Abnormal Psychology Midterm Reviewer PDF

**ABNORMAL PSYCH MIDTERM REVIEWER** **ANXIETY DISORDER** Anxiety disorders are characterized by intense fear and anxiety in response to specific situations. While generalized anxiety disorder (GAD) involves persistent anxiety, other anxiety disorders are often triggered by distinct stimuli and inv...

**ABNORMAL PSYCH MIDTERM REVIEWER** **ANXIETY DISORDER** Anxiety disorders are characterized by intense fear and anxiety in response to specific situations. While generalized anxiety disorder (GAD) involves persistent anxiety, other anxiety disorders are often triggered by distinct stimuli and involve intense fear. **Key Theories and Brain Structures** - **Behavioral Approach System (BAS)**: Regulates appetitive motives (moving toward desired things). - **Mowrer's Two-Factor Theory**: Phobias are developed through classical conditioning (pairing a neutral stimulus with an aversive one) and maintained by operant conditioning (avoiding the stimulus relieves fear, reinforcing avoidance). - **Fear Circuit in the Brain**: - **Amygdala**: Overactive in anxiety disorders. - **Medial Prefrontal Cortex**: Underactive in anxiety disorders, less regulation of the amygdala. - **Behavioral Inhibition System (BIS)**: Activates in response to signals of potential danger, leading to anxiety. - **Fight/Flight System (FFS)**: Related to panic responses, partially regulated by serotonin levels. **Types of Anxiety Disorders** 1. **Separation Anxiety Disorder** - Excessive worry about separation from attachment figures. - Common in children (symptoms must last 4 weeks) and adults (6 months). 2. **Selective Mutism** - Persistent inability to speak in specific situations, despite speaking in others. 3. **Specific Phobia** - Persistent, irrational fear of specific objects or situations (e.g., animals, environment, blood, situational triggers). - Types: - **Animal Type**: Fear of animals (onset around age 7). - **Natural Environment Type**: Fear of natural elements (onset around age 7). - **Blood-Injection-Injury Type**: Can cause fainting due to decreased heart rate. - **Situational Type**: Fear of specific situations (onset in early 20s). 4. **Social Anxiety Disorder (SAD)** - Fear of social scrutiny or evaluation. - Common in adolescents, often peaks at age 13. 5. **Panic Disorder** - Recurrent, unexpected panic attacks with physical symptoms. - Types of Panic Attacks: - **Situationally Bound**: Triggered by specific situations. - **Unexpected**: No specific trigger. - **Situationally Predisposed**: Likely but not guaranteed in specific situations. 6. **Agoraphobia** - Fear of being in places where escape or help may be difficult (e.g., public spaces). - Symptoms persist for at least 6 months. 7. **Generalized Anxiety Disorder (GAD)** - Persistent, excessive worry across various areas of life. - Symptoms last for 6 months or more and affect daily functioning. 8. **Substance/Medication-Induced Anxiety Disorder** - Anxiety triggered by substance use or withdrawal. 9. **Anxiety Disorder Due to Another Medical Condition** - Anxiety resulting directly from a medical condition. **Etiology of Anxiety Disorders** - **Behavioral Factors**: Phobias may result from traumatic experiences, modeling, or verbal instruction. Avoidant behavior sustains the fear. - **Prepared Learning**: Evolutionary predisposition to fear certain stimuli. - **Cognitive Factors**: - **Social Anxiety Disorder**: Negative self-evaluation and focus on internal sensations. - **Panic Disorder**: Catastrophic misinterpretation of physical sensations (e.g., heart racing interpreted as a heart attack). - **Neurological Factors**: Panic disorder associated with hyperactivity in the locus ceruleus (increases norepinephrine). **Treatment Approaches** - **Psychodynamic Treatment for Panic Disorder**: Involves 24 sessions to explore emotions surrounding panic. - **Panic Control Therapy (PCT)**: Uses exposure to panic sensations to help clients build coping mechanisms. **Quick Review Points** - **BAS**: