1
Q
What are the symptoms/characteristics of GAD (generalized anxiety disorder)
A
- excessive anxiety - worrying about everything but there is no apparent danger
- general anxiety that is hard to get rid of
- has to be present for at least 3 months to be diagnosed
- Restlessness
- muscle tension
- Insomnia
- easily fatigued
- irritability
2
Q
What do psychoanalytic therapists believe causes GAD
A
- high anxiety and poor défense mechanisms
- believed all kids have anxiety but are able to use défense mechanisms so no défense =GAD
3
Q
What are psychoanalytic treatments for GAD?
A
- controlling the ID through free-association
- Teaching patient that the thoughts are just thoughts
- controlling impulsivity
4
Q
What do psychodynamic therapists believe causes GAD
A
Poor-parents child relationships
5
Q
What are the psychodynamic treatments for GAD
A
- corrective emotional experiences (therapist replaces the person having caused bad experiences and makes client relieve it in a positive way)
6
Q
What are the biological causes of GAD?
A
- problem with neurotransmitters called GABA
- biological relative thats close can pass it down
7
Q
What are biological treatments for GAD?
A
- anti-anxiety drugs (benzodiazepines - Valium, Ativan, Xanax)
- work similarly to GABA since they’re inhibitory and can calm the brain down
- now we use antidepressants and antipsychotics instead because they aren’t addicting
- relaxation techniques like meditation and mindfulness
8
Q
What is the treatment(s) that work best for GAD
A
CBT + antidepressants/ biological treatments
9
Q
What is a specific phobia?
A
Persistent and reoccurring fear of a specific object or situation. Mainly animals, blood, injury, places, storms.
10
Q
What is agoraphobia?
A
Fear of being in a situation where it will be difficult to escape and that people will see if panic is experiences.
11
Q
What are the behavioural causes of phobias
A
That it is developed through classical conditioning and modeling.
- it is maintained through avoidance (not facing fears)
12
Q
What is the treatment for specific phobias
A
- systematic desensitization
- learning relaxation skills
- creating a fear hierarchy (listing most stressful to least stressful thing)
- confronting each of the feared situations systematically
- taught skills that are incompatible wth fear like relaxation
13
Q
What are the 3 types of ways to do systematic desensitization
A
- In vivo desensitization (direct, live exposure to feared object/thing)
- Covert desensitization (imagining the situation because live replication is not possible)
- Virtual reality (when live situation is hard to duplicate, like: planes, heights, etc)
14
Q
What is flooding?
A
Forced non-gradual exposure to feared object or situation
15
Q
What is modelling?
A
Therapist confronts the thing the client fears and the patient watched
16
Q
What are the 2 treatments for agoraphobia?
A
- Exposure: therapist helps the client go farther and farther from their homes while doing relaxation exercises
- Support groups
17
Q
What are the characteristics and symptoms of social anxiety disorder?
A
- social situations that the person feels anxious about
- severe, persistent fear of being judged
- sees themselves as bad performers
- negative thoughts about self
- embarrassment
- physical reactions like:
- sweating
- blushing
- palpitations
- tendency to seek avoidance of the situation through a SAFETY BEHAVIOUR (behaviour done to suppress fear if fear can’t be avoided)
18
Q
What are the causes for social anxiety disorder according to cognitive theory?
A
- self-defeating beliefs
- believes they are true (ex: unattractive and socially unskilled)
- convinces the self thats true than seeks to perform safety behaviours
19
Q
What is the cognitive treatments for social anxiety disorder?
A
- changing the believes (ex: homework assignment to go out and watch to see no one is watching) through exposure
- social sills assertiveness training (providing reassurance and feedback
- antidepressants are often used but therapy is = effective and less relapse
- combination works best
20
Q
What are the characteristics and symptoms of panic disorders?
