PSYC 316 Week 4 Notes
PSYC 316 Week 4 Notes PSYC 316
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This 22 page Class Notes was uploaded by Sara Karikomi on Saturday September 19, 2015. The Class Notes belongs to PSYC 316 at Northern Illinois University taught by Simon Jencius in Fall 2015. Since its upload, it has received 63 views. For similar materials see Intro-Psycpathology in Psychlogy at Northern Illinois University.
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Date Created: 09/19/15
PSYC 316 Week 4 Chapter 3 Clinical Assessment Diagnosis and Treatment cont d Here s where we left off last week Friday 11 September 1 Neurological and Neuropsychological Tests a Neur0102ical Tests assess brain function according to its structure and activity b Brain Imaging c Assess brain structure and function 1 M magnetic resonance imaging 2 CT computerized tomography 3 ET positron emission topography 4 m functional magnetic resonance imaging d Almost exclusively used in research and rarely in clinical practice 1 Very expensive and time consuming to train and administer e Helps to gather knowledge of brain structures and neurochemicals involved in different human experiences and emotional states Monday 14 September 11 Assessment A Self Monitoring 1 Person is instructed to monitor his or herself and carefully record the frequency of a particular behavior feeling cognition as it happens over times 2 Can help assess infrequent behaviors and overly frequent behaviors 3 Is it valid Does the person record the occurrences accurately When people monitor e g via smart phones it can change their behavior B Assessment of Mental Disorders 1 Only PhDs are trained the last bastion of clinical and school psychologists a Clinical treatment is now common among other professionals such as Psst Social workers etc 2 Responsibility of clinicians to protect these assessment measures a Don t show them talk about them unless for teaching b Why 1 Legal cases 2 School placement 3 Work placement c Neuronsvcholoqical Tests assess brain function indirectly by assessing cognition perception and motor function 1 Bender VisualMotor Gestalt Test d Neuroloqical and Neuronsvcholoqical Test Pros 1 high accuracy e Neuroloqical and Neuronsvcholoqical Test Cons 1 only general screening devices 2 best if used as one of many tests that target wider ranges of skill areas 3 Intelligence Tests a indirectly measure a person s intellectual ability b verbal and nonverbal skills are tested c 32 test score is an intelligence quotient d Intelligence Test Pros 1 Of all clinical tests intelligence tests are the most carefully produced 2 The tests are easily standardized on a large population 3 High validity and reliability e Intelligence Test Cons 1 Other nonintelligence factors can in uence IQ results from test 2 Tests may be biased cultural language tasks 3 Members of a minority may have less experience and be uncomfortable with testtaking which can negatively in uence their results III Clinical Observations A Systematic Observations of Behavior 1 Naturalistic and Analoq Observations a Naturalistic Observations 1 Such observations can be found in natural environments schools homes communities etc 2 The main focus is on the interactions between parents and their children between a teacher and a child or between siblings b Analog Observations 1 Some analog observations are in an arti cial setting if a naturalistic observation model is not possible c Naturalistic and Analog Observation Pros 1 observations provide a lot of useful information d Naturalistic and Analog Observation Cons 1 reliability and validity are questionable client reactivity 2 observer bias observer may focus more on certain behaviors 3 observations may not comply with crosssituational validity SelfMonitoring a A person observes their own behaviors thoughts and feelings records the frequency of the occurrences b Self Monitoring Pros 1 useful in examining infrequent and extremely recurrent behaviors 2 helps measure private thoughts and perceptions c Self Monitoring Cons 1 validity is questionable a information may be recorded inaccurately or dishonestly b people change their behavior when they know they are being watched even by themselves d Neuronsvcholoqical Tests assess brain function indirectly by assessing cognition perception and motor function 1 Bender VisualMotor Gestalt Test e Neuroloqical and Neuronsvcholoqical Test Pros 1 high accuracy f Neurological and Neuronsvcholoeical Test Cons 1 only general screening devices 2 best if used as one of many tests that target wider ranges of skill areas 3 Intelligence Tests 3 b C d indirectly measure a person s intellectual ability verbal and nonverbal