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95 Cards in this Set
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Somatoform disorders
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Characterized by physical symptoms that suggest a physical disorder but for which there is 1) no organic findings to explain the symptom and 2) strong evidence or suggestion that the symptoms are linked to psycholgical factors or conflicts
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What were somatoform disorders formally called?
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hysterical neurosis or conversion reaction
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Medically unexplained symptoms account for what percentage of problems confronted everyday by physicians?
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25% to 50%
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Pain Disorder
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The experience of severe and prolonged pain that is either greatly in excess of what might be expected from the medical problem causing it, or that occurs without any organic symptoms discovered.
Complaints may be used to evoke social responses (i.e. attention). Can be acute or chronic. |
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Acute pain
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Has a duration of less than 6 months. Overraction to pain, associated with some specific event or injury of recent origin.
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Chronic pain
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Having a duration of 6 months or longer. Overraction to pain that is enduring and becomes a focus of that persons life.
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Biopsychosocial model
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Interactional view that emphasizes the interaction among biological, psychological, and social factors in determining behavior and body function.
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Treating Acute Pain
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Generally aimed at reducing the patients anxiety through a trusting Dr-patient relationship, and also through neducation for anxiety and depression.
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Operant Conditioning
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Clinicians who use this in treating pain focus on pain behaviors , and the conditions that strengthen or weaken these behaviors.
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Cognitive Behavioral Therapy
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Pain is a learned response. Occurs by means of observational learning and modeling. - expectancies reguarding pain intensity and behavioral responses to pain are partially based on prior learning history.
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Where do cognitive behavioral focus their attention?
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On strengthening coping stratagies that are useful in modifying the pain experience, elevating mood, and improving overall quality of life.
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Biofeedback
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Provides a way of extending self control procedures to deal with a variety of physiological behaviors that were formerly thought to be involuntary responses, such as heart rate, blood pressure, and brain waves.
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Psychotherapy
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May be helpful in reassuring and encouraging patients suffering from pain to comply with recommend rehibilitation programs.
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What are pain disoders
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They are biobehavioral phenomenon
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What is pertinent to understanding and treating pain patients?
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the patients vulnerabilities, precipitating factors, and mainataining processes
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Somatization disorders
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(Briquet's syndrome) Disorders characterized by a variety of dramatic but vague complaints that are often chronic and which have no discernible cause.
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Common complaints of Somatization disorders
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Headaches, fatigue, heart palpitations, fainting spells, nausea, vomiting, abdominal pain, bowel troubles, allergies, menstraul and sexual problems
Complaints are usually presented in a dramatic, vague, or exagerated way. |
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DSM-IV-TR's criteria for this disorder
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At least 4 pain symptoms in different body sites. 2 gastrointestinal symptoms w/o pain, 1 sex. symptom w/ pain, 1 symptom or defect suggesting a neurological symptom
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Patients with somo. disorders
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believe that they are sick, provide long and detailed histories in support of their belief, and take large quantities of meds.
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Hypochondriasis
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focus on fear of having a specific disease or diseases.
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Somatizing disorders mainly occur in...
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Women and about 1% of women have it
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Conversion Disorders
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report of loss in part or all of some basic bodily function, i.e. blindness, deafness, paralysis
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Onset of conversion disorders
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Usually occurs after a stressful experience that is quite sudden
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Hyteria or Hysterical disorders
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Presence of a physical problem with no physical cause
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Hypochondrasis
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Person has a persistant belief (lasting 6 months or longer) that he or she has a serious illness despite medical reassurance, a lack of physical findings, and failure to help the disease. Show poor insight that they do not recognize the concern is excessive.
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Three major characteristics of Hypochondrasis
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1)physiological arousal 2) a bodily focus and 3) behaviors designed to avoid or check for physical illness
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Most theraputic apprioaches to the disorder
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1) establish a theariputic relationship
2) acknowledge the distress caused by the individuals concerns 3) elicit the persons fears and beliefs about their physical health 4) present alternative rational explanations and explain why the persons ideas may be mistaken |
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Body Dysmorphic Disorders (BDD)
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Have a definite preoccupation with an imagined defect or morbidly excessive concern about a minor unwanted feature of their physical appearence.
