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Abnormal Psychology Exam 1 Study Guide

by: Derek Schrick

Abnormal Psychology Exam 1 Study Guide Psych 433

Marketplace > University of Missouri - Kansas City > Psychlogy > Psych 433 > Abnormal Psychology Exam 1 Study Guide
Derek Schrick
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This study guide covers chapters 1-3, and 5 and included exam questions from class.
Abnormal Psychology
K. Harry
Study Guide
Abnormal psychology
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This 25 page Study Guide was uploaded by Derek Schrick on Sunday February 21, 2016. The Study Guide belongs to Psych 433 at University of Missouri - Kansas City taught by K. Harry in Spring 2016. Since its upload, it has received 105 views. For similar materials see Abnormal Psychology in Psychlogy at University of Missouri - Kansas City.


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Date Created: 02/21/16
Exam 1 Study Guide Ch.1­ Abnormal Behavior in Historical Context Understanding Psychopathology ­ Psychological disorder­ a psychological dysfunction within an individual  associated with distress or impairment in functioning and a response that is not  typical or culturally expected. Phobia­a psychological disorder characterized by marked and persistent fear of  an object or situation. What is a Psychological Disorder? ­ Psychological dysfunction refers to a breakdown in cognitive, emotional, or  behavioral functioning. Behavior is outside of cultural norms. 3 Criteria for Dining a Psychological Disorder 1. Psychological dysfuntion 2. Distress of impairment 3. Atypical response ­ Abnormal behavior­ a psychological dysfunction within an individual that is  associated with distress or impairment in functioning and a response that is not  typical or culturally expected.         Personal Distress of Impairment ­ Distress and suffering are a natural part of life and do not in themselves  constitute as a psychological disorder.         Atypical or Not Culturally Expected ­ the criterion that the response be atypical or not culturally expected is important but also insufficient to determine abnormality by itself.  ­ normal/abnormal= behavioral, psychological, or biological dysfuntions that are  unexpected in their cultural context and associated with present distress and  impairment in functioning, or increased risk of suffering, death, pain, or  impairment. The Science of Psychopathology Psychopathology is the scientific study of psychological disorders. Exam 1 Study Guide Ph.D: clinical and counseling psychologists (trained in research and delivering  treatment) Psy. D: Clinical and counseling "Doctor of Psychology" (trained in delivering  treatment) M.D. : Psychiatrist Psychiatric nurses­ hospital care and treatment LCSW: Licensed clinical social worker (trained in delivering treatment) The Scientist­Practitioner The most important development in recent history of psychology is the adoption  of scientific methods to learn more about the nature of psychological disorders,  their causes, and their treatment. Scientists­practitioners= mental health worker that takes a scientific approach to  their clinical work Clinical description= the unique combination of behaviors, thoughts, and feelings  that make up a specific disorder Begins with… Presenting problem= when saying that a patient "presents" with a specific  problem(s); why person came into clinic (symptoms) Prevalence­ the number of people in the population with disorder Incidence­ the number of new cases occurring over a specific period • Describe onset of disorders  – Acute­ begin suddenly      vs.  insidious onset­ develop gradually over an extended period of time • Describe course of disorders  – Episodic­ means it lasts a short time (ex. mood disorders) ­ Time­limited­ the disorder will improve without treatment in a relatively short period ­ Chronic course­ means it lasts a long time (ex. schizophrenia) • Prognosis­ anticipated course of disorder – Good­ individual will probably recover      vs.  ­ Guarded­ the probable outcome doesn’t look good Exam 1 Study Guide Clinical­ refers to types of problems/disorders that you would find in clinic/hospital and the actives connect with assessment and treatment. Developmental psychology­ study of changes in behavior over time Developmental psychopathology­ study of changes in abnormal behavior Life­Span Developmental Psychopathology­ study of abnormal behavior across  the entire age span         Causation, Treatment, and Etiology Outcomes Etiology­ study of origins; dealing with causation and includes biological,  psychological, and social dimensions. In psychopathology, the effect does not necessarily imply the cause.  