Abnormal Psych: Chapter 5: Anxiety, OCD, and Related- DIsorders

Generalized Anxiety Disorder (part 12) - Biological explanations -Everyday fear reactions are tied to brain circuits. -_________________ -Benzodiazepines (alprazolam, lorazepam, diazepam) provide anxiety relief. -_________________ -GABA carries inhibitory message that ends firing of neuron receptor. -_________________

* Biological explanations -Everyday fear reactions are tied to brain circuits. - Fear circuit hyperactivity may be tied to development of GA. -Benzodiazepine receptors ordinarily receive neurotransmitter gamma-aminobutyric acid (GABA). - GABA carries inhibitory message that ends firing of neuron receptor. -Low GABA could help produce excessive brain circuit communication and contribute to GAD development.

Panic Disorder (part 6) Drug therapies -Various antidepressants bring some improvement to more than ________of patients. -Drugs function in _____________- receptors in the panic brain circuit. -Improvements require maintenance of drug therapy. Some _______________ (especially Xanax [alprazolam]) have proved helpful.

* Drug therapies -Various antidepressants bring some improvement to more than 2/3s of patients. -Drugs function in norepinephrine receptors in the panic brain circuit. -Improvements require maintenance of drug therapy. -Some benzodiazepines (especially Xanax [alprazolam]) have proved helpful.

Generalized Anxiety Disorder (part 2) Sociocultural perspective -GAD is most likely to develop in people faced with ________or ______environments. -Supported by research findings -Some forms of societal stress - _________________ -_________________ -_________________

* Sociocultural perspective - GAD is most likely to develop in people faced with dangerous ongoing social conditions or highly threatened environments. --> Supported by research findings *Some forms of societal stress: -Poverty -Race and ethnicity -Widespread illness

Social Anxiety Disorder (part 2) What causes social anxiety disorder? -_________________ -Interplay of cognitive and behavioral factors -Group of social realm dysfunctional beliefs and expectations held; anticipation of social disasters and dread of social situations -_________ and _______ performed to reduce or prevent these disasters -Tied to genetic ____________, ___________, ___________, _____________, _____________

*Cognitive-behavioral perspective Interplay of cognitive and behavioral factors -Group of social realm dysfunctional beliefs and expectations held; anticipation of social disasters and dread of social situations *Avoidance and safety behaviors performed to reduce or prevent these disasters --> Tied to genetic predispositions, trait tendencies, biological abnormalities, traumatic childhood experiences, overprotective parent-child interactions

Panic Disorder: Cognitive-Behavioral Therapy what does this therapy seek for these individuals? -How does this therapy do this?

*Cognitive-behavioral therap Seeks to correct people's misinterpretations of their bodily sensations 1. Educate about nature of panic attacks: breathing retraining - diaphragmatic breathing 2. Teach applications of more accurate interpretations 3. Teach skills for coping with anxiety, including biological challenge procedures

Cognitive-Behavioral therapies: -Changing maladaptive assumptions -Ellis's __________________(RET) -Breaking down worrying - - --> mindfulness meditation

*Cognitive-behavioral therapies -Changing maladaptive assumption 1. Ellis's rational-emotive therapy (RET) *Breaking down worrying 2. Mindfulness-based cognitive-behavioral therapy -Acceptance and commitment therapy - Mindfulness meditation

Obsessive-Compulsive Disorder (part 3) - obsessions Features & Basic themes

*Obsessions Features - Thoughts that feel both intrusive and foreign -Attempts to ignore or resist them trigger anxiety - Awareness that thoughts are excessive Basic themes -Dirt/contamination -Violence and aggression -Orderliness - Religion -Sexuality

Generalized Anxiety Disorder (part 4) *Freud -All children experience some degree of anxiety and use ego mechanisms to control this. -GAD occurs with high anxiety levels or inadequate defense mechanisms. *Today's psychodynamic theorists - _______ with some Freudian GAD explanations, but ______ GAD can be traced to early parent-child relationships -Research testing psychodynamic explanations -->_________________

*Today's psychodynamic theorists -Disagree with some Freudian GAD explanations, but agree GAD can be traced to early parent-child relationships -Research testing psychodynamic explanations -GAD and defense mechanism; repressed memories; harsh punishment; overprotectiveness

Panic Disorder: -symptoms effect what % of US population yearly? -what % of ppl experience symptoms in thier lifetime ? -what race is more affected? -when does this begin or develop? -what % seek treatment ? -May be accompanied with which disorder?