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Esential feature of BDD
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Belief in an imagined defect in appearance
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BDD causes
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distress or impairment in social situations
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Muscle dysmorphia
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A form of BDD; Preoccupation with extensively muscled physique as an ideal. Primarily found in men
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Treatmen for BDD
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Cognitive-behavioral therapy, therapist ususally respons to this problem by stressing the problem of BDD and the therapy is designed to change body image not appearence
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Factitious disorders
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Conditions are physical and psychological and are voluntarily self-induced by the patient- the only goal is the desire to assume the role of patient; manufature symptoms
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When do Fact. Disorders typically begin and is found much more in?
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Early adulthood, more in women than men
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Munchausen Syndrome
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extreme type of Factitious disorder; marked by repeated knowing, stimulation of disease for the sold purpose of obtaining medical attention.; they fake symptoms and tell incredible tales; named after Baron von Munchausen
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Factitious disorder by proxy
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A form of Munchausen syndrome, mother produces the symptoms of diease in her child.
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Malingering
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They seek medical care and hospitalization in order to achieve some specific goal such as compensation, a disability pension, or evasion of the police
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Anxiety
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Diffuse, vague, very unpleasant feeling of fear and apprehension.
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An Anxious person
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Worries alot, particularly about unknown dangers.They show combos of rapid heart rate, shortness of breath, dizziness, sweating, sleeplessness, frequent urination, and tremors.
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Fear
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Difference between anxiety and fear is that people with fears can easily state what they are afraid of.
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Characteristics of anxiety
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uncertainty, helplessness, and physiological arousal
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anxietas and angor
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Roman words; anxietas indicates a lasting state of fearfullness
angor indicates a momentary state of intense fear- our concept of panic |
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Generalized anxiety disorder
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marked by chronic anxiety over a long period (at least several months)- consists of prolonged, vague, unexplained, but intense fears that do not seem to be attached to any particular object.- resemble normal fears but there is no actual danger
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Phobic disorders
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Anxiety has an identifiable cause- when the stimulius is not present the tension level is relativley low. - their fears are out of proportion with reality and beyond their control.
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Panic Disorder
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consists of recurrent, sudden anxiety attacks in which the individual experiences intense terror and dread. - have a sudden onset.
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Neurosis
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Used to be used to desribe disorders marked by anxiety, personal dissatisfaction, and innapropriate but not psychotic behavior.
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Anxiety Disorders
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20% have been diagnosed with Anxiety disorders
They frequently co-occur with other conditions |
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In GAD anxiety persists for
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6 months or longer
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Symptoms of GAD
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worry, hypervigilance, motor tension and excessive autonomic activity
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% of population that a GAD in any given year
& When it tends to become evidant |
3%, between late teens and early 20's
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In GAD both ___ and ____ seem to be involved
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biology and enviornment
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The brain center that plays an important role in the experience of anxiety
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amygdala
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Panic Attack
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A rapidly rising urge of intense anxiety that occurs suddenly, either with or without clear cues, in an unpredictable fashion.
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The % of the population with panic disorder
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1.7, it tends to run in families
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What triggers panic attacks
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Stressful life events
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How the DSM-IV-TR defines panic disorder
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recurrent, unexpected panic attacks at least 1 month of persistant concern over having them again- marks of panic attacks are severe palpaitations, extreme shortness of breath, chest pains or discomfort, and a feeling of helplessness- victims fear they are going to die, go crazy or do sumthing uncontrolled.
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Panic disorder affects
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women more than men and younger ages more than elderly
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A person who has a panic attack develops anticipatory anxiety
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he or she becomes worried and tnese and afraid that the panic attack will recur
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Imipramine
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drug used in treatment of depression, has been shown to prevent the recurrence of panic attacks, but no effect on anticipatory anxiety- means that people may feel anxious but wont experience a panic attack- decreases frequency of sodium lactate-provoked panic attacks
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Stress is a triggering factor in panic attacks...
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how well one copes with stress depends on vulnerability factors, and resiliance
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Phobia
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fear, panic, dread, or fright
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Most common fear-arousing stimuli
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Animals, objects, or events that presented real dangerin the earlier stages of human evolution- they do not need the actual presence of the feared object to experience intense tension or discomfort
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Soical Phobias
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Characterized by fear and embaressment in dealings with others. often persons greatest fearis that signs of intense blushing, tremors of the hand, and quivering voices will be detected by ppl whom he/she comes into contact
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Social phobias begin...
