Abnormal Psychology Final Exam Review PDF

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Abnormal Psychology Final Exam Review Chapter 6 Panic, Anxiety, Obsessions and Their Disorders  Fear: o Cognitive/Subjective effects- “I’m in danger” o Physiological effects- Increased hear rate, increased respiratory rate, pupil dilation o Behavioral effects- urge to escape or flee  Anxiety: o Cognitive/Subjective effects- “I am worried about what might happen” o Physiological effects- tension, chronic over-arousal o Behavioral effects- general avoidance  Benefits of Anxiety: increased attention and interest, optimal arousal, optimal performance.  Anxiety Disorders- characterized by unrealistic, irrational fears or anxieties that cause significant distress and/or impairments of functioning. Differs in terms of: o Amount of fear/panic vs. amount of anxiety o Kinds of stimuli that concern them  Comorbidity- the simultaneous presence of two chronic diseases or conditions in a patient  Can anxiety disorders be classically conditioned? – Yes! o Exposure to feared cues, objects, or situations (most powerful) o Cognitive restructuring o Some medications  Specific Phobia  DSM-5 Criteria: o Marked fear or anxiety about a specific object or situation. o The phobic object or situation almost always provokes immediate fear or anxiety o The phobic object is actively avoided or endured with intense fear or anxiety o The fear or anxiety is out of proportion to the actual danger posed by the object or situation and to the sociocultural context o The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more o The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning o The disturbance is not better explained by the symptoms of another mental disorder  Types of phobias: o Animal type o Natural environment type o Blood injection/injury type- sometimes provokes vasovagal syncope (fainting accompanied by nausea or dizziness, unique to this phobia) o Situational type o Other type

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o Phobias as a learned behavior: Watson’s Little Albert experiment o Vicarious Conditioning- The learning of various attitudes, feelings, beliefs and emotions, not through direct exposure to a stimulus, but through observing how others react to it o Exposure Therapy Social Anxiety Disorder DMS-5 Criteria: o A marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others o The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated o The social situations almost always provoke fear or anxiety o The social situations are avoided or endured with intense fear or anxiety o The fear or anxiety is out of proportion to the actual threat posed by the social situation and into the sociocultural context o The fear, anxiety , or avoidance is persistent, typically lasting for 6 months or more o The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance or another medical condition o The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder o If another medical condition is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive o Performance Only Social Anxiety- if the fear is restricted to speaking or performing in public o Lifetime prevalence: 12% (60% female) Psychological casual factors: Learned behavior, evolution, perceived uncontrollability/unpredictability, cognitive biases Biological casual factors: Behavioral inhibition, genetics Treatments: Cognitive Behavioral Interventions (prolonged and graduated exposures to the feared situations, cognitive restructuring) and medications Panic Disorder DSM-5 Criteria: o Recurrent unexpected panic attacks, an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time multipe symptoms occur o At least one of the attacks has been followed by 1 month or more of both of the following:  Persistent concern or worry about additional panic attacks or their consequences  A significant maladaptive change in behavior related to the attacks o The disturbance is not attributable to the physiological effects of a substance or another medical condition

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o The disturbance is not better explained by another mental disorder Agoraphobia DSM-5 Criteria: o A marked fear or anxiety about two or more of the following situations:  Using public transportation  Being in open spaces  Being in enclosed places  Standing in line or being in a crowd  Being outside of the home alone o The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic like symptoms or other incapacitating or embarrassing symptoms o The agoraphobic situations almost always provoke fear or anxiety o The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety o The fear or anxiety is out of proportion to the actual gander posed by the agoraphobic situations and to the sociocultural context o The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more. o The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning o If another medical condition is present, the fear, anxiety, or avoidance is clearly excessive o The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder Cognitive Theory of Panic- Trigger stimulus -> Apprehension/worry -> Body sensations -> Interpretation of sensations as catastrophic Treatments- exposure, cognitive behavioral approaches, anxiolytics, antidepressants Generalized Anxiety Disorder DSM-5 Criteria: o Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities o The individual finds it difficult to control the worry o The anxiety or worry are associated with three or more of the following symptoms (you know them) o The anxiety, worry, or physical symptoms cause clinically significant stress or impairment in social, occupational, or other important areas of functioning o The disturbance is not attributable to the physiological effects of a substance or another medical condition o The disturbance is not better explained by another mental disorder Obsessive Compulsive Disorder DSM-5 Criteria: o Presence of obsessions, compulsions, or both

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o The obsessions or compulsions are time consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning o The obsessive compulsive symptoms are not attributable to the physiological effects of a substance or another medical condition o The disturbance is not better explained by the symptoms of another mental disorder Specific if: o With good or fair insight: the individual recognizes obsessive compulsive disorder beliefs are definitely not or probably not true or that they may or may not be true. o With poor insight: the individual thinks obsessive compulsive disorder believes are probably true o With absent insight/delusional beliefs: the individual is completely convinced that the believes are true o Tic related: the individual has a current or past history of a tic disorder. Treatments: Exposure and response prevention (ERP), medication Hoarding Disorder Trichitillomania- a compulsive desire to pull out one's hair.

