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Lecture 5

Psychology 2030A/B Lecture Notes - Lecture 5: Depersonalization, Confabulation, Temporal Lobe Epilepsy


Department
Psychology
Course Code
PSYCH 2030A/B
Professor
David Vollick
Lecture
5

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Posttraumatic Stress Disorder (PTSD): An Overview
Facts and Statistics
o About 7.8% of the general population meet the criteria for PTSD
o Combat and sexual assault are the most common traumas
o Few in air-raid bunkers developed PRSD- few experienced death, etc.
Posttraumatic Stress Disorder (PTSD): Causes and Associated Features
Subtypes and Associated Features of PTSD
o Acute PTSD- May be diagnosed 1-3 months post trauma (don’t diagnose right away because it
may not develop into PTSD)
o Chronic PTSD- Diagnosed after 3 months post trauma
o Delayed onset PTSD- Onset of symptoms 6 months or more post-trauma
o Acute stress disorder- Diagnosis of PTSD immediately post-trauma
Causes of PTSD
o Intensity of the trauma and one’s reaction to it (true alarm)
o Uncontrollability and unpredictability (avalanche)
o Extent, or lack, of social/emotional support, post-trauma (if you have good emotional support
you are at a lower rick of PTSD-either way you are better off with it)
o Direct conditioning and observational learning
Researchers are suggesting that depression way actually be PTSD
o Biological & psychological predispositions, personalities, and genetics affect PTSD
o CRF activation (endocrine), hippocampus damage (memory), brain stem (emotional)
Posttraumatic Stress Disorder (PTSD): Treatment
Psychological Treatment of PTSD
o Cognitive-behavioral treatment (CBT) involves gradual re-exposure (imaginational exposure
in a hierarchy of intensity)
o Increase positive coping skills and social support
o CBTs are highly effective
o Meichenbaum- modification of exposure- therapist helps individual reconstruct the story and
change the meaning behind it and help to adapt positive coping skills
o Eye-movement desensitization and reprocessing- therapist will move fingers and clients eyes
will follow finger while thinking about trauma; it is supposed to somehow rewire the brain;
not much supporting evidence
o SSRI’s can help
Hierarchy: table 5.10 Fear and Avoidance Hierarchy for Marcie
DSM table 5.7: Diagnostic Criteria for OCD
Obsessive-Compulsive Disorder (OCD): An Overview
Overview and Defining Features
o Obsessions- intrusive and nonsensical thoughts, images, or urges that one tries to resist or
eliminate (aggression, sexual)
o Compulsions- thoughts or actions to suppress the thoughts and provide relief
o Most persons with OCD display multiple obsessions (contamination, somatic concerns,
symmetry, sexual, aggressive impulses)
o Most persons with OCD present with cleaning and washing or checking rituals
Summerfeldt- Four Associations
o Aggressive and sexual obsessions- seem to lead to checking rituals
o Symmetry obsessions- lead to ordering and arranging rituals
o Contamination- results in cleaning rituals
o Hoarding rituals- fearing if they throw things away, they might urgently need it eventually
Obsessive Compulsive Disorder (OCD): Causes and Associated Features
Facts and Statistics
o About 2.6% of the general population meet criteria for OCD in their lifetime
o Most people with OCD are female
o OCD tends to be chronic

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o Onset is typically in early adolescence or young adulthood
Causes of OCD
o Parallel to the other anxiety disorders
o Early life experiences and learning that some thoughts are dangerous/unacceptable
o Thought-action fusion-tendency to view the thought as similar to the action
Obsessive Compulsive Disorder (OCD): Treatment
Medication Treatment of OCD
o SSRIs seem to benefit up to 60% of patients
o Relapse is common with medication discontinuation
Psychological Treatment
o Cognitive-behavioral therapy (involving exposure and ritual prevention) is effective with OCD-
no harm
o Medication+CBT does not work as well as CBT alone
o McLean (UBC)- Exposure and ritual prevention vs. CBT-ERP slightly better than CBT- both
improved thoughts
o ERP, with or without clomiprimine, gave superior results than the drug alone
Summary of Anxiety-Related Disorders
Anxiety disorders are the largest domain of psychopathology
From a normal to a disordered experience of anxiety and fear
o Requires consideration of biological, psychological, experimental and social factors (diathesis-
stress)
o Fear and anxiety persist to bodily or environmental non-dangerous cues
o Symptoms and avoidance cause significant distress and impairs functioning (DSM-IV-has to be
distressful and impair function to be a disorder)
Chapter 6- Somatoform and Dissociative Disorders
An Overview of Somatoform Disorders
Soma- meaning body
o Overly preoccupied with their health of body appearance
o No identifiable medical condition causing the physical complaints
DSM-IV-TR
DSM table 6.1- Diagnostic Criteria for Hypochondriasis
Hypochondriasis: An Overview
Problem is anxiety
Chronic onset
Hypochondriasis vs. panic disorder
o Similarities
Both focus on bodily symptoms
o Differences
Hypochondriasis focuses on long-term process of illness; constant concern; constantly
seeking medical treatment; wider range of symptoms (vary from heart problems to
muscle problems)
Panic disorder is in the moment
Overview and Defining Features
o Physical complaints without a clear cause
Severe anxiety focused on the possibility of having a serious long-term disease vs. panic
disorder
Strong disease conviction (almost like they want to have disease)
Medical reassurance does not help
o Facts and Statistics
Good prevalence data lacking- onset at any age
Culture specific
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