skills are tested m test score is an intelligence quotient Intelligence Test Pros 1 Of all clinical tests intelligence tests are the most carefully produced 2 The tests are easily standardized on a large population 3 High validity and reliability Intelligence Test Cons 1 Other nonintelligence factors can in uence IQ results from test 2 Tests may be biased cultural language tasks 3 Members of a minority may have less experience and be uncomfortable with testtaking which can negatively in uence their results IV Classification A DSMS 1 2 3 4 5 Approximately 400 disorders Classify individuals with a particular disorder Categorical approach serves a function but there are some problems Good Describes criteria key clinical features and related features Be aware of the criteria for certain disorders Categorical Svstem 3 b Symptoms are clustered together into diagnoses Patients with more symptomatology will likely qualify for more categorical diagnoses 1 ie anxiety and depression depression and borderline personality disorder eating disorder and anxiety comorbid It is one classi cation system 1 Not right or wrong just varying degrees of usefulness 2 Trying to include more research to include more descriptions of the disorders Classification lifetime prevalence of DSM diagnoses a No Disorders 536 1 maybe have not gone in for diagnosis and may have one b One Disorder 187 c Two Disorders 104 d Three Disorders 173 Is the DSM5 reliable a Will different clinicians agree on a diagnosis using the system b Some argue that it Will be reliable others have doubts Is it Valid a Does it actually predict anything b Is the information accurate for how people truly suffer Advantages of Classification 1 2 Language helps us learn certain terminology about disorders to make discussion easier Treatment providers have a common language Can help the individual reduce selfblame or have an explanation for dif culties Disadvantages of Classification 1 2 3 4 Misdiagnosis Stigma and labeling Selfful lling prophecy Malingering person is not changing or getting better because they hold to their diagnosis and use that as an excuse for not improving Alternatives to the Categorical System Do you have it Yes or no Dimensional systems 1 2 Various factors are considered along a continuum rather than a yes or no determination of Whether something is present ie intelligence Many intellectual assessments are now based on a dimensional system but still use cutoffs to determine the likelihood of the presence of a problem ie learning disorder V Treatment A Current research asks 1 What is the speci c treatment by Whom is the most effective for m individual With that speci c problem and under Which set of circumstances Chapter 4 Anxiety OCD and Related Disorders 1 w A Symptoms of Anxiety Disorders 1 Anxiety and Fear yet they are different 2 What is the difference a Anxiety anticipatory out of proportion to environmental threats a sense of being in danger when in fact the likelihood of being in danger is low worry b m a response to a real threat to one s safety c Both are associated With physiological features a Physiological Response 3 While anxiety is unpleasant experiencing fear and anxiety are often useful a Both prepare us for action Fight of Flight in a dangerous situation b Unfortunately for some such discomfort becomes too severe too frequent lasts too long or is easily triggered 1 These individuals are considered sufferers of an anxiety or related disorder 11 Anxiety Disorders A Most common disorders in the US 1 18 of the adult population every year experience one of the DSMS anxiety disorders a Almost 29 of people develop an anxiety disorder sometime throughout their lifetimes b One 20 of these people seek treatment Disorders are highly Comorbid With others but particularly With other anxiety N disorders B iety Disorders and 0CD 1 Anxiety Disorders in the DSM S a Generalized Anxiety Disorder GAD b Phobias 1 In Vivo Agoraphobia Social Anxiety anticipate embarrassing or humiliating themselves in a social situation a Generalized Social Anxiety any kind of interaction with people b Social Performance Anxiety Panic Disorder a Physiological reactivity is perceived as harmful and that it could possibly result in death b Panic Attacks do not mean Panic Disorder OCD is now under ObsessiveCompulsive related disorders a Involving hoarding III Anxiety Disorders GAD A Generalized Anxiety Disorder GAD 1 9 89 Predominant feature is EXCESSIVE WORRY that is not related to panic attacks or obsessions Sometimes called Free Floating Anxiety A generalized and apprehensive mood that is not triggered by any speci c object or situation For this reason Free Floating Anxiety differs from