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Abnormal Psych Exam 2
Anxiety disorders. somatoform disorders, dissociative disorders, mood disorders
76
Psychology
Undergraduate 4
03/10/2012

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Term
____________ is elicited by a threatening stimulus in the current environment. Onset is acute, duration limited by eliciting situation, and involves the activation of motoric escape / avoidance responses
Definition
fear
Term
define anxiety. how does it differ from fear?
Definition
generally involves unpleasant anticipation of a future situation. More “mood like” than fear: Less acute, less focused, less discrete; and generally does not involve the activation of motoric escape / avoidance responses.
Term
what is panic?
Definition
is an intense, discrete episode of unpleasant physical symptoms typically accompanied by feelings of “fear.” Sometimes evoked an identifiable stimulus, sometimes spontaneous.
Term
what are the three types of panic attacks?
Definition
spontaneous (uncued), situationally-predisposed and situationally bound (cued)
Term
what is the essential feature of panic disorder?
Definition
the repeated occurrence of spontaneous panic attacks
Term
panic disorder is highly comorbid with __________ and ___________
Definition
major depressive disorder and anxiety disorders
Term
what are some of the common symptoms of a panic attack?
Definition
-dyspnea (trouble breathing)
-chest pains
-dimming of visual field
-heart palpitations, tachycardia (increased HR)
-lightheadedness
-dissociative symptoms (depersonalization, derealization)
-paresthesia (numbness, tingling) in lips and extremities
-thoughts of dying, going crazy or losing control
Term
what is the physiological cascade that occurs in hyperventilation?
Definition
1) Hypocapnia: CO2 in the bloodstream falls
2) Respiratory alkalosis: Bloodstream pH increases
3) Hypoxia: The alkalosis triggers cerebral vasoconstriction, diminishing bloodflow to the brain and starving it of oxygen
Term
true or false: Hyperventilation plays a prominent role in several etiological theories of panic disorder
Definition
true
Term
what is agoraphobia?
Definition
Avoidance of places from which escape might be difficult or embarrassing or in which help might not readily be available in the event of panic sx.
Term
__________ is defined by anxiety or worry causing significant distress or impairment in social or instrumental role functioning, associated with: restlessness, muscle tension, impaired concentration, irritability and sleep disturbance
Definition
generalized anxiety disorder (GAD)
Term
what is the core symptom of GAD?
Definition
persistent rumination about multiple topics
Term
true or false: GAD is weakly comorbid with other anxiety disorders and mood disorders
Definition
false. highly comorbid.
Term
true or false: SNS arousal is present in GAD
Definition
false. one theory is that worry is actually an avoidance mechanism employed to prevent emotional processing of threatening images and the experience of SNS arousal
Term
what is social phobia?
Definition
Intense fear and avoidance of one or more specific social situations generally involving the possibility of being watched and evaluated and of doing something embarrassing
Term
____________ is defined as persistent fear of a circumscribed object or situation other than fear of having a panic attack or of humiliation or embarrassment in certain social situations
Definition
specific phobia
Term
what are the 5 main types of specific phobias?
Definition
1. Animal Type: Animals or insects
2. Natural Environment Type: Storms, heights, water, etc.
3. Blood-Injury-Injection Type
4. Situational Type: Public transportation, tunnels, bridges, elevators, flying, driving, enclosed spaces, etc.
5. Other Type: Choking, vomiting, falling, illness, loud sounds, clowns, etc.
Term
why does the BII (blood-injury-injection) type of specific phobia not exactly fit in with the rest?
Definition
because the physiological response is very different. people actually pass out upon sight of these things due to vagus nerve discharge when HR is high --> vasovagal syncope
Term
true or false: all phobias except BII are specifically heritable
Definition
false. most phobias tend to be heritable but not specific (ie if your mom has a phobia you are more likely to have a phobia but not necessarily the same one) but BII is specifically heritable
Term
Define OCD
Definition
Recurrent obsessions or compulsions severe enough to be time-consuming (>1 hr / day) or to cause significant distress or impairment. Insight (reality testing) is usually maintained, although it may fluctuate.
Term
____________ are intrusive, recurrent, ego-dystonic ideas, thoughts, impulses, or images accompanied by feelings of tension and dread.
Definition
obsessions
Term
what is though-action fusion? What disorder is this associated with?
Definition
The idea that thinking about some event increases the likelihood of its actual occurrence. Associated with OCD.
Term
___________ are repetitive behaviors (overt or cognitive) designed to prevent or relieve distress.
Definition
compulsions
Term
why are compulsions negatively reinforced in OCD patients?