-3 percent of U.S. population experience this disorder yearly. - More than 5 percent of people experience symptoms during lifetime. -Often begins in late adolescence or early adulthood -Non-Hispanic white Americans more likely to experience than U.S. racial-ethnic minority groups. -59 percent seek treatment. -May be accompanied by agoraphobia

Generalized Anxiety Disorder: -What percent of the US population is affected ? -what is the ratio of women to men? -what percent receives treatment? -what race is affected?

-Affects 4 percent of U.S. population -around 6% develop at some point -2:1 ratio of women to men -43 percent receive treatment -racial-ethnic differences : normally white people

Integrating the Models: Developmental Psychopathology Perspective: -Examination of how key factors emerge and intersect at points throughout the life span -Biological model: _________________ - Cognitive-behavioral and psychodynamic models: _________________ -Sociocultural model: _________________

-Biological model: Genetic variations to hyperactive fear circuits; behavioral inhibitions -Cognitive-behavioral and psychodynamic models: Role of parenting styles; overprotective -Sociocultural model: Influence of life stress, poverty, school difficulties, family disharmony, peer pressure, community danger on anxiety-related disorder

Panic Disorder: What biological factors contributes to panic disorder? -what is it caused by -what does the panic circuit consist of?

-Caused by a hyperactive panic circuit -Amygdala -Hippocampus -Ventromedial nucleus of hypothalamus -Central gray matter -Locus coeruleus * Predisposition to develop such abnormalities is inherited.

Generalized Anxiety Disorder (part 7) Humanistic treatment approach -_________________ is used to show unconditional positive regard for clients and empathize with them. -Despite optimistic case reports, _________________ -Only limited support for Rogers' explanation of GAD and other forms of abnormal behavior

-Client-centered therapy: is used to show unconditional positive regard for clients and empathize with them. -Despite optimistic case reports, controlled studies have failed to offer strong support. - Only limited support for Rogers' explanation of GAD and other forms of abnormal behavior

Generalized Anxiety Disorder (part 13) - Drug therapies: -Early 1950s: -Late 1950s: -More recently

-Early 1950s: Barbiturates (sedative-hypnotics) -Late 1950s: Benzodiazepines -Significant problems More recently -Antidepressants that increase serotonin and norepinephrine neurotransmitter activity: 60% show relief -Antipsychotics (schizophrenia; psychosis)

Additional requirements or symptoms of Generalized Anxiety Disorder?

-Excessive anxiety experienced under most circumstances - Worry about practically anything; free-floating anxiety -Reduced quality of life

Obsessive-Compulsive Disorder (part 10) Obsessive-compulsive-related disorders - DSM-5 created obsessive-compulsive-related disorders : -_________________ -_________________ (hair-pulling disorder) -_________________ (skin-picking) disorder - _________________

-Hoarding disorder -Trichotillomania (hair-pulling disorder) -Excoriation (skin-picking) disorder -Body dysmorphic disorder

Most common mental disorders in the United States: anxiety disorders - In any given year, ______ of the U.S. adult population experiences one of the six DSM-5 anxiety disorders. -About ________ develop one of the disorders at some point in their lives. - About ________ of these individuals seek treatment.

-In any given year, 19 percent of the U.S. adult population experiences one of the six DSM-5 anxiety disorders. -About 31 percent develop one of the disorders at some point in their lives. -About 42 percent of these individuals seek treatment.

Specific Phobias: Checklist ?

-Marked, persistent, and disproportionate fear of a particular object or situation; usually lasting at least 6 months -Exposure to the object produces immediate fear -Avoidance of the feared situation -Significant distress or impairment

Phobias (part 1) - How do phobias differ from fear? - _________________ -_________________ -_________________

-More intense and persistent fear -Greater desire to avoid the feared object or situation -Create distress that interferes with functioning

Separation Anxiety Disorder: Not Just for Kids Anymore Individuals with separation anxiety disorder feel extreme anxiety, often panic, whenever they are separated from key people in their lives. - _________________ -_________________ -_________________

-Most common disorder among young children -DSM-5 determined separation anxiety can develop in adults. -New categorization as an anxiety disorder is controversial.

