Final Study Guide PSY 600 Pepperdine PDF

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PSY 600 Final STUDY GUIDE – 65 multiple-choice items. DSM-5: Anxiety Disorders 1. What is characteristic of separation anxiety disorder? Does the typical/expected separation anxiety that often occurs during childhood qualify as this diagnosis/disorder? (190-1) developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, at least 3 symptoms necessary, at least 4 weeks in children and adolescents and 6 months or more in adults, typical/expected separation anxiety that occurs in childhood does not qualify for diagnosis 2. What is involved in a specific phobia (Criteria A)? Duration? (p. 197-8) Marked fear or anxiety about a specific object of situation, the phobic object or situation almost always provokes immediate fear or anxiety, is actively avoided or endured with intense fear or anxiety, fear is out of proportion to the actual danger posed by specific object or situation and to the sociocultural context, lasting 6 months or more 3. What is the first DSM criterion for social anxiety disorder (social phobia)? What is the “perceived threat?” Note that there is also concern about showing anxiety symptoms, leading to negative evaluation (2nd criterion). (p. 202) marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (humiliating or embarrassing), lasting 6 months or more, performance specifier indicated this only applies to performance based social situations such as public speaking 4. Are the panic attacks in panic disorder expected or unexpected? Is one attack sufficient? In addition to panic attacks, what else has to occur for 1 or more months (Criterion B)? (p. 208) unexpected, at least one of the attacks has been followed by 1 month or more of persistent concern or worry about additional panic attacks or their consequences, or a significant maladaptive change in behavior related to the attacks designed to avoid having panic attacks. When it cannot be better explained by another anxiety disorder. 5. What are common symptoms of a panic attack (physiological and cognitive)? How many symptoms are needed to qualify as a panic attack? (p. 214) an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, during which time four or more symptoms present, a specifier when the panic attack is actually a symptom of another disorder rather than the entire disorder, symptoms: palpitations, accelerated heart rate, sweating, trembling or shaking, shortness of breath, feeling of choking, chest pain, nausea, feeling dizzy or light headed, chills or heat sensations, numbness or tingling sensations, derealization, fear of losing control or going crazy, fear of dying, sense of impending doom. 6. What is the source of perceived threat for a person with agoraphobia? In the event of developing panic-like symptoms, the person is concerned that _____ or _____. How many settings? (p. 217) marked fear or anxiety about two or more of these 5 situations: using public transportation, being in open spaces, being in enclosed places, standing in line or being in a crowd, being outside the home alone, 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 symptoms. 7. Can substances, medications, or medical conditions contribute to anxiety symptoms? (226-231) Yes, substances like cocaine, amphetamines, caffeine, or withdrawal or use of depressants

Reichenberg Chapter 6 and Related Class Material on Anxiety Disorders 1. Is it important to involve parents when treating children with separation anxiety disorder? (Pg. 179) parental involvement is really important and increases treatment efficacy 2. (p. 186-7) How was “external exposure” utilized in the agoraphobia video (elevator, subway, bus) or snake phobia video? Give a specific example of “habituation” in treatment. Incorporate the terms “long enough” and “often enough” is your description (e.g., the person must remain in the situation “long enough” for anxiety to reach a peak and then decline and to repeat the exposure “often enough” for habituation to occur and anxiety to extinguish). How was habituation demonstrated in the elevator video? How was “expectancy violation” demonstrated in the videos (e.g., Sedata’s belief she would get trapped and die if she was in an elevator, however that expectation was violated. Therefore, her cognitions were revised to see elevators as less threatening.). Give a specific example of its use. 3. What is a concern about using medications prior to interoceptive exposure, during the treatment of phobias, or when treating other anxiety disorders? (p. 188) Is the prognosis for the treatment of specific phobias favorable? (188) Medication is not usually indicated in treatment of specific phobia because its use reduces the person’s ability to benefit from exposure-based treatment. They might be good for short term but not a long-term solution. Prognosis for treatment of specific phobias is favorable. best prognosis of any of the anxiety disorders, 70 to 85% of people experiencing significant improvement 4. What are 2 components of the treatment plan for social anxiety disorder? (Pg. 191) empathy, collaboration, and care not to appear critical or rejecting. Cannot look for immediate results, slow proves, praise client progress. Psychoeducation about the cause of onset and maintenance of fears in social anxiety disorder, exposure to gradually more fearful situations, cognitive restructuring to recognize and self-manage troublesome thoughts, between session assignments. 5. How can therapists help by providing psychoeducation about panic symptoms (and reframing them)? Specifically, how could it help a person understand that the rapid breathing, rapid heart rate, dizziness, and tingling experienced during a panic attack are uncomfortable, but not dangerous? (p. 195-6) What is the treatment of choice for panic disorder (196)? normalizing these reactions as well as reassuring clients that treatment can be effective can help provide motivation to engage in yet another treatment, psychoeducation about the symptoms and treatment is often a good first step, people who understand the physiology of a panic attack are less likely to be terrified when another occurs. CBT most effective treatment of choice for panic disorder 6. Briefly describe what is involved with interoceptive (internal) exposure (e.g., create panic-like sensations by spinning in chair, rapid breathing, brisk exercise, breathing through straw) in Panic Control Therapy? See the handout about how to create panic-like symptoms. What is helpful about evoking these panic-like symptoms (e.g., person gets accustomed to and learns to cope with these symptoms and realizes that, while uncomfortable, they are not dangerous)?

