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Anxiety
unpleasant emotion characterized by a general sense of danger, dread and psychological arousal (normal for threatening/dangerous situation) Freud laid foundation of anxiety
Fear
elative to anxiety, in which danger is an "actual" threat, or more specific
Anxiety Disorder
experiencing severe anxiety and fear in contexts that do not warrant such feelings, muscle tension during minor threat, or no threat anxiety is PRIMARY symptom --also, A.D. high comorbidity- often develop more than 1 disorder if diagnosed
Panic Attack
discrete episode of acute terror in the absence of real danger - NOT diagnosis. cycle of hypervent & phys stressors Uncued- out of no where Situational Predisposed- predictable Situational Bound- always in same situation
Agoraphobia
ear or wide open spaces or crowded places not the fear of the place itself, but of possibly having a panic attack can result in avoidance of situations
Panic Disorder
discrete episodes of intense terror (panic attacks) in the absence of real danger, causing ongoing distress or impairment acute bursts of extreme anxiety UNCUED PA fear of PA can lead to Agoraphobia "fearing fear itself"
Generalized Anxiety Disorder
(GAD)- Chronic, deliberating, pervasive anxiety or nervousness no 'busts'- worried most of the time worries are usually irrational - causes distress and interferes w/ functioning
Phobias
an intense, persistent, and irrational fear and avoidance of a specific object or situation go out of way to avoid, even if disturbance specific & social
Specific Phobia (4)
excessive, unreasonable fear ex. snake phobia-- where can't walk in yard/go to park Animal Phobias- self explanatory Natural Environment Phobias- fear of heights/water/weather events Blood Injection Injury Phobias- needles, med proced, harm 2 self Situational phobias- for or specifi…
Social Phobia
fear of possibility of being observed, judged in public- think they will humiliate/embarrass themselves often recognize fears are excessive some avoid social situations all together ex. having to go to store, speaking in front of others, interviews
Obsessive Compulsive Disorder
an anxiety disorder in which distressing and unwanted thoughts lead to compulsive rituals that significantly interfere with daily functioning obsessions & compulsions
Obsessions (4)
unwanted and upsetting THOUGHTS or IMPULSES Doubt- (leaving front door open) Need for order- shoe by size, food by expiration date Aggression- intolerable thoughts about harming infant Sexual Imagery- recurrent mental pictures of pornography
Compulsions
irrational RITUALS that are repeated in an effort to control or neutralize the anxiety brought on by obsessional thoughts
Post-traumatic Stress Disorder (PTSD)
Frequent re-experiencing of a traumatic event through images, memories, nightmares, flashbacks, etc (MUST involve REAL/SERIOUS THREAT) post-tramatic anxiety occurs more than one month after a traumatic experience not everyone who has trauma gets this
Acute Stress Disorder
significant postraumatic anxiety sxs that occur (immediately after) within one month of a traumatic experience
Separation Anxiety Disorder
excessive anxiety concerning separation from home or attachment figures, usually parents 1/every 25 kids will meet diagnosis extreme: can't be reassured
Anxiety: Biological Explanations
moderate genetic basis-- 30-40% of individuals vulnerability to develop disorders-- varies GREATLY with disorders Amygdala & septal-hippo- phys/arousal, emotion, memories NT's: GABA (inhibit nerve cells, may be deficient in ppl w/ anxiety), Norepine (exessive phys symptoms of anxiety…
Behavioral Inhibition
withdraw from unfamiliar or new stimuli- may be predisposed from genetics
nxiety: Cognitive Factors
General misinterpretations-- fixating on perceived threats, seeing things negatively
Cognitive Distortions
Jumping to conclusions- negative thought patterns Catastrophizing- assuming terrible but incorrect consequences Emotional Reasoning- feelings always reflect how things really are (heart races= actual danger) or assumer everyone know how nervous you are
Anxiety: Family Explantaions
parental modeling of anxiety- stressors, trauma, disasters, crises ex. overprotective parent- can unintentionally imply danger in situation controlling, rejecting parents --parents may model anxiety behaviors may have to do w/ insecure/anxious/resistant attachment
Anxiety: Behavioral Explanations