OCD: checklist

-Occurrence of repeated obsessions, compulsions, or both -The obsessions or compulsions take up considerable time -Significant distress or impairment

Phobias (part 10) Treatments for agoraphobia -Older approaches _________________ -Newer, more successful treatments: -Variety of exposure therapy (cognitive-behavioral) approaches -_________________ - _________________ -Are successful for about 70 percent of agoraphobic clients; relapse in ____________ -Relapses may occur, especially ______________

-Older approaches are less successful. -Newer, more successful treatments: -Variety of *exposure therapy (cognitive-behavioral) approaches: +Support groups +Home-based self-help programs - Are successful for about 70 % of agoraphobic clients ---> relapse in as many as half: especially when panic disorder also exists

Panic Disorder (part 1) - Panic attacks: what are they?

-Periodic, short bouts of panic that occur suddenly, reach a peak within minutes, and gradually pass

Social Anxiety Disorder (part 1) Social anxiety disorder: Checklist

-Pronounced, disproportionate, and repeated anxiety about social situation(s) in which the individual could be exposed to scrutiny by others; typically lasting 6 months or more -Fear of being negatively evaluated by or offensive to others -Exposure to the social situation almost always produces anxiety -Avoidance of feared situations -Significant distress or impairment

Agoraphobia: Checklist?

-Pronounced, disproportionate, or repeated fear about being in at least two delineated situations -Avoidance of the agoraphobic situations -Symptoms usually continue for at least 6 months -Significant distress or impairment

OCD: -symptoms effect what % of US population yearly? -what % of ppl experience symptoms in thier lifetime ? -what race/gender is more affected? -when does this begin or develop? -what % seek treatment ?

-Related to other disorders in features, causes, and treatment responsiveness -Affects 1.2 percent of world population - Begins in childhood or young adulthood; fluctuating severity -Equally common among men and women and racial and ethnic groups -40% seek treatment

Treatment for specific phobias: -Systematic desensitization (Wolpe) - _________________ - _________________ - _________________ -_________________ - _________________ - Flooding -Modeling

-Systematic desensitization (Wolpe) -Relaxation training -Fear hierarchy -in vivo desensitization -Overt desensitization -Virtual reality -Flooding -Modeling

Panic DIsorder: Checklist?

-Unforeseen panic attacks occur repeatedly -One or more of the attacks precede either of the following symptoms: --> At least a month of continual concern about having additional attacks -At least a month of dysfunctional behavior changes associated with the attacks (e.g., avoiding new experiences)

Social Anxiety Disorder (part 1) Social anxiety disorder: -symptoms effect what % of US population yearly? -what % of ppl experience symptoms in thier lifetime ? -what race is more affected? -when does this begin or develop? -what % seek treatment ?

-Yearly symptoms exist in 7 % of U.S. population. -Around 12 % of people experience symptoms during their lifetime. - Non-Hispanic white Americans are more likely to experience than African, Hispanic, or Asian Americans. - Often begins in late childhood or adolescence and into adulthood -Around 40 % seek treatment.

Phobias (part 3) Specific Phobias: : -symptoms effect what % of US population yearly? -what % of ppl experience symptoms in thier lifetime ? -women outnumber men, what ratio? -what % seek treatment ?

-Yearly symptoms exist in 9 percent of all U.S. people - 13 percent of people experience symptoms during their lifetime. -Women outnumber men 2:1. -At most, 32 percent seek treatment.

Phobias (part 4) Agoraphobia: -symptoms effect what % of US population yearly? -what % of ppl experience symptoms in thier lifetime ? -women outnumber men, what ratio? -what % seek treatment ?

-Yearly symptoms exist in around 1 percent of U.S. population. - 1.3 percent of people experience symptoms during lifetime; -gender/class differences: more common in women than men, poor than rich -Around 46 percent seek treatment.

