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Abnormal Psychology: Test 3
PTSD
154
Psychology
Undergraduate 3
10/09/2012

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Term
Define: PTSD
Definition
exposure to some events associated with fear, helplessness, or horror
Term
What do traumatic experiences do to people?
Definition
reshape schema of safety + shatter assumptions of trust
Term
PSTD according to DSM requires... (7)
Definition
1. close exposure to traumatic event

2. continue to re-experiece event

3. avoidance of reminders of trauma

4. emotional numbing

5. interpersonal problems

6. interferes with ability to function

7. symptoms for one month or more
Term
PTSD affects __% of population?
Definition
7.8%
Term
3 most common traumas
Definition
1. sexual assault

2. accidents

3. combat
Term
4 subtypes of PTSD
Definition
1. acute

2. chronic

3. delayed onset

4. acute stress disorder
Term
acute PTSD
Definition
diagnosed 1 month after event occurs
Term
Chronic PTSD
Definition
diagnosis after 3 months

associated with avoidance behaviors

comorbidity with other anxiety disorders
Term
PTSD with delayed onset
Definition
show few symptoms after traumatic event; diagnosed 6+ months after event

develop fullblown PTSD years later
Term
acute stress disorder
Definition
diagnosis of PTSD immediately post-trauma
Term
Contributing factors for PTSD
Definition
1. intensity of trauma and one's reaction to it

2. past traumatic experiences

3. uncontrollability and unpreditability: no control over situation

4. perceived life-or-death event

5. extent of social support

6. direction conditioning and observational learning
Term
Example of how social support can help prevent PTSD
Definition
-hurricane children were less likely to get PTSD if they had social support
Term
Example of how lack of social support can facilitate development of PTSD
Definition
people from Vietnam War did not have a lot of support from community when they came back to U.S.
Term
Why does support from loved ones help to lower risk of getting PTSD?
Definition
lowers cortisol secretion and HPA axis activity
Term
PTSD: what is going on physiologically?
Definition
1. elevated corticotrophin releasing factor (CRF)

2. high activity in HPA axis

3. chronic arousal changes the brain functions and structure
Term
elevated _____ causes high activity in the HPA axis
Definition
CRF (corticotrophin releasing factor)
Term
When can PTSD develop without a person having a light-or-death experience?
Definition
witnessing the trauma of others

ex: physician may break down while treating patients' wounds in war zone
Term
Diathesis-Stress Model
Definition
inherit vulnerabilities, genes

stress and life circumstances activate disorder
Term
List: Biological causes of anxiety (6)
Definition
1. depleted GABA

2. too much norepinephrine

3. epinephrine

4. low serotonin circuits

5. CRF

6. BIS
Term
Corticotropin Releasing Factor (CRF)
Definition
expression of anxiety; activates HPAC axis and makes cortisol
Term
Behavioral Inhibition System (BIS)
Definition
inhibits action

activated by brain stem and amygdala

can be adaptive or chronic
Term
Patient uniformity myth
Definition
lead researchers to make inaccurate generalizations about disorder and treatment

believe that all people with criteria are the same
Term
define: prevalence
Definition
number of people with disorder
Term
define: incidence
Definition
number of new cases
Term
Define: frustro effect
Definition
opposite of placebo effect

people feel disappointed that they are not receiving treatment
Term
__________ is the opposite of the placebo effect
Definition
frustro effect
Term
Cohorts
Definition
participants in each age group are the same age at the same time; therfore more likely to have the same cultural experiences
Term
Cohort effect
Definition
people have different experiences during their lives, even if they grew up during the same time period
Term
define: anxiety
Definition
negative mood state characterized by bodily symptoms of physical tension and apprehension about the future
Term
define: panic attack
Definition
abrupt experience of intense fear or acute discomfort

accompanied by physical symptoms that include: heart palpitations, chest pain, shortness of breath, dizziness
Term
3 types of panic attacks
Definition
1. situationally bound (cued)

2. unexpected (uncued)

3. situationally predisposed (more likely to experience attack in the same place as before)
Term
How does the brain stem contribute to anxiety?
Definition
it monitors and senses changes in bodily functions and relays the potential danger signals to higher cortical processes in limbic system
Term
Fight or Flight response
Definition
-originates in the brain stem

