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Chapter 6-7

Chapter 6-7 Disorders Chart.doc

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Mark Schmuckler

S Disorder Definition Symptoms Etiology Men vs.Women Comorbidity Treatment R Specific Phobia Unwarranted fears - Suffers intense PSYCHOANALYTIC 1 in 10 have it -- Rarely seek treatment (8%) D (varies cross caused by the distress and social or - defence against the anxiety ~ 10 y.o BEHAVIORAL R culturally) presence or occupational produced by repressed ID - Systematic Desensitization O I Blood, Injury, ANTICIPATION of a impairment impulses - In vivo exposure D Injections specific object or - Panic attacks - repression stems from a - Virtual Reality Situation situation particular interpersonal - Role-play T Animals problems of childhood - Modelling E Natural BEHAVIOURAL - Flooding I Environments - Avoidance Conditioning COGNITIVE N - Modelling (Vicarious learning - Homework + social skills A 5 Factors + Anxious Rearing Model) training - Fear of heights or water - Prepared Learning (stimuli) - CBT - Fear of being COGNITIVE - Face fears! observed - cognitive diathesis/bias BIOLOGICAL - Agoraphobia BIOLOGICAL - sedatives, tranquilizers, - Threat fears - biological diathesis anxiolytics - Speaking fears (autonomic liability) - benzodiazepines (Valium, Xanax) Social Phobia Persistent, irrational- avoid situations where Generalized = - Other - Antidepressants (Generalized (Many - MAO **side effects situations) OR fears linked generallythey might be Earlier Onset Anxiety Specific (One to the presence of evaluated, fear of (adolescents + Disorders: -Prozac situation)) other people revealing anxiousness + social - GAD embarrassment interaction) - Specific 7.5% men phobias 8.7% Women - Panic Disorders - Avoidant Personality Disorder - Mood Disorders **Generalized: depression, alcohol abuse Disorder Definition Symptoms Etiology Men vs.Women Comorbidity Treatment Panic Disorder Suffers sudden and - laboured breathing BIOLOGICAL 2% men - Other BIOLOGICAL (Cued or Uncued) often inexplicable - heart palpitations - Mitral valve prolapse 5% women Anxiety - antidepressants (varies cross attack of symptoms - nausea syndrome Adolescence Disorders - SSRI's culturally) - intense apprehension - genetic diathesis (80% of other - self medication  - chest pain PSYCHOLOGICAL anxiety PSYCHOLOGICAL - choking/smothering - fear of fear hypothesis disorders have - Exposure-based treatment - dizziness panic attacks) - In vivo exposure treatment - sweating - MDD - Relaxation training, - terror - GAD cognitive restructuring, - feelings of doom - personality exposure to internal cues - disorders - MBCT DEPERSONALIZATI - drug use ON - DEREALIZATION Generalized Persistent - Difficulty COGNITIVE- Mid-teens (or - Other DIFFICULT TO TREAT Anxiety Disorder anxiousness, worry concentrating BEHAVIOURAL entire lives) Anxiety (18%) about minor items. - worries - environment, not being able 4.2% men Disorders PSYCHOANALYTIC Chronic, - easily tired to control, unpredictable = 7.1% women - Mood - help clients confront the uncontrollable worry - restlessness anxiety, worry disorders true sources of their conflict about all manners of - irritability - worry is a distraction from BEHAVIOURAL things - high level of muscle other distressing images - reformulate anxiety to one tension BIOLOGICAL or more phobias/cued - genetic / Heritability anxieties AND treat - GABA system defect - intensive relaxation training PSYCHOANALYTICAL  - unconscious conflict between COGNITIVE ego and id - helplessness = modelling, (unconscious conflict, thus operant shaping, verbal anxiety without reason) instructions - exaggerate exposure CBT > drugs BIOLOGICAL - Bensodiazepines - antidepressants (comorbid) - **SIDE EFFECTS Disorder Definition Symptoms Etiology Men vs.Women Comorbidity Treatment OCD Anxiety disorder in - fears of BEHAVIOURAL – Lifetime - Early Onset One of the most difficult which the mind is contamination, COGNITIVE prevalence: 1- (~10) = psychological problems to flooded with expressing - learned behaviours reinforced 2% Torrette's treat persistent and sexual/aggressive by fear + anxiety reduction - women > men disorder - only 20% recover uncontrollable impulse, bodily - deficit in prospective memory - early onset ~ - Other completely thoughts (obsessions) dysfunction - a processing abnormality for men *checking Anxiety BEHAVIOURAL and the individual is - extreme doubting threatening visual material compulsion* Disorders - Exposure and Response compelled to repeat - procrastination (cognitive bias) - later onset ~ - Depression Prevention (ERP) -- certain acts again and - indecision - OCD people have trouble women - GAD FLOODING again (compulsion), - fear change ignoring stimuli *cleaning - PTSD 90 min, 15-20 sessions, 3 suffering significant - need for control - thought-action-fusion compulsion* weeks distress and - compulsion is ego- - inflated sense of COGNITIVE- interference with dystonic responsibility BEHAVIOURAL