classical & operant conditioning, and combo Classical: 'trained' (unconditioned response/stimuli, conditioned response/stimuli) Operant- rewards & punishment, reinforment -- i.e. avoidance is negatively reinforced because it removes people from feared unpleasant situations. people feel…
Anxiety: Psychodynamic Explanations
generally- high levels of anxiety arise from disrupted or inadequate early parent-child relationships may lack sense of control b/c of this sense of unpredictability regarding future events if that's threatened
Anxiety Treatments: Biological
Benzos- (Valium, Xanax, Ativan) enhance GABA addicting, no long term relief, could be lethal w/ other depressants Antidepressants (SSRIs)= preferred treatment for most anxiety disorders (80% felt better)
Anxiety Treatment: Cognitive therapy (3)
teaches client that anxious feelings arise from problematic thoughts and maladaptive thought patterns (cognitive distortions) CHALLENGE dysfunctional schemas/thoughts Examine evidence- look realistically of what's happening in stead of assuming the negative in a situation Test Hypot…
Anxiety Treatment: Behaviora
exposure based practices systematic Desensitization & flooding Exposure & response prevention (OCD)
Systematic Desensitization
gradually increasing exposure to a feared object panic disorder: deliberate induction of physiological sensations of panic attack, to conduct systematic desensitization
Flooding
intensive exposure to a eared stimulus (Snake girl) - phobias
Exposure & Response Prevention
interrupts compulsions and negative reinforcement (OCD) ex. contamination OCD- place hand in dirt and not allowed to wash
Moods (EPMP)
range from elevated to depressed, and include emotion, cognitive, motivational, and physical components duration and intensity- important factors in determining psychopathology unipolar- one mood disorder, 'just depression' bipolar- two mood disorder 'depression + mania'
Major Depressive Episode
at least 2 weeks of depressed mood accompanied by a characteristic pattern of depressive symptom symptoms nearly every day
Manic Episode
at least 1 week of elevated, euphoric or irritable accompanied by characterized pattern of manic symptoms
Mixed Episode
at least 1 week of a mixture of manic and depressive symptoms
Hypomanic Episode
at least 4 days of elevated, euphoric or irritable mood that is less severe than a manic episode
Major Depressive Disorder
occurrence of 1 or more major depressive episodes NO mania, hypomanic, 1 major depressive episode (lifetime prevalence 17% of US Population) women 2ce s likely to be diagnosed
Dysthemic Disorder
depression that is LESS servere but more chronic than a major depressive episode -- longer duration -lasting at least 2 years in adults or 1 year in children and adolescents --difference of SEVERITY
Bipolar 1 Disorder
Combo of manic and major depressive episodes (lifetime prevalence 1%) normal mood, interrupt w/ mania & depression
Bipolar II Disorder
combo of HYPOMANIC and major depressive disorders
Suicide
Attempt- actual attempt to kill oneself Ideation- thoughts about death, funerals, etc
Mood Disorders: Bio Explanation
genetics play a predisposing role in depression -bipo- STRONGEST genetic component Abnormal NT function w/ monoamines, mood regulation not amount neurotransmitters available, # of sites available takes time
Mood Disorders: Cognitive Explanation
negative thought process Beck's negative cognitive triad- neg view of self, world, future learned helplessness - prolonged periods of helplessness in misfortune causes them to give up (dogs & shock) -- pessimistic
Mood Disorders: Psychodynamic Explanation
problematic relationships w/ caregivers and family- 1 parent depression can be huge factor for child, abandonment + parental criticism early loss can be linked w/ depression
Mood Disorders: Bio Treatment
Antidepressants: Tricyclics, MAOIs, SSRIs (safer in 80/90s) all work by increasing monoamine levels Lithium & other mood stabilizing drugs are most effective for bipolar disorders -- unpleasant side effects Antidepressants may be no more effective than placebo, may increase suicide in…
Mood Disorders: Cognitive Therapy
record and evaluate negative automatic thoughts then challenge distortions, similar to anxiety disorders
Mood Disorders: Psychodynamic
focus on issues of loss, anger directed inward, problematic childhood experiences and relationships
Inter-Personal Therapy & Family Therapy
IPT: focuses on problematic relationships to coping w/ loss of relationships (good for mood!) Family Therapy- helpful w/ depressed kids when parents are depressed
Substance