-travels through amygdala, hypothalamus, gray matter
Term
performance anxiety
Definition
difficulties when doing something specific in front of people

anxiety; afraid to get embarrassed

most common? public speaking
Term
treatment for social phobias
Definition
Cognitive Behavioral Group Therapy

role playing

exposure-based behavioral therapy
Term
treatment for social phobias: drugs
Definition
Paxil

effexor

zoloft
Term
drugs for performance anxiety
Definition
MAO inhibiters

SSRIs
Term
PTSD
Definition
reoccurring nightmares and memories about traumatic events

my have forgotten some of the event

numbing of emotions
Term
2 subsections of PTSD
Definition
acute and chronic
Term
acute PTSD
Definition
diagnosed 1 month after event occurs
Term
chronic PTSD
Definition
associated with avoidance behaviors

comorbidity with other anxiety disorders
Term
PTSD with delayed onset
Definition
show few symptoms after traumatic event

develop fullblown PTSD years later
Term
treatment for PTSD
Definition
catharsis (reliving traumatic event)

imaginal exposure
Term
symptoms of OCD
Definition
-reoccurring panic attacks

-depression

-generalized anxiety

-avoidance behaviors

-cannot control life
Term
OCD: define OBSESSION
Definition
intrusive nonsensical thoughts, images, or urges that the person tries to resist/eliminate
Term
OCD: define COMPULSION
Definition
thoughts or actions that are used to suppress the obsession and to provide relief
Term
List 5 of most common compulsions
Definition
1. contamination

2. aggressive impulses

3. sexual content

4. somatic concerns

5. symmetry
Term
Define: flashback
Definition
when memories occur suddenly and victims find themselves reliving the event
Term
Pepys + PTSD
Definition
Pepys was in Great Fire of London in 60s.

wrote about the traumatic event

experienced sense of detachment and numbness about event
Term
2 prominent features of PTSD
Definition
1. loss of sleep

2. intrusive dreams
Term
catharsis
Definition
reliving emotional trauma to relieve emotional suffering
Term
Treatment for PTSD (2)
Definition
Catharsis

cognitive therapy

imaginal exposure
Term
imaginal expsure
Definition
content of trauma and emotions associated with it are worked through sstematically
Term
complication of PTSD therapies
Definition
trauma victims repress emotions relating to memories
Term
Drugs for treatment of PTSD
Definition
SSRIs (Paxil and Prozac)
Term
symptoms of OCD
Definition
generalized anxiety

panic attacks

avoidance

depression

lack of control
Term
prevalence of OCD
Definition
1.6%
Term
__% of normal college students engaged in checking behavior that could put them in the range for OCD
Definition
10-15%
Term
why do people with OCD focus their anxiety on the occasional thought rather than on the possibility of a panic attack or some other external situation?
Definition
early experiences taught them that some thoughts are dangerous and unacceptable because the terrible things they are thinking might happen and that would be unacceptable
Term
thought-action fusion
Definition
clients with OCD equate thoughts with the specific actions represented by the thoughts

thinking it is just as bad as doing it
Term
cause of "thought-action fusion"
Definition
attitudes of excessive responsibility and guilt developed during childhood when a bad thought is associated with a bad act
Term
Drug treatment for OCD
Definition
clomipromine

SSRIs
Term
treatment for OCD
Definition
exposure and ritual prevention
Term
exposure and ritual prevention
Definition
rituals are prevented and patient is systematically and gradually exposed to feared thoughts and situations
Term
what do all somatoform disorders have in common?
Definition
there is usually no indentifiable medical condition causing the physical complaints
Term
dissociative experiences
Definition
sensation that you are not really yourself. you're in a dream
Term
conversion hysteria: who?
Definition
FREUD
Term
conversion hysteri
Definition
-unexplained physical symptoms

conversion of unconscious conflicts to more acceptable form
Term
why was term "neurosis" taken out of DSM?
Definition
applied that everything has a cause

too vague and can be applied to all disorders
Term
List: 5 somatoform disorder
Definition
1. hypochondriasis

2. somatization disorder

3. conversion disorder

4. pain disorder

5. body dysmorphic disorder
Term
What is a somatoform disorder?
Definition
-individuals are pathologically concerned with the appearance of functioning of their bodies
Term
what does "hypochondria" mean in greek?
Definition
below the ribs

ulcers were once considered a part of this disorder
Term
what is hypochondriasis
Definition
severe anxiety about getting sick

do not believe doctors
Term
what is the preoccupation with people with hypochondriasis?
Definition
bodily symptoms

misinterpret them for disease
Term
illness phobia
Definition
afraid of developing a disease
Term
__% of people with illness phobia may develop hypochondriasis
Definition
60%
Term
differences between panic disorder and hypochondriasis
Definition
patients with panic disorder are more concerned with immediate symptom-related catastrophes that may occur in several minutes

hypochondriacs focus more on long-term illness

hypochondrias are more likely to seek out answers from doctors and are more likely do demand unnecesary medical procedures

people with panic disorder may avoid emergency rooms

anxiety of individuals with panic disorder are associated with physical symptoms of panic attack
Term
diagnostic criteria for hypochondriasis
Definition
1. preoccupation with fears of having serious disease