Phobia (part 7) * What does research indicate? -_________________: Watson and Rayner (Little Albert) -_______________: Bandura and Rosenthal

-classical conditioning fear: Watson and Rayner (Little Albert) -Modeling: Bandura and Rosenthal

GAD - Drug therapies: Limitations

-effects short-lived and anxiety comes back stronger -ppl taking large doses for extended time become physically dependent -produce side effects: drowsiness, lack of coordination, memory-loss, depression, aggressive behavior

What are the requirements to be diagnosed with Generalized Anxiety Disorder? (3)

1. For 6 months or more, person experiences disproportionate, uncontrollable, and ongoing anxiety and worry about multiple matters. 2. The symptoms include at least three of the following: edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems. 3. Significant distress or impairment.

Social Anxiety Disorder (part 3) Treatments for social anxiety disorder address two distinct features: - _________________ -Medications: _________________ -Cognitive-behavioral therapy: _________________ -_________________ -Social skills and assertiveness training

1. Overwhelming social fears -Medications: Benzodiazepine or antidepressant drugs -Cognitive-behavioral therapy: Exposure therapy and systematic therapy discussions 2. Lack of social skills -Social skills and assertiveness training

The biological perspective suggests that panic attacks may be caused by a type of ________ that is hyperactive in people with panic disorder. A. panic circuit B. anxiety sensitivity C. biological challenge D. neutralizing

A. panic circuit

As part of her treatment for social anxiety, Heather constructs a list of situations that range from not that scary to very scary. Heather's therapist will help her learn to stay relaxed in this different situations, an approach known as: A. systematic desensitization. B. flooding. C. social skills training. D. modeling.

A. systematic desensitization

Which perspective has a focus on changing maladaptive assumptions in treating generalized anxiety disorders? A. the cognitive-behavioral perspective B. the psychodynamic perspective C. the humanistic perspective D. the biological perspective

A. the cognitive-behavioral perspective

Phobias (part 9) * Treatments for specific phobias -Actual contact with the feared object or situation is key to greater success in all forms of _________________

Actual contact with the feared object or situation is key to greater success in all forms of exposure treatment.

-Trichotillomania (hair-pulling disorder)

An impulse-control disorder involving the compulsive, persistent urge to pull out one's own hair.(scalp, eyebrows, eyelashes, etc)

Approximately ___ percent of the U.S. population will be impacted by panic disorder at some point in their lives. A. 1 B. 5 C. 13 D. 33

B. 5

Persistent and excessive feelings of anxiety and worry about numerous events and activities is known as: A. panic disorder. B. generalized anxiety disorder. C. obsessive-compulsive disorder. D. agoraphobia.

B. generalized anxiety disorder.

Tory is bothered by many different concerns. She worries about her job, her friendships, her safety, and her future. This worrying is causing her significant distress and interfering with her daily life. Tory's most likely diagnosis would be: A. panic disorder. B. generalized anxiety disorder. C. obsessive-compulsive disorder. D. agoraphobia. E. social anxiety disorder.

B. generalized anxiety disorder.

Heather is deathly afraid of being eaten by crocodiles, won't watch movies or TV shows with crocodiles in them, never visits the zoo, and is very happy to be living in North Dakota, far from any crocodiles. Would this qualify her as having a phobia? A. yes B. no

B. no

Which of the following disorders occurs equally among men and women? A. social anxiety disorder B. obsessive-compulsive disorder C. agoraphobia D. generalized anxiety disorderE. panic disorder

B. obsessive-compulsive disorder

Obsessive-Compulsive Disorder (part 8) Biological perspective -Early research: _________________ -Family pedigree and twin studies -Recent research: _________________ Abnormal serotonin activity -Abnormal brain structure and functioning -Some research evidence suggests _________________

Biological perspective *Early research: genetic focus --> Family pedigree and twin studies *Recent research: brain circuit (cortico-striato-thalamo-cortical circuit) hyperactive in people with OCD -Abnormal serotonin activity -Abnormal brain structure and functioning -Some research evidence suggests these two lines may be connected.

Generalized Anxiety Disorder (part 11) Biological perspective: -Supported by _____________ and brain researchers -challenged by ________ -Fear reactions are tied to brain circuits.

Biological perspective -GAD is caused chiefly by biological factors. -Supported by family pedigree studies and brain researchers -Challenged by competing explanation of shared environment -Fear reactions are tied to brain circuits.