DSM-5: Obsessive-Compulsive and Related Disorders 1. What is the DSM definition of obsessions? What is the DSM definition of compulsions? What purpose or function do compulsions serve? (235 & 237) What are 2 common obsessions and 2 compulsions that apply to OCD? Obsessions: recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, Compulsions: repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that

must be applied rigidly, purpose is preventing or reducing anxiety or distress or preventing some dreaded event or situation 2. Does a person need both obsessions and compulsions for an OCD diagnosis? What are 2 ways that the obsessions and compulsions in OCD are viewed as “maladaptive” (e.g., causes significant distress, over an hour/day)? (p. 235,7) presence of one or the other or both, they are time consuming and not often pleasant with inability to prevent them or control them, cause impairment and distress in many areas of life 3. What is the primary concern of those with body dysmorphic disorder (242-3)? How does skinpicking or hair removal differ in BDD from that of excoriation and trichotillomania? (246, 251, 254) preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others, excessive repetitive behaviors or mental acts are performed in response to the preoccupation 4. Why do those with hoarding disorder acquire and maintain so many possessions (Criterion B)? (p. 247) Does the DSM diagnosis of hoarding disorder apply if hoarding is the result of a medical condition (e.g., brain injury)? Persistent difficulty discarding or parting with possessions regardless of their actual value, this difficulty is due to a perceived need to save the items and to distress associated with discarding them, not diagnosed if related to other medical condition Re i c he nbe r g , Cha pt e r7 , Obs e s s i v e Co mpul s i v eandRe l a t e dDi s o r de r s 1. What is the recommended treatment for OCD? To what is a person “exposed” in ERP? What is the “response prevention” part? (p. 224) a form of behavioral therapy known as exposure and response prevention therapy (ERP), exposure and ritual prevention enhances brain’s emotional learning by changing connections in the brain’s response to emotional stimuli circuitry, cannot quit when anxiety is high because have not fully worked through the fear and distress of the situation 2 .Wh a ti so newa yat h e r a p i s tc o u l dhe l pe nh a n c emo t i v a t i o nf o rape r s onwi t hh o a r d i n gdi s or d e r ? ( Pg . 2 30 ) Dot h o s ewi t hh o a r d i n gd i s or d e rus ua l l ys e e kt r e a t me n tv o l u nt a r i l y ?( Pg . 2 3 1)s h a me a n de mb a r r a s s me n tma yp r e v e n tp e op l ef r o mi ni t i a l l ys e e ki n gh e l p, c l i n i c i a n sn e e dt ob es u p p or t i v e a n dp e r s i s t e nti nh e l pi n gt h e md e v e l o pmo t i v a t i o nt oc ha n g e ,h e l p i n gc l i e n ti n s t i l lh o pef orf u t u r e i mp r o v e me n t , f o c usong o a l s , a n dv i s u a l i z eh o wt h e yc a nu s et h e i rs p a c e DSM-5: Trauma- and Stressor-Related Disorders 1. What are the 4 main symptom categories of PTSD in the DSM? The first symptom category is criterion B -“intrusion symptoms.” Also see criterion C, D, & E (271-3). Intrusion symptoms, avoidance of stimuli, negative alterations in cognitions and mood, marked alterations in arousal and reactivity 2. What constitutes a trauma for PTSD or acute stress disorder? What is the distinction between PTSD and acute stress disorder in terms of duration of symptoms? (281) traumatic event experienced directly like exposure to war, threatened or actual violent personal assault, natural or human-made disasters, and severe accident. Acute stress means symptoms begin immediately after trauma and persist between 3 days and 1 month. Re i c he nbe r g , Cha pt e r8 , Tr a uma-a ndSt r e s s o r Re l a t e dDi s o r de r s 1. Ideally, when should treatment begin for PTSD? In prolonged exposure therapy, to what is the person exposed (e.g., memory of trauma event and external cues)? (Pg. 257) Relate this to the

