Term
|
Definition
| Apprehension about a future threat. Increase preparedness. Physiological arousal. Most common- 28% |
|
|
Term
|
Definition
| Response to an immediate threat. Triggers Fight or flight. Physiological arousal. |
|
|
Term
|
Definition
| Most common anxiety disorder. Disruptive fear of a particular object or situation. Awareness that fear is excessive and fear must be severe enough to cause distress to social life or normal function. 2 types: specific and social. |
|
|
Term
|
Definition
| Unwarranted excessive fear of a specific object or situation. Exposure triggers intense anxiety but you recognize fear is unrealistic. high comorbidity (cluster around a few fears) |
|
|
Term
|
Definition
| Related to social situation only. Persistent intense fear of social situations like unfamiliar people or social scruntity. Exposure triggers to intense anxiety. Recognize fear unrealistic. |
|
|
Term
| Generalized Social Phobia |
|
Definition
| fearful of any social situation |
|
|
Term
|
Definition
| Only fearful of specific sit like being around a group of ten or more people |
|
|
Term
|
Definition
| Frequent panic attacks unrelated to a specific situation. With/Without Agoraphobia. Must have panic attack plus 4 other symptoms. |
|
|
Term
|
Definition
| sudden intense episode of apprehension, terror, feelings of impending doom. peak intensity within then minutes. |
|
|
Term
|
Definition
| sweating, nausea, labored breathing, dizziness, heart palp, upset stomach, light headedness |
|
|
Term
|
Definition
| Occurs unexpectedly without warning. panic disorder dx requires recurrent uncued attacks. |
|
|
Term
|
Definition
| triggered by specific situations. more likely a phobia. |
|
|
Term
| Panic disorder with Agoraphobia |
|
Definition
| avoidance of situation which escape would be difficult or embarrassing, more chronic. |
|
|
Term
| Generalized anxiety disorder |
|
Definition
| excessive worry about a variety of things which impair function. symptoms last at least 6 mos. |
|
|
Term
|
Definition
| must have at least 3 or more: restlessness, tire easily, poor concentration, irritability, muscle tension, sleep disturbance |
|
|
Term
| Obsessive complusive disorder |
|
Definition
| characterized by persistent uncontrollable thought or urges and by the need to repeat certain acts again and again |
|
|
Term
|
Definition
| intrusive, persistent and uncontrollable thought or urges. Person knows thoughts are irrational and cannot stop thoughts. |
|
|
Term
|
Definition
| repetitive, clearly excessive behaviors or mental acts that person feels driven to perform to reduce the anxiety caused by obsessive thoughts. |
|
|
Term
| Onset of OCD for men/women |
|
Definition
men = early onset
women = later onset, cleaning compulsions |
|
|
Term
| Post Traumatic Stress Disorder |
|
Definition
| Extreme response to severe stressor, emotional numbing from exposure to a traumatic event that involves actual or threatened death or injury. Symptoms present for more than one month. |
|
|
Term
| 3 categories of PTSD: 1. Re-experiencing |
|
Definition
| 1. Re-experiencing the traumatic event through nightmares, intrusive thoughts, or images. |
|
|
Term
| 3 categories of PTSD: 2. Avoidance of stimuli |
|
Definition
refusal to be in presence of location or reminders or traumatic event. ex) refuse to walk down street the rape occurred.
