Chapter 4 Handouts

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Unformatted text preview: Chapter 4 Handouts Chapter 4 Handouts Anxiety Disorders Anxiety 0. What distinguishes fear from anxiety? 0. Fear is a state of immediate alarm in response to a _______________________________________ 1. Anxiety is a state of alarm in response to a _______________________________________ 2. Both have the same _______________ features: increase in respiration, perspiration, muscle tension, etc. Anxiety 1. Is the fear/anxiety response useful/adaptive? 3. Yes, when ________________________ is protective 4. However, when it is triggered by “________________” situations, or when it is too severe or long­lasting, this response can be disabling 0. Can lead to the development of anxiety disorders Anxiety Disorders 5. Most common mental disorders in the U.S. 1. In any given year, ____% of the adult population in the U.S. experience one or another of the six DSM­IV anxiety disorders 0. Only ~20% of these individuals seek treatment 6. Most individuals with one anxiety disorder suffer from a second disorder, as well 7. Anxiety disorders cost $42 billion each year in health care, lost wages, and lost productivity Anxiety Disorders 2. Six disorders: 8. Generalized anxiety disorder (GAD) 9. Phobias 10. Panic disorder 11. Obsessive­compulsive disorder (OCD) 12. Acute stress disorder 13. Posttraumatic stress disorder (PTSD) Generalized Anxiety Disorder (GAD) 14. Characterized by excessive anxiety under most circumstances and worry about practically anything 2. Vague, intense concerns and fearfulness 1. Often called “free­floating” anxiety 2. “Danger” not a factor 15. Symptoms include restlessness, easy fatigue, irritability, muscle tension, and/or sleep disturbance 3. Symptoms last at least six months Generalized Anxiety Disorder (GAD) 3.. The disorder is common in Western society 3 16. Affects ~3% of the population in any given year and ~6% at sometime during their lives 4. Usually first appears in childhood or adolescence 5. Women are diagnosed more than men by 2:1 6. Various theories have been offered to explain the development of the disorder… GAD: The Sociocultural Perspective 4. According to this theory, GAD is most likely to develop in people faced with social conditions that truly are ____________ 3. Research supports this theory (example: Three Mile Island in 1979) 5. One of the most powerful forms of societal stress is _________ 4. Why? Run­down communities, higher crime rates, fewer educational and job opportunities, and greater risk for health problems 5. As would be predicted by the model, there are higher rates of GAD in lower SES groups GAD: The Sociocultural Perspective 7. Since race is closely tied to income and job opportunities in the U.S., it also is tied to the prevalence of GAD 17. In any given year, ~6% of African Americans and 3% Caucasians suffer from GAD 6. African American women have highest rates (6.6%) GAD: The Sociocultural Perspective 8. Although poverty and other social pressures may create a climate for GAD, other factors are clearly at work 18. How do we know this? 7. Most people living in dangerous environments ______________________________________ 19. Other models attempt to explain why some people develop the disorder and others do not… GAD: The Psychodynamic Perspective 20. Freud believed that all children experience anxiety 8. Realistic anxiety when faced with actual danger 9. Neurotic anxiety when prevented from expressing id impulses 10. Moral anxiety when punished for expressing id impulses 21. One can use ego defense mechanisms to control these forms of anxiety, but when they don’t work or when anxiety is too high…GAD develops GAD: The Psychodynamic Perspective 9. Today’s psychodynamic theorists often disagree with specific aspects of Freud’s explanation 10. Researchers have found some support for the psychodynamic perspective: 22. People with GAD are particularly likely to use defense mechanisms (especially repression) 23. Children who were severely punished for expressing id impulses have higher levels of anxiety later in life GAD: The Psychodynamic Perspective 11. Some scientists question the validity of these findings: 24. There are alternative explanations of the data: 24. 11. Discomfort with painful memories or “forgetting” in therapy is not necessarily defensive 25. Some data contradict the model 12. Many (if not most) GAD clients report normal childhood upbringings GAD: The Psychodynamic Perspective 12. Psychodynamic therapies 26. Use same general techniques for treating all dysfunction: 13. Free association 14. Therapist interpretation 27. Specific treatments for GAD: 15. Freudians: focus less on fear and more on control of id 16. Object­relations therapists: help patients identify and settle early relationship conflicts GAD: The Psychodynamic Perspective 13. Psychodynamic therapies 28. Overall, controlled research has found psychodynamic approaches to be of _________________ help in treating cases of GAD 17. Short­term dynamic therapy may be beneficial in some cases GAD: The Humanistic Perspective 29. Theorists propose that GAD, like other psychological disorders, arises