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Flashcards About Chapter 5 Psych Essay

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a state of immediate alarm in response to a serious, known threat to one’s well being
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fear
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a state of alarm in response to a vague sense of being in danger
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anxiety
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experiences of fear and anxiety are often useful when
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they prepare us for action — for fight or flight — when danger threatens
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when discomfort is too severe or too frequent, lasts too long, or is triggered too easily
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people most likely have anxiety
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what is the most common mental disorder in US
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anxiety disorder
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in any given year ____% of the adult US pop. experiences one of anxiety disorders… ____% develop at least one within their lifetime
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18% . 29%
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one _____ of those with anxiety seek treatment
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1/5
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most individuals with one anxiety disorder also have
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a second disorder
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what other disorder is common with anxiety?
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depression
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how many anxiety disorders are there?
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5
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name the 5 anxiety disorders
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generalized anxiety disorder phobias agoraphobia social anxiety disorder panic disorders
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what is GAD?
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Excessive or ongoing anxiety and worry, for at least six months, about two or more activities or events
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another name for GAD
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free floating anxiety
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how many symptoms are needed to be diagnosed with GAD?
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3
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what are the symptoms of GAD?
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Feeling restless Keyed up, or on edge Fatigue and/or sleep problems Difficulty concentrating Muscle tension
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GAD: The Sociocultural Perspective says
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People faced with truly dangerous social conditions are at risk
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One of the most powerful forms of societal stress is
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poverty
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As would be predicted by the sociocultural model, there are higher rates of GAD in ______ groups
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lower SES
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GAD: The Psychodynamic Perspective from Freud says
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all children experience anxiety: Realistic anxiety when they face actual danger Neurotic anxiety when they are prevented from expressing id impulses Moral anxiety when they are punished for expressing id impulses
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GAD: The Psychodynamic Perspective says that GAD developed for children who
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Who experience particularly high levels of anxiety Who’s defense mechanisms are inadequate
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Today’s psychodynamic theorists often disagree with specific aspects of Freud’s explanation of GAD… Researchers have found some support for the psychodynamic perspective:
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People with GAD are particularly likely to use defense mechanisms (especially repression) Adults, who as children suffered extreme punishment for expressing id impulses, have higher levels of anxiety later in life
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GAD: The Humanistic Perspective says
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When people stop looking at themselves honestly and acceptingly they develop GAD
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GAD the Humanistic perspective is illustrated by Carl Rogers:
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Lack of “unconditional positive regard” in childhood leads to “conditions of worth” They have negative thoughts about themselves when they are unable to meet these standards
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Practitioners using humanistic “client-centered” approach try to show
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unconditional positive regard for their clients and to empathize with them
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little research support for
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humanistic treatment for GAD
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GAD: The Cognitive Perspective looks at two types of assumptions
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irrational and silent
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GAD: Behavior is influenced by irrational assumptions:
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It is a dire necessity for an adult human being to be loved or approved of by virtually every significant person in his community It is awful and catastrophic when things are not the way one would very much like them to be
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GAD: Silent assumptions imply imminent danger:
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A situation/person is unsafe until proven safe It is always best to assume the worst
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GAD cognitive perspective: what is the metacognitive theory?
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The most problematic assumptions in GAD are the individual’s worry about worrying (meta-worry)
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GAD cognitive perspective: Intolerance of uncertainty theory
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It is unacceptable that negative events may occur, even if the possibility is very small They worry in an effort to find “correct” solutions
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GAD cognitive perspective: Avoidance theory
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Worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal
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GAD: Two kinds of cognitive treatment approaches:
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Changing maladaptive assumptions Helping clients understand the role that worrying plays, and changing their views and reactions to it
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for GAD cognitive theory, changing maladaptive assumptions is done by:
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Ellis’s rational-emotive therapy (RET) (Point out irrational assumptions Suggest more appropriate assumptions Assign related homework Studies suggest at least modest relief from treatment)
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for GAD cognitive theory, changing reaction to worrying: treatments
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Educate pts about the role of worrying in GAD and have them observe their bodily arousal and cognitive responses across life situations Pt’s learn to identify their worrying and their attempts to control their lives by worrying Pt’s learn to see the world as less threatening, to adopt more constructive ways of coping, and to worry less
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GAD: The Biological Perspective says
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GAD is caused by biological factors
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“GAD is caused by biological factors” is supported by
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pedigree studies (Biological relatives more likely to have GAD (~15%) than general population (~6%)) The closer the relative, the greater the likelihood. There is, however, a competing explanation of shared environment
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GAD: The Biological Perspective says GAD is caused by
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GABA inactivity
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in 1950s _______ were found to reduce anxiety
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Benzodiazepines
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Benzodiazepines work because….
