Exam 2 Notes
Exam 2 Notes PY 358
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This 14 page Bundle was uploaded by Casey Marshall on Tuesday September 22, 2015. The Bundle belongs to PY 358 at University of Alabama - Tuscaloosa taught by Theodore Tomeny in Fall 2015. Since its upload, it has received 54 views. For similar materials see Abnormal Psychology in Psychlogy at University of Alabama - Tuscaloosa.
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Date Created: 09/22/15
CHAPTER 4 What is anxiety 0 A common emotion characterized by 1 physical symptoms 2 futureoriented thoughts and 3 escape or avoidance behaviors o Occurs when people encounter a new situation or anticipate a lifechanging event 0 Usually timelimited and ends when the event is over Public speaking number one fear that American s report FiqhtorFliqht Response 0 Activation of the SNS triggered by fear or stress 0 Sympathetic nervous system SNS increases heart rate and respiration allowing your body to perform at peak efficiency 0 Allows you to use all available resources to escape o Parasympathetic nervous system PNS slows down the heart rate and respiration thus returning the body to a resting state W anxiety disorder PNS is working hard enough SNS working too hard Just How It Works 0 You are walking on a path at a local park ad all of a sudden you see a snake slither out in front of you 0 Physical Symptoms As soon as you see the snake your heart starts racing and your breathing increases body s response 0 Negative Cognitions What is the sake strikes me and it s venomous 0 Escape or Avoidance Behavior You scream for help or run in the other direction How Anxiety Starts Avoidance 0 You see a spider in the bathroom 0 You become anxious You run away from the spider a You feel better but you also learn that scapeavoidance eliminates fear so you are more likely to avoid the next spider and your fear grows only works in the short term the spider s still in the bathroom could possibly even develop a phobia of spiders can t go places where spiders might even be What are some other common examples of avoidance 0 Fight with a friend don t resolve it you just avoid them instead eventually you might even lose the friend or the friend might grow more upset with you 0 Due dates procrastination due date creeps up on you and you grow anxious because it s due tomorrow Normal Anxiety vs Abnormal Anxiety Things to consider feeling anxious occasionally is normal 0 Ex test taking a little anxiety is good and allows you to retain information and study better Functional impairment Sociodemographic factors 0 Sex raceethnicity and SES Women and men seek treatment at equal rates if fear is severe Developmental age 0 Cognitive development not actual chronological age What Do Children Fear DNTK SoHdarty Darkness Strangers Clowns Loud noises Monsters Not all kids are scared off these things why not 0 Experience parents help reduce certain fears or enable certain fears by way of portrayal o Temperament biological problem also with environmental problem Kid s fears change as they get older which most are normal fears depend a lot upon situation What are the Anxiety Disorders Group of disroders characterize by heightened physical arousal cognitive distress and behavioral avoidance of feared objectssituationsevents Often a comorbid disorder Most common disorder among all age groups Panic Attacks Panic Disorder Agoraphobia Generalized Anxiety Disorder Social Anxiety The Facts about Anxiety Disorders 312 of American adults will suffer at some point in their lives Most common disorder among all age groups Onset is around 11 years old Equally distributed among Hispanics nonHispanic blacks and nonHispanic whites Significant economic burden 423 billion Frequent comorbidity issues Fact or Fiction Panic attacks tend to only occur in people diagnosed with a panic disorder false GAD is found to be more common in individuals from lower SES Yes they tend to have more real challenges in life Panic Attacks Discrete period of intense fear and physical arousal Which develops abruptly Symptoms peak in about ten minutes 0 Somatic and cognitive symptoms 0 Common occurrence Two types of attacks 0 Expected panic attacks Ex afraid of heights panic attack before climbing ladder or riding in glass elevator o Unexpected panic attacks Seems to come out of the blue not clear reason why hey had them Remember as many as 283 of adults report having a had a panic attack although only 47 of adults have panic disorder Panic Disorder Multiple panic attacks Agoraphobia 0 Fear of the marketplacequot 0 Can sometimes enter fear situations with trusted companions 0 Fear embarrassment Fear of not being able to escape safety 0 Usually begins in early childhood 0 Women are more likely to experience agoraphobia than men Generalized Anxiety Disorder GAD 0 Excessive worry about future events past transgressions financial status and the health of oneself and loved ones 0 Worries last for months and they are ever present