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Chapter 5 Book Notes

by: Alicia Rinaldi

Chapter 5 Book Notes psy 240

Marketplace > University of Miami > Psychlogy > psy 240 > Chapter 5 Book Notes
Alicia Rinaldi
GPA 3.7
abnormal psychology
Dr. Parlade

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About this Document

Book notes on chapter 5 of Abnormal Psychology by Ronald J. Comer, 8th edition.
abnormal psychology
Dr. Parlade
Class Notes
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This 13 page Class Notes was uploaded by Alicia Rinaldi on Tuesday September 8, 2015. The Class Notes belongs to psy 240 at University of Miami taught by Dr. Parlade in Fall 2014. Since its upload, it has received 46 views. For similar materials see abnormal psychology in Psychlogy at University of Miami.


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Date Created: 09/08/15
Chapter 5 Anxiety ObsessiveCompulsive and Related Disorders Preface A B C 110 G Fear the central nervous system s physiological and emotional response to a serious threat to one s well being Anxiety the central nervous system s physiological and emotional response to a vague sense of threat or danger Generalized anxiety disorder a disorder marked by persistent and excessive feelings of anxiety and worry about numerous events and activities quotfight or ightquot reactions when danger threatens sometimes fear is normal but it becomes an anxiety disorder when it is too severe or frequent lasts too long or is triggered too easily people with generalized anxiety disorder experience general and persistent feelings of worry and anxiety a speci c phobias people experience a persistent and irrational fear of a particular object activity or situation b agoraphobia fear traveling to public places c social anxiety disorder intense fear of social performance situations in which embarrassment may occur panic disorder recurrent attacks of terror e obsessivecompulsive and related disorders feeling overrun by recurrent thoughts that cause anxiety or the need to repeat patterns that reduce anxiety most people with an anxiety disorder suffer from two or more anxiety disorders 0 Generalized Anxiety Disorder A B C free oating anxiety describes people with constant anxiety women with GAD outnumber men 21 The Sociocultural Perspective Societal and Multicultural Factors 1 GAD is most likely to develop in people who are faced with ongoing dangerous societal conditions 2 Poverty one of the most powerful forms of societal stress a Poor people have almost double the rate of anxiety disorders 3 Race in the USA is sometimes tied to GAD 4 Nervios similar to GAD for Hispanics The Psychodynamic Perspective Freud believed all children experience some degree of anxiety and use defense mechanisms to cover it Up a realistic anxiety facing actual danger b neurotic anxiety being prevented from expressing id impulses c moral anxiety punished or threatened for expressing id impulses psychodynamic explanations when childhood anxiety goes unresolved a infant who is constantly reprimanded is likely to develop GAD b overprotected children may be too weak to cope with anxiety c many don t believe Freud but agree that disorders can be traced to early relationships with parents psychodynamic therapies a Freudian therapists use free association and interpretations of transference resistance and dreams b object relations therapists help anxious patients identify and settle childhood relationships that produce anxiety in adulthood c shortterm psychodynamic therapy has been found to reduce levels of anxiety worry and social difficulty E The Humanistic Perspective 1 2 4 GAD arises when people stop looking at themselves honestly and acceptingly Carl Rogers believed that children who fail to receive unconditional positive regard may develop conditions of worth and try to meet standards by denying their true thoughts Clientcentered therapy the humanistic theory developed by Rogers in which clinicians try to help clients by being accepting empathizing accurately and conveying genuineness Controlled studies don t offer strong support for these therapies F The Cognitive Perspective 1 2 psychological problems are often caused by dysfunctional ways of thinking maladaptive assumptions a basic irrational assumptions irrational beliefs that lead people to act and react in inappropriate ways b people are likely to overreact to everyday s ua ons c people with GAD hold assumptions that quoteverything is unsafe until proven safequot 3 NewWave Cognitive explanations a Metacognitive theory people with GAD implicitly hold positive and negative beliefs about worrying worrying is a useful way of coping with threats in life individuals start to believe that worrying is harmful and uncontrollable received considerable research support b intolerance of uncertainty theory certain individuals cannot tolerate the knowledge that negative events may occur no matter how small the possibility people with GAD worry in efforts to nd the quotcorrectquot solution for situations in life lots of research supports this theory c avoidance theory Thomas Borkovec some people have greater bodily arousal than other people and worrying can distract them from this arousal when these