Ex. Have headache.Take aspirin and helps. But, doesn't mean headache  caused by lack of aspirin Historical Conceptions of Abnormal Behavior Three dominant traditions have existed in the past to explain abnormal behavior: 1. Supernatural­ demons; sorcery; 2. Biological­study of diseases/humans (biology) 3. Psychological­ thoughts/feelings; engrained in biological  Structure of the mind: 1. Superego­ conscious ­ driven by: reality/moral principles from parent and culture    2. Ego­ part of our mind that ensures we act realistically (mediator) ­ logical; rational ­ driven by: reality principles 3. Id­ source of our strong sexual and aggressive feeling or energies ­ illogical; emotional; irrational ­ driven by: pleasure principles Classical Conditioning Example Advertising­ promoting beer with good­looking women= associating their beer  with goodlooking women Perfume Food The Beginnings of Behavior Therapy Exam 1 Study Guide Challenged psychoanalysis and non­scientific approaches Early pioneers­ Joseph Wolpe: systematic desensitization Operant conditioning (Thorndike, Skinner) ­ reinforcement­ positive/negative ­ another ubiquitous form of learning ­ voluntary behavior is controlled by consequences Learning traditions influenced the development of behavior therapy ­ behavior therapy tends to be time­limited and direct ­ strong evidence supporting the efficacy of behavior therapies ­ behavior therapy: creating new associations by practicing new behavioral  habits, and/or reinforcing useful behaviors with positive consequences An Integrative Approach: Summary Psychopathology is multiply determined Unidimensional accounts of psychopathology are incomplete Most consider reciprocal (interact with each other) relations among: ­ Biological, psychological, social, and experimental factors Defining abnormal behavior ­ Complex, multifaceted, and has evolved Science of psychopathology is evolving ­ The supernatural tradition no longer has a place in a science of abnormal  behavior ­ Ongoing research informs or understanding What supernatural influences were formerly believed to explain abnormal  behavior? What are the assumptions of the biological approach? How do various psychological approaches explain abnormal behavior? Exam Questions The criterion that a particular behavior be atypical or not culturally expected is  insufficient to define because A.  behavior that occurs infrequently is considered abnormal in very culture B. the atypical behavior must also cause harm or impairment to be considered  abnormal C. behaviors vary from very little from one individual to another within each  culture D. many people behave in ways that deviate from the average, but this  doesn't mean that they have a disorder You just adopted a puppy and you want to teach it to sit. What approach would  B.F. Skinner advise you to take? A. Punish the puppy each time it does not sit B. Give the puppy a treat each time it gets a little closer to sitting perfectly Exam 1 Study Guide C. Give the puppy a treat each time it sits perfectly and not otherwise D. Be patient and understand that behavior shaping occurs naturally over  developmental stages Ch.2- An Integrative Approach to Psychopathology One Dimensional vs. Multidimensional Models  One dimensional Models o Explain behavior in terms of a single cause o Tend to ignore information from other areas o Example: Explaining obsessive-compulsive disorder as the result of family history alone o Example: traumatic event that discomforts and causes OCD  Multidimensional Models o Interdisciplinary, eclectic, and integrative o “System” of influences that cause and maintain suffering o Draw upon information from several sources o Abnormal behavior results form multiple influences Genetic Contributions to Psychopathology • Phenotype vs. genotype Genotype- genes; provide foundries from development/environment Phenotype- how you express your genes • Nature of genes – Deoxyribonucleic acid (DNA) – the double helix – 23 pairs of chromosomes – Dominant vs. recessive genes – Development and behavior is often polygenetic - Multiple genes contribute to multiple factors • Genetic contribution to psychopathology – Less than 50% Neuroscience