a phobia Must be accompanied by a Restlessnessagitation fatigue poor concentration irritability Common in western society a In any given year 4 of US population have symptoms 6 experience symptoms at some point during their lifetime Often appears in childhoodadolescence Women are diagnosed more than Men at a ration of 21 Few get treatment lt25 Multiple theories have tried to explain the disorder s development B Theories to explain GAD l Sociocultural Perspective result of living in dangerous situations a Evidence GAD is higher in low SES groups ethnic minorities etc 1 Poverty is one of the most powerful forms of societal stress b Race has a close relationship to stress in the US therefore it is also tied to GAD C l Multicultural Research results have not displayed a consistent high rate of GAD among Hispanics in the US Other Factors Contributing to GAD Not everyone in these situations has GAD so what else is responsible Other models offer possible explanations for why some develop disorders and why others do not Psvchodvnamic Perspective 3 b d GAD is the result of 3 types of anxiety developed in childhood 1 Realistic Anxiety facing real fear 2 Neurotic Anxiety prevented from expressing id impulses 3 Moral Anxiety punished for expressing id impulses Evidence repression is high in those with GAD adults with these early experiences of being punished for expressing id impulses have higher anxiety in aduhhood Today s psychodynamic theorists often disagree with some of Freud s explanations for why some and not others develop a disorder Many however still hold to Freud s belief that an explanation for the development of a disorder can be due to inadequate relationships between a parent and their child Support for Psychodynamic Perspective 1 GAD sufferers are more likely to use defense mechanisms repression 2 Those who suffered extreme consequences for their expression of id impulses have developed higher levels of anxiety Do these studies show what they claim to show 1 Forgetting is not always defensive 2 Being uncomfortable when facing painful memories is common Humanistic Perspective 3 Anxiety arises when people stop looking at themselves honestly and acceptingly l ie lack of unconditional positive regard in childhood gt conditions of worth high selfstandards worrying about what others think of them 2 Carl Roger s Explanation a When Unconditional Positive Regard is absent in childhood harsh self standards or Conditions of Worth develop i They won t love me unless I ii I have to be or they won t accept me 3 ClientCentered Therapy is used providing the patient with Unconditional Positive Regard and empathy a Controlled studies have not shown strong support b Only limited support for Rogers explanation for the development of GAD and other types of abnormal behavior 4 Coqnitive Persnective a Anxiety is caused by dysfunctional ways of thinking 1 Maladaptive Assumptions a Albert Ellis identi ed Basic Irrational Assumptions i I must be loved by everyone ii This didn t go my way so my life is going to be horrible forever b GAD may develop when these assumptions are generalized to more events 2 Aaron Beck GAD sufferers always assume imminent danger a Everyone and everything is unsafe until proven otherwise b Better safe than sorry 3 Research have been nding consistent evidence that GAD sufferers hold Maladaptive Assumptions about danger in particular b 3 Recent Explanations l Metacognitive Theory Wells a the biggest problematic assumption in GAD is high levels of worry about worrying 2 Intolerance of Uncertainty a the possibility of negative events is unacceptable b worry in an effort to find correct solutions 3 Avoidance Theory a worry reduces high levels of physiological arousal and is experienced therefore as positive 4 Theories have been supported by research 5 Bioloqical Perspective a Biological Theorists believe the cause of GAD stems from biological factors 1 This belief is supported by family pedigree studies a Biological relatives are 15 more likely to have GAD than the general population that presents a 6 likelihood b Evidence for genetic heritability almost double the likelihood in biological relatives i However competing explanations of Shared Environment exist b GABA Inactivity 1 In the 1950s Benzodiazepines Valium and Xanax were found to reduce anxiety Why a Neurons have speci c receptors b Benzodiazepine receptors usually receive GABA which carries inhibitory messages causes neurons to stop ring c In normal fear reactions 1 Certain neurons re more rapidly causing the person to experience general excitability that presents itself as fear or anxiety 2 This triggers a Feedback System in which the brain and body work