people nd themselves in an uncomfortable situation job friends they choose to intellectualize worry about losing the jobfriends rather than feeling physical symptoms of it 4 Cognitive Therapies a Changing maladaptive assumptions Rationalemotive therapy a cognitive therapy developed by Albert Ellis that helps clients identify and change the irrational assumptions and thinking that help cause their psychological disorder Therapists will make individuals practice challenging old assumptions and applying new ones b Breaking down worrying Clients guided to recognize and change dysfunctional use of worrying vi Therapists educate clients on the role of worrying in their disorder and have them observe their bodilycognitive arousal Clients realize the triggers of their worrying Mindfulnessbased cognitive therapy is a part of acceptance and commitment therapy where therapists help clients to become aware of their streams of thoughtsworries and accept them Mb cognitive theory also applies to depression PTSD personality disorders and substance use disorders Mindfulness medication teaches individuals to pay attention to thoughts and feelings that ow through their minds during meditation and not judge them G The Biological Perspective 1 family pedigree studies researchers determine how many and which relatives of a person with a disorder have the same disorder a to nd if studies are hereditary b GAD is hereditary c Researchers aren t sure if similar biology or similar environment causes this trend 2 Biological Explanations GABA Inactivity a Benzodiazepines the most common group of antianxiety drugs which includes diazepamvalium and alprazolam Xanax b GABA the neurotransmitter gamma aminobutyric acid whose low activity has been linked to generalized anxiety disorder Neurons have receptors that receive benzodiazepines like a lock and key Receptors regularly receive gamma aminobutyric acid GABA which carries an inhibitory message When body gets naturally excited the feedback system has to eventually reduce the levels of excitability so GABA is naturally released in brain People have too much anxiety if there are not enough GABA receptors or they don t work well c Problems Other neurotransmitters may play a role Problems establishing causation abnormal GABA responses could be result not cause Does long term anxiety lead to poor GABA reception Circuit that produces anxiety reactions includes the prefrontal cortex anterior cingulate cortex and amygdala 3 Biological treatments a TreatmentsDRUG THERAPY b Antianxiety drug therapy iii iv v vi Sedativehypnotic drugs drugs that calm people at lower doses and help them to fall asleep at higher doses When benzodiazepines bind to neuron receptor sites GABAA receptors they increase the ability of GABA to bind to them and improve GABA s ability to reduce anxiety When medications are stopped many person s anxieties return People can become dependent Drugs produce undesirable side effects Antidepressant meds and antipsychotic meds have recently been found to help c Relaxation training a treatment procedure that teaches clients to relaz at wil so they can calm themselves in stressful situations Physical reaction leads to a state of psychological relaxation Relaxation treatment amp meditation are more effective than no treatmentplacebo Works best with cognitive therapy amp biofeedback d Biofeedback a technique in which a client is given information about physiological reactions as they occur and learns to control their reactions voluntarily ex heart rate muscle tension Clients are connected to a monitor that gives them info about their bodily activities ii Electromyograph EMG a device that provides feedback about the level of muscular tension in the body iii Clients can see or hear when their muscles are becoming moreless tense and try to reduce it iv Has only modest effect on anxiety level III Phobias A phobia a persistent and unreasonable fear of a particular object activity or situation B DSM5 indicates that a phobia is more intense and persistent than a normal fear and the desire to avoid the object or situation is greater C Speci c Phobia a severe and persistent fear of a speci c object or situation other than agoraphobia and social phobia 1 around 912 havehad a speci c phobia and women outnumber men 21 2 What causes speci c phobias a Behavioral explanations how are fears learned most research support i classical conditioning ii modeling a process of learning in which a person observes and then imitates others Also a therapy approach based on the same principle iii behaviorists believe that after acquiring a fear response people try to avoid what they fear so they don t realize these objects are harmless iv stimulus generalization a phenomenon in which responses to one stimulus are also produced by similar stimuli Too much generalization can lead to GAD b how have behavioral explanations fared in research i Little Albert ii Researchers haven t established if fear is ordinarily acquired in this way c A behavioralevolutionary explanation i Some fears are more common than others because human beings have a predisposition to develop certain fears ii Preparedness a predisposition to develop certain fears predispositions are transmitted genetically