numbing, decreased interest in others, distant or estranged from others, unable to experience positive emotions |
|
|
Term
| 3 categories of PTSD: 3. Increased arousal |
|
Definition
| insomnia, irritability, hyper vigilance, exaggerated startle response |
|
|
Term
|
Definition
| occurs right after traumatic event causing extreme fear, helplessness, and horror. experiencing dissociative symptoms during and after the event. |
|
|
Term
| symptoms Acute Stress Disorder |
|
Definition
| 3 symptoms similar to ptsd. occur b/w 2 days and 1 month after trauma and 2/3 with asd develop ptsd w/in 2 years. |
|
|
Term
| Combordity of anxiety disorders |
|
Definition
| 3/4 of those with anxiety disorder meet criteria for another disorder- 60% being major depression. substance abuse, personality disorder (avoidant, dependent, histrionic) |
|
|
Term
| onset of anxiety disorder men vs women |
|
Definition
| women 2x more likely to develop anxiety disorders besides ocd. due to the likelihood more women experience childhood sexual abuse |
|
|
Term
| Genetic Vulnerability of Anxiety Disorder |
|
Definition
| twin studies suggest heritability 20% -40% for phobias, GAD, and PTSD. 50% panic disorder. |
|
|
Term
| Fear circuit/ ^ activity (neurobiological anxiety factor) |
|
Definition
2 team members:
increase amygdala activity
decrease medial prefrontal cortex
activity (reulates amygdala)
* when someone expresses fear there will be more activity in amygdala and there is less activity in the prefrontal cortex. |
|
|
Term
| Neurotransmitters (neurobiological anxiety risk factor) |
|
Definition
3 team members:
decrease serotonin (decrease anxiety)
decrease gaba (decrease anxiety)
increase norepinephrine
* when a person has anxiety they have low serotonin and gaba and more norepinephrine. |
|
|
Term
| Panic Disorder(biological anxiety risk factors) |
|
Definition
increase in locus cerulus activity
- major source of norepinephrine
- drugs that stimulate this brain region can induce panic attacks |
|
|
Term
| GAD (biological anxiety risk factors) |
|
Definition
|
|
Term
| OCD (biological anxiety risk factors) |
|
Definition
| increase activity in orbitofrontal cortex, caudate nucleus, and anterior cingulate |
|
|
Term
| PTSD (biological anxiety risk factors) |
|
Definition
decrease in hippocampus (learning and memory)
increase in cortisol sensitivity and norepinephrine |
|
|
Term
| Social risk factors of anxiety disorders |
|
Definition
negative life events:
severe stressors often precede onset
80% w/ panic disorder
70% w/ any anxiety disorder |
|
|
Term
| PTSD (social risk factor) |
|
Definition
| nature and severity of trauma important. |
|
|
Term
| Anxiety disorder (personality risk factors) |
|
Definition
behavioral inhibition: tendency to be agitated, distressed, and cry in unfamiliar novel settings.
Neuroticism: tendency to react to stressful events w/ negative affect |
|
|
Term
| Anxiety disorder (cognitive risk factors) |
|
Definition
perceived control: belief that one lacks control over their environment, more vulnerable to developing anxiety disorders if trauma in childhood.
*Attention to threat - tendency to notice negative environmental causes and selective attention to signs of threat |
|
|
Term
| Social Phobia (cognitive risk factors) |
|
Definition
-negative self evaluation and harsh self-judgement
- fear of negative evaluation by others (expect others to dislike them)
-excessive attention to internal cues (heart rate) |
|
|
Term
| Panic Disorder (cognitive risk factors) |
|
Definition
- lack of perceived control triggers panic
- fear bodily changes (interpreted as impending doom, beliefs increase anxiety and arousal) |
|
|
Term
| Panic Disorder (cognitive risk factors) |
|
Definition
- lack of perceived control triggers panic
- fear bodily changes (interpreted as impending doom, beliefs increase anxiety and arousal)
- W/ Agoraphobia: expect actions of catastrophic consequences of having public panic attack |
|
|
Term
| GAD (cognitive risk factors - borkovec's cog. model) |
|
Definition
- Worry to cope and distract themselves
- Worry reinforcing; distracts from negative emotions & images
» Allows avoidance of more disturbing emotions (previous trauma)
» Avoidance prevents extinction of underlying anxiety
» Less able to identify their own negative feelings |
|
|
Term
|
Definition
» Yadasentience Deficit
– Subjective feeling of completion