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Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain) and GABA makes the neuron stop firing
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Malfunctions such has ______ and _______ in the feedback system are believed to cause GAD
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To few GABA receptors AND Ineffective receptors
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Research conducted in recent years indicates that the root of GAD is probably more complicated than a
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single neurotransmitter (GABA)
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GAD: Biological Treatments
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drug therapy Relaxation training Biofeedback
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drug therapy for GAD
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Early 1950s: Barbiturates (sedative-hypnotics) Late 1950s: Benzodiazepines More recently: Antidepressant and antipsychotic medications
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facts about relaxation training as GAD treatment
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Research indicates that relaxation training is more effective than placebo or no treatment Best when used in combination with cognitive therapy or biofeedback
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Biofeedback uses
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electrical signals from the body to train people to control physiological processes
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Electromyograph (EMG) provides
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feedback about muscle tension
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biofeedback found to have its greatest impact when used as an
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adjunct to other methods for treatment of certain medical problems (headache, back pain, etc.)
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phobia is From the Greek word for ____
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fear
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a phobia is a
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Persistent and unreasonable fears of particular objects, activities, or situations
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People with a phobia often avoid
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the object or thoughts about it
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phobias compared to common fears….
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phobias are …. More intense and persistent fear Greater desire to avoid the feared object or situation Distress that interferes with functioning
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Most phobias technically are categorized as “specific” which is…..
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an intense and persistent fear of a specific object or situation
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with phobias When exposed to the object or situation, sufferers experience
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immediate fear
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most common phobias
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animals or insects heights enclosed spaces thunderstorms blood
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Each year close to ______% of all people in the U.S. have symptoms of specific phobia More than _____% develop such phobias at some point in their lives
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9% and 12%
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are women or men more likely to have phobia
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women 2:1
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Vast majority of people with a specific phobia (do/do not) seek treatment
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DO NOT
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Each model offers explanations for what causes specific phobias, but evidence tends to support the ________ explanations
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behavioral
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Phobias develop through
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conditioning
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Other behavioral explanations for What Causes Specific Phobias
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Phobias develop through modeling Phobias are maintained through avoidance Phobias may develop into GAD when a person acquires a large number of them
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What Causes Specific Phobias? A behavioral-evolutionary explanation
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Theorists argue that there is a species-specific biological predisposition to develop certain fears Called “preparedness” because we are theoretically more “prepared” to acquire some phobias than others Model explains why some phobias (snakes, spiders) are more common than others (meat, houses)
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How Are Specific Phobias Treated?
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Systematic desensitization Flooding Modeling
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two types of systematic desensitization
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In vivo desensitization (live) Covert desensitization (imaginal)
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what is Flooding
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Forced non-gradual exposure
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what is Modeling
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Therapist confronts the feared object while the fearful person observes
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the key to success for phobia treatments is
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ACTUAL contact with the feared object or situation
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People with agoraphobia are
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afraid of being in public places or situations where escape might be difficult, should they experience panic or become incapacitated
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In any given year, about ____% of adults experience agoraphobia, women twice as frequently as men
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2%
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Explanations for Agoraphobia
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Although broader than specific phobias, agoraphobia is often explained in ways similar to specific phobias Many also are prone to experience extreme and sudden explosions of fear – called “panic attacks” – and may receive a second diagnosis of panic disorder
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How is Agoraphobia Treated?
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Behavioral therapy with an exposure approach is the most common and effective treatment for agoraphobia
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Between _______% of clients with agoraphobia who receive exposure treatment find it easier to enter public places and the improvement lasts for years
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60-80%
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Social Anxiety Disorder is a
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Severe, persistent, and irrational fears of social or performance situations in which scrutiny by others and embarrassment may occur
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People judge themselves as performing less competently than they actually do either ______ or ______
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narrow or broad
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ex. of narrow for Social Anxiety Disorder
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talking, performing, eating, or writing in public
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ex. of broad for Social Anxiety Disorder
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general fear of functioning poorly in front of others
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What Causes Social Anxiety Disorder?
