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Abnormal Psychology Chapters 5-7

by: Megan Standiford

Abnormal Psychology Chapters 5-7 PSYC 3014

Megan Standiford
Virginia Tech
GPA 2.7

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About this Document

These notes cover part of what will be on our next exam.
Abnormal Psychology
Dr. John Richey
Class Notes
Psychology; Abnormal Psychology
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This 5 page Class Notes was uploaded by Megan Standiford on Tuesday February 23, 2016. The Class Notes belongs to PSYC 3014 at Virginia Polytechnic Institute and State University taught by Dr. John Richey in Winter 2016. Since its upload, it has received 13 views. For similar materials see Abnormal Psychology in Psychlogy at Virginia Polytechnic Institute and State University.


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Date Created: 02/23/16
Chapter 5-7 Fear vs Anxiety  Squirrel story (fear was when the stimulus was there; anxiety when the stimulus was not there)  Fear- subjective experience of threat  Anxiety- apprehensive expectation  Empirically validated treatment for anxiety o Exposure with response prevention (EX/RP) o Subjective Units of Distress  Predetermined fears? o We are biologically hardwired to fear certain things o We are biologically prepared to experience fear  All anxiety disorders have a shared feature  And a unique feature o Physiological hyperarousal PTSD  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  Criterion C- Avoidance o Efforts to avoid thoughts/conversations about event o Efforts to avoid people/activities  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  UCS becomes CS+ Social Phobia  A) marked and persistent fear that is excessive or unreasonable o Cued by the presence or anticipation of a specific object or situation Specific Phobia  The most common anxiety disorder  Fairly easy to treat (6-8 sessions) Social Phobia (AKA social anxiety disorder)  2nd most common of all the anxiety disorders  13% life prevalence  Unique feature: o Fear of negative evaluation  Fear of social rejection  Interferes with otherwise normal functioning  Recognized as excessive  Bashful bladder syndrome o Cannot go to the bathroom in public because they fear someone will hear them Panic Disorder  Unique feature o Panic Attacks  Short, unexpected bursts of intense fear or discomfort, in the absence of real danger  Panic disorder can lead to agoraphobia (fear of leaving ones house)  False alarm theory o Panic is a fight of flight reaction that is triggered at an inappropriate time GAD (General Anxiety Disorder)  Unique feature o Excessive worry  Vague fears not tired to a specific event or person  Apprehensive expectation  Worry on more days than not  For at least 6 months OCD (Obsessive Compulsive Disorder)  Unique features 1. Obsessions i. Recurrent, un wanted thoughts 2. Compulsions i. Repetitive, (often complex) rituals meant to reduce the anxiety caused by obsessions Trichotillomania  Chronic hair pulling resulting in noticeable hair loss  "O/C" spectrum disorder Unipolar depression  Also called major depression  Features o Common  1/5 women  1/6 men  Lifetime prevalence= 17% o Persistent  Average episode length is 8 months  Single episode is rare  The likelihood of having another episode is highly dependent on how many episodes you have had in the past o Painful  Physical distress  Insomnia  Psychomotor agitation/retardation o Fatal  Mechanism of death? - suicide  Symptoms o Cardinal symptoms  Sad mood  Anhedonia (Loss of pleasure/positive feeling)  Individual must endorse at least one of these symptoms o Two week minimum  Persistent depressive disorder o Formerly dysthymia o Similar to MDD  Less severe  Longer duration (2 years minimum) o Average duration  10 years  Comorbidity o Anxiety and depression are highly comorbid o Approximately 65% of depressed patients are also anxious o More common to have anxiety first, and develop depression o If you treat the anxiety, the depression should go away  Tripartite model o Depression- low positive affect o Anxiety- high physiological hyperarousal o Both- presence of negative affect  Postpartum depression o Depressive episode up to 1 year after birth  Statistically, post-partum women have the same rate of depression as non post- partum women Suicide  Rates o 1 person every 18 minutes o 80 per day o 30,000 per year in USA o 11th leading cause of death in USA o Homicide is 13th leading cause of death o 5 million people living in the US have attempted suicide at least once o For every 25 attempts, 1 completion  Who is most at risk? o Age bracket?  Elders (65+) o Race?  Most- white Americans  Least- African American o Gender?  Males  Suicide completion o 2/3 men die by firearm o 1/3 women die my firearm o Women attempt suicide more o Men complete suicide more Why do people die by suicide?  o Thwarted belongingness- desire to connect and be a part of functioning society o Acquired capability- repeated practice attempts at suicide or repeated exposure to violent or lethal activities o Perceived burdensomeness- perception that others would be "better off without me"  The following have increased rates of suicide o Medical doctors o Professional athletes o Prostitutes  Read pg. 207-208 (Taijin Kyofusho)  Read pg. 251 (Mindfulness-Bases Cognitive Therapy)  Bipolar Disorder Bipolar I  Also called manic depression  The important thing about bipolar disorder is the Chronicity of events o Chronicity= the temporal pattern o Manic and depressive episodes cannot be superimposed in time o Mani episode must be >1 week o Depression follows standard criteria o Manic and depressive episodes do not necessarily have to alternate  Manic episode o Criterion A  Distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week  Or any duration, if hospitalization is necessary o Criterion B  During mood disturbance, 3 or more  Inflated self-esteem or grandiosity  Distractibility  Increase in goal-directed activity  Flight of ideas or perception that thoughts are racing  Decreased need for sleep  More talkative than usual or pressure to keep talking  Excessive involvement in pleasurable activities that have a high potential for painful consequences 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  Important point o It can be difficult to discriminate between remitted depression and a manic episode o If patient identifies 3 distinct phases  Consistent with Bipolar disorder  "euthymic" phase  (1) Depressed, (2) Manic, (3) Euthymic o If patient identifies 2 distinct phases  Consistent with major depression  Childhood (pediatric) bipolar o One of the most frequently misdiagnosed childhood disorders o Frequently mistaken for conduct disorder or AD/HD  Cyclothymia o Period of at least 2 years, characterized by both hypo-manic and hypo-depressive episodes  Rapid cycling o Rare, within bipolar I cases (5-10% of BPD cases) o 4 episodes (either Manic or Depressive) within 1 year Bipolar II  Similar to bipolar I, however instead of a full manic episode, the patient has hypomanic episodes  Hypomania o A) distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days o B) three or more symptoms of mania  Bipolar II will frequently progress into Bipolar I Treatment  Medication for bipolar disorder is effective  Tolerability or medication for bipolar is low o Patients typically do not take their meds o Why?  People may enjoy the feeling during a manic episode (elevated energy)  Pharmacotherapy o Mood stabilizer o Antidepressant  Cognitive-behavioral therapy o Reduce stressful life events that precipitate Manic episodes   Depressive episodes  Social rhythms therapy o Empirically validated behavioral treatment o Eat, wake up, go to bed: at the same time


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