Panic Disorder (part 3) Biological perspective -_________________ -Panic attacks caused by abnormal norepinephrine activity in locus ceruleus - _________________ -Brain circuits and amygdala are more complex root of the problem -May be an _________________ to abnormalities in these areas

Biological perspective *Initial theory -Panic attacks caused by abnormal norepinephrine activity in locus ceruleus *More recent theory -Brain circuits and amygdala are more complex root of the problem -May be an inherited predisposition to abnormalities in these areas

Obsessive-Compulsive-Related Disorder (part 9) Biological treatment -_________________ -Clomipramine (Anafranil) and similar drugs -Improvement in 50 to 80 percent of those with OCD -______________ if medication is stopped -Research suggests that _______________ may be most effective

Biological treatment -Serotonin-enhancing antidepressants -Clomipramine (Anafranil) and similar drugs -Improvement in 50 to 80 % of those with OCD -Relapse occurs if medication is stopped. -Research suggests that combination therapy (medication + cognitive-behavioral therapy approaches) may be most effective

________ is a disorder in which people pull out hair from their body (e.g., scalp, eyebrows, eyelashes). A. Excoriation disorder B. Body dysmorphic disorder C. Trichotillomania D. None of these

C. Trichotillomania

Which neurotransmitter has been implicated in playing a role in panic disorder? A. serotonin B. GABA C. norepinephrine D. glutamate

C. norepinephrine

Yesterday while waiting for the bus, Tina was overwhelmed with a sense of dread. Her heart was racing, she had difficulty breathing, and she felt like she was going to die. This has been happening more frequently, and you suspect Tina has: A. generalized anxiety disorder. B. agoraphobia .C. panic disorder. D. social anxiety disorder.

C. panic disorder.

Which of these is NOT a type of exposure therapy? A. systematic desensitization B. flooding C. social skills training D. modeling

C. social skills training

Phobias (part 2) *Categories of phobias - _________________ -_________________

Categories of phobias -Specific phobias -Agoraphobia

Fear:

Central nervous system's physiological and emotional response to a serious threat to one's well-being

Anxiety

Central nervous system's physiological and emotional response to a vague sense of threat or danger

OCD- Cognitive-behavioral perspective - Disorder grows from human tendencies to have unwanted, intrusive, unpleasant thoughts -To avoid negative outcomes, individuals attempt to _________________ -Reductions in anxiety after ________________ -Exceptionally high standards of conduct; thought-action fusion

Cognitive-behavioral perspective -Disorder grows from human tendencies to have unwanted, intrusive, unpleasant thoughts -To avoid negative outcomes, individuals attempt to neutralize their thoughts with actions (or other thoughts) -Reductions in anxiety after neutralizing strategies -Exceptionally high standards of conduct; thought-action fusion

Generalized Anxiety Disorder (part 8) *Cognitive-behavioral perspective -_____________and ____________ often cause psychological disorders. -Treatment focus involves the nature of behavior and thoughts. *Early approach -______________ or ______________ (Ellis) -_________________ (Beck)

Cognitive-behavioral perspective -Problematic behaviors and dysfunctional thinking often cause psychological disorders. -Treatment focus involves the nature of behavior and thoughts. *Early approach -Maladaptive or basic irrational assumptions (Ellis) -Silent assumptions (Beck)

Panic Disorder (part 7) Cognitive-behavioral perspective -Biological factors are _________________ _____________ are misinterpreted as signs of medical catastrophe and controlled by avoidance and safety behaviors. -______________ may exist. *Biological challenge test/ Interoceptive -Procedure used to ________ panic and assess panic disorder

Cognitive-behavioral perspective -Biological factors are only part of the cause of panic attacks. -Bodily sensations are misinterpreted as signs of medical catastrophe and controlled by avoidance and safety behaviors. -Anxiety sensitivity may exist. -Biological challenge test/ Interoceptive response: Procedure used to produce panic and assess panic disorder

What disorders are the most common mental disorders in the US?

anxiety disorders

thought-action fusion

belive that intrusive negative thoughts are equivalent to actions and capable of causing harm

Which of the following is true about the prevalence of generalized anxiety disorder (GAD)? A. Women are diagnosed with this disorder at three time the rate of men. B. Rates of GAD are higher among blacks and Hispanics as compared to non-Hispanic whites. C. Lifetime prevalence of GAD is approximately 11 percent. D. Rates of GAD are higher among low-SES populations compared to high-SES groups.

