Violate the "do no harm" part of ethics

• critical incident stress debriefing after trauma
• scared straight
• facilitated communications
• DARE disorder
• boot-camp for conduct disorder
• attachment therapies
• recovered-memory techniques
• DID oriented therapy
• grief counseling for individuals w/ normal bereavement
• expressive-experiential therapies 

Emotion

-definition

-what it does

-parts

Def: rapid appraisal of personal significance of situations

Emotion energizes behavior and prepares for action

A,B,C's

-affect/physiology

-behavior

-cognition

• effects on cognition
• learning essential for survival
• can impair learning if non-adaptive
• Social
• affects behavior of others
• learn to regular our own behavior
• Health
• influences well-being, growth
• stress related to diseases 

Smile- from birth

Social smile- 6 to 10 weeks

Laugh 3-4 months

General distress- from birth

Anger- 4 to 6 months

First fears: 6 to 12 months

Stranger anxiety: 8 to 12 months

-shame

-embarassment

-guilt

-envy

-pride

-emerge at about 2.5 years old

-need adult instructino about when to feel them

Infancy

-developes over 1st yr w/ brain development

-caregiver input is important

early childhood

-learn strategies for self-regulation

-personality affects ability to self-regulate

middle childhood/adolescence

-rapid gains in regulation

-coping skills lead to emotional self-efficacy

Develop pre-wired evolutionary fears in early childhood

-e.g. snakes, heights

-more compex fears are not understood

Fears shaped by culture developed in middle childhood/adolescence (e.g. social phobia)

• safe emotional experience (noone can actually hurt you in a scary movie)
• sensation seeking (adrenalin rush)
• cultural (haunted house w/ friends makes for bonding)
• social reinforcement (laughing after being scared)
• opponent-process theory (relaxing feeling after scary situation ends, attempt to maintain internal homeostasis)

• monsters
• ghosts
• darkness
• preschool/child care
• animals

Consider development: concrete fears lead to more abstract and social fears with age 

• Trauma: Bad experience/trauma
• Modeling: Saw someone else have a bad experience
• Negative Information: heard someone had bad experience
• Biology: genetics

Could be all of the above.. additive effect over time from all sources

Associative: learned pathways or pairing w/ the feared stimuli (trauma, modeling, negative info)

Non associative: biological, genetic causes

-prepared aspect of learning certain phobias, not pre-wired but increased predisposition

-determined with retrospective reports of people with fears (when associative cause can't be found you assume non-associative cause

Specific phobia

-types

• Most common mental health disorder
• Several Types:
• animal (insects included)
• natural environment (storms)
• situational (elevators, small spaces)
• blood-injection-injury (vasvagal response is common, get a drop in blood pressure and often faint)
• other type phobias (sirens, clowns)
• Fear must interfere w/ everyday life

Panic attacks followed by at least 1month of distress, concern, or bx changes to prevent having another one

Panic attack is NOT a diagnosis, but you need a panic attack to have panic disorder

• Fear of open spaces AND fear of not being able to escape
• often afraid of having a panic attack and nobody being there to help
• safety behaviors are commonly present (eg cell phone, going out with a safe person) 

general fear of being socially and critically evaluated over several settings

OR

specific fears (e.g. test anxiety), it can occur in only one setting

Excessive fear about being away from home or guardians

The only actual child anxiety disorder left; the rest are written for adults with a note of what it might look like in children

Controversy: disorder of the child or the parent

Worrying about Worrying

Persistent worry across multiple settings that is significantly impairing

• clusters of symptoms surrounding a traumatic experience
• re-experiencing of the instance of some sort (intrusive thoughts, dreams)
• hyperarousal (being in the startle mode at all times)
• avoidance 

• similar to PTSD for the first month
• dissociative symptoms are often seen that aren't always present in PTSD
• numbing
• derealization
• depersonalization

Most kids w/ this diagnosis w/ have both problematic obsessions (intrusive thoughts) and compulsions (bx exhibited in an attempt to supress obsessions)

-generally occupy about an hour or more a day

-some kids may show either just obsessions or just compulsions

-substance induced

-due to a medical condition

-adjustment disorder

NOT an official DSM diagnosis

According to one study children w/ school refusal had:

-30% disruptive behavior disorder

-20% anxiety or mood disorder

-50% no problem

Most commonly diagnosed as either separation anxiety, social phobia, or specific phobia

A period of intense fear in which 4 or more symptoms develop abruptly and peak within 10 minutes

-Seen across all disorders (not just panic disorder)

Symptoms:

-palpitations, pounding heart

-sweating

-trembling/shaking

-shortness of breath or smothering

-feeling of choking

-chest pain or discomfort

-nausea or abdominal distress

-feeling dizzy, unsteady, lightheaded, or faint

-derealization

-etc. 

(he said specifics wont be on test)

• systematic desensitization
• reinforced practice
• participant modeling
• CBT 
• common components:
• fear hierarchy
• graduated exposure
• reinforcement
• modeling
• common mistakes:
• talking it out
• forced exposure
• flooding
• relaxation alone
• distraction
• confused tx names/theories

MASC - one of strongest empirically based

RCMAS- has a lie scale

SCARED- good at differentiating between different anxiety disorders

Both of general distress (de-emphasize this for differntial diagnosis)

Depression has anhedonia

Anxiety has physical arousal