Motivates toward positive goals. - **BIS**: Activates in response to negative or unexpected events, leading to anxiety. - **Fear Circuit**: Involves amygdala (overactive) and medial prefrontal cortex (underactive in anxiety). - **Mowrer's Theory**: Phobias develop through classical conditioning and are maintained by avoidance behavior. - **Panic Attacks**: Sudden intense fear; types include cued, uncued, and predisposed.. **BIPOLAR AND RELATED DISORDERS** **Key Concepts** **Affect**: Outward expression of emotion. - **Blunted/Flat Affect**: Limited emotional response; seen in schizophrenia. - **Reactive Affect**: Changes with conversation or situation (normal). - **Labile Affect**: Rapid mood changes; often seen in mania. **Mood**: Persistent emotional state. - **Euthymic**: Normal mood. - **Expansive**: Excessive enthusiasm; symptom of bipolar. - **Dysthymic**: Low mood. - **Elated**: High mood. **Mood Episodes** 1. **Manic Episode**: - Elevated, expansive, or irritable mood lasting at least 1 week. - Includes decreased need for sleep, flight of ideas, increased activity, distractibility, talkativeness, and grandiosity. - Often lasts 3-4 months if untreated. 2. **Hypomanic Episode**: - Less severe than mania, lasting at least 4 days. - Does not cause marked impairment in daily life. 3. **Major Depressive Episode**: - Persistent depressed mood or loss of interest/pleasure. 4. **Mixed Episode**: - Symptoms of both mania and depression almost daily for at least 1 week. **Specifiers for Bipolar Disorder Episodes** 1. **Psychotic Features**: Hallucinations or delusions (mood-congruent or incongruent). 2. **Anxious Distress**: Severe anxiety increasing risk of suicide. 3. **Mixed Features**: Depressive episodes with some manic symptoms. 4. **Melancholic Features**: Severe depressive symptoms with lack of response to pleasure. 5. **Catatonic Features**: Lack of movement or waxy flexibility. 6. **Atypical Features**: Increased sleep and appetite during depression. 7. **Peripartum Onset**: Occurs around childbirth. 8. **Seasonal Pattern**: Depression in fall/winter and mania in spring/summer (SAD). **Types of Bipolar and Related Disorders** 1. **Bipolar I Disorder**: - Alternates between major depressive and manic episodes. - **Rapid Cycling**: At least 4 manic/depressive episodes per year. - Men often have earlier onset, usually with mania as the first episode. 2. **Bipolar II Disorder**: - Alternates between depressive and hypomanic episodes. - **Rapid Cycling**: Four or more hypomanic/depressive episodes per year. - Common treatments: Carbamazepine and lithium (mood stabilizers). 3. **Cyclothymic Disorder**: - Chronic fluctuating mood involving hypomanic and depressive symptoms that do not meet full criteria for hypomanic or depressive episodes. - Duration: At least 2 years for adults, 1 year for children/adolescents. **Additional Notes** - **Unipolar Mood Disorders**: Only depression or mania is present, usually depression. - **Etiology**: Factors like reward sensitivity and sleep disruption can trigger manic episodes. **Top of Form** **DEPRESSIVE DISORDERS** **General Concepts of Depression** - **Depression**: Sometimes called \"psychological fever.\" It's an emotional state characterized by sadness, low self-esteem, hopelessness, and helplessness, often using **Introjection** as a defense mechanism (taking on others\' feelings as one\'s own). - **Interpersonal Relationships**: Relationship issues often precede depression, especially in men. Marital conflict tends to have a strong effect on depression. **Types of Depressive Disorders** 1. **Unipolar Major Depressive Disorder (MDD)**: - Requires 5 or more of the following symptoms: depressed mood, thoughts of death, loss of pleasure (anhedonia), sleep and appetite disturbances, concentration issues, psychomotor disturbances, fatigue, or low energy. 2. **Disruptive Mood Dysregulation Disorder (DMDD)**: - Characterized by severe temper outbursts (verbal or behavioral) that are disproportionate to the situation. - Outbursts occur at least 3 times a week, across at least two settings (e.g., home and school), and have been persistent for at least 12 months. - Symptoms should start by age 10 and not meet criteria for mania. 