Knowing that you have thought or cleaned enough
» Attempts to suppress intrusive thoughts
– Trying to suppress thoughts may make matters worse
(also true for PTSD and dissociation) |
|
|
Term
| Phobias/PTSD (behavioral risk factors) |
|
Definition
» Pairing of stimulus with
aversive UCS leads to fear
(Classical Conditioning)
» Avoidance maintained
through neg. reinforcement
(Operant Conditioning)
» Conditioning occurs through
direct trauma, modeling, or
verbal instruction
» Prepared Learning: innate
fear of certain objects |
|
|
Term
| Panic Disorder (behavioral risk factors) |
|
Definition
» Classical conditioning of
panic in response to
bodily sensations
- interoceptive conditioning: classical conditioning of panic in response to bodily sensation
-People with panic disorder
sustain classically
conditioned fears longer |
|
|
Term
| OCD (behavioral risk factor) |
|
Definition
- Operant reinforcement
» Compulsions negatively
reinforced by anxiety |
|
|
Term
| 3 common aspects to psy treatment |
|
Definition
- Exposure» Face the situation or object that triggers anxiety
– Should include as many features of the trigger as possible
– Should be conducted in as many settings as possible
-Systematic Desensitization» Relaxation training plus imaginal exposure
-Cognitive approaches» Increase belief in ability to cope with the anxiety trigger
- Challenge expectations about negative outcomes |
|
|
Term
|
Definition
*Exposure
» environmental exposure more effective than systematic desensitization
* Social phobia
» Exposure
– Role playing or small group interaction
» Social skills training
– Reduce use of safety behaviors
*Cognitive therapy
» Enhances treatment for social but not specific phobias |
|
|
Term
|
Definition
- Exposure plus ritual prevention(most widely used treatment)
- Cognitive therapy (usually also involves exposure)
» Challenge beliefs about anticipated consequences of not
engaging in compulsions |
|
|
Term
| Panic disorder & Agoraphobia (Psy Treatment) |
|
Definition
-Panic Disorder Control Therapy: (PCT) exposure to somatic sensations (heart rate)associated w/ panic attack in a safe setting and use of coping strategies (deep breathing) to control symptoms.
- cognitive Beh. Therapy (CBT): increase patients awareness of thoughts that make physical sensations threatening and patient learns to challenge and change maldaptive beliefs. |
|
|
Term
|
Definition
» relax training and cognitive therapy
» Challenge and modify negative thoughts
» Increase ability to tolerate uncertainty
» Worry only during “scheduled” times
» Focus on present moment |
|
|
Term
|
Definition
» exposure to memories and reminders of original trauma
» Either direct (in vivo) or imaginal
» Treatment may initially increase symptoms
» More effective than medication or supportive therapy |
|
|
Term
| Anxiety disorder medications |
|
Definition
Anxiolytics
» Drugs that reduce anxiety
Two common types of medications used to treat anxiety
» Benzodiazepenes (e.g., Valium, Xanax)
» Antidepressants
– Tricyclics, Selective Serotonin Reuptake Inhibitors (SSRIs)
Side effects
» Withdrawal from benzodiazepenes
» Weight gain, nervousness, high blood pressure from SSRIs
Relapse common after medication discontinuation |
|
|
Term
| Mood Disorders: 2 broad types |
|
Definition
I. Involves only depressive symptoms
II. Involves manic symptoms (Bipolar Disorder) |
|
|
Term
| Depression (mood disorder) |
|
Definition
» Sadness
» Feelings of worthlessness and guilt
» Withdrawal from others
» Changes in sleep and appetite |
|
|
Term
|
Definition
» Intense elation or irritability
» Hyperactivity, talkativeness, distractibility |
|
|
Term
| Major Depressive Disorder |
|
Definition
* MUST HAVE Depressed mood OR loss of interest or pleasure(anhedonia)for min period of 2 weeks
» Not due to normal bereavement
PLUS 4 of the following symptoms:
» Change in sleep patterns (sleeping more or less)
» Change in appetite or weight (eating more or less)
» Psychomotor agitation or retardation
» Loss of energy, fatigue
» Feelings of self-blame, worthlessness, guilt
» Difficulty concentrating, indecisiveness
» Thoughts of death or suicide |
|
|
Term
|
Definition
| symptoms tend to dissipate overtime |
|
|
Term
|
Definition
| once depression occurs, future episodes are likely to occur |
|
|
Term
| MDD epidemiology and prevalence |
|
Definition
- after one mdd episode, 50% likely to develop 2nd episode.
