Psych 8

Question 1

Diagnostic criteria/time frame for panic attacks

Answer 1

♣ Recurrent unexpected panic attacks (periods of intense fear and discomfort) without an identifiable trigger
♣ One or more panic attacks followed by > 1 month of continuous worry about future attacks

Question 2

Tx of specific phobia

Answer 2

Exposure therapy

Question 3

Tx of social phobia related to performance anxiety

Answer 3

Beta blockers or short acting benzos prn

Question 4

Tx for general social anxiety disorder

Answer 4

First line = SSRI/SNRI

Benzos PRN

Question 5

Tx of OCD

Answer 5

SSRI - requires higher doses than needed to treat depression

Question 6

Tx of Generalized anxiety disorder (GAD)

Answer 6

SSRI, Buspirone, TCAs, short-term benzos

Question 7

Tx of Panic disorder

Answer 7

• First line = SSRI
• Can switch to TCA if SSRI not effective
• Benzos until SSRI kicks in + PRN

Question 8

Defense mechanism:

• Consciously replacing an unacceptable wish with a similar but acceptable course of action
• E.g. Redirection of aggression towards father into sports

Answer 8

Sublimation

Question 9

• Alleviating negative feelings via unsolicited generosity

- E.g. Mafia boss donates to charity

Answer 9

Altruism

Question 10

• Intentionally withholding idea or feeling from awareness temporarily
• E.g. Don’t worry about big game until it’s time to play

Answer 10

Suppression

Question 11

• Appreciating amusing nature of anxiety-provoking situation
• Expressing unpleasant or uncomfortable feelings without causing discomfort to self or others

Answer 11

Humor

Question 12

• Regulating situations and events of external environment to relieve anxiety

Answer 12

Controlling

Question 13

• Transferring avoided feeling or ideas to a neutral person
• Shifting emotions from an undesirable situation to one that is personally tolerable
• E.g. Father yells at child because his boss yelled at him

Answer 13

Displacement

Question 14

• Avoiding negative feelings by excessive use of intellectual functions and by focusing on irrelevant details
• E.g. Physician dying from cancer describe the pathophysiology of his disease in detail to his 12-year-old son

Answer 14

Intellectualization

Question 15

• Separating feelings from ideas and events
• Unconsciously limiting the experience of feelings or emotions associated with a stressful life event in order to avoid anxiety
• E.g. Describing murder in detail without an emotional response

Answer 15

Isolation of affect

Question 16

• Explanations of an event in order to justify outcomes or behaviors and to make them acceptable
• E.g. My boss fired me because she is not meeting her quota, not because I am underperforming

Answer 16

Rationalization

Question 17

• Unconsciously replacing warded-off feelings by emphasis on its opposite
• Doing the opposite of an unacceptable impulse
• E.g. Really sexual person becomes a monk
• E.g. Man in love with his married coworker insults her

Answer 17

Reaction formation

Question 18

• Involuntarily withholding an idea or feeling from consciousness
• E.g. Child does not remember sexual abuse

Answer 18

Suppression

Question 19

• Giving in to an impulse, even if socially inappropriate, in order to avoid the anxiety of suppressing that impulse
• E.g. Man who has been told his therapist is going on vacation “forgets” his last appointment and skips it

Answer 19

Acting out

Question 20

• Not accepting reality that is too painful

* E.g. Woman scheduled for breast biopsy cancels appointment because she believes she is healthy

Answer 20

Denial

Question 21

• Performing behaviors from an earlier stage of development in order to avoid tension associated with current phase of development
• E.g. Adult bring teddy bear when they have to spend the night in the hospital

Answer 21

Regression

Question 22

• Attributing unacceptable internal impulses to an external source
• E.g. Accusing wife of cheating because of your desire to cheat

Answer 22

Projection

Question 23

• Modeling behavior after another person who is more powerful
• E.g. Abused child becomes an abuser

Answer 23

Identification

Question 24

• Labeling people as all good or all bad

* Often seen in borderline personality disorder

Answer 24

Splitting

Question 25

* Attempting to reverse a situation by adopting a new behavior * E.g. Man who has had a brief fantasy of killing his wife by sabotaging her car takes the car in for a complete checkup

Answer 25

Undoing

Question 26

What is psychoanalysis

Answer 26

♣ Goal is resolve unconscious conflicts by bringing repressed experiences and feelings into awareness and integrating them into the patient’s conscious experience ♣ Best suited patients: not psychotic, intelligent, and stable in relationships and daily living

Question 27

What disorders do psychoanalysis work best for

Answer 27

* Cluster B and C personality disorders * Anxiety disorders * Problems coping with life events * Sexual disorders * Persistent depressive disorder

Question 28

What is transference

Answer 28

o Projection of unconscious feelings regarding important figures in the patient’s life onto the therapist o E.g. Patient with repressed feeling of abandonment by her father becomes angry when therapist is late for appointment

Question 29

What is counter-transference

Answer 29

o Projection of unconscious feelings about import figures in therapist’s life on the patient o Therapist must be aware of this so as not to let it interfere with objectivity

Question 30

What is behavioral therapy

Answer 30

♣ Seeks to treat psychiatric disorders by helping patients change behaviors that contribute to their symptoms

Question 31

What are the theories that suggest how behaviors are learned

Answer 31

- Classical conditioning = A stimulus can evoke a conditioned response (e.g. Pavlov’s dog) - Operant conditioning = Behaviors can be learned when followed by positive or negative reinforcement (e.g. rat learns to press lever when it receives food)

Question 32

What is systematic desensitizon

Answer 32

o Patient performs relaxation techniques while being exposed to increasing doses of an anxiety-provoking stimulus

Question 33

What is flooding and implosion

Answer 33

o Through habituation, the patient is confronted with a real (flooding) or imagined (implosion) anxiety-provoking stimulus and not allowed to withdraw from it until he or she feels calm and in control o E.g. a patient with fear of flying is forced to fly on an airplane

Question 34

What is aversion therapy

Answer 34

o A negative stimulus (e.g. electric shock) is repeatedly paired with specific behavior to create an unpleasant response o Used to treat addictions or paraphilia (e.g. Antabuse for alcoholics)

Question 35

What is token economy

Answer 35

o Rewards are given after specific behaviors to positively reinforce them

Question 36

What is biofeedback

Answer 36

o Physiological data (such as HR and BP) are given to patients as they try to mentally control physiological states o Can be used to treat anxiety disorders, migraines, hypertension, chronic pain, asthma, and incontinence

Question 37

What is cognitive therapy

Answer 37

♣ Seeks to correct faulty assumptions and negative feelings that exacerbate psychiatric symptoms ♣ The patient is taught to identify maladaptive thoughts and replace them with positive ones

Question 38

What is CBT

Answer 38

♣ Focuses on patient’s current symptoms and problems by examining the connection between thoughts, feelings, and behaviors

Question 39

Tx of borderline personality disorder

Answer 39

DBT

Question 40

What is DBT

Answer 40

♣ A form of CBT that is effective in reducing the urges to engage in self-harm behavior and reduces hospitalizations in patients with borderline personality disorder

Question 41

4 components of DBT

Answer 41

* Mindfulness = being fully aware and present in the moment * Distress Tolerance = tolerating pain in difficult situations * Interpersonal Effectiveness = how to ask for what you want and say no while maintaining self-respect and relationships with others * Emotion Regulation = changing emotions that you want to change