when people stop looking at themselves honestly and acceptingly 30. This view is best illustrated by Carl Rogers’s explanation: 18. Lack of “____________________” in childhood leads to “_______________________” (harsh self­standards) 19. These threatening self­judgments break through and cause anxiety, setting the stage for GAD to develop GAD: The Humanistic Perspective 31. Therapy based on this model is “______________” and focuses on creating an accepting environment where clients can “experience” themselves 20. Although case reports have been positive, controlled studies have only sometimes found client­centered therapy to be more effective than placebo or no therapy 21. Only limited support has been found for Rogers’s explanation of causal factors GAD: The Cognitive Perspective 14. Theorists believe that psychological problems are caused by maladaptive and dysfunctional thinking 15. Since GAD is characterized by excessive worry (cognition), this model is a good start… GAD: The Cognitive Perspective 0. Theory: GAD is caused by maladaptive assumptions 22. Albert Ellis identified ________________________: 6. It is necessary for humans to be loved by everyone 7. It is catastrophic when things are not as one want them to be 7. 8. If something is fearful, a person should be terribly concerned and dwell on the possibility that it will occur 9. One should be competent in all domains to be a worthwhile person 23. When these assumptions are applied to everyday life, GAD may develop GAD: The Cognitive Perspective 32. Aaron Beck is another cognitive theorist 24. Those with GAD hold unrealistic silent assumptions that ________________________: 10. Any strange situation is dangerous 11. A situation/person is unsafe until proven safe 33. Research supports the presence of these types of assumptions in GAD, particularly about dangerousness GAD: The Cognitive Perspective 16. What kinds of people are likely to have exaggerated expectations of danger? 34. Those whose lives have been filled with ______________________________________ 25. To avoid being “blindsided,” they try to predict events; they look everywhere for danger (and therefore see danger everywhere) 26. Theory still under investigation GAD: The Cognitive Perspective 35. Second­Generation Cognitive Explanations 27. In recent years, two new promising explanations have emerged: 12. ____________________ theory 0. Developed by Wells; holds that the most problematic assumptions in GAD are the individual’s beliefs about worrying itself 13. ____________________ theory 1. Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal 28. Both theories have received considerable research support GAD: The Cognitive Perspective 17. Two kinds of cognitive therapy: 36. ____________________________________ 29. Based on the work of Ellis and Beck 37. Helping clients understand the special role that ________________ plays, and changing their views about it GAD: The Cognitive Perspective 18. Cognitive therapies 38. Changing maladaptive assumptions 30. Ellis’s rational­emotive therapy (RET) 14. Point out irrational assumptions 15. Suggest more appropriate assumptions GAD: The Cognitive Perspective 19. Cognitive therapies 19. 39. Focusing on worrying 31. Therapists begin with psychoeducation about worrying and GAD 16. Assign self­monitoring of somatic arousal and cognitive responses 32. As therapy progresses, clients become increasingly skilled at identifying their worrying and its counterproductivity GAD: The Cognitive Perspective 20. Cognitive therapies 40. Focusing on worrying 33. With continued practice, clients are expected to see the world as less threatening; to adopt more constructive ways of coping; and to worry less 34. Research has begun to indicate that a concentrated focus on worrying is a helpful addition to traditional cognitive therapy GAD: The Biological Perspective 21. Theory holds that GAD is caused by biological factors 41. Supported by ____________________________ 35. Blood relatives more likely to have GAD (~15%) than general population (~6%) 36. The closer the relative, the greater the likelihood 17. Issue of ___________________________ The Biological Perspective 22. ___________________________ 42. 1950s – Benzodiazepines (Valium, Xanax) found to reduce anxiety 43. Why? 37. Neurons have specific receptors (______________) 38. Benzodiazepine receptors ordinarily receive gamma­aminobutyric acid (GABA, a common NT in the brain) 18. GABA is an __________________________; when received, it causes a neuron to stop firing GAD: The Biological Perspective 44. In the normal fear reaction: 39. Key neurons fire more rapidly, creating a general state of excitability experienced as fear or anxiety 40. A feedback system is triggered; brain and body activities work to reduce excitability 19. Some neurons release GABA to inhibit neuron firing, thereby reducing experience of fear or anxiety 41. Problems with the feedback system are believed to cause GAD 20. Possible reasons: ________________, ________________, ________________ GAD: The Biological Perspective 23. Promising (but problematic) explanation 45. Other NTs also bind to GABA receptors 46. Research conducted on lab animals raises question: Is “fear” really fear? 47. Issue of ______________________ 47. 