Contributions to Psychopathology  The field of neuroscience – The role of the nervous system in disease and behavior • Branches of human nervous system – The central nervous system (CNS) • Brain and spinal cord - Neurons used to transmit info throughout the nervous system Exam 1 Study Guide – The peripheral nervous system (PNS) • Somatic and autonomic branches - Somatic= smile, walking, jumping, talking; controls voluntary muscles + conveys sensory info to CNS - Autonomic= breathing, digestion, heart beat, hormone release; controls involuntary muscles Sympathetic- expends energy Parasympathetic- conserves energy Overview: Neuroscience and Brain Structure • Two main parts: 1. Brainstem • Contains hindbrain, midbrain, thalamus and hypothalamus (between brainstem and forebrain) 2. Forebrain • Contains limbic system, basal ganglia, cerebral cortex (larges part of the brain, the wrinkled outer structure) Neurotransmitters • Functions of Neurotransmitters – “Chemical messengers” - transmit messages between brain cells – Other chemical substances in the brain • Agonists- increase activity of neurotransmitter by mimicking effects • Inverse agonists- produce affects opposite of a neurotransmitter • Antagonists- inhibit or block function of neurotransmitter • Most drugs are either agonistic or antagonistic Serotonin • Also known as 5-hydroxytryptamine (5-HT) • Influences information processing, behavior, mood and thoughts • Dysregulated serotonin may contribute to depression • Very low serotonin linked to instability and impulsivity Norepinephrine • Also called noradrenaline • Involved in alarm responses and basic bodily processes (e.g. breathing) Dopamine • Implicated in depression and ADHD • Link between excessive dopamine and schizophrenia • Link between reduced dopamine and Parkinson’s disease Exam 1 Study Guide Implications of Neuroscience for Psychopathology • Relations between brain and abnormal behavior – Example: Obsessive Compulsive Disorder (OCD) • Man developed OCD after part of his frontal cortex was damaged during brain surgery • Psychosocial influences – Can change brain structure and function • Treatments for mental health problems may now focus on the brain regions found to be relevant for these problems • Psychotherapy – Also can change brain structure and function – Medications and psychotherapy are often used together The Contributions of Behavioral and Cognitive Science • Conditioning and cognitive processes (raising hand, waiting in line) – Early research on classical conditioning: Simple associations are learned between two things that tend to occur together – Later research indicated that it is not that simple – this sort of learning is influenced by higher-order cognitive processes. • Other types of learning – Respondent and operant learning – Learned helplessness – Social learning • Modeling and observational learning – Prepared learning Cultural, Social, and Interpersonal Factors in Psychopathology • Cultural factors – Influence the form and expression of behavior - Culturally- 90% women have phobia (men= no phobia b/c not manly) • Gender effects – Men and women may differ in emotional experience and expression • Social support effects on health and behavior – Frequency and quality important – Related to mortality, disease, and psychopathology Social Stigma of Psychopathology • Culturally, socially, and interpersonally situated • Problems with social stigma – May limit the degree to which people express mental health problems Exam 1 Study Guide • E.g., concealing feelings of depression > unable to receive support from friends – May discourage treatment seeking Life-Span and Developmental Influences Over Psychopathology • Life-span developmental perspective – Addresses developmental changes – Influence and constrain what is normal and abnormal • The principle of equifinality – From developmental psychopathology – Several paths to a given outcome – Paths vary by developmental stage Summary of the Multidimensional Perspective of Psychopathology • Multiple causation – The rule, not the exception • Take a broad, comprehensive, systemic perspective – Biological and neuroscientific – Cognitive and emotional – Social, cultural, and developmental factors • A multidimensional, comprehensive approach puts us in the best position to: – Understand the causes of psychopathology – Alleviate and prevent psychopathology The Effects of alcohol on students in social situations: - Develop