Chapter 7 Mood Disorders and Suicide  Mood: o Mania (extreme happiness) o Hypomania (moderate happiness) o Euthymia (contentness) o Dysthymia (moderate depression) o Depression  Depressive Episodes: o Mood affects: depressed mood, decreased interest or pleasure o Behavioral Symptoms- weight change, appetite disturbance, sleep disturbance, psychomotor change, loss of energy o Cognitive symptoms – worthlessness or inappropriate guilt, concentration difficulties or indecision, thoughts of death or suicide  Major Depressive Disorder- distress/impairment for at least 2 weeks plus the usual DSM5 criteria  Course of the Disordero can be a single episode or reccurent episodes o The majority of episodes remit, and a typical episode lasts between 6-9 months o Recurrence occurs in 40-50% of people, with an increasing probability as the # of episodes increase  Specifiers: o MDD with melancholic features o MDD with psychotic features

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o MDD with atypical features o MDD with catatonic features o MDD with seasonal pattern (Seasonal Affective Disorder) Prevalence: o Children: more common in girls than in boys Persistent Depressive Disorder- a type of depression that lasts a long time, usually for 2 years or more Double Depression- The coexistence of Major Depressive Disorder and Persistent Depressive Disorder Beck’s Cognitive Theory- Early experience -> formation of dysfunctional core beliefs -> critical incidents -> beliefs activated -> negative automatic thoughts -> depressive symptoms Negative Cognitive Triad o The Self o The World o The Future All or nothing thinking Manic and Hypomanic Episodes o Elevated or irritable mood o Inflated self esteem o Decreased need for sleep o Pressured speech o Racing thoughts o Distractibility o Increased goal directed activity or psychomotor agitation o Excessive involvement in high risk pleasurable activities Bipolar 1 Disorder- marked impairment for at least 7 days or a hospitalization o Lifetime prevalence- 0.4-1.6% Bipolar 2 Disorder- depressive episode for at least 4 days (no marked impairment or hospitalization required) o Lifetime prevalence- 0.5% Treatments: Cognitive behavioral therapy, electroconvulsive therapy, transmagentic stimulation, selective serotonin reuptake inhibitors Nonsuicidal Self Injury (NSSI)- direct, deliberate destruction of body tissue in the absence of any intent to die o Lifetime prevalence- 15-20% Popular hypothesis: pain has affective benefits for some people (pain-offset relief) Suicidal Behavior- self injurious behavior enacted with at least some intent to die Deaths from suicide has decreased because the use of treatment has increased 41,149 ?? Myths and Misconceptions about Suicide People often die by suicide on a whim Suicide is cowardly

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Suicide is selfish Prevalenceo 1963-1971 suicides decreased by 1/3 in great Britain o 22% reduction in overdose deaths in the UK o Nearly 25% of suicide attempts leave a note 1978 R. Seiden Study- a follow up study on individuals who attempted suicide on the golden gate bridge and survived There is no evidence of iatrogenic effects- making a person more likely to do something after talking about that same subject

Chapter 9 Eating Disorders  Anorexia Nervosa  DSM-5 Criteria: o Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health o Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain even though at a significantly low weight o Disturbance in the way in which ones body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or persistent lack of recognition of the seriousness of the current body weight  Specifiers: o Restricting subtype o Binge eating/ purging subtype  Associated features: o Perfectionism o Temperature regulation problems, fidgety, restlessness o Depressive symptoms o Obsessive compulsive features  Minnesota starvation experiment o 36 psychologically healthy men volunteers o Metabolic baseline for 3 months o Starvation for 6 months o Refeeding for 6 months o Lead to decreases in stamina, strength, body temp, heart rate, and sex drive o Lead to obsessions with food, fatigue, irritability, depression, apathy, indecision, concentration issues  Prevalence o Usually starts in adolescence/ young adulthood o From onset to remission: 7 years in women, 3 years in men o Standardized mortality rate: 5.86% (20% of deaths are from suicide)  Treatments o Weight restoration and medical stabilization

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o Olanzapine o Maudsley approach o Treatment team Bulimia Nervosa DSM-5 criteria: o Recurrent episodes of binge eating o Recurrent inappropriate compensatory behaviors In order to prevent weight gain such as self induced vomiting, misuse of laxatives, diuretics, or other meds, fasting, or excessive exercise o The binge eating and inappropriate compensatory behaviors both occur, an average, at least once a week for 3 months o Self evaluation in unduly influenced by body shape and weight o The disturbance does not occur exclusively during episodes of anorexia nervosa Prevalence: o Adolescence/young adulthood o Can be chronic or intermittent o After 15 years, 50% still have symptoms o Cross over with other eating disorders o Standardized mortality rate: 1.93% Treatments: o SSRI’s o Cognitive behavioral therapy Binge Eating Disorder DSM-5 Criteria: o Recurrent episodes of binge eating Prevalence: o Childhood, adolescence, young adulthood, late adulthood o Many people are in weight loss programs o Higher remission rates than anorexia or bulimia o Mortality may be increased Sociocultural theories o Media pressure o Peer pressure o Family pressure o Internalization of the thin ideal Psychological theories o Perfectionism o Negative urgency o Emotion regulation o Genetic factors Treatments: o SSRI’s o Appetite suppressants, anticonvulsants

