Treatment of Anxiety Disorders CBT for depression and Anxiety Fall 2013 Crib Exam 2 DRAFT 2 October 28 2013 Mood Chapter 6 Anxiety OCD Trauma Chapter 9 Schizophrenia Chapter on depression Briefly describe each disorder floor Bipolar disorder no depressive required could just be mania which is BP1 once diagnosed with Bipolar can t be major depressive disorder due to the documented manic episode o Bipolar 1 one or more episodes of MANIA shoots through ceiling o Bipolar 2 one or more depressive episode with 1 hypomania shoots through Major depression episodic and recurrent depressed mood absence of pleasure anhedonia 2 weeks of symptoms can t have prior DSM diagnosis of anxiety or depression disorders including bipolar Dysthymic disorder persistent depressive disorder 2 years 1 children Chronic depressive disorder 95 of people diagnosed develop MDD depressed mood and 2 symptoms must be present Cyclothymic disorder type of bipolar disorder numerous periods of hypomania and depressive episodes cyclic but dragged on duration of 2 years or 1 in youth Define Pressured speech rapid speech one way conversation uninterruptable Flight of ideas rambling about anything and everything coming to mind hard to keep on topic How is mania different from hypomania Mania 1 week symptoms often leads to hospitalization functional impairment and distress intense elation irritability Hypomania hypo less 4 days no severe impairment symptoms like mania but not as severe Describe Cognitive behavioral therapy CBT by Aaron Beck Negative triad negative view of self world and future negative schema underlying tendency to see world negatively which causes cognitive bias process info in a negative way What is attribution theory Stable and global attributions cause hopelessness if you make internal failures worldly you are likely to become depressed Ex I failed my math test I must suck at life What are risk factors for suicide 1 in 10 000 men 4x likely to succeed women are more likely to attempt but don t result in death men guns hang women pills higher risk with old age increasing in adolescents children 48 heritable divorced widowed elevates risk 4 5 fold How does the focus of treatment for depression differ between CBT and Interpersonal therapy Interpersonal short term focuses on current relationships CBT identify and change dysfunctional patterns of thinking and behaving directly modify irrational negative beliefs Describe the treatment of Behavioral Activation increase participation in positively reinforcing activities to disrupt spiral of depression withdrawal and avoidance What are some of the more common biological treatments for depression e g meications etc ECT for nonresponders to medications MAO antidepressants tranylcypromine parnate tricyclic antidepressants imipramine amitriptyline tofranil Elavil Selective Serotonin Reuptake inhibitors SSRIs antidepressants fluoxetine sertraline Prozac Zoloft What are the common medications used for Bipolar disorder mood stabilizers lithium anticonvulsants divalproex sodium Depakote antipsychotics olanzapine zyprexa Chapter Anxiety Define Specific phobias fear of objects or situations out of proportion to any real danger leads to avoidance no awareness fear is excessive ex flying snakes heights high comorbidity of specific phobias Social anxiety disorder fear of unfamiliar people or social scrutiny embarrassment humiliation more intense than shyness 33 diagnosed with avoidant personality disorder Panic disorder anxiety about recurrent panic attacks unrelated to specific situations intense urge to flee peak within 10 minutes Uncued attacks Occur unexpectedly diagnosis requires current uncued attacks Cued Attacks triggered by specific situation ex seeing a snake more likely phobia Agoraphobia fear of being in places where escaping to get help would be difficult if anxiety symptoms occurred causes significant impairment crowds stores malls tunnels trains bridges etc Generalized anxiety disorder uncomfortable worry for 6 months interferes with daily life Common worries relationships health finances daily hassles Often begins in adolescence Introceptive Experience noticing of physical symptoms sweating nausea anxiousness which causes panic What is Taijin kyofusho Japanese fear of offending someone or embarrassing them Briefly describe each of the following risk factors for anxiety Behavioral conditioning Mowrer s 2 factor model modeling seeing another harmed by stimulus verbal instruction parent warning child Those with anxiety develop fear more readily Genetic vulnerability twin studies show genetic predisposition for anxiety disorders Behavioral inhibition shyness tendency to be agitated distressed or cry in unfamiliar circumstances predicts anxiety in childhood social anxiety in adulthood Neuroticism to react with negative affect no expression link with anxiety and depression Higher levels 2x likely to develop anxiety disorder safety behaviors preformed to maintain safe in a dangerous situation which reinforces the idea its dangerous Ex Giving a speech safety behavior talking fast to speed up speech cognitive restructuring identifying automatic thoughts and modifying negative thoughts automatic thoughts or Negative Automatic Thoughts NATs Thoughts that occur automatically in response to a given situation could be fear or anxiety or avoidance Cognitive therapies work to change negative automatic thoughts into more rational responses Define Define Prepared learning evolutionary prep to fear certain stimuli that could be potentially life threatening heights snakes systematic desensitization relaxation plus gradual exposure creation of hierarchy of events exposure with response prevention most common psychological treatment face situation object that triggers anxiety in multiple settings 70 90 effective Forcing client to sit in office after sticking hands in dirt not being able to wash them Chapter on OCD and Trauma Define Obsessive compulsive disorder combo of repetitive thoughts and urges usually contamination sexual urges and aggressive impulses obsessions and repetitive behaviors and mental acts such as cleaning touching counting and checking compulsions gambling and eating are not compulsions because they are pleasurable PTSD extreme response to severe stressor actual or threatened death injury anxiety or avoidance of stimuli mood change and increased arousal reactions increase risk of self harm 1 month ASD similar to PTSD but only 3 days 1 month ASD High risk of
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