A
- unpredictable periodic attacks and never knowing when they will occur
- worry about when the next will occur or worry about having another one
- fears of going crazy, dying, losing control, etc
- extreme physical sensations
- nausea
- hyperventilation
- sweating
- shaking
- dizziness
- heart palpitations
21
Q
What is the biological perspective of panic disorders?
A
- accidental realization that antidepressants or better led to theory that irregular norepinephrine activity in the locus coeruleus.
- diathesis-stress is another possibility
22
Q
What are the biological treatments for panic disorders?
A
- antidepressants and benzodiazepines are 80% effective if patient remains on them
- can break the panic - fear - anticipation cycle of panic attacks
- combination is best because most dont want to be o medication for rest of life
23
Q
What are the cognitive theory of causes of panic disorders?
A
- overly sensitive to certain bodily sensations (ANXIETY SENSITIVITY)
- misinterprets signs of medical catastrophes
24
Q
What are the cognitive treatments for panic disorders
A
- teaching accurate interpretations of feelings i the body
- educating o panic attacks and body sensitivity
- intéroceptive exposure. (Biological challenge procedure - exposure to unpleasant situations)
25
From the film clip what is intéroceptive exposure and intensive exposure therapy?
Intéroceptive: explaining what occurs during session then being exposed to unpleasant sensations.
- in clip: running on spot with therapist for a minute which led to finding it hard to breathe, increased heart rate, and feeling hot. This mimics the feeling for a panic attack
Intensive exposure:
- exposure therapy like going on the subway.
- starts with panic techniques
- therapist is reassuring
- eventually able to do it on own and overtime the anxiety decreases
26
What are the characteristics of OCD?
OBSESSIONS: intrusive, foreign, persistent thoughts and resisting them causes anxiety.
- can be germs, religion, aggression, etc
COMPULSIONS: developing rituals to stop the thoughts and if it is not done they believe something bad will occur
- can be cleaning, counting, touching, etc
- affects he functioning of the persons life
- understand it is unreasonable but the fear of something terrible occurring is persistent
- temporary relief occurs when doing the compulsion
27
What are the behavioural causes of OCD?
Compulsions decrease anxiety
- this réalisation can happen by chance but the realization that it os rewarding makes the person continue doing it.
- OPERANT CONDITIONING
28
What are the behavioural treatments for OCD
- exposure and response/ritual prevention
- actively preventing rituals and systematically gradually exposing feared though or situation which leads to REALITY TESTING (client learns no harm will occur when ritual is or isn’t performed)
29
What are the cognitive causes of OCD?
- trying to neutralize the ‘bad’ thoughts but often failing
30
What are the cognitive treatments for OCD?
- identify then change the disorder thoughts/cognitions
- educate the client about behaviours to understand than change them
31
What are the biological causes of OCD
- problem/abnormality in serotonin activity or in the brain structure and its functioning
- particular areas of the brain not functioning correctly:
- orbitofrontal cortx
- caudate nucleus
- in charge of thoughts so if its not working it can be the cause of OCD
32
What are the biological treatments of OCD?
- antidepressants that increase serotonin levels (50-80% effectiveness)
- meds and CBT seems to be most effective
33
What are the symptoms of unipolar depression?
- persistent and reoccur in low mood
- loss of pleasure or interest in activities that were once enjoyed
- lethargy or agitation
- fatigue/loss of energy
- problems with attention and concentration
- wight gain or loss due to increased or decreased appetite
- sleeping more or less
- feelings of hopelessness, worthlessness or self-esteem issues
- suicidality
34
What was stated in the film clip on theories and treatments of unipolar depression?
- caused by genetics, chemical imbalance or trauma (often all 3)
- chemical imbalance changes the way neurotransmitters are received
- antidepressants are given such as Prozac or other SSRI’s
35
What are some diagnostic criteria’s for unipolar depression
- must occur for 2+ weeks
- no mania
- causes dysfunction in life
- decreased interest of pleasure in daily activities almost all the time
36
What is persistent depressive disorder (dysthymia)
Mood disorder that involves persistent depressed mood lasting more than 2 years with no absence of symptoms
37
What is double depression?
