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Study Guide for Test 2

by: Jess

Study Guide for Test 2 PSYC 3014

Virginia Tech

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These notes cover Anxiety Disorders, Unipolar and Bipolar Depression, Somatoform and Dissociation Disorders, and Eating Disorders
Abnormal Psychology
Dr. John Richey
Study Guide
PSYC, 3014, abnormal, Psychology
50 ?




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This 8 page Study Guide was uploaded by Jess on Friday October 7, 2016. The Study Guide belongs to PSYC 3014 at Virginia Polytechnic Institute and State University taught by Dr. John Richey in Fall 2016. Since its upload, it has received 39 views. For similar materials see Abnormal Psychology in Psychology (PSYC) at Virginia Polytechnic Institute and State University.

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Date Created: 10/07/16
Study Guide Test 2 Fear and Stress Anxiety Disorders Fear vs. Anxiety  Fear: subjective experience of threat o In response to environmental stressor  Anxiety: apprehensive expectation o No threat  The empirically validated treatment (EVT) for anxiety is EXPOSURE WITH RESPONSE PRVENTION  SUDS: subjective units of distress (0-100)  Habituation curve- waiting for stress to relief and decrease down curve  We are biologically hard-wired to fear certain things o We are biologically prepared to experience fear  All anxiety disorders have a shared feature and a unique feature o Shared feature: “physiological hyperarousal” PTSD  Post-Traumatic Stress Disorder  Criterion A- “Event” o Pt has experienced, witnessed or been confronted with event(s) involving actual or threatened death o Can be direct or indirect  Criterion B- “Intrusion Symptoms” o Recurrent/intrusive memories o Recurrent distressing dreams o Dissociative reaction (“flashbacks”) o Physiological hyperarousal during exposure to cues resembling event  Criterion C- “Avoidance” o Efforts to avoid thoughts/conversations about events o Efforts to avoid people/activities o This can prolong the disorder  Criterion D- “Alteration of thoughts and mood” o Inability to recall key features of the event o Feeling alienated from others o Constricted affect (cannot express positive emotions)  Criterion E- “Arousal and Reactivity” o Irritable/aggressive behavior o Self-destructive/reckless behavior o Exaggerated startle response  PTSD may be the only truly “classically conditioned” disorder o Presence of a stressor is paired with the cues that precede it  UCS becomes CS+ Abnormal psychology (9/22/16) Anxiety (part 2) - All anxiety disorders have a shared feature and a unique feature PTSD Treated? Exposure/response prevention - Graduated exposure to increasingly feared stimuli. - - In vivo (real-life) or ‘’imaginal’’ They have to classify all criteria to be diagnosed Social Phobia (called social anxiety disorder) - The 2 nd most common of all the anxiety disorders - 13% lifetime prevalence - Unique feature: fear of negative evaluation - Fear of social rejection - Interferes with otherwise normal functioning - Recognized as excessive - Consequences: Marihuana, alcohol, drugs. ‘’Bashful Bladder’’ syndrome (Public bathroom) Panic disorder - Unique feature: Panic Attacks: Short, unexpected burst of intense fear or discomfort, in the absence of real danger. - Those with the disorder worry about the possibility of having another attack - Panic disorder can lead to agoraphobia - 2 types agoraphobia with panic and without panic (very rare) False alarm theory - Panic is a ‘’fight or fight’’ reaction that is triggered at an inappropriate time. Generalized anxiety disorder - Unique feature: excessive worry - Vague fears not tied to a specific event or person - Apprehensive expectation - Worry on more days than not - For at least 6 months Obsessive compulsive disorder - Unique features: - 1 Obsessions: Recurrent, unwanted thoughts - 2 Compulsions: Repetitive (often complex) rituals meant to reduce the anxiety caused by obsessions Trichotillomania - Chronic hair pulling resultin in noticiable hair loss - 0/c spectrum disorder Unipolar Depression  Also called major depression  Features: o Common  1 out of every 5 women  1 out of every 6 men  Statistics represent lifetime prevalence (17%) o Persistent  Average episode length is 8 months  Single episode is rare or never occurring  Likelihood of having a future episode increases with each episode  1 episode – 50-60%  2 episodes – 70%  3 episodes – 90% o Painful  Physical distress  Insomnia  Psychomotor agitation/retardation o Fatal  Mechanism of death?  Suicide Persistent Depressive Disorder  Formerly “Dysthymia”  Similar to MDD o Less severe o Longer duration (2 years minimum) o Average duration is 10 years Comorbidity o Anxiety and depression are highly comorbid o Approximately 65% of depressed pts are also anxious  Tripartite Model (Clark and Watson, 1991) o Dissects the constructs  Identifies the “discriminant” features of each  Identifies the “convergent” feature o Unique feature (anxiety) = high physiological hyperarousal o Unique feature (depression) = low positive affect o Shared feature = high negative affect Postpartum Depression  Depressive episode up to 1 year after birth  Statistically, postpartum women have the same tare of depression as non- postpartum women o Given the same level of stressful events Suicide Suicide Rates  1 person every 18 minutes  80 per day  30,000 per year in USA  11 leading cause of death in USA th  Homicide is 13 leading cause of death Who is most at-risk?  Age 65+  Caucasians  Males Suicide Completion  2 of 3 men die by firearm  1 of 3 women die by firearm  Women attempt suicide more  Men complete suicide more Why do people die by Suicide?  