Chapter 5 – Trauma, Anxiety, Obsessive-Compulsive, and Related Disorders

anxiety

fight-or-flight response

cortisol

post-traumatic stress disorder (PTSD)

PTSD with prominent dissociative (depersonalization/derealization) symptoms

adjustment disorder

stress-inoculation therapy

specific phobias

Animal-type phobias

Natural environmental type phobias

Situational type phobias

Blood-injection-injury type phobias

Agoraphobia

negative reinforcement

prepared classical conditioning

applied tension technique

social anxiety disorder

panic attacks

panic disorder

anxiety sensitivity

interoceptive awareness

interoceptive conditioning

conditioned avoidance response

generalized anxiety disorder (GAD)

seperation anxiety disorder

behavioral inhibition

obsessions

obsessive-compulsive disorder (OCD)

hoarding

Trichotillomania

Excoriation

body dysmorphic disorder

exposure and response prevention

What is a key difference between adaptive fear responses and maladaptive anxiety responses?

The hypothalamus activates the adrenal-cortical system by releasing _____, which signals the pituitary gland to secrete _____, the body's "major stress hormone."

Which of the following hormones is often used as a measure of stress? A. Cortisol B. Thyroxine C. Serotonin D. Renin

Post-traumatic stress disorder (PTSD) is a consequence of:

Which of the following statements is true of post-traumatic stress disorder (PTSD)? A. Common events, such as traffic accidents, are rarely associated with PTSD. B. About 25 percent of adults will develop PTSD at some time in their lives. C. Even the mildest symptoms of PTSD prevent normal functioning. D. Women are at greater risk of developing PTSD than men.

Janie's house was broken into and the perpetrator brutally attacked her. Since then, she has been dreaming about the attack and often wakes up screaming and crying. According to Janie, she feels as though she is reliving the attack in each dream. Janie is most likely:

Janie's house was broken into and the perpetrator brutally attacked her. Since the attack, she has withdrawn from family and friends. Janie is most likely:

Janie's house was broken into and the perpetrator brutally attacked her. Since the attack, she has been overly cautious and watchful. The smallest noise startles her. If someone looks at her "strangely," she becomes very anxious. Janie is most likely:

Post-traumatic stress disorder (PTSD) sufferers may report _____ about having lived through a traumatic event.

Which of the following is least likely to cause post-traumatic stress disorder (PTSD)? A. Natural disasters B. Child birth C. Physical abuse D. War-related trauma

Which of the following environmental, social, and psychological factors increases an individual's vulnerability to post-traumatic stress disorder (PTSD)? A. Having a strong support network of friends and family B. Having experienced the traumatic event first-hand C. Having adopted a non-avoidant coping strategy to deal with the traumatic event D. Having experienced no anxiety and depression symptoms before the traumatic event

_____ to be diagnosed with post-traumatic stress disorder (PTSD) and most of the other anxiety disorders including panic disorder, social phobias, and generalized anxiety disorder.

Which of the following statements is true about cross-cultural and gender differences in post-traumatic stress disorder (PTSD) symptoms? A. Mexican women are less likely to feel helpless than Mexican men after a traumatic event. B. Mexican men are less likely to get the material support they need after a traumatic event compared to Mexican women. C. The tendency to dissociate in response to severe stress is extremely rare among Latinos. D. African Americans have higher rates of PTSD compared to whites, Hispanics, and Asian Americans.

Which of the following is true of the brain areas of post-traumatic stress disorder (PTSD) sufferers? A. The amygdala appears to be less responsive to emotional stimuli. B. The medial prefrontal cortex tends to be unregulated. C. The hippocampus may shrink due to overexposure to neurotransmitters and hormones. D. The medial prefrontal cortex is more active in the case of severe symptoms of PTSD.

Which of the following statements is true of acute stress disorder? A. It is diagnosed when symptoms arise within one month of exposure to a stressor and last no longer than six months. B. The sufferer of acute stress disorder persistently avoids reminders of the trauma and is constantly aroused, but does not reexperience the trauma. C. To receive the diagnosis, individuals must exhibit at least one dissociative symptom. D. In acute stress disorder, dissociative symptoms are common, including detachment, derealization, and depersonalization.

When they are not exposed to trauma reminders, post-traumatic stress disorder (PTSD) sufferers tend to have resting levels of cortisol that are:

The overexposure of the brain to _____ may cause memories of the traumatic event to be planted more firmly in memory.