42. Do physiological events CAUSE anxiety? How can we know? What are alternative explanations? GAD: The Biological Perspective 43. Biological treatments 21. Antianxiety drugs 2. Pre­1950s: barbiturates (sedative­hypnotics) 3. Post­1950s: benzodiazepines 4. Provide temporary, modest relief 5. Rebound anxiety with withdrawal and cessation of use 6. Physical dependence is possible 7. Undesirable effects (drowsiness, etc.) 8. Multiply effects of other drugs (especially alcohol) 9. 1980s: buspirone (BuSpar) 10. Different receptors, same effectiveness, fewer problems GAD: The Biological Perspective 24. Biological treatments 48. Relaxation training 44. Theory: Physical relaxation leads to psychological relaxation 45. Research indicates that relaxation training is more effective than placebo or no treatment 46. Best when used in combination with cognitive therapy or biofeedback GAD: The Biological Perspective 49. Biological treatments 47. Biofeedback 22. Therapist uses electrical signals from the body to train people to control physiological processes 23. EMG is the most widely used; provides feedback about muscle tension 48. Found to be most effective when used as an adjunct to other methods for the treatment of certain medical problems (headache, back pain, etc.) Phobias 25. From the Greek word for “fear” 50. Formal names are also often from the Greek (see “A Closer Look, p. 106) 26. Persistent and unreasonable fears of particular objects, activities, or situations 27. Phobic people often avoid the object or thoughts about it Phobias 28. We all have some fears at some points in our lives; this is a normal and common experience 51. How do phobias differ from these “normal” experiences? 0. _____________________________________ 1. Greater desire to avoid the feared object or situation 2. ______________________________________ Phobias Phobias 29. Most phobias are categorized as “specific” 52. Also two broader kinds: 49. Social phobia 50. Agoraphobia Specific Phobias 30. Persistent fears of specific objects or situations 31. When exposed to the object or situation, sufferers experience immediate fear 32. Most common: phobias of specific animals or insects, heights, enclosed spaces, thunderstorms, and blood Specific Phobias 0. ~9% of the U.S. population have symptoms in any given year 1. ~12% develop a specific phobia at some point in their lives 1. Many suffer from more than one phobia at a time 2. Women outnumber men 2:1 3. Prevalence differs across racial and ethnic minority groups 4. Vast majority do NOT seek treatment Social Phobias 33. Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur 53. May be ____________ – talking, performing, eating, or writing in public 54. May be ____________ – general fear of functioning inadequately in front of others 55. In both cases, people rate themselves as performing less adequately than is objectively true Social Phobias 56. Can greatly interfere with functioning 51. Often kept a secret 57. Affect ~7% of U.S. population in any given year 2. ~12% develop a social phobia at some point in their lives 58. Women outnumber men 3:2 59. Often begin in childhood and may persist for many years What Causes Phobias? 34. Each model offers explanations, but evidence tends to support the __________________: 35. Phobias develop through ______________ 60. Once fears are acquired, they are continued because feared objects are avoided 61. Behaviorists propose a classical conditioning model… Classical Conditioning of Phobia What Causes Phobias? 36. Other behavioral explanations 62. Phobias develop through ___________________ 52. Observation and imitation 52. 63. Phobias are maintained through ______________ 64. Phobias may develop into GAD when a person acquires a large number of phobias 53. Process of _______________________: responses to one stimulus are also elicited by similar stimuli What Causes Phobias? 65. Behavioral explanations have received some empirical support: 54. Classical conditioning study involving Little Albert 55. Modeling studies 56. Bandura, confederates, buzz, and shock 66. Research conclusion is that phobias CAN be acquired in these ways but there is no evidence that this is how the disorder is ordinarily acquired What Causes Phobias? 37. A behavioral­evolutionary explanation 67. Some phobias are much more common than others; for example: animals, blood, and heights vs meat, grass, and houses What Causes Phobias? 38. A behavioral­evolutionary explanation 68. Theorists argue that there is a species­specific biological ____________ to develop certain fears 57. Called “____________”: humans are more “prepared” to develop phobias around certain objects or situations 58. Unknown if these predispositions are due to evolutionary or environmental factors How Are Phobias Treated? 