an explanation for alcohol abuse and dependence using behavioral and cognitive theory Behavioral Theory: - Conditioned responses - Feeling accepted when drinking; talking to people you usually wouldn’t; reinforcement of behavior Cognitive Theory: - various factors from family members Exam Questions: 1. Your uncle spent most of his teen years in a hospital undergoing treatment for a severe physical illness. As an adult, he is rather shy and withdrawn, particularly around women. He has been diagnosed with social phobia, and you believe that it is entirely due to lack of socialization during his teen year. a. Multidenensional b. Intergrative Exam 1 Study Guide c. One-dimensional d. biological 2. The most accurate way to think of genes is that they? a. Set boundaries for our development b. Determine both our physical but not psychological characteristics c. Determine physical but not psychological characteristics d. Actually have very little to do with any of the characteristics that we apple 3. The most recent estimates of the contribution of genetics to the development of personality characteristics such as shyness or activity level are appropriately ________ percent? a. b. 30-50 c. d. Ch. 3 Clinical Assessment and Diagnosis Assessing Psychological Disorders  Purposes of clinical assessment o Clinical assessment- systematic evaluation of psychological, biological, and social factors in an individual presenting with a possible psychosocial disorder  To understand the individual  To predict behavior  To plan treatment  To evaluate treatment outcome o Diagnosis- process of determining whether the particular problem afflicting the individual meets all criteria for a psychosocial disorder  Reliability- the degree to which a measurement is consistent o Consistency in measurement o Examples include test-retest and inter-rater reliability  Test-retest- take a test and get 80%... take test again a week later and should expect similar result  Inter-rater-when two or more psychologists see same patient and get same result  Validity- the degree to which a technique measures what it is designed to measure o What an assessment measures and how well it does so  Standardization- Application of certain standards to ensure consistency across different measurements Exam 1 Study Guide o Ensures consistency in the use of a technique o Provides population benchmarks for comparison o Examples include structured administration, scoring, and evaluation procedures The Clinical Interview and Physical Exam  Clinical Interview o Most common clinical assessment method o Structures or semi-structures  Example of semi-structures interview- Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5) has modules pertaining to anxiety, mood, and related disorders, designed to assess DSM-5 criteria  Mental Status Exam o Trick for clinicians is to organize their observations of other people in a way that gives them sufficient information to determine whether a psychological disorder might be present o Components of Mental Status Exam:  Appearance and behavior- overt behavior, attire, appearance, posture, expressions, hygiene, groomed, twitch/fidgety  Thought processes- rate of speech, continuity of speech, content of speech  Mood and affect- predominant feeling state of the individual, showing same emotions that person is saying (sad but smiling)  Intellectual functioning- Type of vocabulary, use of abstractions and metaphors  Sensorium- Awareness of surroundings in terms of person (self + clinician), time, and place-“oriented times three” *ON EXAM  Physical exam o First pit stop because many individuals visit family physician first and are given a physical Behavioral Assessment and Observation  Behavioral Assessment- takes one step further than mental status exam by using direct observation to assess formally an individual’s thoughts, feelings, and behavior in specific situations or contexts. o Focus on the present- here and now o Direct observation of behavior-environment relations o Purpose is to identify problematic behaviors and situations o ABCs- identify antecedents, behaviors, and consequences Exam 1 Study Guide  Behavioral observation and behavioral assessment o Can be either formal or informal o Self-monitoring vs. being observed by others o Problem of reactivity using direct observation Psychological Testing: Projective Tests  Psychological testing o Must be reliable and valid  Projective tests o Rooted in psychoanalytic