Which of the following is a heritable risk factor for PTSD? A. Overdeveloped medial prefrontal cortex B. Fraternal twins among first-degree relatives C. Abnormally low cortisol levels D. Higher volume of the hippocampus

Patrick is a Vietnam War veteran who has a recurring nightmare of being on the frontline. Any sound that remotely resembles gunfire makes him anxious. Although he has been suffering for years with this problem, he now decides to seek treatment. His psychologist has suggests that he identify the thoughts and situations that evoke anxiety and rank them. His psychologist begins to help him work through each situation by using relaxation techniques. This technique is called:

Almost _____ of people with a specific phobia never seek treatment.

Which of the following biological treatments has been successful in dealing with post-traumatic stress disorder (PTSD) symptoms such as nightmares, irritability, and sleep problems? A. MAOIs and SSRIs B. SSRIs and benzodiazepines C. Benzodiazepines and tricyclics D. Tricyclics and barbiturates

Which diagnosis is most likely when panic attacks that are not usually provoked by any particular situation become a common occurrence, leading one to begin to worry about having the attacks and change behaviors as a result?

Ruth is afraid of being in large open spaces. She is especially worried that she will not be able to leave the area if she begins to panic. Ruth is most likely experiencing _____.

Tina and her parents live on a farm where field mice are very common. One night, a mouse crawled on Tina while she was sleeping. The experience frightened Tina so badly that she now avoids any situation where she might come across a mouse. She always checks her bed carefully each night. Tina is most likely exhibiting behaviors related to _____.

Bradley was 12 years old when lightning struck his home. Now he becomes very anxious every time the sky darkens. If a storm begins, he exhibits panic symptoms and frantically searches for an area in the house where he feels safe. Bradley is most likely suffering from _____.

Susan is deathly afraid of the wind since she and her family survived Hurricane Ike. She gets very worried and panicky when the sky gets dark and the wind begins to blow. Susan is most likely experiencing:

When June was 7 years old, she and her mother were stuck in an elevator. Several other people were in the elevator as well. The elevator became hot and stuffy, and breathing became difficult. June remembers experiencing shortness of breath, palpitations, and dizziness. Now June refuses to ride elevators. When she is with other people, she makes excuses to use the stairs. June is probably suffering from _____.

Janelle is terrified of needles and the sight of blood. When she was younger, she had to have several stitches because of a bicycle accident. The cut on her forehead was deep and bled profusely. At the sight of blood, Janelle feels her blood pressure and heart rate drop, and on one occasion, she even fainted. Janelle is most likely suffering from _____.

Which of the following phobias is more likely to run in families? A. Natural environment type phobias B. Blood-injection-injury type phobias C. Situational type phobias D. Animal-type phobias

According to Freudian theory, phobias develop when:

Which of the following behavioral theories has been useful in explaining the reinforcement of phobias? A. Observational learning B. Operant conditioning C. Social-cognitive learning D. Social learning

June has been avoiding riding elevators since she was 7 years old. When she is with other people, she makes excuses to use the stairs and feels relief upon avoiding elevator rides. June's fear of elevators is being maintained by _____.

Theorists who argue that phobias can develop through observational learning posit that:

Trudy's mother is afraid of bees. Her mother always screams and runs away every time she sees them. Trudy, seeing her mother's response, also runs and screams every time she sees a bee. In this case, Trudy's behavior can be explained by which theory?

The idea that people learn to fear or avoid selected objects or situations that are vestiges of evolutionary history, and individuals are biologically prepared to quickly associate fear responses with certain objects is called _____.

According to the prepared classical conditioning theory, Rachel is more likely to be afraid of which of the following? A. School B. Snakes C. Parties D. Flying

The most significant problem with the behavioral theory of phobias is that:

Anna is terrified of speaking in public. She always finds an excuse to avoid public speaking or gets someone to speak for her. Once Anna had a full-blown panic attack when her boss called on her unexpectedly to speak at a meeting. Anna is most likely exhibiting symptoms of:

Which of the following would be most useful in treating blood-injection-injury phobias? A. Systematic sensitization B. Modeling C. Applied tension technique D. Flooding

Drake has a fear of dogs. As part of his therapy, Drake must first observe his therapist petting a dog and then, when instructed, must do the same. Which behavioral treatment is most likely being used in this situation?

What differentiates flooding from systematic desensitization?

Julie has been diagnosed with ornithophobia—the fear of birds. For her treatment, her therapist makes her sit in a room filled with caged birds for several hours. Which behavioral treatment in being used in this situation?