- avg # of episodes is 4 |
|
|
Term
|
Definition
| saddness plus 3 other symptoms for 10 days. sign impairments in functioning even though full dx criteria is not met |
|
|
Term
|
Definition
chronic depression/depressed mood for at least 2 years (w/o maj. dep.) plus TWO other symptoms » Poor appetite or overeating
» Sleeping too much or too little
» Psychomotor agitation or retardation
» Loss of energy
» Feelings of worthlessness
» Difficulty concentrating or indecisiveness
» Recurrent thoughts of death or suicide |
|
|
Term
|
Definition
» Dysthymia PLUS major depressive episode
95% of dysthimic disorder developed mdd |
|
|
Term
| Epidemiology and prevalence Depression |
|
Definition
MDD twice as common women than men
- more common among people of poverty
- lifetime prevalence 16.4% MDD and 2.5% dysthmia |
|
|
Term
|
Definition
» 2/3 of those with MDD will also meet criteria for anxiety
disorder at some point (Mineka, et al., 1998) |
|
|
Term
|
Definition
involves episode of depression altering w/ mania
- 3 types |
|
|
Term
|
Definition
| state of intense extreme elation/irritable |
|
|
Term
|
Definition
| w/in same week experience mania and depression |
|
|
Term
|
Definition
-symptoms of mania but less intense
-four or more days of elevated mood
-doesnt interfere w. function
-hypomania alone is not a dsm dx categ. |
|
|
Term
| Manic and Hypomanic episodes |
|
Definition
- elevated expansive or irritable mood
PLUS 3 of the following (4 if mood is irritable):
» Psychomotor agitation or increase in goal-directed behavior
» Excessive talking or pressured speech
» Flights of ideas; racing thoughts
» Reduced need for sleep
» Grandiosity or inflated self esteem
» Easily distractible
» Excessive involvement in pleasurable activities with negative
consequences (e.g., unprotected sexual activity, spending sprees) |
|
|
Term
|
Definition
» Symptoms last for 1 week OR require hospitalization
» Symptoms cause significant distress or functional impairment |
|
|
Term
|
Definition
» Symptoms last at least 4 days
» Clear changes in functioning but impairment is not marked |
|
|
Term
|
Definition
| at least one episode of mania or mixed episode for one week |
|
|
Term
|
Definition
| at least one major depressive episode w. at least one episode of hypomania at the same time for at least 4 days |
|
|
Term
|
Definition
| milder, chronic form of bipolar disorder that last at least 2 years and numerous periods of hypomanic and depressive symptoms |
|
|
Term
| epidemolgy and consequences of bipolar disorder |
|
Definition
-prevalence rates are lower - 1%
- ave age of onset in 20s
- no gender diff
- severe, recurrent, suicide rates high |
|
|
Term
| seasonal depressive/bipolar disorder |
|
Definition
| episodes happen regularly at a particular time of year |
|
|
Term
| Rapid cycling depressive/bipolar disorder |
|
Definition
| At least 4 episodes w/ in a particular |
|
|
Term
|
Definition
| w/in 4 weeks after giving birth |
|
|
Term
|
Definition
| extreme physical immobility or excessive peculiar physical movement. . plus symptoms of mood disorder. |
|
|
Term
|
Definition
| delusions and halluncinations |
|
|
Term
|
Definition
| inability to experience pleasure "anhedonia" |
|
|
Term
| Genetic factors of mood/depressive disorders |
|
Definition
Heritability estimates 93% bi dis 37% MDD
- higher rates for women than men |
|
|
Term
|
Definition
(Low levels of norepinephrine, dopamine, & serotonin)
- Individuals who are vulnerable to depression may have less
sensitive serotonin receptors |
|
|
Term
|
Definition
–(High levels of norepinephrine & dopamine)
- Dopamine receptors may be overly sensitive in BD but lack
sensitivity in MDD |
|
|
Term
| Mood disorder Biological factors |
|
Definition
- Brain imaging: focus on activity levels of brain structure
» Overactivity of HPA axis
» Triggers release of cortisol
» Injecting cortisol in
animals produces
depressive symptoms |
|
|
Term
| Social risk factors mood disorders |
|
Definition
- lack of social support one factor in onset of depression
- interpersonal difficulties such as marital conflict predicts depression