Severe mood disorder where one had major depressive episodes and persistent depression with fewer symptoms
38
What are the biological causes of depression
- genetic factors: if it runs in the family, person has increased chances of getting it
- biochemical factors: serotonin and norepinephrine contribute as well as dopamine and cortisol
39
What are the biological treatments of depression?
Antidepressants
- monoamine oxidase inhibitors
- tricyclics (dont work right away or as well)
- second generation antidepressants (SSRI’s)
- blocks serotonin or norepinephrine reuptake
Electroconvulsive therapy (ECT)
- applying shock/electrical impulses to 1 side of brain to create seizures
40
What are the psychoanalytic/dynamic theories for depression?
- theorized that the death of a loved one causes a regression in the oral stage to cope (older Freudian theory)
- newer theory is that bad relationships with parents can lead to insecurities
41
What are the psychoanalytic/dynamic treatments for depression?
- reviewing past events and feelings
42
What is the behavioural theory for depression?
- theory that decreased rewards in life leads to decreased behaviours that are constructive
- research suggests that amounts of social rewards can lead to depression if doesn’t receive enough
43
What are the behavioural treatments for depression?
- countering this by increasing pleasurable activities
- help increase social skills
- rewarding appropriate behaviours
- may not do much if used alone which is why its often combined
44
What are the cognitive theories for depression?
- learned helplessness (learning that one has little to no control over life)
- idea was created through experiment by Seligman and the lab dogs who learned escape wasn’t possible and gave up
- attributions (attributions made about self)
- internal attributions which are global, internal and stable
- better attributions which are external, specific and unstable
45
What are the 4 cognitive components of negative thinking?
1. Maladaptive attitudes - self depleating attitudes developed in childhood
2. Cognitive triad - interpreting self, experiences and future negatively
3. Errors in thinking - 9 faulty ways of thinking/cognitive dysfunctions
4. Automatic negative thoughts - not realizing one is having negative thoughts
46
What are some characteristics of bipolar disorder in the film clip “overview of bipolar disorder”
- extreme mood swings that’s debilitating
- chronic, incurable, and life-threatening
- can be treated with medications and therapy
- dramatic shifts in mood and thought
- cyclical and can happen at any time
- elevated sex drive, recklessness, hallucinations and delusions, hostility, fast talking
- same symptoms of major depression when in depressed state
47
What are the 5 symptoms/main areas of functioning of mania
1. Emotional - giddy, euphoric, irritable
2. Motivational - need for constant involvement and socialization
3. Behavioural - fast talking and thinking
4. Cognitive - disorganized thoughts and lack of of concentration
5. Physical - decreased need for sleep
48
What is the main difference between bipolar 1 and bipolar 2?
Bipolar 1 has full manic episodes and major depressive episodes and can have mixed episodes and bipolar 2 has hypomanic episodes (less severe and often not psychotic) and major depressive episodes
49
What is cyclothymic disorder?
- many periods of hypomanic symptoms and mild depression
- Symptoms for 2+ years to get diagnosis
- often develops in teenage years
- has periods of normal mood
- may progress to bipolar 1 or 2
50
What are the biological causes of bipolar?
- inherited genetically through an inherited predisposition
- the closer to te person genetically, the greater the risk of developing it
51
What is te permissive theory?
- low serotonin “opens the door” to developing mood disorders with norepinephrine
- low serotonin and low norepinephrine = depression
- low serotonin and high norepinephrine = mania
52
What is the treatment for bipolar disorder? List 3 problems with it
- lithium therapy
1. Hard to find the correct dosage
- too little can lead to mania or depression
- too much can lead to lithium intoxication
2. Weight gain
3. Compliance can be an issue since they may enjoy mania
53
List the diagnostic criteria’s of dissociative amnesia
- individual isn’t able to recall important and stressful about their lives
- more extensive than just forgetting
- not caused by physical injury or substance abuse
- caused by trauma
- causes distress or impairment in functioning
54
List the diagnostic criteria’s of dissociative identity disorder
- has to have 2 or more distinct personalities called subpersonalities
- has different characteristics, identities, physiological characteristics like BP like allergies
- 1 dominant personality at any given time
- abrupt transitions
- recurrent and persisted gaps in memory
- trauma, personal details or what occurred during the switch
- distress or impairment to functioning
55
What are the prevalences of DID?