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in late childhood or early adolescence, then may crystalize into a phobia in late adolenscence.
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Prominent feature of Social Phobia
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Blushing
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Diagnosis of social phobia
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anxiety that is chronic, pervasive, and disabling across diverse situations that involve contact with others
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agoraphobia
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fear of entering certain fear-evoking or unfamiliar situations, which often accompanies panic attacks - afraid of his or her own internal cues. - they dread the awful anxiety of a panic attack and is afraid of losing control in a crowd.
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When does Agoraphobia begin
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usually in late teens
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How agoraphbic people are helped
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when they learn from a therapist how to identify and correct maladaptive thoughts about anxiety and consequences- cognitive and behavioral techniques are effective
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Association between childhood seperation anxiety and agoraphobia is stronger in?
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more women than men
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Obsessive-compulisve disorder
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shows the driven quality od the thoughts and rituals seen in people with this condition- have recurrent obsession or compulsions that are severe enough to be time-consuming or cause marked distress or significant impairment
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Obsessive behavior
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Unable to get an idea out of the mind
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Compulsive behavior
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feel compelled to perform a particular act or series of acts over and over again
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Obsessions ususally involve
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doubt, hesitation, fear of contamination or fear of ones own aggression
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Most common forms of compulsions are
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checking, odering, counting, touching and washing
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About ___ % of people with obsessive compulsive disorder have intrusive thoughts but do not act on them
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25
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United States and Canada's figures
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1.9 to 3.1 cases per 100 people with the usual age of onset between ages 20 and 29
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Obsessive Compulisve most common among...
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upper-income individuals who are somewhat more intelligent than average, tends to begin in late adolecence and early adulthood, and males and females are =ly likely to suffer.
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One of most dramatic forms of obsessive compulsive
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Hoarding- they collect collect and collect
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Four broad types of preoccupations of OC
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1) checking 2) cleaning 3) slowness 4) doubting and conscientiousness - these often increase during times of stress
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Peopl who suffer from OC
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are very cautious, they unreasonably anticipate catastrophe and loss of control- they fear what might happen to them
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DSM-IV-TR criteria for OC
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having recurrent and persistant thoughts, impulses, or images that are not simply general worries and real-life problems
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differential diagnosis
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a decision as to which of several diagnoses is most appropriate
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Whats helpful for patients with OCD
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certain serotonin-related drugs (Prozac) are helpful with sum patients
Cognitive-behavioral therapies are promising |
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Posttraumatic Stress Disorder (PTSD)
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Development of symptoms in response to events of such severity that most people would be stressed by them. Symptoms often include a feeling of numbness in response or psychological reexperiencing of the event in thoughts, dreams, and nightmares
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PTSD percentage of the general population
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.5% in men and 1.2% in women
Americans currently have a 5-10% chance of developing PTSD at some time during their lifetimes |
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DSM-IV-TR's criteria for PTSD
3 essential characteristics |
hyperarousal, avoidance, and reexperience- the most distressing is reexperience
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Reexperience
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involves unwanted and disruptive thoughts that interfere with normal functioning
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PTSD acute and delayed
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acute= condition begins within 3 months of the trauma
delayed= symptoms emerge more than 6 months after the event |
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People are more vulnerable to PTSD when
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they are socially withdrawn, inhibited, irritable, pessimistic, and impulsive, as well as have tendencies toward dissociation
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Frequent characteristic of PTSD
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Tendency to reexperience the event- painful intrustive recolections are common- painful guilt feelings are common, as are depression, restlessness and irritablility
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Intrusive state
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individual cannot stop having frightening thought related to the tramtic event
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Denial State
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individual ignores the implications of threats and losses, forgets important problems, and may show a withdrawal of interest in life
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Treatments of PTSD
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most widley used medications are antidepressants and benzodiazepine tranquilizers- help to reduce intrusive symptoms; psychotherapy is also good with this reducion; exposure therapy; cognitive behavioral therapy helps reduce anxiety; family and community based programs
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Two important tasks that face clinicians
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one is understanding the nature of the problem and the other is treating it
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