PSY 280 Chapter 7 Exam 2

Question Answer
DSM-IV-TR vs. DSM-5 ~In DSM-IV-TR, obsessive-compulsive and related disorders and trauma-related disorders were included with anxiety disorders~Some common symptoms, risk factors, and treatments with anxiety disorders~DSM-5 creates new chapter for OCD
Obsessive- Compulsive Disorder (OCD) ~Repetitive thoughts and urges (obsessions)~Repetitive behaviors and mental acts (compulsions)
Body dysmorphic Disorder ~Repetitive thoughts and urges about personal appearance
Hoarding disorders ~Repetitive thoughts about possession
obsessions ~intrusive, persistent, and uncontrollable thoughts or urges~interfere with normal activities~often experienced as irrational~most common: contamination, symmetry and/ or order, religious, and sexual and aggressive impulses
compulsions ~impulse to repeat behaviors or mental acts to avoid distress~e.g.cleaning counting,touching,checking~extremely difficult to resist impulse~may involve rituals~compulsive gambling, eating,NOT compulsions~compulsions only serve reduce anxiety
• Obsessions are defined by ¦ Recurrent, intrusive, unwanted thoughts, urges, or images¦ The person attempts to ignore, suppress or neutralize them
• Compulsions are defined by ¦ Repetitive behaviors or thoughts that the person feels compelled to perform to prevent distress or a dreaded event¦ The person feels driven to perform the repetitive behavior or thoughts in response to obsessions or according to rigid rules
• Compulsions are defined by(2) ¦ The acts are excessive or unlikely to prevent the dreaded situation¦ The obsessions or compulsions are time consuming (e.g. at least one hour per day) or cause clinically significant distress or impairment
¬ Obsessive- compulsive disorder (OCD)(2) ¦ Develops either before age 10 or during late adolescence/early adulthood¦ Sex difference unclear¦ OCD often chronic¦ Pattern of symptoms is similar across cultures
¬ Etiology of OCD ¦ Behavioral explanation- negative reinforcement of compulsions, including thought suppression, to decrease obsessions¦ Cognitive explanation- “just not right”; intolerance of uncertainty; thought-action fusion
¬ Mechanisms of OCD ¦ Era related negativity? ERN¦ X axis: Make decision that is either correct or incorrect¦ Dotted line: Error response Straight: Correct response
¬ Mechanisms of OCD (2) ¦ Brain responds to mistakes within 10 seconds in front part of brain coming from the interior cingulate¦ OCD patients have a bigger ERN; have a stronger response to mistakes
¬ Body dysmorphic Disorder ¦ Pre-occupied with an imagined or exaggerated defect in appearance¦ Engage in compulsive behaviors specific to their appearance¦ High levels of shame, anxiety, and depression¦ Occurs slightly more often in women ¦ Nearly all have another disorder
¬ DSM-5 criteria hoarding disorder ¦ Persistent difficulty discarding or parting with possessions, regardless of their actual value¦ Perceived need to save items¦ Distress associated with discarding¦ The symptoms result in the accumulation of a large number of possessions
¬ Treatment of Obsessive-Compulsive and Related Disorders medications • SSRIs• Tricyclic antidepressants
Treatment of Obsessive-Compulsive and Related Disorders Exposure plus response prevention (ERP) • Not performing the ritual exposes the person to the full force of the anxiety provoked by the stimulus• The exposure results in the extinction of the conditioned response (the anxiety)
¬ Treatment of Obsessive-Compulsive and Related Disorders Cognitive therapy • Challenge beliefs about anticipated consequences of not engaging in compulsions¦ Usually also involves exposure
¬ Posttraumatic stress disorder (PTSD) ¦ Extreme response to severe stressor• Anxiety, avoidance of stimuli associated with trauma emotional numbing¦ Exposure to a traumatic event that involves actual or threatened death or injury E.g. war, rape, natural disaster
¬ Posttraumatic stress disorder (PTSD) (2) ¦ Symptoms present for more than a month¦ Women and PTSD • Rape most common type of trauma
¦ Four categories of symptoms of PTSD • Intrusively re-experiencing the traumatic event; Nightmare, intrusive thoughts, or images• Avoidance of stimuli; refuse to walk on street where rape occurred
¦ Four categories of symptoms of PTSD (2) • Other signs of mood and cognitive changes; memory loss, negative thoughts and emotions, self-blame, blaming others, withdrawal• Increased arousal and reactivity;Irritability, aggressiveness, recklessness or self destructiveness, insomnia
¬ Acute Stress Disorder (ASD) ¦ Symptoms similar to PTSD¦ Duration shorter• Symptoms occur between 3 days and 1 month after trauma¦ As many as 90% of rape victims experience ASD¦ ASD predicts higher risk of PTSD within 2 years
¬ etiology of PTSD ¦ most trauma survivors do not develop PTSD¦ avoidance ¦ Negative trauma-related cognitions: Self, world, blame, may predict onset of PTSD• Predict treatment (exposure and CT) change in symptoms
¬ Prevention of PTSD ¦ Battlemind: preparation for soldiers¦ Propranolol soon after trauma¦ Morphine soon after trauma
¦ Psychological debriefing • 1 sessions given to all individuals post trauma • promotes expression of emotion, normalization• doesn’t help and might be harmful
¦ Brief CBT • several sessions given to those at risk shortly after• Psyched, imaginable exposure, CR, reverse avoidance• Works
¬ Treatment of PTSD Medications (SSRIs)• Relapse common if medication is stopped
¦ Treatment of PTSD Prolonged exposure (PE) therapy • Either direct (in vivo) or imaginable¦ Virtual reality (VR) effective• More effective than medication or supportive therapy• Treatment can be difficult at first¦ Possible increase in symptomatology
Treatment of PTSD cognitive therapy ¦ Enhance beliefs about coping abilities¦ Adding CT to exposure does not improve treatment¦ Cognitive Processing Therapy

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