- behavior of depressed people often leads to rejection : excessive reassurance seeking, few positive facial expressions, self disclosures, slow speech. |
|
|
Term
| Psychological risk factors mood disorders |
|
Definition
- Affect» High negative affect or Low positive affect
- In response to positive stimuli, depressed individuals
experience:
» Fewer positive facial expressions
» Report less pleasant emotion
» Show less motivation
-Neuroticism
» Tendency to react with higher levels of negative affect
» Predicts onset of depression |
|
|
Term
| Cognitive risk factors mood disorders |
|
Definition
Cognitive theories (Beck)
– Negative triad: Negative view of- Self, World, Future
– Negative schemata: underlying tendency to see the world negatively
» Negative schemata cause cog. biases: Tendency to process information in negative ways |
|
|
Term
| Psychological treatments mood disorders |
|
Definition
Interpersonal Psychotherapy (IPT)
» Short term psychodynamic therapy
» Focus on current relationships
- Cognitive Therapy
» Monitor and identify automatic thoughts: Replace negative thoughts with more neutral or positive thoughts
» Behavioral activation: doing something pleasant to get your mind off bad things
» Behavioral Couples Therapy
-Enhance communication and satisfaction
» Bipolar Disorder (psycho-ed)
- Provide info about symptoms, triggers, & treatments |
|
|
Term
| Biological treatments mood disorders |
|
Definition
ECT: reserved for severed depression with high suicide, depression w/ psychotic features, or treatment non responsive.
- induced brain seizure and unconsciousness, side effect: memory loss |
|
|
Term
|
Definition
-MAO inhibiters: antagonist
-Trycycllic antidepressants
-SSRI's |
|
|
Term
|
Definition
- CT as effective as med for severe depression
- CT more effective than med at preventing relapse |
|
|
Term
| Meds for Bipolar disorder |
|
Definition
- Lithium: up to 80% receive at least some relief with this mood stabilizer
- side effects: tremors, lack of coordination, dizziness, blurred vision. |
|
|
Term
|
Definition
- refusal to maintain normal body weight which is less than 85% bodyweight age and height
- intense fear of gaining weight/fat cant be too thin, no such thing
- distorted body image, feel fat even when emaciated
- amennorhea: loss of menstrual period |
|
|
Term
| Anorexia Nervosa: Restricting Type |
|
Definition
| Severly limiting food intake |
|
|
Term
|
Definition
|
|
Term
| Epidemiology of Anorexia Nervosa |
|
Definition
- Onset early to middle teen years
- Usually triggered by dieting and stress
- Women 10x as likely to develop disorder as men
» Symptomatology in men similar to that of women
- Often co-morbid with depression, OCD, phobias, panic,
alcoholism & Personality DOs
» In men, co-morbid with substance dependence, mood disorders, or schizophrenia
- Suicide rates high in anorexia
» 5% completing
» 20% attempting |
|
|
Term
| Physical Damage and Prognosis |
|
Definition
- Low BP & heart rate, kidney & gastrointestinal problems
- Loss of bone mass
- Brittle nails, dry skin, hair loss
- Lanugo (soft, downy body hair)
- Depletion of potassium & sodium
» Can cause tiredness, weakness, & death
» May take several years; relapse common
- Difficult to modify distorted view of self, especially in cultures that
highly value thinness |
|
|
Term
|
Definition
- Uncontrollable eating binges followed by compensatory behavior to prevent weight gain
–Binge: An excessive amount of food consumed in under 2 hours
– Occur at least 2x per week for 3 months, often in secret |
|
|
Term
|
Definition
|
|
Term
| Bulimia Nervosa- non purging |
|
Definition
| fasting, excessive exercise |
|
|
Term
|
Definition
| extreme weight loss in anorexia at or above normal weight in bulimia |
|
|
Term
|
Definition
- Binges often triggered by stress and negative emotions
- Typical food choices:
» Cakes, cookies, ice cream, other easily consumed, high calorie foods
Avoiding a craved food can increase likelihood of binge
- Loss of control during binge
» Reports of losing awareness or dissociation
» Shame and remorse often follow |
|
|
Term
|
Definition