everyday functioning - inability to tolerate - exposure and response - AWARE OF uncertainty prevention + to show there ABSURDITY of - thought supression = are no catastrophic compulsions obsessive phenomena consequences of not doing BIOLOGICAL rituals - genetics - Cognitive Restructuring - brain tumours, head injuries, - Inference-based approach encephalitis BIOLOGICAL (frontal lobes & basal ganglia) - drugs that increase - long term OCD = attention serotonin levels (SSRI) and memory deficits - some tricyclics PSYCHOANALYTIC - psychosurgery - overly harsh toilet training (cingulatomy) (stuck in anal stage) (sexual or - deep brain stimulation aggressive instinctual forces system not under control) PSYCHANALYTIC - ID vs defense mechanism - resembles how to treat - compulsive rituals to exert phobias control for inferiority complex - lifting repression and confronting true fears **Not very effective - learn to tolerate the uncertainty and anxiety that all people feel Disorder Definition Symptoms Etiology Men vs.Women Comorbidity Treatment PTSD extreme response to a - Re-experiencing the - presumed etiology – a - 12 out of 13 - substance Best to intervene ASAP severe stressor, traumatic event traumatic event or events that adolescents who abuse disorders - Psychological first-aid – including increased - Avoidance of the person directly experiences experienced (PTSD immediate response to mental anxiety, avoidance of stimuli/numbing of or witnessed involving death of sexual/physical precedes it) heath after a disaster or stimuli associated responsiveness another, threat of death to abuse had PTSD terrorist event with the trauma, and a -Symptoms of increase oneself, serious injury, threat to- 1 in 10 lifetime - Crisis intervention numbing of emotional arousal (lack of sleep, physical integrity of self/others,prevalence - teaching relaxation training, responses difficulty concentrating, AT RISK - males relative cognitive restructuring - intense fear, horror hyper vigilance, - death, threat to life, early to females have - exposure to thoughts and or helplessness exaggerated startle separation from parents, family higher levels of images of the frightening responses) history of disorders, preexisting trauma exposure event Acute Stress - anxiety, depression, disorder, previous exposure to - BUT females - educating patients on PTSD Disorder: anger, substance abuse, trauma have higher - confronting fears Symptoms are the marital problems, poor - dissociation symptoms during levels of PTSD - systematic desensitization same as those of physical trauma - corrective aspects of PTSD, but lasts health/occupational - insecure attachment style exposure (presently safe, for 4 weeks or less impairment PSYCHOLOGICAL remembering =/= -suicidal thoughts - classical conditioning of fear experiencing, no loss of (avoidances built-up + control, anxiety decreases negatively reinforced by being - EMDR away from CS (alleyway) - rationale-emotive therapy - lost of control + predictability - training in problem solving PSYCHODYNAMIC - constructive-narrative - memories of traumatic events process occur constantly so it is either - psychoactive drugs: consciously suppressed or antidepressants, tranquilizers repressed SSRI BIOLOGICAL ASSESS CLIENT - diathesis of PTSD PREFERENCE FOR - genetic vulnerability DRUGS (~comorbid with (personality of neuroticism) depression) OR EXPOSURE - increased sensitivity of -social support is critical noradrenergic receptors Disorder Definition Symptoms Etiology Men vs.Women Comorbidity Treatment S Pain Disorder the onset and - dependent on - Iatrogenic disability – - Positive - Pain Treatment: R maintenance of pain, tranquilizers and pain unconscious motives that association 1. Validating that the pain D caused largely by killers reinforce pain (sympathy from between reports is real and not just in the R psychological factors - causes severe distressothers, attention from others) of pain patient’s head O I & impairment symptoms and 2. Relaxation training D Most common - hard to pinpoint whereMALINGERING (?) diagnoses of 3. Rewarding for behaving somatoform disorder the pain is due to its several of the in ways inconsistent with M psychological influence anxiety disorders pain (toughing it out) R - significant grey-matter and/or depression - antidepressants reduce F decreases in the pain when associated with O prefrontal, cingulated, depression T and insular cortex A regions (modulates M subjective pains) O S - Everything interpreted in the context of pain Bodily Preoccupation with - frequent consultations - Women: - depression - only 9% show remission Dysmorphic imagined or with plastic surgeons breast, hips, - social phobia over the course of one year Disorder (BDD) exaggerated defects in - constantly looking in legs, face, skin - eating disorder - hard to treat physical appearance mirror (hours) to check - Men: height, - suicidal PSYCHOLOGICAL and for defects penis size, ideation P
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