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People with this disorder hold a group of social beliefs and expectations that consistently work again them, including: Unrealistically high social standards or Views of themselves as unattractive and socially unskilled
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Cognitive theorists hold that, because of these beliefs, people with social anxiety disorder anticipate that social disasters will occur and they perform “________” and “_______” behaviors to prevent them
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avoidance or safety
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In addition for ______________, after a social event, they review the details and overestimate how poorly things went or what negative results will occur
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social anxiety disorder
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Treatments for Social Anxiety Disorder: Two components must be addressed:
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Overwhelming social fear: (Address fears behaviorally with exposure) Lack of social skills: (Social skills and assertiveness trainings have proved helpful)
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Social fears are often reduced through
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medication (antidepressants)
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social fears are treated through
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medication psychotherapy social skills training
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psychotherapy is where
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People treated with psychotherapy are less likely to relapse than people treated with drugs alone One psychological approach is exposure therapy, either in an individual or group setting Cognitive therapies have also been widely used
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Social skills training is where
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Therapists provide feedback and reinforcement Allows pt to practice skills with other group members
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Panic
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________, an extreme anxiety reaction, can result when a real threat suddenly emerges
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_______ are periodic, short bouts of panic that occur suddenly, reach a peak, and pass
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panic attacks
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Sufferers of _______ often fear they will die, go crazy, or lose control
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panic attacks
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panic Attacks happen in the absence of a
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real threat
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More than _______ of all people have one or more panic attacks at some point in their lives, but some people have panic attacks repeatedly, unexpectedly, and without apparent reason
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1/4
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_______ are when people have panic attacks repeatedly, unexpectedly, and without apparent reason
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panic disorders
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example 0f ____________: they may worry persistently about having an attack or plan their behavior around possibility of future attack
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panic disorder
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with panic disorders, women are _____ as likely to as men to be affected
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twice
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Poor people are ______% more likely than wealthier people to experience these disorders
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50%
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The prevalence for panic disorders is (the same/different) across cultural and racial groups in the U.S. and seems to occur in cultures across the world
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the same
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Approximately ______ of those with panic disorder are in treatment
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1/3
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Panic disorder often (but not always) accompanied by
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agoraphobia
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Panic Disorder: The Biological Perspective: In the 1960s, clinicians discovered that people with panic disorder were not helped by benzodiazepines, but were helped by ____
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antidepressants
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Researchers worked ________ from their understanding of antidepressant drugs
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backward
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What biological factors contribute to panic disorder?
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Neurotransmitter brain circuits amygdala genetic factors
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which neurotransmitter is a factor that contributes to panic disorder
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norepinephrine
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norepinephrine is irregular in people with
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panic attacks
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It is possible that some people with panic disorder inherit a predisposition to abnormalities in the _____ and ______
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brain circuits and amygdala
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Genetics as a factor of panic disorder: Among monozygotic (MZ, or identical) twins, the rate is as high as ____% Among dizygotic (DZ, or fraternal) twins, the rate is only ____%
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31% 11%
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biological treatment for panic disorders
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drug therapy
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antidepressants function at the _______ receptors in the panic brain circuit
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norepinephrine
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antidepressents Bring at least some improvement to_____% of patients with panic disorder
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80%
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Some _________ (especially Xanax [alprazolam]) work for panic disorders
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benzodiazepines
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Panic Disorder: The Cognitive Perspective: Cognitive theorists recognize that biological factors are only part of the cause of panic attacks
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full panic reactions are experienced only by people who misinterpret bodily events
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Cognitive treatment is aimed at
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correcting misinterpretation of bodily events
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Panic-prone people may be very sensitive to certain bodily sensations and may misinterpret them as
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signs of a medical catastrophe
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why do people experience misinterpretations?
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Experience more frequent or intense bodily sensations Have experienced more trauma-filled events over the course of their lives They focus on bodily sensations much of the time, are unable to assess the sensations logically, and interpret them as potentially harmful
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Panic Disorder: The Cognitive Perspective: the cognitive therapy tries to
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Tries to correct people’s misinterpretations of their bodily sensations
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what are the 3 steps for cognitive therapy for panic disorders?
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Step 1: Educate clients Step 2: Teach clients to apply more accurate interpretations (especially when stressed) Step 3: Teach clients skills for coping with anxiety (relaxation, breathing)
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cognitive therapy for panic disorders may also use _________ procedures to induce panic sensations
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biological challenge
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OCD Made up of two components
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obsessions and compulsions
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obsessions are
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Persistent thoughts, ideas, impulses, or images that seem to invade a person’s consciousness
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compulsions are
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Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety
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Diagnosis of OCD is called for when symptoms:
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Feel excessive or unreasonable Cause great distress Take up much time Interfere with daily functions
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Between ____% and _____% of U.S. population suffer from OCD in a given year
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1% and 2%
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OCD is _____ common in men and women and among different racial and ethnic groups
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equally
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OCD usually begins by
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young adulthood and typically persists for many years, although symptoms may fluctuate over time
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It is estimated that more than ____% of those with OCD seek treatment
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40%
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What Are the Features of Obsessions and Compulsions?