2. preoccuption persists despite medical reassurance

3. significant distress and impairment

4. at least 6+ months
Term
prevalence of hypochondriasis
Definition
1-14% closer to 7%
Term
koro
Definition
belief and panic that genitals are retracting into abdomen

chinese males

guilty about masturbation, shitty sex, or promiscuity
Term
dhat
Definition
anxiety disorder in india

dizziness, weakness, fatigue

symptoms attributed to semen loss
Term
List culturally different hypochondriasis (2)
Definition
1. koro

2. dhat
Term
contributing factors for hypochondriasis
Definition
-develops in context of stressful life events

-disproportionate incidence of disease in their family

-strong memories of illness
Term
treatments of hypochondriasis
Definition
Cognitive behavior therapy



stress management treatment
Term
Somatization disorder used to be called..
Definition
Briquet's syndrome
Term
diagnostic criteria for somatization disorder
Definition
1. history of physical complaints before age 30
Term
difference between somatization and hypochondriasis
Definition
hypochondriacs seek help instantly

somatization patients feel weak and ill all of the time and may avoid exercise
Term
why is it difficult to diagnose somatization disorder?
Definition
requires 8+ symptoms out of 35
Term
undifferentiated somatoform disorder
Definition
somatization disorder with less than 8 symptoms
Term
causes of somatization disorder
Definition
1. history of family illness

2. genetics; linked to antisocial personality disorder
Term
what personality disorder goes with somatization disorder?
Definition
antisocial personality disorder
Term
what does antisocial personality disorder and somatization disorder have in common?
Definition
1. impulsiveness: sexual behavior and attention seeking + continuous development of new disorders
Term
treatment for somatization disorder
Definition
CBT

reduce stress

antidepressants
Term
Conversion disorders
Definition
have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking
Term
aphonia
Definition
difficulty speaking due to conversion disorder
Term
globus hystericus
Definition
sensation of lump in throat that makes it difficult to eat, talk, or swallow
Term
malingering
Definition
faking symptoms
Term
la belle indifference
Definition
(wrong) belief that conversion reactions had the same quality of indifference to symptoms thought to be present in somatization disorder
Term
cause of conversion disorder
Definition
stressful life event
Term
why do people malinger?
Definition
fake symptoms to get government compensation or get out of work
Term
factitious disorders
Definition
voluntarily produce physical symptoms

between malingering and conversion disorder

my be assuming sick role to get attention
Term
factitious disorder by proxy
Definition
making people sick so that you get pity and attention
Term
munchausen syndrome by proxy is also known as..
Definition
factitious disorder by proxy
Term
manchausen syndrome by proxy: physical presentation of the child
Definition
misrepresentation of an illness or accident
Term
manchausen syndrome by proxy: obtaining diagnosis about abuse
Definition
the perpetrator usually tells doctors about abuse
Term
manchausen syndrome by proxy: victims
Definition
children,by mother
Term
Anna O
Definition
conversion disorder

reoccuring thoughts about her hand turning into a snake - arm paralyzed everytime thoughts occurred

paralysis extended to the rest of her body

treated with catharsis + it worked
Term
causes of conversion disorder according to freud
Definition
1. traumatic event

2. represses conflict, making it unconscious

3. anxiety increases and threatens to emerge into consciousness and the person converts it into physical symptoms
Term
what is the "primary gain" or reinforcing event that maintains the conversion symptom
Definition
reduction of anxiety by converting unconscious thoughts to physical manifestations
Term
what is the secondary gain in conversion disorder?
Definition
attention or avoidance
Term
treatment of conversion disorder
Definition
catharsis

discuss the stressful event

reduce secondary gain (supportive consequences of the conversion symptoms)