Thwarted belongingness o Feeling unconnected with others  Acquired capability o Repeated “practice” attempts at suicide OR repeated exposure to violent of lethal activities  Perceived burdensomeness o Perception that others would be “better off without me”  Not everyone who “wants” to commit suicide can do it  Requires a buildup of “courage to commit” o This is the “acquired capability” o If a pt has a past attempt, it launches them into a moderate or severe category Bipolar Disorder  Also called Manic Depression  Important thing is the “chronicity” of events o The temporal pattern o Important for diagnosing o Episodes cannot be superimposed in time o Episodes must be > 1 week o Depression follows “standard” criteria o Manic and depressive episodes do not have to alternate  Manic Episode o Criterion A-  Distinct period of abnormality and persistently elevated, expansive, or irritable mood, lasting at least 1 week  Or any duration, if hospitalization is necessary o Criterion B-  During mood disturbance, 3 or more:  Inflated self-esteem  Decreased need for sleep  More talkative  Flight of ideas of thoughts racing  Distractibility  Excessive involvement in pleasurable activities o Criterion C-  Disturbance is severe enough to produce functional impairment, or hospitalization o Criterion D-  Disturbance is NOT due to the direct effects of a substance  It can be difficult to discriminate between remitted depression and a manic episode  If patient identifies 3 DISTINCT phases o Consistent with Bipolar disorder o “euthymic” phase  If a patient identifies with 2 DISTINCT phases o Consistent with major depression Childhood (pediatric) bipolar  One of the most frequently misdiagnosed childhood disorders  Frequently mistake for conduct disorder or AD/HD “Cyclothymia”  Period of at least 2 years, characterized by both hypo-manic and hypo- depressive episodes “Rapid Cycling”  Rare, within Bipolar 1 cases (5-10% of BPD cases)  4 episodes (either M or D) within 1 year Bipolar II  Similar to Bipolar I, however instead of a “full” manic episode, the patient has a “hypomanic” episode  Hypomania o Distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days o Three (or more) symptoms of mania Somatoform Disorders/Dissociation Disorders Somatoform Disorders-  Patient complains of bodily symptoms that suggest a medical problem  No medical problem is actually present Differential Diagnoses  The process of distinguishing one disorder from another  Malingering o Faking symptoms to achieve a goal  Factitious Disorder o Faking symptoms o No apparent reason for fake symptoms Hypochondriasis-  Pt either believes or very strongly suspects that she/he is sick with a very serious or life threatening illness  Make sure can distinguish a difference between this and a panic attack  Video on youtube  Clinical features: o Minor symptoms or anomalies support and augment this concern o Concerns persist despite reassurance of physicians o Many doctor visits  Impairment: o Symptoms can lead to total preoccupation o Pt can become invalid/bed-ridden o Affects males and females about equally  Onset characteristics: o Late teens/ early 20’s Somatization Disorder-  Physical/bodily problems that do not have an organic basis  Somatic Symptom Disorder (another name)  Psychological cause is also nonspecific  Preoccupation with numerous physical symptoms o This is where it usually differs from hypochondriasis in where there are multiple symptoms and can lead to different problems instead of one illness Etiology:  The origins of the disorder are not well understood  A combination of: o High negative affectivity o Biased interpretation of symptoms as threatening Conversion Disorder-  Patient experiences physical/medical symptoms without organic origin  Symptoms are due to a specific even or series of events Factitious Disorder by Proxy  Also called Munchausen’s By Proxy  Pt feigns or induces a medical condition in another person (usually a child) Body Dysmorphic Disorder-  Preoccupation with imagined defect in appearance  Most commonly: facial appearance Dissociative Disorders-  Disruption in a person’s consciousness, memory or perception  Refer to book (pg. 276, 278) o Dissociative Disorder o Dissociative Amnesia/Fugue  Dissociative Identity Disorder o Patient manifests 2 or more distinct personalities o Thought to emerge as the result of physical or sexual abuse o The existence of DID is highly controversial o If it does exist, it is extremely rate  Only about 200 cases in the world o Not the same thing as Schizophrenia  Schizophrenia has one and only one identity Eating Disorders Over 50% of undergraduate females report being dissatisfied with their bodies. However, not all of these individuals go on to develop an eating disorder.  Can be conceptualized at 2 levels 1. Manifest/Observable: a pattern of aberrant/ unusual eating behavior 2. Latent/ Unobservable: constructs that drive the behavior Anorexia Nervosa  DSM-IV Criteria: o Refusal to maintain body weight at or above 85% of expected weight o Intense fear of gaining weight, even though underweight o Undue influence of body weight on self-perception o For females: Absence of ≥ 3 menstrual cycles  90-95% of A.N. patients are female o Prevalence ~ 1-2% for females, < 0.3% males  More common in Caucasians  More common in middle and upper S.E.S.  Anorexia in men is equally serious  Physical consequences: o Hair loss o Tooth loss o Brittle bones o Even death, due to  Heart failure  Kidney failure o Thin/brittle yellow nails o Cracked skin o Low BP  Mortality rates o Adjusted for prevalence, A.N. has the highest mortality rate of any disorder o 12-13 times higher than non-anorexic men/women o Death from “natural causes” occurs earlier  Unique feature: o Early onset (12-14 years) has better prognosis  More precipitated by negative life events o Later onset (18-22 years) has worse prognosis  More precipitated by internal, psychological characteristics  According to the DSM-5: o A “restricting” subtype o A “compensatory” subtype  Researchers shows that the compensatory subtype is better conceptualized as Bulimia w/ low weight  One construct that is thought to be casually related: Perfectionism o Leads to a greater discrepancy between ideal self and actual self Bulimia Nervosa  DSM-5 Criteria: o Recurrent episodes of binge eating:  Eating in < 2 hours an amount of food that is “definitely larger” that most people would eat  A sense of lack of control over eating during the episode o Recurrent, inappropriate compensatory bx. o Binges/compensatory bx > 2x per week  “compensatory” behavior  Relatively “normal” weight  “body dissatisfaction”  “impulsivity”


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