tradition o Used to assess unconscious processes o Project aspects of personality onto ambiguous test stimuli o Require high degree of inference in scoring and interpretation o Examples:  The Rorschach inkblot test; Thematic Apperception Test  Reliability and validity data tend to be mixed  CBT Thought Record- way to track though processes; in order to get person to use automatic thought processes (for anxiety, depression) Objective Tests and Personality Tests  Objective tests o Roots in empirical tradition o Test stimuli are less ambiguous o Require minimal clinical inference in scoring and interpretation in scoring and interpretation  Personality Tests- used if people aren’t aware of their unconscious thoughts and feelings o Minnesota Multiphasic personality Inventory (MMPI) o Extensive reliability, validity, and normative database Psychological Testing and Objective Tests  Intelligence tests o Nature of intellectual functioning and IQ  Originally developed as a measure of degree to which children’s performance diverged from others in their grade o The deviation IQ  Compare a person’s scores against those of other people who are the same age o Verbal and performance domains Neuropsychological Testing Exam 1 Study Guide  Purpose and goals o Measure abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning o Assess broad range of skills and abilities o Goals is to understand brain-behavior relations  Examples o The Luria-Nebraska and Halstead-Reitan batteries  Designed to assess for brain damage  Test diverse skills ranging from grip strength to sound recognition, attention, concentration  *KNOW function and what is used for  Problems with neuropsychological tests o False positive: mistakenly shows a problem where there is none o False negatives: fails to detect a problem that is present Neuroimaging and Brain Structure  Neuroimaging: Pictures of the brain o Two objectives  Imaging brain structure o Computerized axial tomography (CAT or CT scan)  Utilizes X-rays  Magnetic resonance imaging (MRI) o Utilizes strong magnetic fields o Better resolution than CT scan Neuroimaging and Brain Function  Imaging brain function o Positron emission tomography (PET) o Single photon emission computed tomography (SPECT) o Both involve injection of radioactive isotopes  Isotopes react with oxygen, blood, and glucose in the brain o Functional MRI (fMRI)- brief changes in brain activity Psychophysiological Assessment  Psychophysiological assessment o Assess brain structure, function, and activity of the nervous system  Psychophysiological assessment domains o Electroencephalogram (EEG)- brain wave activity. Exam 1 Study Guide  ERP- Event related potentials = brain response to a specific experience (e.g., hearing a tone) o Heart rate and respiration- cardiorespiratory activity o Electrodermal response and levels- sweat gland activity  Uses of routine psychophysiological assessment o Disorders involving a strong physiological component  Examples o PTSD, sexual dysfunctions, sleep disorders o Head aches and hypertension Diagnosing Psychological Disorder: Foundations in Classification  Diagnostic classification o Classification is central to all sciences o Assignment to categories based on shared attributes or relations  Idiographic strategy- what is unique about an individuals personality, cultural background, or circumstances  Nomothetic strategy- often used when identifying a specific psychological disorder, to make a diagnosis History of the DSM  Prior to 1980, diagnoses were made based on biological or psychoanalytic theory  Introduction of DSM-III in 1980 revolutionized classification o Classification newly relied on specific lists of symptoms, improving reliability and validity o Diagnoses classified along five “Axes” describing types of problems The DSM-5  Basic characteristics o Removed axial system o Clear inclusion and exclusion criteria for disorders o Disorders are categorized under broad headings o Empirically-grounded, prototypic approach to classification Unresolved Issues in DSM-5  The problem of comorbidity o Defined as two or more disorders for the same person o High comorbidity is extremely common o Emphasizes reliability, maybe at the expense of validity (i.e., may artificially “split” diagnoses that are very similar) Summary of Clinical Assessment and Diagnosis Exam 1 Study Guide  Clinical assessment and diagnosis o Aims to fully understand the client o Aids in understanding and ameliorating