together to reduce the excitability a Some neurons release GABA to reduce neuron ring which reduces the feelings of fear or anxiety 3 GAD can be caused by malfunctions in the Feedback System a There may be too few receptors or ineffective receptors d Unfortunately The Biological Perspective provides a good but somewhat problematic explanation for GAD 1 Research has shown that other neurotransmitters may be at work in anxiety and GAD 2 CORRELATION DOES NOT MEAN CAUSATION What comes rst physiological experiences or anxiety 3 Complicating the theory research has also shown that GAD probably stems from more than a single neurotransmitter 6 Psvchodvnamic Theorvbased Treatments for GAD a Treatment Techniques 1 same general techniques are used in a Psychodynamic Therapist s treatment for all psychological problems a Free Association b Interpretations of resistance and transference c Dream interpretation 2 Treatments for GAD a Freudians focus more on controlling id rather than focusing on fear b Objectrelations therapists help to identify and settle early relationship problems 3 Some controlled studies have found that Psychodynamic treatments are only mildly helpful to GAD sufferers a Exception shortterm psychodynamic therapy 7 Psychotherapy Treatments for GAD a Dynamically and humanistically oriented texts do not work with the exception of shortterm dynamic approaches b Cognitive approaches have much more support 1 Change maladaptive assumptions through cognitive reframing and socratic questioning 2 Help clients understand the special role that worrying plays change their views and reactions to it accept that it isn t positive and that it s an attempt to control things that they may not be able to control 8 Coenitive Treatments for GAD a Two Kinds of Coqnitive Approaches to Treatment 1 Change the Maladaptive Assumptions Ellis and Beck 2 Help clients understand worry s role in their lives 3 Change client s view and reaction to worry b Coqnitive Therapies 1 Changing Maladaptive Assumptions a Ellis RationalEmotive Therapy RET i Therapists help patients by pointing out irrational assumptions suggesting more appropriate assumptions and assign related homework for the patient to apply to their everyday lives ii Studies show that this form of treatment provides slight relief 2 Breaking Down Wogying a Therapists educate clients about the role of worrying in GAD b Clients are encouraged to observe their bodily arousal and cognitive responses to their lives c Results i Clients acquire skills to identify their worries and fruitless attempts to control their lives through worrying ii Clients practice and learn to see the world as less threatening iii Clients adopt better coping methods and eventually worry less d Research indicates that focusing on worrying is helpful when paired with traditional Cognitive Therapy e These methods are similar to Mindfulnessbased Cognitive Therapy 9 Biological Treatments for GAD a Relaxation Training 1 Biological technique nonchemical 2 Theory physical relaxation gt psychological relaxation 3 Research relaxation training is more effective than placebo or no treatment 4 These Biological Treatments work best when in cooperation with Cognitive Therapy or Biofeedback a Biofeedback i Patients are able to see their physiological reactions heart rate etc to help them controlreduce their anxiety ii Electrical signals from the body are used to teach patients to control their physiological responses iii Electromyograph EMG most widely used device that shows information about the patient s muscle tension iv This treatment provides a moderate effect but works best when in cooperation with other treatment methods for other medical issues headaches back pain etc IV Anxiety Disorders A iety Disorders Phobias Persistent and unreasonable fears of a particular object activity or situation Avoidance is Kev phobic individual will often avoid the phobic stimulus 3 Differs from regular fears a More intense and persistent b Greater desire to avoid c Distress interferes with functioning d Most phobias are speci c but there are a few broad categories ie agoraphobia Specific Phobias a Speci c object or situation b Immediate fear upon presentation of the phobic stimulus c Most common speci c animalsinsects heights thunderstorms and blood 1 AND Public Speaking 2 WHY d In any given year almost 9 of US population have symptoms of Speci c Phobia Over 12 develop such phobias at some time throughout their lifetime e Many have multiple phobias at a time t WomenMen 21 or more g Very few seek treatment 1 Why Because treatment means being in contact with phobic object Agoraphobia fear that you will be in a situation from which you cannot escape