69. Surveys reveal that ~____% of those with specific phobia and ___% of those with social phobia currently are in treatment 70. Each model offers treatment approaches phobias 24. Shown to be ______________________ 25. Fare better in head­to­head comparisons than other approaches 26. Include desensitization, flooding, and modeling Treatments for Specific Phobias 71. Systematic desensitization 60. Technique developed by Joseph Wolpe 27. Teach ___________________ 28. Create ___________________ 29. Sufferers learn to relax while facing feared objects 11. Since relaxation is incompatible with fear, the relaxation response is thought to substitute for the fear response 61. Several types: 59. Behavioral techniques (_________________) are most widely used, especially for specific 30. In vivo desensitization (live) 30. 31. Covert desensitization (imaginal) Treatments for Specific Phobias 72. Other behavioral treatments: 62. Flooding 32. Forced nongradual exposure 63. Modeling 33. Therapist confronts the feared object while the fearful person observes 73. Clinical research supports each of these treatments 64. The key to success is ___________________________ with the feared object or situation Treatments for Social Phobias 39. Treatments only recently successful 74. Two components must be addressed: 65. _________________________________ 34. Address fears behaviorally with exposure 66. _________________________________ 35. Social skills and assertiveness trainings have proved helpful Treatments for Social Phobias 75. Unlike specific phobias, social phobias respond well to medication (particularly _______________ drugs) 76. Several types of psychotherapy have proved at least as effective as medication 67. ______________________________________________ ______________________________________________ 68. One psychological approach is exposure therapy, either in an individual or group setting 69. Cognitive therapies also have been widely used Treatments for Social Phobias 40. Another treatment option is social skills training, a combination of several behavioral techniques to help people improve their social functioning 77. Therapist provides feedback and reinforcement Panic Disorder 78. Panic, an extreme anxiety reaction, can result when a real threat suddenly emerges 79. The experience of “panic attacks,” however, is different 70. Panic attacks are ______, _________ _______ of panic that occur _________, _____________, and __________ 71. Sufferers often fear they will die, go crazy, or lose control 72. __________________________________________ Panic Disorder 41. Anyone can experience a panic attack, but some people have panic attacks __________, _____________, and ________________ 80. Diagnosis: Panic disorder 73. Sufferers also experience dysfunctional changes in thinking and behavior as a result 73. of the attacks 36. Example: sufferer worries persistently about having an attack; plans behavior around possibility of future attack Panic Disorder 81. Often (but not always) accompanied by agoraphobia 74. From the Greek “____________________________” 75. Afraid to leave home and travel to locations from which escape might be difficult or help unavailable 76. Intensity may fluctuate 77. There has only recently been a recognition of the link between agoraphobia and panic attacks (or panic­like symptoms) Panic Disorder 82. Two diagnoses: panic disorder with agoraphobia; panic disorder without agoraphobia 78. ~3% of U.S. population affected in a given year 79. ~5% of U.S. population affected at some point in their lives 83. Likely to develop in late adolescence and early adulthood 84. Women are twice as likely as men to be affected 85. Approximately 35% of those with panic disorder are in treatment Panic Disorder: The Biological Perspective 5. In the 1960s, it was recognized that people with panic disorder were not helped by ___________, but were helped by _________________ 86. Researchers worked backward from their understanding of antidepressant drugs Panic Disorder: The Biological Perspective 87. What biological factors contribute to panic disorder? 80. NT at work is _____________________ 37. Irregular in people with panic attacks 38. Research suggests that panic reactions are related to changes in norepinephrine activity in the locus ceruleus 81. Although norepinephrine is clearly linked to panic disorder, what goes wrong isn’t exactly understood 39. May be excessive activity, deficient activity, or some other defect 40. Other NTs and brain circuits seem to be involved Panic Disorder: The Biological Perspective 42. It is also unclear why some people have such abnormalities in norepinephrine activity 88. ______________________ is one possible reason 82. If so, prevalence should be (and is) greater among close relatives 41. Among monozygotic (MZ, or identical) twins = ____% 41. 42. Among dizygotic (DZ, or fraternal) twins = ____% 83. Issue is still open to debate Panic Disorder: The Biological Perspective 89. Drug therapies 84. Antidepressants are effective at preventing or reducing panic attacks 43. Function at norepinephrine receptors in the panic brain circuit 44. Bring at least some improvement to 80% of patients with panic disorder 45. ~50% recover markedly or fully 46. Require _____________ of drug therapy; otherwise relapse rates are high 85. Some benzodiazepines (especially Xanax [alprazolam]) also have proved helpful Panic Disorder: The Biological Perspective Panic Disorder: The Cognitive Perspective 43. Cognitive theorists and practitioners recognize that biological factors are only part of the cause of panic attacks events 91. Cognitive treatment is aimed at correcting such misinterpretations Panic Disorder: The Cognitive Perspective 44. Misinterpreting bodily sensations 92. Panic­prone people may be overly sensitive to certain __________________________ and may misinterpret them as signs of a medical catastrophe; this leads to panic 93. Why might some people be prone to such misinterpretations? 