human suffering o Based on reliable, valid, and standardized information Conducting Research in Psychopathology  Questions driving a science of psychopathology o What problems cause distress or impair functioning? o Why do people behave in unusual ways? o How can we help people behave in more adaptive ways? Basic Components of Research  Starts with a hypothesis or “educated guess” o Not all hypotheses are testable o Hypotheses in science are formulated so that they are testable  Research design o A method to test hypotheses o Independent variable  The variable that causes or influences behavior o Dependent variable  The behavioral influenced by the independent variable (change) Considerations in Research Design  Internal validity vs. external validity o Internal validity: Extent to which results of a study are due to the independent variable o External validity: Extent to which results of a study are generalizable to the population it’s studying  Ways to increase internal validity by minimizing confounds o Use of control groups o Use of random assignment procedures o Use of analog models Studying Individual Cases  Case study method o Extensive observation and detailed description of a client o Foundation of early historic developments in psychopathology  Limitations o Lacks scientific rigor and suitable controls o Internal validity is typically weak o Often entails numerous confounds Exam 1 Study Guide Summary of Research Methods  Nature of research o Establishing and testing hypotheses  Research design o Varies depending on the questions posed o Each has unique benefits and drawbacks  Abnormal psychology is founded in the scientific method o Understand the nature of abnormality and human suffering o Understand the causes of psychological disorders o Understand the course of psychological disorders o Understand how to prevent and treat psychological disorders  Replication is the cornerstone of science and programmatic research  Research must occur in the context of ethical considerations and values Jack suffered head injury in car accident. What tests and methods of assessment should you use for your evaluationi? - CAT scans, neuropsychological assessment, Exam Questions: 1. In a mental status exam, it is important to determine if the individual is “oriented times three”. This refers to? a. Person place and time 2. When observation data are being collected, the observers presence may cause a person to behave differently, a phenomenon known as a. reactivity Ch. 5 - Anxiety Disorders, Trauma- and Stressor-Related, and Obsessive-Compulsive and Related Disorders Exam 1 Study Guide The Complexity of Anxiety Disorders Fear  Immediate, present­oriented  Sympathetic nervous system activation Anxiety  Apprehensive, future­oriented  Somatic symptoms = tension Both: Negative affect Anxiety, Fear, and Panic: Some Definitions Panic attacks –abrupt experience of intense fear  Symptoms: palpitations, chest pain, dizziness Two types Expected  Unexpected Diagnostic Criteria for Panic Attack Has to reach a peak within minutes Have to experience 4 of the sympotoms People can feel nauseous, sweating, detached for ones self, etc. (Table 5.1) Biological Contributions Increased physiological vulnerability; *Sends signal to motion senses of brain Polygenetic influences Corticotropin releasing factor (CRF)  Brain circuits and neurotransmitters GABA, Noradrenergic, Serotonergic systems  CRF and the HPAC axis Limbic system­* signal that sends for fear or danger; accessing danger and  what needed to do to get out of danger Behavioral inhibition system (BIS) Brain stem Septal­hippocampal system  Amygdala Fight/flight (FFS) system  Panic circuit & alarm and escape response Biological vulnerability­ heritable contribution to negative affect  “Glass is half empty”  Irritable  Driven Exam 1 Study Guide Specific Psychological vulnerability­ physical sensations are potentially  dangerous  Anxiety about health, dogs, world is dangerous place  Nonclinical panic Generalized psychological vulnerability­sense that events are  uncontrollable/unpredictable  Tendency toward lack of self­confidence  Low self­esteem  Inability to cope Comorbidity of Anxiety and Related Disorders High rates of comorbidity  55% to 76% Commonalities  Features Vulnerabilities  Links with physical disorders  Physical disorders Suicide Suicide attempt rates  Similar to major depression  20% Increases for all anxiety disorders  Comorbidity with depression? Generalized Anxiety Disorder (GAD) Clinical description  Shift from possible crisis to crisis  Worry about minor, everyday concerns Job, family, chores, appointments  Problems sleeping GAD in children  Need only one physical symptom  Worry = academic, social, athletic performance Generalized Anxiety Disorder (GAD) Statistics  3.1% (year)  5.7% (lifetime)  Similar rates worldwide  Insidious onset Early adulthood  Exam 1 Study Guide Chronic course GAD in the elderly  Worry about failing health, loss  Up to 10% prevalence  Use of minor tranquilizers: 17­50% Medical problems?  