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obsessions compulsions
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obsessions are
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Thoughts that feel both intrusive and foreign Attempts to ignore or resist them trigger anxiety
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compulsions are
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“Voluntary” behaviors or mental acts
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performing behaviors for OCD reduce anxiety by
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only for a short time
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with OCD, behaviors often develop into
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rituals
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common forms of compulsions:
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Cleaning Checking Order or balance Touching, verbal, and/or counting
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Compulsive acts often occur in response to
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obsessive thoughts
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Compulsions seem to represent a yielding to
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obsessions
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Compulsions also sometimes serve to help control
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obsessions
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Many with OCD are concerned that they will act on their
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obsessions
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Compulsions usually do not lead to
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violence or “immoral” conduct
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OCD: The Behavioral Perspective: Behaviorists have concentrated on explaining and treating
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compulsions rather than obsessions
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OCD: The Behavioral Perspective: In a fearful situation, they happen to perform a particular act (washing hands) When the threat lifts, they associate the improvement with
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the random act
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OCD: Behavioral perpective: After repeated associations, they believe the compulsion is
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changing the situation
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OCD: The Behavioral Perspective: Treatment
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behavioral therapy:
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example of behavioral therapy for OCD:
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Exposure and response prevention (ERP)
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Exposure and response prevention (ERP) is where
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Clients are repeatedly exposed to anxiety-provoking stimuli and are told to resist performing the compulsions
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Between ____ and _____ percent of clients have been found to improve considerably with ERP, and improvements often continue indefinitely
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55 and 85
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with OCD, as many as _____% fail to improve at all from ERP, and the approach is of limited help to those with obsessions but no compulsions
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25
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OCD: The Cognitive Perspective: Cognitive theorists begin by pointing out that everyone has
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repetitive, unwanted, and intrusive thoughts
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OCD: The cognitive perspective: People with OCD blame themselves for normal (although repetitive and intrusive) thoughts and expect that
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terrible things will happen as a result
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OCD: The Cognitive Perspective: To avoid such negative outcomes, they attempt to “_______” their thoughts with actions (or other thoughts)
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neutralize
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Neutralizing thoughts/actions may include:
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Seeking reassurance Thinking “good” thoughts Washing Checking
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People with OCD tend to:
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Be more depressed than others Have exceptionally high standards of conduct and morality Believe thoughts are equal to actions and are capable of bringing harm Believe that they can, and should, have perfect control over their thoughts and behaviors
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Cognitive therapists focus on the
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cognitive processes that help to produce and maintain obsessive thoughts and compulsive acts
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Cognitive-Behavioral Therapy (CBT) with OCD:
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psychoeducation as well as exposure and response prevention exercises
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Research suggests that a combination of the ______ and _______ models is often more effective than either intervention alone for OCD
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cognitive and behavioral
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Family pedigree studies provided the earliest clues that OCD may be linked in part to _______
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biological factors
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Studies of twins found a ______% concordance rate in identical twins, versus _______% in fraternal twins
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53% and 23%
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OCD: The Biological Perspective: biological therapies
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Serotonin-based antidepressants Research suggests that combination therapy (medication + cognitive behavioral therapy approaches) may be most effective
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Serotonin-based antidepressants for OCD
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Clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox) Bring improvement to 50-80% of those with OCD Relapse occurs if medication is stopped
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In recent years, a growing number of clinical researchers have linked some excessive behavior patterns (e.g., hoarding, hair pulling, shopping, sex) to
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OCD
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DSM-5 has created the group name “Obsessive-Compulsive-Related Disorders” and assigned four patterns to that group:
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hoarding disorder, hair-pulling disorder, excoriation (skin-picking) disorder, and body dysmorphic disorder
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Theorists typically account for obsessive-compulsive-related disorders by using the same kinds of explanations that have been applied to
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OCD
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clinicians typically treat clients with these disorders by applying the kinds of treatment used with OCD, particularly
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antidepressant drugs, exposure and response prevention, and cognitive therapy