D. Rates of GAD are higher among low-SES populations compared to high-SES groups.

Generalized Anxiety DIsorder (GAD)

Disorder marked by persistent and excessive feelings of anxiety and worry about numerous events and activities

Fear reactions not always conditioned. -Disorder not ordinarily acquired through _____________ or _____________ (Gamble and colleagues)

Fear reactions not always conditioned. -Disorder not ordinarily acquired through classical conditioning or modeling (Gamble and colleagues)

Obsessive-Compulsive Disorder (part 4) Compulsions: what are some features? what are these features developed into often times? what are some themes?

Features: -Various forms of voluntary behaviors or mental acts - Feel mandatory/unstoppable -Recognition that behaviors are unreasonable -Performing behaviors reduces anxiety for a short time -Behaviors often develop into rituals Themes: -Cleaning compulsions -Checking compulsions -Order or balance -Touching, verbalizing, and/or counting compulsions

Profile of Anxiety Disorders and Obsessive-Compulsive Disorder: Female-to-Male Ratio -Generalized Anxiety Disorder: -Specific phobia: -Agoraphobia: -Social anxiety disorder: -panic disorder: -obsessive-compulsive disorder:

Female-to-Male Ratio -Generalized Anxiety Disorder: 2:1 -Specific phobia: 2:1 -Agoraphobia: 2:1 -Social anxiety disorder: 3:2 -panic disorder: 5:2 -obsessive-compulsive disorder: 1:1

Phobia (part 6) How are fears learned? -Classical conditioning -US: _________--> UR: _____________ -CS: _________--> CR: _____________ - Modeling -________________ -________________

How are fears learned? Classical conditioning -US: Entrapment --> UR: Fear -CS: Running water --> CR: Fear Modeling -Observation -Imitation

Generalized Anxiety Disorder (part 6) - _________________ - GAD arises when people stop looking at themselves honestly and acceptingly. -Carl Rogers' explanation -_________________ (i.e., harsh self-standards). -_________________

Humanistic perspective: - GAD arises when people stop looking at themselves honestly and acceptingly. Carl Rogers' explanation: -Lack of unconditional positive regard in childhood leads to conditions of worth (i.e., harsh self-standards). -Threatening self-judgments break through and cause anxiety, setting the stage for GAD to develop.

Generalized Anxiety Disorder (part 9) *Never cognitive-behavioral explanations -_________________ (Wells) and meta-worries - _________________ (Koerner and colleagues) -_________________ (Borkovec)

Never cognitive-behavioral explanations - Metacognitive theory (Wells) and meta-worries -Intolerance of uncertainty theory (Koerner and colleagues) -Avoidance theory (Borkovec)

Which disorder is not higher or lower in chance of developing it for women compared to men?

OCD

obsessive-compulsive disorder what are obsessioms? what are compulsions?

Obsessions: - Persistent thoughts, ideas, impulses, or images that seem to invade a person's consciousness Compulsions: - Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety

Profile of Anxiety Disorders and Obsessive-Compulsive Disorder: One-Year Prevalence: -Generalized Anxiety Disorder: -Specific phobia: -Agoraphobia: -Social anxiety disorder: -panic disorder: -obsessive-compulsive disorder:

One-Year Prevalence: -Generalized Anxiety Disorder: 4% -Specific phobia: 9% -Agoraphobia: 1% -Social anxiety disorder:7% -panic disorder: 3.1% -obsessive-compulsive disorder: 1-2%

Profile of Anxiety Disorders and Obsessive-Compulsive Disorder: Percentage Receiving Clinical Treatment Currently: -Generalized Anxiety Disorder: -Specific phobia: -Agoraphobia: -Social anxiety disorder: -panic disorder: -obsessive-compulsive disorder:

Percentage Receiving Clinical Treatment Currently: -Generalized Anxiety Disorder:43% -Specific phobia: 32% -Agoraphobia: 46% -Social anxiety disorder: 40% -panic disorder: 59% -obsessive-compulsive disorder: 40%

Profile of Anxiety Disorders and Obsessive-Compulsive Disorder: Prevalence Among Close Relatives: -Generalized Anxiety Disorder: -Specific phobia: -Agoraphobia: -Social anxiety disorder: -panic disorder: -obsessive-compulsive disorder:

Prevalence Among Close Relatives: -Generalized Anxiety Disorder: Elevated -Specific phobia:Elevated -Agoraphobia:Elevated -Social anxiety disorder:Elevated -panic disorder: Elevated -obsessive-compulsive disorder: Elevated

Obsessive-Compulsive Disorder (part 5) Psychodynamic perspective What is the theory behind this perspective? -What stage of development did Freuid say OCD is related to? -do all psychodynamic theorists agree? Treatment:: -what are the techniques used?