Sleep problems?  Falls  Cognitive impairments Causes Inherited tendency to become anxious  “Neuroticism”  Less responsiveness “Autonomic restrictors”  Threat sensitivity  Frontal lobe activation Left vs. right Treatments Psychological  Cognitive­behavioral treatments Exposure to worry process  Confronting anxiety­provoking images  Coping strategies Acceptance  Meditation  Similar benefits  Better long­term results Pharmacological  Benzodiazepines Risks versus benefits  Antidepressants Treatment Medications Multiple systems  serotonergic  noradrenergic  benzodiazepine GABA SSRIs (e.g., Prozac and Paxil)  High relapse rates Psychological intervention  Exam 1 Study Guide Exposure­ based  Reality testing  Relaxation Breathing Panic control treatment (PCT)  Exposure to interoceptive cues  Cognitive therapy  Relaxation/breathing High degree of efficacy Combined psychological and drug treatments  No better than individual  CBT = better long term Specific Phobias Clinical description  Extreme and irrational fear of a specific object or situation  Significant impairment  Recognizes fears as unreasonable  Avoidance Blood­injection­injury phobia  Decreased heart rate and blood pressure  Fainting  Inherited vasovagal response  Onset = ~ 9 Situational phobia  Fear of specific situations Transportation, small places  No uncued panic attacks  Onset = early to mid 20s Natural environment phobia  Heights, storms, water  May cluster together  Associated with real dangers  Onset = ~7 Animal phobia  Dogs, snakes, mice, insects  May be associated with real dangers  Onset = ~7 Statistics  12.5% (life); 8.7% (year)  Female : Male = 4:1  Chronic course  Onset = ~ 7 Exam 1 Study Guide Treatment Cognitive­behavior therapies  Exposure Graduated Structured  Relaxation Separation Anxiety Disorder Clinical Description  Characterized by children’s unrealistic and persistent worry that something will happen to their parents or other  important people in their life or that something will happen to the children  themselves that will separate them from their parents (for example, they will be lost, kidnapped, killed, or hurt in an accident) 4.1% meet criteria for children, 6.6% for adults Social Anxiety Disorder (Social Phobia) Clinical description  Extreme and irrational fear/shyness  Social/performance situations  Significant impairment  Avoidance or distressed endurance  Generalized subtype Statistics  12.1% (life); 6.8% (year)  Female : Male = 1:1  Onset = adolescence Peak age of 13  Young (18–29 years), undereducated, single, and of low socioeconomic class, 13.6%  Over 60, 6.6% Treatment Medications  Beta blockers  SSRI (Paxil, Zoloft, and Effexor)  D­cycloserine Psychological  Cognitive­behavioral treatment Exposure  Rehearsal  Exam 1 Study Guide Role­play Highly effective one study 84% improvement Selective Mutism (SM) Clinical description  Rare childhood disorder characterized by a lack of speech  Must occur for more than one month and cannot be limited to the first month of school  Comorbidity with SAD  Treatment Cognitive­Behavioral like the treatment for social anxiety best Trauma and Stressor­Related Disorders Attachment disorders  Posttraumatic stress disorder Posttraumatic Stress Disorder (PTSD) Clinical description  Trauma exposure  Extreme fear, helplessness, or horror  Continued re­experiencing (e.g., memories, nightmares, flashbacks)  Avoidance Emotional numbing  Reckless or self­destructive behavior  Interpersonal problems  Dysfunction  One month Statistics  6.8% (life); 3.5% (year)  Prevalence varies Type of trauma  Proximity Most common traumas  Sexual assault 2.4 to 3.5 increase  Accidents  Combat Causes Trauma intensity Generalized biological vulnerability  Twin studies  Exam 1 Study Guide Reciprocal gene­environment interactions Generalized psychological vulnerability  Uncontrollability and unpredictability Social support Neurobiological