allows happening 0 Lasts at least six months 0 Onset late teens early childhood 205 0 Account for 12 of PCP primary care provider visits 0 Common in lower SES 0 More likely to occur in adults than children Social Anxiety Disorder 0 The third most common psychiatric disorder 0 A pervasive pattern of social timidity characterized by fear that the person will behave in a way that will be humiliating or embarrassing Intense feat that others will detect anxiety 0 Social situations that create distress speaking eating drinking or writing in the presence of others engaging in social interactions and initiating conversations o The situations that tend to make them anxious change with age Real People Real Disorders Ricky Williams 0 Heisman trophy winner 0 1St round college draft pick for the NFL 0 Conducted interviews with his helmet on 0 Difficulty interacting with others 0 At times unable to leave the house to run errands Specific Phobias 0 Severe and persistent fears of circumscribed events objects or situations that lead to significant disruption in areas of functioning Four groups 0 Animal phobias 0 Natural environment phobias o Bloodinjectioninjury phobias vasovagal syncope o Situational phobias ex Claustrophobia ObsessiveCompulsive Disorder 0 A condition involving obsessions intrusive thoughts often combined with compulsions repetitive behaviors that can be extensive time consuming and distressful Obsessions vs Compulsions 0 Example Howie Mandel 0 Fear of burning one s house down let me check the stove 13 times spin around and check again idiosyncratic patterns with their checking Posttraumatic Stress Disorder PTSD After an event that involves actual or threatened death serious injury or a threat to physical integrity emotional distress leads to avoidance of stimuli associated with the trauma 0 Persistent symptoms of increased SNS arousal 0 Classic symptoms associated with PTSD o Nightmares flashbacks actually reliving itquot all senses are engaged lake of sleep or sleep disturbance emotional dullness feelings of guilt 911 Trauma Grief PTSF and Resilience Experiences lived by inner city adolescents o Stabbings o Shootings 0 Murder 0 90 of Americans have been exposed to trauma but only 5 to 11 develop PTSD as a result 0 What are some protective factorsquot that shield one from developing PTSD 0 Social support 0 If they do or do not have genetic predisposition for it 0 Type of trauma 0 What does resilience mean 0 When you do ok experiencing some sort of stressor you bounce back 0 Exposure to trauma is not enough to develop PTSD Separation Anxiety Disorder SAD 0 Severe and unreasonable fear of separation from a parent or caregiver 3 to 5 of all children suffer o More common among girls 0 Children from all ethnic backgrounds are equally to suffer from SAD How do Anxiety Disorders Develop Biology says 0 Heredity factors 0 TemperamentTrait anxiety personality traits 0 Differences in brain functioning and brain structure 0 Neurotransmitters particularly serotonin and GABA natural valiumquot 0 Figure 46 o Freud says 0 A conflict exists between the id childishquot wants and ego adutquot ways of thinking 0 Sexual and aggressive impulses 0 Defense mechanisms especially repression and displacement result in problems Behavioral theories 0 Leaned behavior one becomes classically conditioned o Vicarious learning theory 0 Information transmission Parents tell kids you should be afraid of strangers fears can become maladaptive and can cause problems later on 0 Cognitive theories 0 Information is processed differently leading to the development of anxiety Aaron Beck and maladaptive thoughts Fear of Fear model One is hypersensitive to bodily sensations Anxiety sensitivity Distorted cognitions maintain disorders Figure 48 000000 Anxiety Treatments Biological Treatment Options 0 Medication 0 Use of Selective Serotonin Reuptake Inhibitors SSRIs for the depletion of serotonin in the neural synapses Prozac Luvox and Zoloft 0 Use of Benzodiazepines to allow GABA to transmit nerve signals more effectively which reduces anxiety Valium and Xanax Figure 49 o Psychosurgery O 0 Only considered if a patient has failed to benefit from medication and therapy Cingulotomy more common option thin probed burn selective portions of the cingulate bundle Capsulotomy Psychodynamic O 0 Uses free association and dream interpretation as a reflection of the patient s experience in the outside worldquot Little knowledge of the effectiveness of treatment Psychological Treatment Options Behavioral O O O O O O O Wellresearched approach Exposure a client faces fears to get over them Exposure therapy Imaginal exposure 70 improve after this treatment with remission rate of 93 after two years and 62 after then years excluding combatrelated PTSD Virtual reality exposure Social skills training SST 0 Cognitive Behavioral Therapy CBT O O O 0 CHAPTER 5 Wellresearched approach Exposure in combination with cognitive restructuring to change negative cognitions Hypothesis testing to see