Psychodynamic perspective -Theory: Battle between the id and the ego defense mechanisms lessens anxiety in overt thoughts and actions -Freud: OCD related to the anal stage of development -Not all psychodynamic theorists agree - Treatment -Classical techniques of free association and therapist interpretation; have little research support -Short-term psychodynamic therapies are more direct and action-oriented.

Generalized Anxiety Disorder (part 5) Psychodynamic therapies: - - Specific treatments for GAD: - - -

Psychodynamic therapies: -Free association -Therapist interpretations of transference, resistance, and dreams to reduce fear of id impulses and control Specific treatments for GAD: -Freudians focus less on fear and more on control of id. -Object-relations therapists attempt to help patients identify and settle early relationship problems. -Short-term psychodynamic therapy is more effective than longer treatments.

Excoriation (skin-picking) disorder

Recurrent picking at one and resulting in skin lesions, with repeated attempts to decrease or stop picking.

Phobias (part 8) - Behavioral-evolutionary explanation -Some specific phobias are much more common than others. -Species-specific biological predisposition to develop certain fears: _________________

Species-specific biological predisposition to develop certain fears: preparedness -Explains why some phobias (snakes, spiders) are more common than others (meat, houses)

Panic Attacks: -feature at least 4 of these symptoms of panic:

Symptoms: - Heart palpitations -Tingling in the hands or feet -Shortness of breath - Sweating -Hot and cold flashes -Trembling - Chest pains -Choking sensations -Faintness -Dizziness, -Feeling of unreality (APA, 2013)

Drug therapies: : what are the trade names? Genetic names:- Alprazolam Chlordiazepoxide Clonazepam Clorazepate Diazepam Estazolam Lorazepam Midazolam Oxazepam

Trade Names: Alprazolam- Xanax Chlordiazepoxide- Librium Clonazepam- Klonopin Clorazepate- Tranxene Diazepam- Valium Estazolam- ProSom Lorazepam- Ativan Midazolam- Versed Oxazepam- Serax

Profile of Anxiety Disorders and Obsessive-Compulsive Disorder: Typical Age at Onset -Generalized Anxiety Disorder: -Specific phobia: -Agoraphobia: -Social anxiety disorder: -panic disorder: -obsessive-compulsive disorder:

Typical Age at Onset -Generalized Anxiety Disorder: 0−35 years -Specific phobia: Variable -Agoraphobia: 15−35 years -Social anxiety disorder: 10−20 years -panic disorder: 15−35 years -obsessive-compulsive disorder: 4−25 years

Obsessive-Compulsive Disorder (part 7) Cognitive-behavioral therapy: -Focus on the cognitive processes that help to produce and maintain obsessive thoughts and compulsive acts -Use _________________ exercises -_________________ -Use videoconferencing in recent years -_________________

Use exposure and response prevention exercises -Set example -Use videoconferencing in recent years -Between 50 and 70 % improvement with therapy.

Phobias (part 5) What causes specific phobias? - _________________ receive most research support -Focus primarily on ________________ - First fear of certain objects, situations, or events are learned through conditioning. -Once fears are acquired, individuals avoid dreaded object or situation and _______________

What causes specific phobias? -Cognitive-behavioral theories receive most research support *Focus primarily on behavioral dimension: -First fear of certain objects, situations, or events are learned through conditioning. -Once fears are acquired, individuals avoid dreaded object or situation and permit fears to become entrenched.

exposure and response prevention/ exposure and ritual prevention:

a cog-beh technique used to treat OCD that exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing compulsive acts

gamma-aminobutyric acid (GABA).

a neurotransmitter whose low activity in the brain's "fear circuit" has been linked to anxiety.