if you become panicked or incapacitated a Experienced by 2 of US adult population in any given year b WomenMen 21 c Twice as common among low SES d About 20 are in treatment but the other 80 is not e MOST avoid crowded places driving and public transport f Many are prone to panic attacks brought on by these situations or in isolation B Causal Explanations for Phobias 1 Of all the possible explanations the Behavioral explanations are the most strongly supported a Behavioral Explanations 1 Conditioning some support a Classical Conditioning paired association predominantly i Baby Albert 2 Modeling phobias develop through observation and imitation some support a Bandura 3 Phobias are maintained through Avoidance a Negatively reinforced 4 Best explanation a Preparedness Theory b BehavioralEvolutionarv Explanation 1 Some Speci c Phobias are more common than others 2 BehavioralEvolutionary Theorists believe that there are speciesspeci c biological dispositions to the development of certain fears a Preparedness humans are theoretically more prepared to develop certain phobias than others b This model explains Why some phobias are more common than others i Fear of snakes spiders heights ancestors were afraid of poisonous snakes poisonous spiders dangerous animals and of falling to their deaths C How are Speci c Phobias Treated l Behavioral approaches are the gold standard particularly exposurebased treatments a Desensitization l Developed by Joseph Wolpe a Relaxation fear hierarchy relaxationboredom is incompatible with fear b In Vivo or imaginal sometimes start with latter 2 In Vivo Desensitization person is actually exposed to the situation or object of their phobia instead of an imagined encounter 3 Covert Desensitization learning to relax around images of the situation or object of their phobia instead of a real encounter b Flooding 1 Forced nongradual exposure c Modeling 1 Therapist models interaction with feared stimulus d Virtual Reality is becoming popular 1 Good outcome 2 Virtually Better D Treatment for Agoraphobia 1 Behavioral Therapy with an emphasis on EXPOSURE is most common and effective a Therapist helps client move farther and farther from their home b Techniques are similar to those used in treatment of Speci c Phobia but also make use of Support Groups and HomeBased SelfHelp Programs Between 6080 of agoraphobic clients who have received treatment nd it easier to enter the public places they once feared Such improvement can last for years a Unfortunately the improvements are only partial Since the improvements are not complete relapse is possible and common E iety Disorders Social Anxietv l 2 8995 8 Formerly called Social Phobia Persistent irrational anxiety about social or performance situations involves fears related to others scrutiny or embarrassment a Can be m specific types of situations b Or M general fear of functioning in front of others c Sufferers believe that they perform worse than they actually do 1 Fear of Positive Evaluation a Complimenting someone s performance worsens their anxiety Can be very debilitating M of US population each year 60 are women Often begins in childhoodearly adulthood Low SES people are about 50 more liker to experience Social Anxiety Causal Explanations a Cognitive is the leading and most supported theory 1 Sufferers hold social beliefs and expectations that work against them in social situations a These beliefs are generally related to i Unrealistically high social standards e g I cannot appear stupid ii Views of self as unattractive or socially incompetent b Anticipate negative social interactions and then either avoid or do safety behaviors leave early other rituals i What effect does this have c After events sufferers usually ruminate on the experience and overestimate how poorly things went as well as think about the short and long term negative consequences Treatment for Social Anxiety Disorder a In the past two decades have developed pretty effective treatments using CBT l Addresses overwhelming social fears through exposure and reframing 2 Addresses lack of social skills a Social skills or assertiveness trainings 3 No medication during this treatment Why b Though medications antidepressants F ietv Disorders Panic Disorder An extreme anxious reaction that sometimes results when real threat is present 2 Panic Attacks however are periodic bursts of panic that occur suddenly peak and then pass a Marked by fears of death that one is going crazy or has lost control b Happen in the absence of true threat 3 25 of people will have one or more panic attacks in their lifetime However some have repeated unexpected attacks for no apparent reason This is Panic Disorder 5 As a