video of the young woman who had been sexually assaulted – she was exposed to her “trauma story” and also to external cures like the telephone, country/western music, wooded area. Early intervention is important to prevent transition of acute stress disorder into full PTSD, traumafocused CBT has most evidence-based support along with stress inoculation training, emotional processing of trauma, prolonged exposure, and cognitive processing therapy, prolonged exposure is exposure to the trauma memory and to activate fear memory while providing new information that is incompatible with the fear so new learning occurs, encourage expressed emotion 2. Besides prolonged exposure therapy, what are two other evidence-supported interventions for PTSD? (2589) prolonged exposure, cognitive processing therapy, anxiety management therapy, eye movement desensitization and reprocessing

DSM - 5: Substance-Related and Addictive Disorders 1. What are 4 DSM symptoms in the criteria for a substance use disorder? (Hint: consider the 4 PICSIR categories in the asynch video). How many symptoms are required, over what period of time? (490) Note: substance abuse and substance dependence are terms that are no longer used in DSM5. at least 2 symptoms within a 12-month period 2. Besides typical symptoms of being “under the influence” (slurred speech, incoordination), what else is needed for the DSM diagnosis of alcohol intoxication? (497) Alcohol withdrawal is also a diagnosis. 3. What are 2 similarities of the criteria for gambling disorder and the substance use disorders (consider applying the terms of “impaired control and social impairment” or elements of tolerance and withdrawal). (586) “impaired control and social impairment” as well as elements of tolerance and withdrawal Reichenberg Chapter 17: Substance Related and Addictive Disorders 1. Recall that, according to the Stages of Change Model (class handout in Unit 1.4.2 @ 2Pep), in the precontemplation stage, people are not thinking seriously about changing and are not interested in help. In the contemplation stage, people are more aware of the consequences of their behavior and may consider the possibility of changing, while also remaining ambivalent about it. A goal of motivational enhancement therapy is to help individuals progress through these stages, thereby enhancing their internal desire and readiness to change. 2. What is the primary goal of motivational enhancement therapy (e.g., to help increase the person’s internal motivation to change)? (Pg. 426 & 435) How is “client-provided assessment data” used? 435) Motivational enhancement therapy has been found to reduce anger and hostility, reduce resistance to the therapist, enhance readiness for behavioral change, and produce abstinence rates twice that of controls, combines feedback on client-provided assessment data with motivational interviewing and reflective listening to help clients mobilize their own internal motivators to change. By incorporating assessment into treatment, therapists can provide information on frequency, dependence, and negative consequences into the therapy session and assist in the development of coping skills to help reduce use 3. What are 4 components of a combination intervention for the treatment of substance use disorders? Note: Some answer options include: Detox, individual therapy, group therapy, family therapy, relapse prevention. Relapse prevention is important to build into any treatment because it helps