through evolution 3 How are speci c phobias treated a exposure treatments behavioral treatments in which persons are exposed to the objects or situations they dread i desensitizing ii ooding iii modeling b systematic desensitization a behavioral treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations they dread i vivo desensitization actual confrontation ii covert desensitization imagining the confrontation c ooding a treatment for phobias in which clients are exposed repeatedly and intensively to a feared object and made to see that it is actually harmless without a gradual buildup d modeling the therapist confronts the feared object or situation while the client observes e key to getting over fear is actual contact with feared object D Agoraphobia 1 JUN an anxiety disorder in which a person is afraid to be in public places or situations from which escape might be difficult or embarrassing or help unavailable if paniclike symptoms were to occur often are homebound because of fear explanations for agoraphobia a classical conditioning modeling stimulus generalizations b many with agoraphobia experience panic attacks treatments for agoraphobia a exposure where they venture further and further from their homes b support groups amp homebased selfhelp programs clients and families can carry out exposures themselves c treatments tend to help but they re incomplete and relapses may occur E social anxiety disorder 1 a severe and persistent fear of social or performance situations in which embarrassment may occur 2 7 in any given year have a disorder and 12 lifetime 60 are females 3 25 in treatment 4 what causes social anxiety disorder a Holding unrealistically high standards b View themselves as unattractive socially unskilled or socially inadequate c Scared of incompetence 5 Treatments for social anxiety disorder a How can social fears be reduced i Medications antidepressants ii Exposure therapy forcing them to experience dreaded situation iii Cognitive therapy b How can social skills be improved i Social skills training a therapy approach that helps people learn or improve social skills and assertiveness through role playing and rehearsing of desirable behaviors ii Modeling roleplay rehearsing feedback amp reinforcement iii Training seems to work in most settings IV Panic Disorder A preface 1 panic attack periodic short bouts of panic that occur suddenly reach a peak within minutes and gradually pass 2 symptoms palpitations of the heart tingling in handsfeet shortness of breath hotcold ashes chest pains faintness dizziness fear of dyinglosing control 3 panic disorder an anxiety disorder marked by recurrent and unpredictable panic attacks 4 panic disorder can lead to agoraphobia B The Biological Perspective 1 Antidepressants help panic disorder 2 What biological factors contribute to panic disorder e Norepinephrine a neurotransmitter whose abnormal activity is linked to panic disorder and depression Locus ceruleus a small area of the brain that seems to be active in the regulation of emotions many of its neurons use norepinephrine i Scientists could produce panic attacks in humans by injecting them with chemicals that increase norepinephrine activity Amygdala a small almondshaped structure in the brain that processes emotional information i Amygdala is stimulated when someone feels scared and produces an quotalarmandescapequot circuit response Brain circuit for panic reactions is different from the circuit for anxiety reactions so panic disorder is biologically different Abnormalities in norepinephrine may be caused by genetic predisposition 3 Drug therapies a Certain antidepressants prevent or reduce frequency of panic attacks b Drugs bring improvement to 80 of patients C The Cognitive Perspective 1 The cognitive explanation misinterpreting bodily sensations a People may misinterpret sensations as signs of a medical catastrophe b Then panic grows about quotlosing controlquot C Biological challenge test a procedure used to produce panic in participants or clients by having them exercise vigorously or perform some other potentially panicinducing task in the presence of a researcher or therapist Anxiety sensitivity a tendency to focus on one s bodily sensations assess them illogically and interpret them as harmful e People with anxiety sensitivity are 5 times more likely to develop panic disorder 2 Cognitive therapy a Trying to correct people s misinterpretations of their body sensations b Teaching people the true causes of sensations and nature of panic attacks plus coping skills c Sometimes use biological challenge procedures to induce a panic attack then practice calming down d Works for 80 of people V Obsessivecompulsive disorder a disorder in which a person has recurrent and unwanted thoughts a need to perform repetitive and rigid actions or both A obsession a persistent thought idea impulse or image that is experienced repeatedly feels intrusive and causes anxiety B compulsion a repetitive and rigid behavior or mental act that a person feels driven to perform in order to prevent or reduce anxiety C a diagnosis of OCD is called for when obsessions or compulsions feel excessive or unreasonable cause great distress take up much time or interfere with daily functions D