whether this worst thingquot actually happens Generate positive coping cognitions to counteract the negative thoughts 70 of patients improve Relaxation training and biofeedback Somatic Symptom Disorders Somatic Symptom and Related Disorders Conditions in which physical symptoms or concerns about an illness cannot be explained by a medical or psychological disorder Four different disorders somatic symptom disorder conversion disorder illness anxiety disorder and factitious disorder Somatic Symptom Disorder Pierre Briquet 17961881 Once called hysteria or Briquet s syndrome The presence of many symptoms that suggest a medical condition but without a recognized organic basis One or more somatic symptoms that are distressing result in significant disruption of daily life Although any one somatic symptom may not be continuously present the state of being symptomatic is persistent typically more than 6 months Excessive thoughts feelings or behaviors related to somatic symptoms or associated with health concerns as manifested by at least one of the following o Disproportionate and persistent thoughts about the seriousness of one s symptoms 0 Persistently high levels of anxiety about health concerns 0 Excessive time and energy devoted to these symptoms or health concerns Conversion Disorder Pseudoneurological complaints such as motor or sensory dysfunction Paralysis or blindness 10 to 15 found to have an actual diagnosable medical condition Symptom groups motor deficits sensory deficits and seizures and convulsions 0 Ex get into a car accident and then a few months later they can t walk Does not follow known neurological patterns of the human body Glove anesthesia can occur as loss of sensitivity in hand and wrist 0 Physical anatomy cannot explain the symptom patter of glove anesthesia La belle indifference Fact or Fiction People with illness anxiety disorder have a high level of worry about physical illness and constantly seek reassurance from a physician but might refuse to got to the hospital 0 True Not all worries or concerns about contracting an illness equate to the diagnosis of illness anxiety disorder 0 Yes some people suffer from transient hypochondriasisquot Illness Anxiety Disorder Fears or concerns about having an illness that persist despite medical reassurance Obsessive about their health Often elicit negative reactions from physicians 78 experience comorbidity with anxiety disorder and major depression Preoccupation with having or acquiring a serious illness Somatic symptoms are not present or if present are only mild in intensity High level of anxiety about health Performs excessive healthrelated behaviors Illness preoccupation present for at least 6 months Preoccupation not better explained by another mental disorder Factitious Disorders Factitious Disorder Physical or psychological signs or symptoms of illness are intentionally produced in what appears to be a desire to assume a sick role Malingering occurs when an individual intentionally produces physical symptoms to avoid military service criminal prosecution or work or to obtain financial compensation or drugs Factitious disorder imposed on self occurs as an individual imposes deceptive practices designed to produce signs of illness on self Factitious disorder imposed on another occurs as an individual produces physical symptoms on another normally mother imposing on a child 622 of children die as a result of medical illnesses imposed on them How Do Somatic Symptom Disorder Impact Individuals 10 to 15 of adults in the US report work disability as a result of chronic back pain Only 33 of patients with conversion disorder work fulltime People with somatic symptom disorders work on average 78 days less than everyone else per month Medically unexplained physical symptoms make up 1530 of PCP appointments Doctorshopping Treatment of these disorders accounts for 20 of all medical care expenses Research Hot Topic The Challenge of Chronic Fatigue Syndrome CFS Once called a somatoform disorder Diagnostic criteria Huge economic impact CDC estimates 052 people affected in US Total annual loss of 91 billion 23 billion from lost household productivity and 68 billion from lost labor Real medical condition Some people with CFS have an extremely difficult time convincing medical professionals of their disorder How can this be changed Can occur as a result of stress challenged or the presence of a vnrus Are Certain Populations More at Risk for Somatic Symptom Disorders Sex race and ethnicity Somatoform disorder is reported more frequently by women 0 Factitious disorder imposed on another 7798 are women Racial and ethnic breakdowns no differences The use of sociocultural explanations eg family and community problems healthcare training Developmental Issues to Consider Diagnostic criteria consistent Etiology How it all comes together Biological brain malfunction vs structural abnormalities Psychodynamic intrapsychic conflict personality and defense mechanisms Behavioral modeling and