Definition
because they lead to a temporary reduction of distress produced by obsessive thoughts
Term
what are some common obsessions?
Definition
-contamination
-doubt
-harming people
-violating social taboos
-violent or disturbing thoughts or images
Term
what are some common compulsive rituals?
Definition
-cleaning
-symmetry and orderliness
-repeating, checking, counting, touching
-confessing
-hoarding? may become separate in DSM 5, generally have poor insight
Term
what is PTSD?
Definition
Syndrome developing after a “traumatic event” which elicited intense fear, helplessness, or horror. Onset may be immediate or delayed.
Term
what are some of the main symptoms associated with PTSD?
Definition
-re-experiencing the event in vivid dreams, flashbacks or intrusive thoughts
-avoiding stimuli associated with the event
-numbness of emotional responsiveness
-increased arousal
Term
why is PTSD unique in the DSM?
Definition
because it requires a specific etiology
Term
what are some major criticism of PTSD?
Definition
difficult to define what constitutes a "trauma", this continues to broaden and change with time (bracket creep)

etiology should be specifically and strongly associated with the disorder, not the case.
Term
what is acute stress disorder?
Definition
Similar to PTSD with an emphasis on dissociative sx (derealization, depersonalization, memory difficulties). Sx develop and resolve within one month. (If sx persist, the dx is typically changed to PTSD).
Term
______________ appears to be a strong predictor of later PTSD
Definition
peritraumatic dissociation
Term
true or false: all anxiety disorders display significant heritability and show little shared environment effect
Definition
true. GAD 38%, panic 32%, animal phobia 26%, social phobia 17%, OCD 25%-70% (wide range from different studies)
Term
In Ledoux's high-road, low-road theory the ______ road is quick and dirty (unconcious) and the ______ road is slow and detailed (concious)
Definition
low, high
Term
what are the three NT systems linked to anxiety and fear?
Definition
seratonin, norepinepherine and GABA
Term
the _________________ in the pons contains about 50% of the NE cell bodies in the brain
Definition
Locus coeruleus (LC)
Term
The LC is under strong inhibitory control from _____ receptors

Definition
α2
Term
Central NE activity enhances _____________, ________________ and _____________
Definition
vigilance,
attention, memory
Term
 α2 antagonists (e.g., yohimbine) are ____________ in humans, while α2 agonists (e.g., clonidine) are ____________
Definition
anxiogenic, anxiolytic
Term
Why are there implications for the treatment of traumatic memories with β-blockers (e.g. propranolol)?
Definition
Because central NE activity is necessary for the creation of emotional memories
Term
SSRI’s (selective serotonin reuptake inhibitors), which block 5-HTT
(the serotonin reuptake transporter; a.k.a. SERT), are ______________
acutely but _____________ when administered chronically
Definition
anxiogenic, anxiolytic
Term
For which anxiety disorders are SSRIs widely prescribed?
Definition
OCD, PTSD, social phobia and panic disorder
Term
SERT is encoded by a gene (SLC6A4) with a tandem repeat polymorphism in the
promoter region called ____________ and has 2 alleles, ____ and ____
Definition
5-HTTLPR(5-HTT-Linked Promoter Region), L (long) and S (short)
Term
true or false: L carriers display greater amygdala activation to emotionally provocative
stimuli than S carriers
Definition
false. S carriers display greater amygdala activation even though the short allele is less active.
Term
 Developmental disruption from diminished 5-HTT activity is __________
, whereas chronic 5-HTT inhibition in adults is generally _____________
Definition
anxiogenic, anxiolytic
Term
5-HT1A (autoreceptor) agonists (e.g., buspirone) are (anxiolytic or anxiogenic)?
Definition
anxiolytic, meaning that inhibiting 5-HT release reduces anxiety
Term
How do benzodiazepine (BZD) ligands affect the release of GABA?
Definition
because Ionotropic GABAA
receptor is structurally linked to a
benzodiazepine (BZD) binding site--a GABA-BZD receptor complex. GABA’s inhibitory effect is therefore modulated by the type of ligand present at the BZD
binding site
Term
What is the heritability rate of panic disorder?
Definition
32-48% with the rest being accounted for by non-shared environmental influences (no environment or epistasis factors)
Term
what are some findings linking panic disorder and 5-HT?
Definition
1. finding that there is a SNP in
SLC6A4 that is fairly strongly and specifically associated with panic disorder
2. finding that 5-HT1A reduced by
1/3 in anterior and posterior cingulate and by 41% in Raphé nucleus of panic
patients
Term
what is the hyperventilation theory of panic disorder?