Which of the following statements is true about social phobia? A. Social phobia is relatively common, with a lifetime prevalence of about 3 percent in the United States. B. Social phobia tends to develop in either late adolescence or early adulthood. C. Over 90 percent of adults with social phobia report severe childhood trauma that contributed to their symptoms. D. Social phobia often co-occurs with mood disorders, other anxiety disorders, and avoidant personality disorder.

Which of the following is true of cognitive theorists' perspectives on social anxiety disorder? A. They view social anxiety disorder as merely a behavioral problem with no cognitive factors contributing to the behavior. B. They suggest that social anxiety disorders are rooted in early childhood experiences. C. They argue that people with social anxiety disorders tend to focus on the negative aspects of social situations. D. They posit that people with social anxiety disorders externalize their anxiety of the social situation and make others uncomfortable.

According to the cognitive theories of phobias, people with social phobias:

What therapy can individuals can practice their feared behaviours in front of others while the therapist coaches them in the use of relaxation techniques.

Which of the following statements about panic disorder is true? A. People with panic disorder often fear they have life-threatening illnesses, though they are less likely to have a personal or family history of serious chronic illness. B. Many people with panic disorder feel ashamed of it and try to hide it from others. C. About 28 percent of people will develop panic disorder at some time, usually between late adolescence and the mid-thirties. D. People with panic disorder may become demoralized and depressed but rarely do they become suicidal.

Family history studies reveal that the heritability of panic disorder is _____.

Fluctuations in _____ levels might cause imbalances or dysfunction of the serotonin or GABA systems in females, leading to panic attacks.

Gerald has been diagnosed with obsessive-compulsive disorder (OCD). He has been taking his medicine regularly, but has begun to experience side effects such as constipation and drowsiness. Which drug is he most likely taking for his symptoms?

Sally believes that the bodily symptoms she experiences during a panic attack have harmful consequences. This is known as _____.

Which of the following theories have been integrated into a model to explain the factors associated with panic disorders? A. Biological and cognitive B. Cognitive and social C. Social and biological D. Biological, psychological, and social

Which of the following is true about the integrated model of panic disorder? A. Many people who experience panic disorders have recurrent panic attacks because of structural damage to the brain. B. Panic disorders seem to develop as a result of a biological vulnerability to a hypersensitive fight-or-flight response. C. People will not typically develop a panic disorder if they engage in constant catastrophizing cognitions about their physiological symptoms. D. Avoidance of situations that evoke panic attacks remains isolated to those specific situations, and has no occasion to generalize to other situations.

Jacob has been diagnosed with panic disorder without agoraphobia. He was taking his medication regularly until recently. Since discontinuing his medication, he is experiencing severe withdrawal symptoms and rebound of anxiety symptoms. Which medication was Jacob most likely taking?

Which of the following suppresses the central nervous system and influences functioning in the GABA, norepinephrine, and serotonin neurotransmitter systems? A. Tricyclic antidepressants B. Benzodiazepines C. MAOIs D. SSRIs

Cognitive theorists suggest that people who experience panic attacks engage in all of the following behaviors EXCEPT: A. paying close attention to their bodily sensations. B. reasoning that the attack is only a temporary response. C. misinterpreting bodily sensations in a negative way. D. engaging in snowballing catastrophic thinking.

Terrence has been seeing a therapist for his recurrent panic attacks. His therapist teaches him relaxation techniques to help him gain control over his anxiety symptoms. Terrence is also taught to identify the thoughts that are intrusive and aggravate his symptoms. He is encouraged to note these thoughts in a daily journal. Terrence's therapist is most likely using _____ to treat his panic disorder.

Which of the following treatments is most effective in preventing relapse in clients with panic disorders? A. Cognitive therapies B. Biological therapies C. Behavioral therapies D. Cognitive-behavioral therapies

Children with a genetic predisposition toward anxiety or who are behaviorally inhibited may not develop a specific phobia, unless:

People diagnosed with generalized anxiety disorder (GAD):

Judith worries daily about whether her husband made it safely to work, how her children are getting on in school, what she should cook for dinner, and if the family will be satisfied with the meal she prepares. Judith is sluggish most of the time, and has trouble concentrating on positive things. Judith is most likely suffering from:

Which of the following applies to generalized anxiety disorder (GAD)? A. People with GAD often feel tired due to chronic muscle tension and sleep loss. B. GAD most commonly begins in late adolescence or early adulthood. C. GAD has a lifetime prevalence of about 25 percent in women and men. D. Other anxiety disorders generally do not co-occur with GAD.