- many or all cases are IATROGENIC meaning: unintentionally produced by therapists
- # of diagnoses are occurring due to 2 reasons:
1. More clinicians believe the disorder exists
2. Diagnosis procedures are more accurate
56
What are the psychodynamic causes of dissociative amnesia?
- single instance of stress or trauma
57
What are the psychodynamic causes of DID?
- lifetime of trauma
58
What are the behavioural causes of dissociative disorders?
- caused by operant conditioning
- one forgets the trauma in order to decrease the anxiety since its rewarding
- dissociation allows for an escape behaviour
59
What are te 3 treatments for dissociative amnesia?
1. Psychodynamic - make the unconscious conscious
2. Hypnotic therapy - guided recall forgotten events
3. Intravenous injections (IV) or barbiturates - a sedative that calms the patient in order to release inhibitors/trauma
60
What are the treatment steps for DID?
1. Get the patient to recognize they have DID
2. Have patient recover by accepting the memories/ traumas
- tends to use the same techniques as dissociative amnesia (psychodynamic, hypnotic and barbiturates )
3. Integrate the subpersonalities into 1 personality
- problem is that resistance to this is common and has to learn new coping and social skills
61
What are the diagnostic criteria’s of somatic symptom disorder?
- at least 1 upsetting bodily symptom
- causes anxiety or distress about the bodily symptom
- has excessive thoughts
- disrupts one’s daily life
- persistent ad recurring symptoms for more than 6 moths
- physical symptoms caused by something psychological
62
What are the 2 kinds of somatic symptom disorders. Explain
1. Somatisation pattern.
- many long-lasting physical problems with little to no physical basis
2. Predominant pain pattern
- pain is the primary feature and often develops after an accident or incident that causes injury and it pursues for a long time
63
What are the psychoanalytic causes of somatic symptom disorders
- conversion of unconscious conflicts into physical symptoms
- started because of Electra conflict
64
What are the psychodynamic causes of somatic symptom disorders
- unconscious conflicts from childhood that havent been faces
- believe that symptoms play a role in 2 ways:
1. Primary gain - defence mechanism to suppress unconscious conflicts
2. Secondary gain- in order to avoid problem or draw attention to them
65
What are the behavioural causes of somatic symptom disorders?
- physical symptoms bring rewards to those who are suffering
- if sympathy is received, symptoms are more occurrent
- OPERANT CONDITIONNING
66
What are the cognitive causes of somatic symptom disorders?
- symptoms are a form of communication
- a safe way to express difficult emotions due to stigma of mental illness
67
What are the multicultural causes of somatic symptoms
- conversion is the norm in many non-western cultures
68
What are the 3 treatments for somatic symptom disorders?
- insight therapy/psychodynamic : free association
- exposure therapy : thoughts of traumatic events brought back up while doing relaxation exercises
- drug treatment : anti - anxiety or antidepressants
69
What are the diagnostic criteria’s of illness anxiety disorders?
- chronic anxiety about health
- No mild or existing physical symptoms
- excessive health-related behaviours
- lasts for 6+ months even if not continuous
70
What are the behavioural causes of illness anxiety disorder?
- classical conditioning or modeling
71
What are the cognitive causes for illness anxiety disorder?
- over sensitivity to bodily cues
72
What are the 3 treatments for illness anxiety disorder?
1. Antidepressants (SSRI)
2. Exposure and response prevention therapy (ERP)
3. CBT
**similar to the treatments of OCD
Psychological Disorders
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