PSYCH 330 1st EditionExam # 2 Study Guide Lectures: 7-11Exam 2 will be over chapters 4 (Anxiety, OC, and Trauma Disorders), 6 (Bipolar and Depressive Disorders), and 9 (Substance-Related and Addictive Disorders). Since class was cancelled so many times there are only four lectures for the material, but I’ll fill in the missing information here. I encourage you to read along in your textbook as well for a fuller understanding of the subjects.Lecture 8 (Feb. 5)What is Anxiety?Commonly, a patient who believes themselves to be a experiencing an anxiety disorder will tell you their “nerves” are shot, or something of the like. But as a professional, a deeper understanding of what makes up true anxiety is needed.The Triple Reason System (Developed in 1968), is a good starting point. This system measures physiological, cognitive, and behavioral aspects of a person. For someone with anxiety, you would see symptoms like the ones on this chart.Physiological Cognitive BehavioralShortness of Breath “I can’t handle…” Decreased SleepSweaty Palms “I’m too overwhelmed…” FidgetyDilated Pupils Attention/Concentration IssuesWithdraw/AvoidanceMuscle Tension “I’m dying…” CryingDizziness “I’m losing control…” Decreased Eye ContactElevated Blood Pressure “Everything is falling in aroundme…”Substance AbuseWhat Kind of Life Events Can Create Anxiety?- Relationships- Trauma- Occupational/Educational Stressors- Death/BirthSo How Can You Measure Anxiety?- The Holmes and Rahe Social Readjustment Scale is a 5-10 minute survey to take that measures how vulnerable you are to anxiety. The higher you score, the more vulnerable you are.Is Anxiety Always Harmful?- No, actually. Anxiety can be a very good motivator when in proper moderation. Think about it. If you weren’t worried about your grade, you wouldn’t do a paper or study for atest.- The Yerkes-Dodson Law states that you perform with a moderate level of anxiety on a daily basis. It also states basically that difficult tasks are performed better with low anxiety levels, and simple tasks are performed better with higher anxiety levels.Significance of Mental Anxiety- It is the largest mental health problem in the U.S.- There are also comorbity rates with other mental health problems and medical heath issues.Fight/Flight Response- As you should already know, humans have a central nervous system (CNS) and a peripheral nervous system (PNS) There is a diagram in chapter 4 in your book that helps explain this.- The sympathetic nervous system (SNS) in the PNS increases heart rate and respiration. This is what is activated in a panic or stress response.- The parasympathetic nervous system does the exact opposite. This is what brings your body back to normal after the threat or stress is dealt with.- In people with panic disorders, an excess of chemicals rush to the brain because of the SNS, and that’s why they have such a sudden attack of panic.Normal vs Abnormal Anxiety- As I said before, feeling anxious occasionally is completely normal.- It’s usually time limited and ends.- But if it’s effecting your functional impairment (as in, effecting your ability to live or do something), then the anxiety becomes abnormal.- When you are a child, you are expected to have many fears of somewhat silly things, like sharks or monsters or the like.- But as you age, you should see a decrease in both the number of anxieties you have as well as the types of fears you have.Socio-Demographic Factors- Women have 2-3 times the frequency of developing anxiety disorders than males. This could be misleading, since it’s possible factors such as self-reporting would possibly limit male participation. - But, both males and females who get diagnosed seek treatment in equal numbers.- Minority races such as African Americans, Asian Americans, and Hispanics present with fewer cases of anxiety disorders than Caucasians.Prevalence- In a 12 month period, 18.1% of the adult population will have an anxiety disorder.- 22.8% of these cased (about 4.1% of the population) will be severe.- The average age of onset is early-around 11 years old.- Older adults (60+) have a markedly less chance of developing an anxiety disorder, with one exception. General Anxiety Disorder (GAD) in older adults have just as high if not slightly higher rates of development as other ages.Anxiety in Older Adults- There are overlaps of symptoms in younger and older adults with anxiety disorders.- For older adults as well as other ages, anxiety disorders are highly comorbid with depression.- Anxiety disorders are also highly comorbid with medical illnesses, and there are associations between anxiety disorders and cognitive decline in older adults.- Late age of onset is uncommon (over 60).- Both pharmacotherapy and cognitive behavioral therapy have shown as effective treatments in older adults.Lecture 9 (Feb. 10)According to the DSM-5, there are categories of mental disorders, such as:Anxiety Disorders:- Panic Attacks- Panic Disorder and Agoraphobia- Generalized Anxiety Disorder- Social/Specific Phobias- Separation Anxiety DisorderObsessive-Compulsive Disorders:- OCD- Body Dysmorphic Disorder (The inability to perceive one’s body accurately; instead one sees a fault or shortcoming)- Hoarding Disorder- Trichotillomania (obsessive hair pulling; unconscious or conscious)- Excoriation (obsessive skin picking)Trauma and Stress Related Disorders:- Posttraumatic Stress Disorder- Acute Stress Disorder- Adjustment DisorderCoping with Anxiety- Maladaptive ways include:a. Escape and Avoidanceb. Procrastinationc. Alcohol/Drug Abused. Distraction- Adaptive ways include:a. Deep Breathingb. Progressive Muscle Relaxation (PMR)c. Mindfulness (Mindfulness-Based Stress Reduction (MBSR))d. Self-Monitoringe. Social Supportf. Exposure (Imagination vs In Vivo; Expressive Writing)g. Behavioral ActivationPanic AttacksSymptoms:- Derealization (the world around you feels like a dream)- Depersonalization (an out-of-body experience)- Dyspnea (shortness of breath & hyperventilation)- Heart Paplitations- Nausa- Trembling- Choking Sensation- Dizziness/Lightheadedness/Vertigo- Chest Pain- Perspiration- Hot Flashes- Headaches- Paresthesia (numbing/prickling sensation in fingers/toes)- Fear of dying/fear of insanityDuration:- 10-15 minute episodes (average).- It can be up to 2-3 hours
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