reinforcement 0 Environment stress sexual abuse family separationloss family conflictviolence and sexual assault 0 Distorted cognitions somatic amplification 0 Inaccurate beliefs prevalence of illness symptoms and treatment Figure 53 0 Not just one factor contributes to the development of these disorders Therefore it is best to incorporate the biological psychological social and cultural factors when discussing the onset of somatoform disorders Does the medical profession influence somatoform disorders Why or why not Treatment not Without Reluctance and Resistance 0 Challenges of getting people to reveal their symptoms to a professional Emphasis placed on physical symptoms 0 The refusal to believe one has psychological problem in need of a psychological intervention Biological and Psychological Treatment Options 0 Psychological 0 Basic education of the mindbody connection when it comes to symptoms 0 Cognitive behavioral therapy CBT Somatic symptom disorder is when one or more physical complaints are present for at least six months which causes distress and functional impairment Malinqerinq A Crafty Skill or a Facade A condition in which physical symptoms are produced intentionally to avoid military service criminal prosecution or work or to obtain financial compensation or drugs Dissociative Disorders Real or Imaqined Longstanding controversial diagnostic group 0 Definition 0 A set of disorders characterized by disruption in the usually integrated functions of consciousness memory identity or perception of the environment 0 Five types of dissociative experiences 0 Depersonalization derealization amnesia identity confusion and identity alteration Dissociative Amnesia Amnesia vs Dissociative Amnesia 0 Both deal with the inability to recall important information however amnesia occurs after a medical condition or event and dissociative amnesia follows trauma 0 Three types of dissociative amnesia o Localized amnesia o Generalized amnesia o Selective amnesia Dissociative Fugue 0 Definition 0 A disorder involving loss of personal identity and memory often involving a flight from a person s usual place of residence 0 Fugue means flight 0 Associated with physical or mental traumas depression or legal problems 0 Most likely to seek treatment after realization of loss of identity or memory of if approached by the police Dissociative Identity Disorder DID Formerly called multiple personality disorder not to be confused with schizophrenia Hollywood s depiction The Three Faces of Eve and Sybil 0 Definition 0 A presence within a person of two or more distinct personality states each with its on pattern of perceiving relating to and thinking about the environment and self 0 Alternative personalities or alters DepersonalizationDerealization Disorder 0 Defintion o Feelings of being detached from ones body or mind a state of feeling as if one is an external observer of one s own behavior 0 Characterized by 0 Incidence of comorbidity with other medical consitions or other psychiatric disorders 0 Feelings of being detached from one s body or unfamiliarity Functional Impairment and Epidemiology Lack of research Impariment result of dissociative disorder or another psychological disorder Inconsistencies in research reporting prevalence Sex Race Ethnicity Development 0 Both men ad women suffer from dissociative disorders 0 May represent a culturebound syndromequot 0 Onset ranges from adolescence to early adulthood 159 to 228 years 0 Children and dissociative disorders Biological and Psychological Factors Involved in Dissociative Disorders Biologicalabnormal brain functioning structural abnormalities neurochemical changes and other neurological conditions 0 Psychosocial failure of normal personality integration severely abused children childhood sexual abuse recovered or false memories a method to cope or block a traumatic event a way to compartmentalize trauma in the form of alters and viewed as an iatrogenic disease Ethics and Responsibility 0 Recoveredfalse memories 0 Controversy surrounding child abuse and DID Definition of abuse 0 Posttraumatic Model of DID No clear link exists between abuse and DID Important things to consider some children do suffer abuse some abused children develop mental disorders as adults Can Therapy Cause DID See Page 186 0 Let s examine the evidence 0 Number of cases of DID rose from 79 in 1970 to tens of thousands in 2000 after movie Sybil 80 to 100 have no knowledge of alters before therapy Explanation The correlation between alters treatment and the therapist awareness and appropriate cues to produce DID 0 Conclusion Post Treatment Factors Involved in Dissociative Disorders Antidepressants Cognitivebehavioral therapy 0 Used to work on misinterpretation of normal symptoms of fatigue stress or even substance abuse 0 Challenge misinterpretations by teaching individuals to explore alternative explanations and cognitive restructuringquot 0 Exposure therapy to face fears
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