result of attacks person with Panic Disorder has changes in cognitions and behavior a Changes in Cognition life was great until panic attack then life went to hell b Changes in Behavior altering life by introducing safety behaviors and avoidance 6 Often Cormorbid with Agoraphobia a Panic gt Agoraphobia b Agoraphobia gt Panic 1 Some individuals fear leaving home and traveling to places that they cannot escape or find help Such situations Panic Disorder can lead to Agoraphobia 7 Causal Explanations Biological Perspective a 1960s Clinicians found that Benzodiazepines did not help those suffering from Panic Disorder They found that they were however helped by antidepressants b Biological Factors Contributing to Panic Disorder l Norepinephrine a Irregular in individuals suffering from panic attacks i Research panic reactions are related to changes in norepinephrine activity in the Locus Ceruleus 2 Recent research has found that the more complex root of the Panic Disorder issue stems from brain circuits and the amygdala a Some individuals may inherit a predisposition to abnormality in these brain areas 3 Genetics a Those with close relatives that suffer from Panic Disorder are more likely to develop it than those with a more distant relative that suffers from Panic Disorder i Monozygotic Twins the rate among identical twins is about 31 ii Dizygotic Twins the rate among fraternal twins is as little as 11 4 Drug Therapies a Antidepressants rather than Benzodiazepines are effective at preventing or reducing Panic Attacks i Such medications work at the site of norepinephrine receptors in the brain circuit associated with panic These medications show improvement in 80 of Panic Disorder sufferers ii Improvement require constant drug therapy iii m Benzodiazepines Xanax however have brought some relief to patients as well because the medication indirectly affects norepinephrine activity 8 Causal Explanations Cognitive Perspective a Some individuals misinterpret physiological arousal and apply harmful assumptions about what s happening ie I m going to die I m having a heart attack b Some individuals have higher Anxiety Sensitivity and misinterpret their bodily sensations 1 These people are more prone to notice physiological arousal and may be more likely to misinterpret as harmful 2 Such individuals may have also experienced more traumatic events throughout their lifetimes 9 Coenitive Theranv for Panic Disorder a This form of therapy which is strongly supported helps the patient to correct their misinterpretation of their bodily sensations 1 Educate client about panic causes of physiological sensations tendency to misinterpret 2 Apply more accurate interpretations ie this is uncomfortable not harmful 3 Teaching better coping skills Relaxation b Biological Challenge procedures can be used to induce panic C d 1 Inducing physical sensations that cause panic sensations a Jumping running stairs These Cognitive treatments are helpful to those with Panic Disorder 1 Around 80 of treated patients are free of panic for 2 years compared to the 13 of the control group population 2 Cognitive treatments were found to be just as helpful as antidepressants Although the idea is still being examined a combination of therapies seem to be most effective G ObsessiveCompulsive Disorder Obsessions increase anxiety Compulsions decrease anxiety 1 Two Components 3 b C Obsessions 1 Persistent often intrusive thoughts ideas impulses or images that invade a person s consciousness 2 Attempts to ignore or resist cause anxiety 3 Common themes dirtcontamination violenceaggression orderliness religion sexuality a Religion If I do something wrong I m going to hell b Sexuality Questioning sexuality guilt etc Compulsions come after obsession 1 Repetitive rigid behaviors hand washing or mental acts counting to a certain number that they are undertaken to prevent or reduce anxiety 2 These are voluntary but feel mandatoryunstoppable 3 Usually recognized as unreasonable but believe something terrible will happen without the performance 4 Performing behaviors reduces anxiety but only for a short time 5 Can develop into rituals 6 Common forms cleaning checking Did I turn the oven off I know I checked it three times already but I have to check again orderbalance touching verbal counting Compulsions are a response to obsessions 2 Diagnosis 3 Symptoms are unreasonable and excessive distressing timeconsuming and an interruption to one s daily tasks inconvenient 3 Psvchodvnamic Behavioral Cognitive and Biological models offer the most helpful explanations a b 0CD The Psvchodvnamic Persnective This theory believes that anxiety disorders develop when children fear their id impulses