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o Interpersonal Therapy Obesity is not an eating disorder Adolphe Quetelet derived the formula for BMI (weight/height) 1972 Ancel Keys appropriated BMI as a proxy for body fat % 1998 the NIH lowered the overweight threshold for BMI from 27.8 to 25 BMI has misdiagnosed 51% of healthy people as unhealthy Has no scientific reason or evidence that it should be predictive of health Flawed assumptions in traditional weight management paradigm: o Weight loss will prolong life o Anyone who is determined can lose weight and keep it off through diet and exercise o The pursuit of weight loss is a practical and positive goal o The only way for people living with obesity to improve health is to lose weight o Obesity related costs place a large burden to the economic health system and this can be corrected by focused attention to obesity treatment and prevention Fat phobia and weight stigma are associated with greater negative health outcomes than weight alone Set Point Weight Theory- suggests theres a 10-20 pound range that your body will fight to maintain. Can temporarily go outside that range, but will eventually return. Can produce weight cycling and weight gain. Weight does not equal health, behaviors and habits do.

Chapter 10 Personality Disorders  Enduring pattern of behavior that is pervasive, inflexible, stable, and of long duration that causes clinically significant distress or impairment in functioning and affects two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control  Cluster A- odd or eccentric tendencies, unusual behavior ranging from suspiciousness to social detachment o Paranoid Personality Disorder o Schizoid Personality Disorder o Schizotypal Personality Disorder  Cluster B- dramatic, emotional, and erratic tendencies o Histrionic Personality Disorder o Narcissistic Personality Disorder o Borderline Personality Disorder o Antisocial Personality Disorder  Cluster C- anxious or fearful tendencies o Avoidant Personality Disorder o Dependent Personality Disorder o Obsessive Compulsive Personality Disorder  Paranoid Personality Disorder (cluster A)  DSM-5 Criteria:

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o A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, o Does not occur exclusively during the course of schizophrenia, a bipolar disorder, or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to physiological effects of another medical disorder. o Does not equal psychotic o “I cannot trust people” Schizoid Personality Disorder (cluster A) DSM-5 Criteria: o A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, o Does not occur exclusively during the course of schizophrenia, a bipolar disorder, or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to physiological effects of another medical disorder. o “relationships are messy, undesirable” Schizotypal Personality Disorder (cluster A) DSM-5 Criteria: o A pervasive pattern of detachment of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for close relationships as well as cognitive or perceptual distortions and eccentricities of behavior o Does not occur exclusively during the course of schizophrenia, a bipolar disorder, or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to physiological effects of another medical disorder. o “Its better to be isolated from others” Histrionic Personality Disorder (cluster B) DSM-5 Criteria: o A pervasive pattern of excessive emotionality and attention seeking o “People are there to serve or admire me” Narcissistic Personality Disorder (cluster B) DSM-5 Criteria: o a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy o “Since I am special, I deserve special rules” Antisocial Personality Disorder (cluster B) DSM-5 Criteria: o A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years o The individual must be at least 18 years old o There is evidence of conduct disorder with onset before age of 15 years o The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder Borderline Personality Disorder (cluster B) DSM-5 Criteria:

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o A pervasive pattern of instability of interpersonal relationships, self image, and affects, marked by impulsivity o Frantic efforts to avoid real or imagined abandonment o A pattern of unstable and intense interpersonal relationships characterized by alternating between extreme of idealization and devaluation o Identity disturbance: marked by persistent unstable self image or sense of self o Affective instability die to a marked reactivity of mood o Chronic feelings of emptiness o Inappropriate, intense anger o Reaccurrent suicidal or damaging behaviors Avoidant Personality Disorder (cluster C) DMS-5 Criteria: o a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation o “if people know the real me, they will reject me” Dependent Personality Disorder (cluster C) DSM-5 Criteria: o A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation o “I need people to survive, to be happy” Obsessive Compulsive Personality Disorder (cluster C) DSM-5 Criteria: o A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. o “People should do better, try harder” Psychopathology Hervey Cleckley wrote The Mask of Sanity Factor 1- interpersonal, affective (behavior) Factor 2- lifestyle, antisocial A low percentage of psychopaths are actually violent Dialectical Behavioral Therapy- behavioral therapy paired with mindfulness techniques o DBT individual therapy o DBT group skills training therapy o DBT phone coaching o DBT consultation team o Includes 4 sets of behavioral skills:  Mindfulness...