model  Threatening cues activate CRF system  CRF system activates fear and anxiety areas Amygdala (central nucleus)  Increased HPA axis activation Cortisol Treatment Cognitive­behavioral treatment  Exposure Imaginal Graduated or massed  Increase positive coping skills  Increase social support  Highly effective Psychoanalytic therapy, catharsis  Medications SSRIs Adjustment Disorders Anxious or depressive reactions to life stress that are generally milder than  one would see in acute stress disorder or PTSD but are nevertheless impairing in terms of interfering with work or school performance, interpersonal relationships,  or other areas of living Attachment Disorders Disturbed and developmentally inappropriate behaviors in children, emerging  before five years of age, in which the child is unable or unwilling to form normal  attachment relationships with caregiving adults Reactive Attachment Disorder The child will very seldom seek out a caregiver for protection, support, and  nurturance and will seldom respond to offers from caregivers to provide this kind  of care Disinhibited Social Engagement Disorder A pattern of behavior in which the child shows no inhibitions whatsoever to  approaching adults Exam 1 Study Guide Obsessive­Compulsive Disorder (OCD) Clinical description Obsessions  Intrusive and nonsensical  Thoughts, images, or urges  Attempts to resist or eliminate Compulsions  Thoughts or actions  Suppress obsessions  Provide relief Obsessions 60% have multiple obsessions  Need for symmetry  Forbidden thoughts or actions  Cleaning and contamination  Hoarding Compulsions Four major categories  Checking Ordering  Arranging  Washing/cleaning Association with obsessions Tic disorder Tic disorder is characterized by involuntary movement (sudden jerking of  limbs, for example), to co­occur in patients with OCD Obsessive­Compulsive Disorder (OCD) Statistics  1.6% to 2.3%(life); 1% (year)  Female = Male  Chronic  Onset = childhood to 30s medial 19 Causes Similar generalized biological vulnerability Specific psychological vulnerability  Early life experiences and learning  Thoughts are dangerous/unacceptable  Thought­action fusion Exam 1 Study Guide Distraction temporarily reduces anxiety  Increases frequency of thought Treatment Medications  SSRIs 60% benefit High relapse when discontinued  Psychosurgery (cingulotomy) 30% benefit  Cognitive­behavioral therapy Exposure and ritual prevention (ERP)  Highly effective 86% benefit  No added benefit from combined treatment with drugs Body Dysmorphic Disorder (BDD) A preoccupation with some imagined defect in appearance by someone who  actually looks reasonably normal Comorbid with OCD 10%  Course lifelong  Onset – early adolescence through 20s  Reaction to a horrible or grotesque feature  Two treatments SSRIs  Exposure and response prevention Plastic Surgery and Other Medical Treatments Fully 76.4% had sought this type of treatment and 66% were receiving it 8% to 25% of all patients who request plastic surgery may have BDD Hoarding Disorder Estimates of prevalence range between 2% and 5% of the population, which is twice as high as the prevalence of OCD Men = women  Individuals usually begin acquiring things during their teenage years and often experience great pleasure, even  euphoria, from shopping or otherwise collecting various items OCD tends to wax and wane, whereas hoarding behavior can begin early in life and get worse with each passing decade Trichotillomania (Hair Pulling Disorder) and Excoriation (Skin Picking  Disorder) Exam 1 Study Guide The urge to pull out one’s own hair from anywhere on the body, including the  scalp, eyebrows, and arms, is referred to as trichotillomania Excoriation (skin picking disorder) is characterized by repetitive and  compulsive picking of the skin, leading to tissue damage 1­ 5%  Habit reversal training, show best results Exam Questions 1. For GAD, the typical pharmacological treatment of choice has been the  bategory of drugs known as? Benzodiazepines 2. What would be the most affective treatment for anxiety disorders? Cognitive behavior disorder 3. An individual who suffers from panic disorder might become anxious about climbing stairs, exercising or being in hot rooms because these activities  produce sensations similar to those accompanying a panic attack. In  psychological terms, the exercise and hot rooms have become? a. Conditioned stimuli


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