individuals recognize their triggers and overcome or replace their cravings. 1. Detoxification with opioid substitute treatment 2. Inpatient treatment 3. Outpatient treatment 4. Ongoing support (12step support groups, psychosocial therapy, and family therapy if appropriate) DSM-5: Feeding and Eating Disorders 1. What are essential diagnostic features of anorexia nervosa (p.338-339)? What are the 2 specifiers? How is the severity of anorexia nervosa determined? A: 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 B: intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight C: disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition or the seriousness of the current low body weight. restricting type: during the last 3 months, individual has not engaged in recurrent episodes of binge eating or purge behavior Binge-Eating: during last 3 months individual has engaged in recurrent episodes of binge eating or purging behavior 2. What are 3 DSM criteria for bulimia nervosa? Note the frequency and timeframe requirements. How is the severity of bulimia nervosa determined? (p.345) eating in a discrete period of time an amount larger than necessary, sense of lack of control overeating during the episode, compensatory behaviors: self-induced vomiting, misuse of laxatives, diuretics, medications, fasting, or excessive exercise, severity based on number of episodes of inappropriate compensatory behavior, occur at least once a week for 3 months 3. What is involved in a binge? What is the key distinction between bulimia nervosa and binge eating disorder (BED)? Frequency and timeframe for BED? How is severity determined? (p.350) binge eating disorder does not involve any compensatory behavior. Marked distress and lack of control, occurs at least once a week for 3 months Reichenberg, Chapter 11: Feeding and Eating Disorders 1 .Fo rt h epe r s o nwi t hb u l i mi a ,wh a ta r ec o mmo nt r i g g e r sf o rbi n g e s( u s ua l l yn e g a t i v ee mo t i on a l s t a t e s ) ?Wha ti st h epo s s i bl eg a i nofs e l f i n du c e dv o mi t i n g ?( Pg s . 3 2 2 3 2 3)t e n s i o n , a nx i e t y , f o o d c r a v i n g s , u n ha p p i n e s s , i n a b i l i t yt oc o n t r o la p p e t i t e , h u n g e r , a n di n s o mni a ,c o n s i d e r e dc op i n g me c ha n i s mf o rt h er e g u l a t i ono fi n t e n s ee mo t i o ns . Vo mi t i n gs e e mst oi n c r e a s ef e e l i n g so fs e l f c o n t r o la n dt or e d uc ea n x i e t y , a n dt h e s es e c o n da r yg a i n st owe i g h tl o s sma k ei td i ffic u l tb e h a v i o rt o e x t i n gu i s h . 2 .Wh a ta r es o medi s t i n c t r e s e a r c h s u p po r t e dt r e a t me nt sf o rbu l i mi a , a n or e xi a , a ndBED?( CBTE, v i s i o n1 2We b s i t eo f DBT, I PT, f a mi l yt he r a p yi nt het e xtp g s . 3 1 9 3 2 1,3 2 53 26 )Al s os e eDi Tr e a t me nt sf o rg oo di d e a s . NOTE:amu l t i d i s c i pl i n a r ya p p r oa c hc o mbi n e sma n yt r e a t me n t c o mpo n e nt sa ndi sNOTad i s t i nc t a pp r o a c h . Al s o , ma n u a l i z e da n ddi a gn o s t i ct r e a t me n t sa r eNOT s p e c i fict r e a t me n t s . 3 .Ho wc o mmo ni sb i n g ee a t i n gd i s o r d e rr e l a t i v et oo t h e re a t i n gdi s o r de r s ?( 3 26 )Tr e a t a b l e ?( 3 31 ) a ffe c t i n g7mi l l i o na d u l t sa n d1 . 6% o ft e e ns , v e r yc o mmo na n d8% c o mor b i dob e s i t y , h i g hl y t r e a t a bl ewi t hr e mi s s i onh i g he rt ha na n or e x i aorb ul i mi a DSM-5: Neurodevelopmental Disorders 1. A diagnosis of intellectual disability (ID) requires deficits in intellectual functioning and what else?

How is the severity level determined of someone with ID determined? (33) deficits in intellectual

functions, deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility, levels of severity determined through conceptual, social, and practical domains 2. What are the two DSM categories of impairment for autism spectrum disorder (Criterion A & B)?

How is severity level determined? (p.50) persistent deficits in social communication and social interaction across multiple contexts, restricted and repetitive patterns of behavior, interests, or activities. Level 3 – requires very substantial support Level 2 – requires substantial support Level 1 – requiring some support 3. For ADHD, what are examples of inattentive symptoms? hyperactivity-impulsivity symptoms?

(59-60) In how many settings do these symptoms need to be evident? often fails to give close attention to details, careless mistakes in work, often has difficulty sustaining attention in tasks, does not seem to listen when spoken to directly, does not follow through on instructions or finish tasks, difficulty organizing tasks and activities, avoids or dislikes tasks requiring sustained mental effort, easily distracted by extraneous stimuli. Types of ADHD: combined presentation (inattentive and hyperactive/impulsive), predominantly inattentive presentation, predominantly hyperactive/impulsive presentation, symptoms evident in at least 2 different settings of individual’s life. 4. What combination of tic...