obsessions cause anxiety compulsions preventreduce anxiety E 12year 3 lifetime equally common in men women and different races 40 seek treatment F what are the features of obsessions and compulsion 1 Obsessive wishes impulses images ideas or doubts 2 Common themes dirt or contamination violence aggression orderliness religion sexuality 3 Most people realize their behaviors are unreasonable but feel that they must do them anyway 4 Cleaning compulsions checking compulsions orderbalance touching verbal counting G The Psychodynamic perspective Battle between anxietyprovoking id impulses and anxiety reducing defense mechanisms is played out in ouvert thoughts and actions Isolation an ego defense mechanism in which people unconsciously isolate and disown undesirable and unwanted thoughts experiencing them as foreign intrusions Undoing an ego defense mechanism whereby a person unconsciously cancels out an acceptable desire or act by performing another act Reaction formation an ego defense mechanism whereby a person suppresses an unacceptable desire by taking on a lifestyle that expresses the opposite desire Freud traced 0CD back to anal stage not clearly supported by research Psychodynamic therapists try to help individuals uncover amp overcome underlying con icts amp defenses using free association and therapist interpretation little evidence it is helpful H The Behavioral Perspective 1 2 4 5 Focus on explaining and treating compulsions rather than obsessions Repeated accidental associations cause people to believe that their action is bringing good or badluck Exposure and response or ritual prevention a behavioral treatment for 0CD that exposes a client to anxietyarousing thoughts or situations and then prevents the client from performing his or her compulsive acts 5585 improve with e amp r prevention some don t overcome all their symptoms and 14 fail to improve at all the cognitive perspective 1 2 3 everyone has repetitive unwanted and intrusive thoughts neutralizing a person s attempt to eliminate unwanted thoughts by thinking or behaving in ways that put matters right internally making up for the unacceptable thoughts population with OCD tends to a be more depressed than other people J b have exceptionally high standards of conduct and morality c have an in ated sense of responsibility in life d believe their intrusive negative thoughts are equivalent to actions capable of causing harm e generally believe they should have perfect control over their thoughts amp behaviors 4 therapists focus on cognitive processes involved in 0CD then challenges these cognitions 5 combination of behavioral amp cognitive approach is more effective than either alone a clients are taught to view their thoughts as inaccurate occurrences rather than dangerous cognitions b then they become less inclined to act on them The Biological Perspective 1 Abnormal serotonin activity a Serotonin a neurotransmitter hose abnormal activity is linked to depression obsessivecompulsive disorder and eating disorders b Drugs that increase serotonin activity Anafranil amp Prozac help 0CD so researchers concluded that 0CD is caused by low serotonin activity c GABA and dopamine may play important roles in development of 0CD d Serotonin may act as a neuromodulator a chemical whose primary function is to increase or decrease activity of key neurotransmitters 2 Abnormal brain structure and functioning a Orbitofrontal cortex a region of the brain in which impulses involving excretion sexuality violence and other primitive activities normally arise b Caudate nuclei structures in the brain within the region known as the basal ganglia that help convert sensory information into thoughts and actions 3 c When thoughts arise in the orbitofrontal cortex they move onto the caudate nuclei and the most powerful impulses are sent to the thalamus where they can be acted upon d Some believe these parts of the brain are overactive Biological therapies a Antidepressants improve 5080 of cases b Obsessionscompulsions often cut in half with 8 weeks of treatment K Obsessivecompulsive related disorders 1 lm A group of disorders in which obsessivelike concerns drive people to repeatedly and excessively perform speci c patterns of behavior that greatly disrupt their lives Hoarding disorder a disorder in which individuals feel compelled to save items and experience signi cant distress if they try to discard them resulting in an excessive accumulation of items and possessions Hair pulling disorder aka trichotillomania a disorder in which people repeatedly pull out hair from their scalp eyebrows eyelashes or other parts of the body Excortiation disorder aka skinpicking disorder a disorder in which people repeatedly pick at their skin resulting in signi cant sores or wounds Body dysmorphic disorder a disorder in which individuals become preoccupied with the belief that they have certain defects or aws in their physical appearance The perceived defects or aws are imagined or greatly exaggerated All these diseases treated similarly to 0CD Stress management program an approach to treating generalized and other anxiety disorders that teaches clients techniques for reducing and controlling stress


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