94. One possibility: Experience more frequent or intense bodily sensations Panic Disorder: The Cognitive Perspective 95. Misinterpreting bodily sensations 86. Panic­prone people also have a high degree of “anxiety sensitivity” 47. They focus on bodily sensations much of the time, are unable to assess the sensations logically, and interpret them as potentially harmful Panic Disorder: The Cognitive Perspective 96. Cognitive therapy 87. Attempts to correct peoples misinterpretations of their bodily sensations 48. Step 1: Educate clients 49. About panic in general 90. In their view, full panic reactions are experienced only by people who misinterpret bodily 50. About the causes of bodily sensations 50. 51. About their tendency to misinterpret the sensations 52. Step 2: Teach clients to apply more accurate interpretations (especially when stressed) 53. Step 3: Teach clients skills for coping with anxiety 54. Examples: relaxation, breathing Panic Disorder: The Cognitive Perspective 45. Cognitive therapy 97. May also use “_______________________” procedures to induce panic sensations 88. Induce physical sensations which cause feelings of panic: 55. Jump up and down 56. Run up a flight of steps 89. Practice coping strategies and making more accurate interpretations Panic Disorder: The Cognitive Perspective Obsessive­Compulsive Disorder 46. Made up of two components: 98. Obsessions 90. __________________________________________ __________________________________________ 99. Compulsions 91. __________________________________________ __________________________________________ Obsessive­Compulsive Disorder 47. Diagnosis may be called for when symptoms: 100. Feel excessive or unreasonable 101. Cause great distress 102. Consume considerable time 103. Interfere with daily functions Obsessive­Compulsive Disorder 104. Classified as an anxiety disorder because obsessions _________________ anxiety, while compulsions are aimed at ____________________________ anxiety 92. Anxiety rises if obsessions or compulsions are avoided 105. Between 1% and 2% of U.S. population has OCD in a given year; around 3% over a lifetime 106. Ratio of women to men is _______ 107. It is estimated that more than 40% of those with OCD seek treatment What Are the Features of Obsessions and Compulsions? 48. Obsessions 108. Thoughts that feel intrusive and foreign 109. Attempts to ignore or avoid them trigger anxiety 109. What Are the Features of Obsessions and Compulsions? 49. Compulsions 3. “Voluntary” behaviors or mental acts 0. Feel mandatory/unstoppable 4. Person may recognize that behaviors are irrational 1. Believe, though, that catastrophe will occur if they don’t perform the compulsive acts 5. Performing behaviors reduces anxiety 2. ________________________________________! 6. Behaviors often develop into _____________ What Are the Features of Obsessions and Compulsions? 50. Compulsions 110. Common forms/themes: 93. Cleaning 94. Checking 95. Order or balance 96. Touching, verbal, and/or counting What Are the Features of Obsessions and Compulsions? 51. Are obsessions and compulsions related? 111. Most (not all) people with OCD experience both 112. Compulsive acts often occur in response to obsessive thoughts 97. Compulsions seem to represent a yielding to obsessions 98. Compulsions also sometimes serve to help control obsessions What Are the Features of Obsessions and Compulsions? 52. Are obsessions and compulsions related? 113. Many with OCD are concerned that they will act on their obsessions 99. Most of these concerns are unfounded 100. Compulsions usually do not lead to violence or “immoral acts” Obsessive­Compulsive Disorder 53. OCD was once among the least understood of the psychological disorders 54. In recent years, however, researchers have begun to learn more about it 55. The most influential explanations are from the psychodynamic, behavioral, cognitive, and biological models… OCD: The Psychodynamic Perspective 114. Anxiety disorders develop when children come to fear their id impulses and use ego defense mechanisms to lessen their anxiety 115. OCD differs from anxiety disorders in that the “battle” is not unconscious; it is played out in explicit thoughts and action 101. Id impulses = obsessive thoughts 102. Ego defenses = counter­thoughts or compulsive actions 102. 