-Onset late adolescence or early adulthood
- Prevalence 1% – 2%
- Co-morbid with depression, personality DOs,anxiety, substance abuse, conduct disorder
- Suicide attempts & completions higher than general population but lower than anorexia |
|
|
Term
| Physical change & prognosis Bulimia |
|
Definition
-Menstrual irregularities
-Potassium depletion from purging
-Laxative use depletes electrolytes which can cause cardiac irregularities
-Loss of dental enamel from vomiting
» Teeth appear “jagged”
- 70% recover (10% remain fully symptomatic)
- Early intervention linked with improved outcomes
- Poorer prognosis with co-morbid depression & substance abuse |
|
|
Term
|
Definition
-Diagnosis in need of further study
-Associated with obesity and history of dieting
-Involves:
» Recurrent binges (rapid eating, eating alone)
» Loss of control during binge
» Binge causes distress
-Often accompanied by obesity (2%-25% meet criteria)
» Body mass index (BMI) > 30
-Equally prevalent among different ethnic groups (2%-4%) |
|
|
Term
| Genetic Factors eating disorders |
|
Definition
- Family and Twin studies support genetic link
» 1st degree relatives with both eating disorders increases one’s risk
» Higher MZ concordance rates for both anorexia and bulimia
» Body dissatisfaction, desire for thinness, binge eating, and weight
preoccupation all heritable |
|
|
Term
| Biological factors eating disorder |
|
Definition
- endogenous opiods
» Substances that reduce pain, enhance mood, & suppress appetite
» Released during starvation
– May reinforce restricted eating of anorexia
» Excessive exercise increases opioids
» Low levels of opioids (beta-endorphins) in bulimia promote craving
– Reinforce binging |
|
|
Term
| Cognitive behavioral view anorexia |
|
Definition
» Focus on body dissatisfaction & fear of fatness
» Certain behaviors (e.g., restrictive eating, excessive exercise)
» Perfectionism & personal inadequacy lead to excessive weight concerns
» Feelings of self control due to weight loss are
» Criticism from family & peers regarding weight can also play a role |
|
|
Term
| Cognitive behavioral bulimia nervosa |
|
Definition
» Self-worth strongly influenced by weight (low self-esteem)
» Rigid restrictive eating triggers lapses which can become binges
– Many “off-limit” foods
» Disgust with oneself and fear of gaining weight lead to compensatory
- stess and negative affect trigger binges
behaviors (e.g., vomiting, laxative use) |
|
|
Term
| Socio cultural risk factors eating disorders |
|
Definition
- U.S. society values thinness
» Anorexia found in many cultures
» As countries become more like western cultures, bulimia increases
-Dieting, especially among women, has become more prevalent
» Often precedes onset
- Body dissatisfaction and preoccupation with thinness
also predict eating disorders
» Culturally influenced
- Societal objectification of women
» Women viewed as sexual objects
- Unrealistic media portrayals
» Women may feel shame when they don’t match the ideal
-Overweight individuals are viewed negatively, creating
more pressure to be thin |
|
|
Term
| Eating disorder treatments |
|
Definition
- Most dont get treatment
» Denial common
- antidepressants
» Effective for bulimia but not anorexia
» Drop out and relapse rates high
- CBT for bulimia
» Challenge societal ideals of thinness
» Challenge beliefs about weight and dieting
» CBT more effective than medication
-CBT for anorexia
» Immediate goal is to increase weight to avoid medical complications
and avoid death
» Second goal is long term maintenance of weight gain
» Alter all-or-nothing thinking
» Reductions in symptoms through1 year
» Also effective for binge-eating disorder |
|
|
Term
| Prevention intervention Eating disorder |
|
Definition
- Psychoeducational approaches: dissonance reduction intervention
– Challenge society’s notion of beauty (e.g., the thin ideal)
» Healthy weight intervention
– Developing healthy weight & exercise programs
»De-emphasize sociocultural influences
- Resisting & rejecting social pressures to be thin
» Risk Factor Approach
- Identify those most at risk and intervene early |
|
|