CBT
Term
pain disorder
Definition
pain in one or more sites in the body that is associated with distress or impairment

pain is real and it hurts but has unknown cause
Term
body dysmorphic disorder
Definition
people that think they are so ugly that they wont even talk to people because they think they will get made fun of
Term
body dysmorphic disorder
Definition
people that think they are so ugly that they wont even talk to people because they think they will get made fun of
Term
average number of body parts of concern to people with BDD
Definition
5-7
Term
what are the top concerns of people with BDD
Definition
skin and hair
Term
behavior trends common with people with BDD
Definition
tanning

rituals/checking themselves

skin picking

excessive grooming

become fixated with mirrors

suicide
Term
_% of people with BDD thought their ugliness was real
Definition
33-55%
Term
what % of people have BDD?
Definition
1%
Term
drug treatments for BBD
Definition
SSRIs

clmipramine

fluvoxamine
Term
_% of people that request plastic surgery may have BDD
Definition
8-25%
Term
2 types of dissociation
Definition
1. depersonalization

2. derealization
Term
depersonlization
Definition
perception alters so that you temporarily lose the sense of your own reality

no longer know who you are
Term
derealization episode
Definition
sense of reality of external world is lost

things may change shape or size
Term
4 dissociative disorders
Definition
1. depersonalization

2. dissociative amnesi

3. dissociative fatigue

4. dissociative trance disorder
Term
depersonalization disorder prevalence
Definition
.8%
Term
depersonalization disorder: cognitive deficits
Definition
attention, short term memory

spatial reasoning
Term
brain functioning differences in people with depersonalization disorder
Definition
-greatly reduced emotional responding

tendency to selectively inhibit emotional expression

deficits in perception, emotion regulation

dysregulation in HPA axis
Term
generalized amnesia
Definition
people who are unable to remember anything, including who they are
Term
localized or selective amnesia
Definition
more common

failure to recall specific events, usually traumatic

common during war

emotional reactions to these events during hypnosis
Term
dissociative fugue
Definition
memory loss revolves around a specific incident

end up in places and dont know how or why they got there

take on new identity
Term
amok
Definition
dissociative fugue disorder

kill or hurt people/animals while in a trance

do not remember it
Term
dissociative trance disorder
Definition
-trances are often thought to pertain to possession by spirit

commonly accepted in religious sects
Term
dissociative identity disorder
Definition
average number of identities = 15

used to be called multiple personality disorder
Term
alters
Definition
different identities in Dissociative trance disorder
Term
Diagnostic criteria for dissasociative trance disorder
Definition
1. amnesia

2. dissasociation of personality
Term
"host" identity
Definition
person that becomes the patient and asks for treatment
Term
transition from one alter to another is called
Definition
switch
Term
sociocognitive model of DID
Definition
alters evolve after therapists suggest that they exist
Term
how to spot a malinger with DID
Definition
optical changes are stronger in people with DID

malingerers are determined to exhibit all of their "symptoms at once" and people with the disorder try to hide them
Term
comorbid psych disorders with DID
Definition
substance abuse

anxiety

depression

personality disorders
Term
causes of DID
Definition
abuse as a child

sexual or physical abuse

trauma
Term
autohypnotic model
Definition
people who are suggestible may be bale to use dissociation as a defense against extreme trauma
Term
__% of DID patients had imaginary childhood friends
Definition
50%
Term
biological contributions to DID
Definition
smaller hippocampal and amygdala volume
Term
characteristics of hypochondriasis (3)
Definition
1. severe anxiety over physical problems that are medically undetectable

2. affects women and men equally

3. may emerge at any age
Term
characterization of somatization disorder
Definition
1. multiple physical symptoms without a medical basis

2. runs in families

3. rare - most prevalent among women in low income families

4. onset usually in adolescence
Term
characteristics of conversion disorder
Definition
1. severe physical dysfunctioning

2. affected people are unaware that they can function normally

3. coincides with somatization disorder sometimes

4. most prevalent in low SES groups
Term
characteristics of BDD
Definition
1. socially disabling preoccupation with ugliness

2. effects men and women equally

3. associated with OCD
Term
characteristics of DID
Definition
1. adopt new alters

2. avg number of alter is 15

3. childhood onset

4. primarily in western cultures
Term
characteristics of depersonaliztion disorder
Definition
1. fears of detachment

2. feels like an outside observer of body

3. distress in functioning

4. rare
Term
characteristics of dissociative fugue
Definition
1. memory loss + unplanned journey

2. assume new identity of confused about old identity

3. associated with intolerable situations

4. fugue states end abruptly

5. adult onset
Term
characteristics of dissociative amnesia
Definition
1. generalized: inability to remember anything, including identity

2. localized: inability to remember specific events (traumatic)

3. adult onset
Term
characteristics of dissociative trance disorder
Definition
1. sudden changes in personality + trance or "posession"

2. distress and impairment

3. associated with stress/trauma

4. more common in women
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