7. At its core, OCD is related to aggressive impulses and the competing need to control them OCD: The Psychodynamic Perspective 116. The battle between the id and the ego 103. Three ego defenses mechanisms are common: 57. ________________: disown disturbing thoughts 58. _________________: perform acts to “cancel out” thoughts 59. _________________: take on lifestyle in contrast to unacceptable impulses 104. Freud believed that OCD was related to the anal stage of development 60. Period of intense conflict between id and ego 105. Research has not supported this explanation OCD: The Psychodynamic Perspective 56. Psychodynamic therapies 117. Goals are to uncover and overcome underlying conflicts and defenses 118. Main techniques are free association and interpretation 119. Research evidence is poor 106. Some therapists now prefer to treat these patients with short­term psychodynamic therapies OCD: The Behavioral Perspective 57. Behaviorists concentrate on explaining and treating compulsions rather than obsessions 58. Although the behavioral explanation of OCD has received little support, behavioral treatments for compulsive behaviors have been very successful OCD: The Behavioral Perspective 120. ________________________________ 107. People happen upon compulsions randomly 61. In a fearful situation, they happen to perform a particular act (washing hands) 62. When the threat lifts, they associate the improvement with the random act 108. After repeated associations, they believe the compulsion is changing the situation 63. Bringing luck, warding away evil, etc. 109. The act becomes a key method to avoiding or reducing anxiety OCD: The Behavioral Perspective 59. Key investigator: Stanley Rachman 121. Compulsions do appear to be rewarded by an eventual decrease in anxiety 110. Studies provide no evidence of the learning of compulsions OCD: The Behavioral Perspective 122. Behavioral therapy 111. _______________________________________ (ERP) 64. Clients are repeatedly exposed to anxiety­provoking stimuli and prevented from responding with compulsions 65. Therapists often model the behavior while the client watches 65. 66. _____________________ is an important component 67. Treatment is offered in individual and group settings 68. Treatment provides significant, long­lasting improvements for most patients 12. However, as many as 25% fail to improve at all and the approach is of limited help to those with obsessions but no compulsions OCD: The Cognitive Perspective 60. Cognitive theory begins by pointing out that everyone has repetitive, unwanted, and intrusive thoughts 123. People with OCD blame themselves for normal (although repetitive and intrusive) thoughts and expect that terrible things will happen as a result OCD: The Cognitive Perspective 124. Overreacting to unwanted thoughts 112. To avoid such negative outcomes, they attempt to ____________ their thoughts with actions (or other thoughts) 113. Neutralizing thoughts/actions may include: 114. Seeking reassurance 115. Thinking “good” thoughts 116. Washing 117. Checking OCD: The Cognitive Perspective 61. When a neutralizing action reduces anxiety, it is reinforced 125. Client becomes more convinced that the thoughts are dangerous 126. As fear of thoughts increases, the number of thoughts increases OCD: The Cognitive Perspective 62. If everyone has intrusive thoughts, why do only some people develop OCD? 127. People with OCD tend: 118. To be more depressed than others 119. To have higher standards of morality and conduct 120. To believe thoughts are equal to actions and are capable of bringing harm 121. To believe that they can and should have perfect control over their thoughts and behaviors OCD: The Cognitive Perspective 63. Cognitive therapies 128. Focus on the cognitive processes that help to produce and maintain obsessive thoughts and compulsive acts 129. May include: 122. Psychoeducation 123. Habituation training OCD: The Cognitive Perspective 64. Cognitive­Behavioral Therapy (CBT) 130. Research suggests that a combination of the cognitive and behavioral models often is 130. more effective than either intervention alone 131. These treatments typically include psychoeducation and exposure and response prevention exercises OCD: The Biological Perspective 132. Two recent lines of research indicate that biological factors play a key role in OCD: 124. NT _________________________ 69. Evidence that serotonin­based antidepressants reduce OCD symptoms 125. _____________________________ 70. OCD linked to orbital region of frontal cortex and caudate nuclei 71. Frontal cortex and caudate nuclei compose brain circuit that converts sensory information into thoughts and actions 72. Either area may be too active, letting through troublesome thoughts and actions OCD: The Biological Perspective 65. Some research provides evidence that these two lines may be connected 133. Serotonin plays a very active role in the operation of the orbital region and the caudate nuclei 126. Low serotonin activity might interfere with the proper functioning of those brain parts OCD: The Biological Perspective 134. Biological therapies 127. Serotonin­based antidepressants 73. Examples: clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox) 74. Bring improvement to 50%–80% of those with OCD 75. Relapse occurs if medication is stopped 128. Research suggests that combination therapy (medication + cognitive behavioral therapy approaches) may be most effective 76. May have same effect on the brain ...
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