Definition
that hyperventilation-induced hypocapnia (decreased levels of CO2 in the bloodstream) causes acute anxiety
Term
what is the suffocation false alarm theory of panic disorder?
Definition
that panic patients suffer from an
overly sensitive suffocation detector (or asphyxiostat) which is triggered by trivial increases in bloodstream CO2
Term
true or false: smoking increased risk for later development of panic disorder
Definition
true
Term
what is somatization?
Definition
The expression of psychological distress in the form of physical symptoms.
Term
what are somatoform disorders?
Definition
a group of disorders in which no organic etiology can be determined for physical symptoms (disorders in which somatization plays a central role)
Term
________________ is a somatoform disorder in which a pt has multiple, chronic, unexplained symptoms that begin before the age of 30
Definition
somatization disorder or briquet's syndrome
Term
true or false: somatization disorder is highly comorbid with personality disorders (esp. histrionic, antisocial and borderline)
Definition
true
Term
_______________ is disorder in which the pt holds the obsessive belief that they have a serious disease due to misinterpretation of physical symptoms. this belief is not alleviated with medical assurance otherwise .
Definition
hypochondriasis
Term
________________ is characterized by a preoccupation with pain in the absence of physical findings which account for its existence or its intensity
Definition
pain disorder
Term
what is undifferentiated somatoform disorder?
Definition
Diagnosis given to medically4unexplained
physical sx conditions that do not meet the
full criteria for another somatoform disorder
Term
what is conversion disorder?
Definition
A loss of, or deficit in, voluntary motor or sensory
function which cannot be accounted for by physical
findings
Term
what are common symptoms in conversion disorder?
Definition
paralysis, gait or coordination disturbances, anesthesias, partial or complete blindness, deafness, aphonia (inability to speak), convulsions
Term
_____________________ is characterized by an excessive anxious preoccupation with an imagined or trivial defect in appearance
Definition
body dysmorphic disorder (dysmorphophobia)
Term
what are some common symptoms related to body dysmorphic disorder?
Definition
covering of the problematic area, obessive grooming or mirror checking, multiple medical visits and procedures, social withdrawl
Term
what is facticious disorder (aslo called munchusens disorder)?
Definition
a disorder in which a person brings physical symptoms upon themselves and then procedes to feign illness. appears that the person does this attract wanted attention although person is thought to be concious only of mechanism and NOT of motivation
Term
what is malingering?
Definition
a disorder very similar to that of facticious disorder but in which it is presumed that the person is aware of BOTH mechanism and motivation
Term
what are 3 etiological theories hypothesized for somatoform disorders?
Definition
1. sick-role enactment
2. self-handicapping
3. perceptual augmentation/cognitive misinterpretation
Term
true or false: somatoform disorders are highly comorbid with depression and anxiety disorders
Definition
true
Term
what is the essential feature of dissociative disorders?
Definition
: Disturbance in
the normally-integrated functions
of consciousness, memory,
identity, and perception of the
environment.
Term
true or false: dissociative disorder symptoms are always gradual and persistent
Definition
false. they can be gradual or sudden in onset and may be transient or persistent
Term
_____________ is characterized by the inability to recall important personal information, usually of a traumatic or stressful nature, that is: a) too extensive to be explained as normal forgetting; and b) medically
unexplained
Definition
dissociative amnesia
Term
what are the primary types of dissociative amnesia?
Definition
1. Localized: Inability to recall specific periods, events, or parts of events
2. Generalized: Inability to recall entire life history, including identity. If
accompanied by sudden, unexpected travel, this type of amnesia is called fugue
Term
what is dissociative fugue?
Definition
similar to dissociative amnesia but characterized by sudden, unexpected travel paired with confusion about identity or assumption of a new identity
Term
what is depersonalization disorder?
Definition
A disorder characterized by persistent or recurrent episodes of depersonalization or
derealization (i.e., a change in usual sense of reality about
one’s self or one’s environment). Reality testing remains
intact (i.e., the experience is “as if”). Onset is sudden.
Term
in what age group does depersonalization disorder usually occur?
Definition
adolescence or early adulthood
Term
depersonalization disorder patients show significantly higher metabolic activity in __________________ region associated with multimodal sensory integration
Definition
parietal-occipital-temporal junction
Term
what is dissociative identity disorder?
Definition
a disorder characterized by the presence of multiple personalities or personality states within one person accompanied by the inability to recall important personal information
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