preferred term for psychoactive (brain effecting) drugs and alcohol
Substance Intoxication
experience of reversible condition due to the effect of a substance on the CNS
Substance Abuse
the repeated use of substances that lead to recurring problems consequences and problems w/ substance use (DUI)
Substance Dependence
maladaptive pattern of substance use leading to either psychological dependence or significant impairment or distress "Addiction" attempts to stop that doesn't succeed loss of control
Tolerance & Withdrawal
Tolerance- need for increasing amount, body's adaptation to substance Withdrawal- physical, psychological or behavioral symptoms if use is decrease or stopped
Categories of Substances: Depressants
alcohol, benzo (valium), barbiturates, inhalants (glue) S L O W or inhibit CNS, act on GABA (aroused) make people relaxed/sleepy, reduce concentration and impair motor thinking skills
Categories of Substances: Stimulants
increase CNS-- produce feelings of optimism & energy depressed may choose stimulant caffeine, cocaine, nicotine, ritalin/adderall, amphetamines
Categories of Substances: Opioids
relieves pain and produces euphoria opium poppy morphine, heroin, codeine, methadone
Categories of Substances: Hallucinogens/ PCP
Hallucinogens- substances LSD, MDMA (ecstacy) and peyote PCP- powder .. many on same effects as hallo, toxic and dangerous
Categories of Substances: Cannabis
marijuana- more widely used illegal drug in the world some evidence for pain relief and appetite improvement for severe illness happiness, humor, dream-like state
Substance Disorders: Explanations, Disease Model
Disease (MEdical) Model- dominant approach to explaining and treating substance use disorders today argues that substance dependence is like other MEDICAL diseases
Substance Disorders: Explanations, Psychological Model
Psychological Model- views substance dependence as symptoms of underlying problem
Multiple Causality
idea that multiple components are useful (best approach) -same as diathesis-stress model
Substance Disorders: Bio explanations
Genetics how easily metabolize, (adoption and twin studies show high correlations of dependence among family members) dopamine in mesolimibic POWERFUL REINFORCE effects (flood reward pathway)
Substance Disorders: Cognitive Explanations
Cognitive Distortions: positive expectancies- belief that substance use is better than it really is-- schemas are created that "support substance use"
Substance Disorders: Behavioral Explanations
Classical- learn by association (environmental cues w/ drug use) Operant- positive reinforces for drugs, or negtaive w/ withdrawal symptoms Modeling/Social learning - learned from family, peers, and media
Substance Disorders: FAmily Explanations
Co-dependency- family members unconsciously collude with or enable a family member's substance misuse
Substance Disorders: Psychodynamic Explanations
substance misuse as a symptom or result of other forces and problems within the client ex. substance use viewed as maladaptive coping (or defense) strategy -- numb painful/emotion pain w/ something can't deal with
Motivational Interviewing
multimodal (different treatments) assessments and therapy method for enhancing motivation to change by exploring and resolving ambivalence opposite in tough love-- HIGH empathy, no confrontation
Substance Disorders: Bio Treatments (5)
Agonists- safer but similar subtance provided in monitored setting (methadone for heroin) Antagonists- reduce cravings, not as pleasurable (monthly injection- get sick w/ alcohol) Partial Agosnists- can act flexibly as either 1 or 2, depening on NT production Aversives- make use comf…
Substance Disorders: Cognitive Treatment
challenging and changing distorted cogntive schemas, building coping skills- changing expectancies challenges what they say i.e. "user and always will be" BUILD POSITIVE coping statements: "I can recover"
Substance Disorders: Behavioral Treatment
skills training- recognizing trigger and risks Contingency Management- program that involved reinforcements and punishments to shape behavior ( expensive, long term debatable) ---reward healthy behavior & punish for those that don't behave
Substance Disorders: Family Therapy
avoids focus on 'identified patient' examines larger family dynamic instead establishes appropriate roles
Self Help Groups (12 Step)
combines principles of many theoretical approaches with a spiritual emphasis group format encourages charing and sense of community sponsonred by 1 person

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