maladaptive assumptions (Ellis) :

a notion that continues to be influentail

preparedness

a predisposition to develop certain fears -some theorists say these come from an evolutionary process transmitted genetically (ancestors)

family-pedigree study

a research design in which investigators determine how many and which relatives of a person with a disorder have the same disorder

anxiety sensitivity

a tendency to focus on one's bodily sensations, assess them illogically, and interpret them as harmful (ASI)

social skills training:

a therapy apporach that helps people learn and improve social skills and assertiveness through role playing and rehearsing of desirable behaviors. and nonverbal skills

agoraphobia

an anxiety disorder in whih a person is afraid to be in public situations from which escape might be difficult or help unavailble if panic-like or embarrassed symptoms were to occur

Treatment for specific phobias: Flooding:

an exposure treatment for phobias in which clients are exposed repeatedly and intensively to a feared object and made to see that it is actually harmless

Treatment for specific phobias: systematic desensitization (wolpe)

an exposure treatment that uses relaxation training and a fear hierarchy to help clients w/ phobias react calmly to the objects or situations they dread, -reaction response thought to substitute fear

Intolerance of uncertainty theory (Koerner and colleagues)

certain individuals cannot tolerate the knowledge that negative events may occur "control" "restore certainty"

Treatment for specific phobias: participant modeling

client is actively encouraged to join in with therapist

systematic desensitization = "covert in vivo or covert/overt desensitization

covert iin vivo = actual in person confrontation ex. fear of heights --> first: stand on chair or climb a step ladder covert = imagined ex. client imagines frightening event while therapist describes their fear.

sedative hypnotic drugs

drugs that calm peopel at lower doses and help them fall asleep at higher doses. -these benzodiazepines seem less addictive than previous sedative-hypnotic meds like barbiturates and appear to produce less tiredness.

panic disorders

have recurrent attacks of terror

common specific phobias:

heights, animals or insects, enclosed spaces, thunderstorms, blood

mindulness-based cognitive-behavioral therapy (steven haze): acceptance & commitment therapy:

help clients become aware of their streams of thoughts, including their worries, as they're occuring and accept them as mere events of the mind. -clients less upset and influenced by them in their behaviors and life decisions. "thoughts are just thoughts and dont ahve power"

social anxiety disorder

intensely afraid of social or performance situations, in which they may become embarrassed

body dysmorphic disorder

involves excessive preoccupation with an imagined defect in physical appearance

Sample fear (Hierarchy) Ladder

is used for social anxiety disorder

Treatment for specific phobias: modeling

it is the therapist who comfronts the feared object or situation while client observes.

Social anxiety disorder may be narrow or braod

narrow: fear of talking in public or eating in front of others broad: fear of functioning poorly infront of others -in both forms individuals repeatedly judge themselves as performing less competently than they actually do.

mindfulness meditation-

pay attention to the thoughts and feelings that flow through their mind during meditiation and to accept them in a nonjudging way.

rational-emotive therapy (RET) (ellis) -

point out the irrational assumptions held by clients. -Suggest more appropriate assumptions, and assign homework that gives the clients practice at challenging old assumptions and applying new ones. ex. "you can't hurt him emotionally, only physically you can. He believes you can hurt him emotionally, he assumes he is unloveable, that's why he says you have hurt him."

locus ceruleus

small area of brain that seems to be active in the regulation of emotions. many of its neurons use norepinephrine.

Which disorders do the elderly face a lower chance of developing?

specific phobias, social anxiety disorder, panic disorder, OCD

Avoidance theory (Borkovec)

suggest that people with GAD have greater bodily arousal (higher heart rate, perspiration, respiration) than others and worrying actually serves to reduce this arousal perhaps by distracting the individual from their unpleasant physical feelings.

The metacognitive theory (wells)

suggets people with GAD implicity hold both positive and negative beliefs about worrying. -positive: worrying is useful way of appraising and coping with threats in life -negative: "meta-worrying" worrying about the fact that they are worrying

Basic irrational assumptions (Ellis)

the inaccurate and inappropriate beliefs held by ppl w/ various psychological problems.

Benzodiazepines

the most common group of antianxiety drugs, (alprazolam, lorazepam, diazepam) or valium, xanax, and ativan = provides the most relief from anxiety.

"fear circuit" cosists of

the prefrontal cortex. anterior cingulate cortex insula and amygdala