3. **Major Depressive Disorder (Single and Recurrent Episodes)**: - Involves sad mood or loss of pleasure in usual activities, with additional symptoms like sleep disturbance, weight changes, fatigue, guilt, concentration issues, or recurrent suicidal thoughts. - Symptoms are present nearly every day for at least two weeks. - Typically untreated episodes last 4-9 months. - More common in Western countries, with about 4-7 episodes expected over a lifetime. **Psychological and Personality Factors in Depression** - **Neuroticism**: A trait marked by heightened sensitivity to negative events, increasing susceptibility to depression and anxiety. **Suicidal Thoughts and Behaviors** - **Suicidal Ideation**: Talking about wanting to die. - **Suicidal Gesture**: Actions indicating intent, such as giving away possessions. - **Suicidal Plan**: Developing a method to end one\'s life if things don't improve. - **Suicidal Attempt**: Making an actual attempt on one\'s life. - **Suicidal Act or Behavior**: Making plans for a violent death with means readily available. **Durkheim's Types of Suicide** 1. **Altruistic Suicide**: Culturally approved sacrifices, like Japan's harakiri. 2. **Egoistic Suicide**: Caused by lack of social support; often seen in socially isolated older adults. 3. **Anomic Suicide**: Triggered by major life disruptions (e.g., job loss). 4. **Fatalistic Suicide**: Results from feeling trapped with no control over one's future. 5. OBSESSIVE-COMPULSIVE AND RELATED DISORDERS **OBSESSIVE COMPULSIVE AND RELATED DISORDERS** **1. Obsessive-Compulsive Disorder (OCD)** - **Core Features**: - **Obsessions**: Recurrent, persistent thoughts that the person attempts to ignore or suppress. Types include symmetry, forbidden thoughts/actions, contamination, and hoarding. - **Compulsions**: Repetitive behaviors (e.g., hand-washing, checking) intended to reduce stress. - **Specifiers**: - **Insight**: Good/Fair, Poor, or Absent Insight (delusional beliefs). - **Tic-Related**: Linked with a history of tic disorders. - **Onset and Prevalence**: - Typically starts in childhood to early adulthood (median onset at 19). - Affects males and females equally and is chronic. - **Etiology**: - **Cognitive and Behavioral Factors**: - **Yedasentience**: The feeling of "enough" (thought, action) is disrupted. - **Operant Conditioning**: Compulsions are reinforced as they reduce anxiety. - **Mistrust of Memory**: People with OCD often lack confidence in their memory, prompting ritualistic behavior. - **Thought Suppression**: Frequent efforts to suppress obsessive thoughts. **2. Body Dysmorphic Disorder (BDD)** - **Features**: - Preoccupation with perceived physical defects. - Engages in repetitive behaviors (e.g., mirror-checking, grooming) in response to these concerns. - Preoccupation lasts several hours daily and is not focused on weight/fat. - **Onset and Course**: - Onset typically in early adolescence to 20s; lifelong course. - Often comorbid with OCD (10%). **3. Hoarding Disorder** - **Features**: - Persistent difficulty discarding possessions, leading to cluttered spaces. - Strong need to save items; distress associated with discarding. - Living areas may be unusable due to accumulation of items. **4. Trichotillomania (Hair-Pulling Disorder)** - **Features**: Compulsive urge to pull out hair from any part of the body (e.g., scalp, eyebrows). **5. Excoriation (Skin-Picking Disorder)** - **Features**: Compulsive skin-picking, resulting in tissue damage. **6. Substance/Medication-Induced Obsessive-Compulsive and Related Disorder** - **Features**: Symptoms triggered by substance use or withdrawal. **7. Obsessive-Compulsive Disorder due to Another Medical Condition** - **Features**: OCD-like symptoms caused by a medical condition. **Treatment for OCD and Related Disorders** 1. **Medications**: - SSRIs (Selective