and lessen their anxiety through the use of Ego Defense Mechanisms OCD is different from other Anxiety Disorders 1 Struggles are represented in obsessive thoughts and actions a Id Impulses obsessive thoughts b Ego Defenses compulsive actions According to Freud OCD was related to the anal stage of development characterized by intense con ict between the id and ego As it can be expected not all Psychodynamic Theorists agree Research has not supported this explanation 1 Psychodynamic Therapies Working to recognize and move past underlying con icts and defenses using free association and interpretation a Again these methods are not very well supported by evidence b ShortTerm Psychodynamic Therapies are a new alternative 5 0CD The Behavioral Perspective 3 b An individual will perform a compulsive act when encountering a fearful situation When the threat dissipates the individual will associate the decreased sense of threat with the compulsive act After more of such associations occur the individual believes that their compulsive behavior changes the circumstances The compulsive act is their goto when attempting to lessen or avoid their anxiety Stanley Rachman Compulsions can be seen to be rewarded by decreased anxiety Behavioral Therapy Exposure and Response Prevention ERP 1 Client is repeatedly exposed to the object of their anxiety and are encouraged to resist their compulsive action they would normally use to reduce their anxiety 2 Modeling Therapist models the patient s anxietytriggering behavior for the patient HOMEWORK is important to treatment 3 Between 55 and 85 of clients have reported signi cant and lasting improvement following ERP 6 0CD The Cognitive Perspective 3 b d 6 These theorists emphasize that everyone has intrusive thoughts OCD sufferers blame themselves for these intrusive thoughts and believe they will lead to threatening results To avoid the negative outcomes they believe are inevitable they try to neutralize their intrusive thoughts with compulsive actions or thoughts 1 Neutralizing thoughts or actions a Seeking reassurance b Thinking good thoughts c Compulsive washing d Checking double checking triple checking When a neutralizing action lessens the individual s anxiety they come to believe that it will always work They also reinforce the belief that their thoughts are dangerous As their fear of their thoughts increase they increase Why do only some individuals develop OCD while others do not 1 Individuals with OCD a Most likely have extremely high standards for their behavior and morals b Believe thoughts are just as bad as actions and will lead to horrible consequences c Believe that they should be able to control their intrusive thoughts and behaviors Cognitive Therapy 1 Cognitive Therapists place an emphasis on the cognitive processes that lead to and maintain obsessive thoughts and compulsions a Psychoeducation b Client should learn to identify challenge and change their faulty cognitive processes CognitiveBehavioral Therapy CBT 1 Research Cognitive and Behavioral models working together provides better results than only working with one of the models 7 0CD The Bioloqical Perspective a The key role of biological factors come from two lines of research 1 Abnormal Serotonin Activity a Serotoninbased antidepressants have proven to reduce symptoms of OCD i Other neurotransmitters might be at play b Abnormal Brain Structure and Functioning i Frontal Cortex and Caudate Nuclei composes the brain circuit that is responsible for converting sensory information into thoughts and actions One area may be overactive c More Research two lines may be connected other neurotransmitters along with Serotonin are important in the functions of the Orbitofrontal Cortex and Caudate Nuclei Abnormal neurotransmitter activity may be one of the explanations for malfunctioning circuit 8 Biological Therapies a Serotoninbased Antidepressants have been proven to improve 5080 of OCD sufferers Relapse is possible if medication stops b Research a combination of therapies have been proven to be most effective 1 Medication paired with Cognitive Behavioral Therapies H ObsessiveCompulsiveRelated Disorders 1 More clinical researchers have found patterns in excessive behaviors such as hoarding Trichotillomania hair pulling and shopping these behaviors have been linked to OCD a DSMS has created a new group ObsessiveCompulsiveRelated Disorders in the hopes that naming these new disorders will set the stage for new research better understanding and improved treatment This group has four patterns 1 Hoarding Disorder 2 HairPulling Disorder 3 ShinPicking Disorder 4 Body Dysmorphic Disorder
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