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Abnormal Psychology. WEB. Anxiety as a Normal and an Abnormal Response. Some amount of anxiety is “normal” and is associated with optimal levels of functioning. Only when anxiety begins to interfere with social or occupational functioning is it considered “abnormal.”. The Bell Curve.

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Anxiety as a Normal and an Abnormal Response

  • Some amount of anxiety is “normal” and is associated with optimal levels of functioning.

  • Only when anxiety begins to interfere with social or occupational functioning is it considered “abnormal.”



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Phobic Disorders

  • Phobias

  • Specific phobias

  • Social phobia

  • Agoraphobia



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Social Phobia

  • General characteristics

    Fear of being in social situations in which one will be embarrassed or humiliated


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Panic Disorder With and Without Agoraphobia

  • Panic disorder

  • Panic versus anxiety

  • Agoraphobia

  • Agoraphobia without panic




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Treating Anxiety Disorders

  • Medications

  • Behavioral and cognitive-behavioral treatments


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Generalized Anxiety Disorder

  • General characteristics

  • Prevalence and age of onset

  • Comorbidity with other disorders


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Generalized Anxiety Disorder:Biological Causal Factors

  • Genetic factors

  • A functional deficiency of GABA

  • Neurobiological differences between anxiety and panic


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Obsessive-Compulsive Disorder

  • Obsessions- repetitive unwanted ideas that the person recognizes are irrational

  • Compulsions- repetitive, often ritualized behavior whose behavior serves to diminish anxiety caused by obsessions


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Post-Traumatic Stress Disorder

  • Critical Component

    • Symptoms occurs AFTER a traumatic stressor


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Symptoms Categories

  • Intrusive

    • distressing recollections

    • dreams

    • flashbacks

    • psychological trigger reactions

    • physiological trigger reactions


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Symptoms Categories

  • Avoidance

    • avoid thoughts, feelings or discussions

    • avoid activities, places

    • memory blocks

    • anhedonia (without pleasure)

    • numb

    • alexithymia (emotions unknown)

    • feeling of doom


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Symptom Categories

  • Hyperarousal Symptoms

    • sleep disturbance

    • anger problems

    • concentration

    • startle response

    • “on guard” hypervigilence


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Mood Disorders

  • Major Depressive Disorder

  • Bipolar I and Bipolar II

  • Cyclothymia

    • Hypomania

  • Dysthymia

  • Schizoaffective disorder


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Categories of Personality Disorders

  • Cluster A

    • Paranoid

    • Schizoid

    • Schizotypal


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Personality Disorders

  • Paranoid personality disorder

  • Schizoid personality disorder

  • Schizotypal personality disorder

  • Histrionic personality disorder


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Categories of Personality Disorders

  • Cluster B

    • Histrionic

    • Narcissistic

    • Antisocial

    • Borderline


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Categories of Personality Disorders

  • Cluster C

    • Avoidant

    • Dependent

    • Obsessive-compulsive


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The Clinical Picture in Schizophrenia

  • Positive symptoms

    • Delusions: fixed firm beliefs with no basis in reality

      • Most common are grandiose, persecutory and referential

    • Hallucinations: disturbances in perception

      • Can occur in any of the five senses

        • Most common are auditory and visual


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The Clinical Picture in Schizophrenia

  • Formal Thought Disorder (a positive symptom)

    • Disturbances in speech that reflect underlying problems in cognition or thinking

      • Most common forms are tangentiality and circumstantiality

      • Less common are neologisms, word salad and clang associations


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The Clinical Picture in Schizophrenia

  • Negative symptoms (Nancy Andreasen)

    • Avolition

    • Anhedonia

    • Alogia

    • Flat Affect

    • Asociality


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The Classic Subtypes of Schizophrenia

  • Undifferentiated type

  • Catatonic type

  • Disorganized type

  • Paranoid type



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Substance-Related Disorders Methods of taking substances:

7 sec

inhaling

20 sec

IV

4 min

snort

or

Intramuscular

injection

30 min

oral


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When is addiction addiction?

  • What is substance use?

  • What is substance abuse?

  • What is substance dependence?

    Where is the line???????


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Substance Abuse

leads to impairment or distress

one of these within 1 yr:

failure to full fill role obligations

physically hazardous

legal problems

persistent social problems

Substance Dependence

leads to impairment or distress

3 of the following:

tolerance

withdrawal

delirium tremens (DTs)

take more than intended

persistent desire

fail to control use

lots of time spent obtaining, using, or recovering from

use in place of activities

continuing despite physical or psychological problems

DSM-IV Criteria


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Solomon’s Opponent Process Theory of Addiction

  • Basic Premise- People take, abuse and become dependent on drugs because of the effect of these drugs

  • The Clements Corollary- noone ever becomes addicted to thorazine

    • A State- the initial pleasant effect

    • B State-unpleasant effects occurring as a result of drug withdrawal


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The Clinical Picture of Alcohol Abuse and Dependence

  • Alcohol’s effects on the brain

  • Physical effects of chronic alcohol use

  • Psychosocial effects of abuse and dependence


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Short-term effects:

absorbed from the stomach into the blood

metabolized by the liver (1 oz/hr)

it is a drug

acts within brain to:

stimulate GABA receptors

reduces tension

 dopamine/serotonin levels

pleasurable aspects of intoxication

inhibits glutamate receptors

diminishes cognitive abilities

Long-term effects:

reduced food intake

ETOH: no nutrient value

impairs food digestion

results in vitamin deficiency

B-complex

can lead to brain damage/amnesia

kills brain cells

leads to loss of gray matter from the temporal lobes

Korsakoff’s Syndrome

suppresses the immune system

Alcohol (ETOH)


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Alcohol (ETOH)

  • A “drink”:

    • 1 oz. Spirits = 1 glass wine = 1 beer

  • DWI (Driving while intoxicated)

    • takes approximately 2-4 drinks over one hour

    • lighter weight, empty stomach will require less

    • legal blood alcohol limit (.10%)

  • DUI (Driving under the influence)

  • The CAGE


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Alcohol Addiction: Treatment

  • Admitting the problem

    • a prerequisite for therapy (video clip)

  • Inpatient Hospital treatment

    • expensive & does not lead to better results

    • may be necessary for safe detoxification

  • Aversion therapy

    • Antabuse - drug that creates nausea

    • uses operant conditioning principles

  • Controlled drinking training

  • Self-Help groups

    • Alcoholics Anonymous


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