passed a Civil Service exam at age 24, and was offered a job in the post office on the evening shift. She enjoyed this job since it involved little contact with others. She was offered, but refused, several promotions because she feared the social pressures. Although by now she supervises a number of employees, she still finds it difficult to give instructions, even to people she has known for years. She has no friends and avoids all invitations to socialize with co-workers. During the past several years, she has tried several therapies to help her get over her "shyness" and depression.
Lorraine has never experienced sudden anxiety or a panic attack in social situations or at other times. Rather, her anxiety gradually builds to a constant high level in anticipation of social situations. She has never experienced any psychotic symptoms.
-marked and persistent fear around social performance situations, anxiety provoked by exposure to social situations, social situations are avoided, interferes with routine and is not due to the use of drugs
Other sets by this creator
Write the letter of the term that correctly identifies each underlined word.
Many explorers(1) have been drawn to Antarctica (2), even though the continent has the harshest environment in the world. It (3) is dry, windy, and extremely cold. Ninety-eight percent of its surface is (4) a sheet of ice. In the summer of 1911-1912, two groups of explorers actually reached(5) the South Pole. The English group, led by Robert Falcon Scott, picked their way carefully(6) across the dangerous (7) ice with its deep crevasses. When they finally reached the pole, however, they found that another team had been there before (8) them. The Norwegian(9) group, led by Roald Amundsen, had reached the pole one month before Scott, and (10) they had left their flag to mark the spot.