Serotonin Reuptake Inhibitors) are commonly used. 2. **Psychological Treatment: Exposure and Response Prevention (ERP)**: - Developed by Meyer, this approach tailors exposure therapy to OCD-related rituals. - **Exposure**: Confronting feared objects or situations. - **Response Prevention**: Deliberately refraining from compulsive behavior. - **Examples**: - **OCD**: Touching a dirty dish (exposure) without washing hands (response prevention). - **BDD**: Engaging with people who might judge their appearance (exposure) while avoiding self-checking rituals like mirror-gazing (response prevention). - **Hoarding Disorder**: Discarding items (exposure) and resisting sorting/counting rituals (response prevention). **TRAUMA AND STRESSOR-RELATED DISORDERSBottom of Form** **1. Reactive Attachment Disorder (RAD)** - **Features**: - A rare, severe disorder primarily seen in children who struggle to form healthy attachments with caregivers. - Exhibits socially inappropriate behavior and difficulties with forming normal, loving relationships. **2. Disinhibited Social Engagement Disorder (DSED)** - **Features**: - Characterized by overly familiar behavior with strangers, lack of typical stranger anxiety, and ease in approaching unfamiliar adults. **3. Acute Stress Disorder (ASD)** - **Features**: - Triggered by exposure to traumatic events (e.g., serious injury, death, sexual violation). - At least **8 symptoms** lasting between **3 to 31 days** after trauma, including intrusive memories, flashbacks, dissociative reactions, avoidance, hypervigilance, and altered reality perception. **4. Post-Traumatic Stress Disorder (PTSD)** - **Features**: - Similar to ASD but symptoms persist **more than one month**. - Common triggers: natural disasters, abuse, combat/war trauma. - **Symptoms**: - **Re-experiencing the event**: Intrusive memories, flashbacks, nightmares. - **Avoidance**: Evading reminders or thoughts related to the trauma. - **Mood and cognitive changes**: Persistent negative beliefs, emotional numbing, memory gaps, self-blame. - **Increased arousal and reactivity**: Irritability, self-destructive behavior, concentration issues, hypervigilance, exaggerated startle response. - **PTSD Specifiers**: - **Acute**: 1-6 months. - **Chronic**: Over 6 months. - **Delayed-Onset**: Symptoms appear 6+ months post-trauma. - **With Dissociative Symptoms**: Experiences of depersonalization (feeling detached from oneself) or derealization (feeling of unreality). **Behaviors of Sexually Abused Individuals by Age** - **Young Children**: Self-destructive behaviors (e.g., head banging). - **School Age (6-12 years)**: Truancy, running away. - **Adolescents**: Substance abuse, aggression. - **Adults**: Struggle with anger control. **Etiology of PTSD** 1. **Social Factors**: - **Trauma Nature**: Severity, duration, and proximity of trauma increase PTSD risk. - **Social Support**: Emotional support post-trauma can aid recovery, while lack of support heightens vulnerability. 2. **Psychological Factors**: - **Shattered Assumptions**: - **Personal Invulnerability**: Trauma disrupts belief in personal safety. - **World's Justice**: Events seem senseless or unjust. - **Good People's Protection**: Assumption that bad things happen only to "bad" people is challenged. - **Pre-existing Distress**: Pre-existing anxiety or depression increases PTSD susceptibility. - **Coping Styles**: - **Avoidant Strategies**: Isolation or substance use is linked to higher PTSD risk. - **Dissociation**: Short-term dissociation post-trauma raises PTSD risk. - **Meaning-Making**: Searching for meaning in trauma can be beneficial, aiding emotional integration. 3. **Genetics**: - Twin studies suggest genetic predisposition, especially in identical twins. **Adjustment Disorders (AD)** - **Features**: - Reaction to stress manifesting as emotional or behavioral symptoms, categorized by: - **Depressed Mood** - **Anxiety** - **Mixed Anxiety and Depressed Mood** - **Disturbance of Conduct** - **Mixed Emotional and Conduct Disturbance** - **Unspecified**