Cognitive theorists maintain that people with generalized anxiety disorder (GAD) focus on threats at both the _____ levels.

According to cognitive theory, which of the following statements is true about people diagnosed with generalized anxiety disorder (GAD)? A. They are always anticipating a negative event, and they tend to think it through. B. They believe that worrying can help them avoid bad events by motivating them to engage in problem solving. C. They actively conjure up visual images of what they worry about, as a way of habituating to the negative emotions associated with the event. D. Their chronic anxiety is the result of having had highly controlled and predictable experiences in their childhood.

People diagnosed with general anxiety disorder are thought to have deficient levels of:

The _____ drugs such as Xanax, Librium, Valium, and Serax provide short-term relief from anxiety symptoms but have side effects and addictiveness that preclude long-term use.

_____ are thoughts, images, ideas, or impulses that are persistent, that uncontrollably intrude upon consciousness, and that cause significant anxiety or distress.

_____ are repetitive behaviors or mental acts that an individual feels he or she must perform.

Lee is a high school teacher. He has difficulty grading his papers because he constantly checks and rechecks the students' answers. He fears that he has made a mistake in the calculations. Lee's checking routines are not limited to his students' work. He also checks the locks on his classroom door several times before leaving school, and performs these kinds of rituals at home as well. Lee is most likely exhibiting:

Which of the following is an example of an obsession? A. Repeatedly checking the locks on all doors B. Constantly thinking about cleanliness and contamination C. Washing hands several times a day D. Spending hours sorting and resorting possessions

Which of the following is an example of a compulsion? A. Repeatedly checking the locks on all doors B. Constantly worrying about cleanliness and contamination C. Spending hours thinking about the orderliness of the house D. Fearing incessantly about the welfare of loved ones

Which of the following is a true statement about obsessive-compulsive disorder (OCD)? A. People with OCD do not know that their thoughts and behaviors are irrational. B. Obsessive thoughts are distressing to people with OCD. C. Children with OCD often confide in their parents about their obsessive-compulsive habits. D. The prevalence of OCD seems to differ greatly across countries that have been studied.

The statement "often, the link between the obsession and the compulsion is the result of 'magical thinking'" means that the person with OCD believes that repeating a behavior a certain number of times will:

According to cognitive-behavioral theories of obsessive-compulsive disorder (OCD), all of the following are true about people diagnosed with OCD EXCEPT: A. they may be depressed or generally anxious much of the time, so even minor negative events are more likely to invoke intrusive, negative thoughts. B. they judge their negative, intrusive thoughts as more unacceptable than most people would and become more anxious and guilty about having them. C. they appear to believe that they should be able to control all thoughts, and have trouble accepting that everyone has horrific notions from time to time. D. they believe that having intrusive thoughts means they are going crazy, but they do not equate having the thoughts with actually engaging in the behaviors.

People with obsessive-compulsive disorder (OCD) often get some relief from their symptoms when they take drugs that better regulate the neurotransmitter _____.

According to cognitive-behavioral theories of obsessive-compulsive disorder (OCD), compulsions develop largely through _____.

Which of the following statements is true of the biological treatments for obsessive-compulsive disorder (OCD)? A. Benzodiazepines are useful in most cases. B. Patients generally do not relapse once they discontinue medication. C. Antidepressant drugs affecting serotonin levels help reduce symptoms of OCD. D. Controlled studies suggest that placebos are more effective than antidepressant medication.

_____ involves repeatedly exposing the client to the focus of an obsession and preventing compulsive responses to the resulting anxiety.

In exposure and response prevention therapy, repeated exposure to the content of the obsession:

In exposure and response prevention therapy, by preventing a person from engaging in compulsive behavior:

Which of the following is a good example of the use of exposure and response prevention therapy? A. A person afraid of germs is allowed to clean his or her hands as often as desired. B. A person afraid of flying is taught to first imagine buying an airline ticket. C. A person afraid of having a disorganized room is taught to reappraise her or his current room in a more positive way. D. A person afraid of contamination is asked to hold a dirty handkerchief for more than an hour.

Which of the following disorders is most common among adults over age 65? A. Panic disorder B. Obsessive-compulsive disorder C. Post-traumatic stress disorder D. Generalized anxiety disorder

Briefly describe the four categories of phobias. Provide examples of each.