Anxiety abnormal psychology
cognitive panic disorder
think catastrophic thoughts (make it life threating thought) makes physiologic sensations stronger
Specific Phobias: Treatment
- In the case of specific phobia, no pharmacological intervention has been shown to be effective. - Nearly all empirically-supported therapies for specific phobias involve exposure to the feared stimulus: ( Systematic desensitization, Participant modeling) - Exposure therapies involving actual, rather than imagined, contact appear to be the most effective approaches
Specific Phobia
- Specific phobia involves intense and persistent fear triggered by specific objects or situations. - The fear reaction is excessive. - Most individuals with phobias realize that their reactions are excessive or unreasonable, but this realization does not reduce the phobic response. - Specific phobia is not diagnosed unless it lasts at least 6 months and interferes significantly with a person's life or is associated with marked distress.
agoraphobia treatments
-Behavioral and cognitive-behavioral interventions o Exposure-based CBT o Virtual-reality exposure therapy - Psychodynamic Therapy o Unconscious roots of anxiety symptoms, e.g., possibly related to attachment conflicts -Pharmacological treatment o SSRI anti-depressant
Specific Phobias
-The DSM-5 provides for including subtype indicators in the diagnosis of specific phobia: ( Animal type o Natural environment type o Blood-injection-injury type o Situational type o Other types (fear of choking, clowns, noises)) -The specific phobia diagnosis has been one of the most reliable in the anxiety disorder category. ( However, its reliability was not assessed in the DSM- field trials)
biological cause of panic disorders
-clusters in families -heredity involved -1st degree relatives more likely (8 times) to show disorder -over reactive in fear network in brain
s anxiety
20 statements that evaluate how respondents feel right now at that moment
Specific Phobias:Psychodynamic Causal Factors
The psychoanalytic theory of phobia formation emphasizes some initial repression of an anxietyarousing conflict, the projection of the conflict onto the external world, and then displacement of the anxiety onto some other target
treatment of panic disorder
antidepressant medications psychodynamic therapy behavioral/cognitive-behavioral therapies
agoraphobia
anxiety of being in place or situation where escape is hard
symptoms of panic attack
chest pain, feelings of chocking, dizziness, hear of dying
panic attack
develops rapidly of fear and anxiety they are not diagnosable disorders some people think their attack is heart attack
parasympathetic
fainting, counters sympathetic
sympathetic nervous system
fast non normal heartbeat/breathing, dry mouth
fear response
fear response in people is unlearned, but new fears can be learned can influenced by others through observation
behavioral panic disorder
internal and environemtal q's Q's become conditioned
psychodynamic panic disorder
internal/emotional conflicts ego defenses have anxiety though defense mechanisms
anxiety men vs women
more common in females than males (2-1 ratio)
comorbidity
person diagnosed with one or more disorder
what triggers panic attacks
sodium lactate smoking (increased risk) asthma (increased risk) cafeeine (stimulants)
panic disorder
sppntaneous, happens rapidly, person gets worried about future panic attacks not due to another medical condition onset is adolescene and mid 30's 5% of populatiob effected
Generalized Anxiety Disorder: Psychodynamic Causal Factors
• Anxiety is created by unconscious conflict, which overwhelms the ego defenses with unacceptable impulses and produces a widespread overt anxiety reaction.
Social Anxiety Disorder: Treatment
• Benzodiazepines appear to be effective in short-term relief for social anxiety. SNRIs have also been used effectively. • Psychodynamic Therapy- Talking about self in relation to others | transference interpretations assist patient understand anxiety as it plays out in session • Cognitive-behavioral therapies are effective treatments. o These techniques typically involve systematic exposure to feared social situations, often combined with relaxation training or desensitization. o Newer CBT applications, including virtual reality technologies that provide computer-generated scenarios of public speaking situations, also appear promising for treating social anxiety.
Specific Phobias: Causal Factors
• Biological explanations • Behavioral explanations • Psychodynamic explanation
Specific Phobias: Behavioral Causal Factors
• Classical/operant conditioning o Two-factor theory of phobia • Pavlovian conditioning in which object or situation is paired with a traumatic event or a strong sensation of fear • Operant conditioning in which avoidance behavior is negatively reinforced by the reduction in fear that avoidance produces • Observational learning (rewards behavior)
Generalized Anxiety Disorder 2
• Comorbidity of GAD with additional diagnoses, such as depression and disorders within the anxiety disorder category (including panic disorder), is fairly common. o The DSM-5 diagnosis is not very reliable, with a kappa of 0.20, falling in the "questionable" range. • GAD is more frequently diagnosed among females. • Twelve month prevalence is around 2.9% of the U.S. adult population
Generalized Anxiety Disorder
• Generalized anxiety disorder (GAD) is characterized by a nearly constant state of worry and apprehension about a wide variety of events or activities, on most days over a 6-month period. • Several symptoms of autonomic arousal are present, including disturbed sleep and concentration, muscle tension, irritability, and fatigue, to the extent that they interfere with daily life. • People with GAD find their worries difficult to control, distressing, and physically troublesome. o However, they do not progress into panic attacks.
Specific Phobias: Treatment
• In the case of specific phobia, no pharmacological intervention has been shown to be effective. • Nearly all empirically-supported therapies for specific phobias involve exposure to the feared stimulus: o Systematic desensitization o Participant modeling • Exposure therapies involving actual, rather than imagined, contact appear to be the most effective approaches.
Specific Phobias 2
• Phobias are relatively common disorders, with lifetime prevalence rates of over 12% of the population. • Women are diagnosed with phobias twice as often as men. • First symptoms of phobias tend to appear in childhood or early adolescence; prevalence declines among the elderly.
Generalized Anxiety Disorder: Biological Causal Factors
• Several brain pathways also active in other anxiety disorders, including the amygdala and the limbic system and the prefrontal cortex, are implicated in GAD. • Inhibition of these pathways, mediated by the neurotransmitter GABA, is assumed to be deficient in GAD sufferers. • Genetic evidence is mixed; its modest heritability may be somewhat smaller than that for other anxiety disorders.
Generalized Anxiety Disorder: Cognitive-behavioral Causal Factors
• Similar to that for panic disorder, interoceptive and exteroceptive stimuli become predictive of worry and apprehension to the point that widespread anxiety occurs as a conditioned response. • This would be most likely to occur in people who have a history of uncontrollable and unpredictable events, and who would also be less likely to identify periods of safety from threat, resulting in hypervigilance. • This results in a cognitive tendency to over-appraise and attend to threatening interoceptive and exteroceptive cues, and such an interpretive bias can increase vulnerability to anxiety disorders. Generalized
Social Anxiety Disorder (Social Phobia)
• Social anxiety disorder (also called social phobia) is similar to specific phobia except that the symptoms are connected to situations in which the person is exposed to unfamiliar people, or to the scrutiny of others, and fears acting in a way that might prove embarrassing or humiliating. • Exposure to these situations almost immediately triggers distressing fear symptoms, which at times may escalate into panic attacks.
Social Anxiety Disorder
• Social anxiety disorder involves shyness and social anxiety that is severe enough to interfere with normal life in terms of occupational, academic, or interpersonal functioning and which has occurred for at least six months. • The diagnosis can be sub-typed as performance only if the fear is limited to performing or speaking in public.
Social Anxiety Disorder: Causal Factors
• Social anxiety disorder runs in families; first degree relatives of sufferers have two to six times greater risk of developing the condition. • The amygdala may respond differently to novel faces rather than to familiar faces in people with social anxiety disorder. • Learning models assume social anxiety disorder develops in similar ways as other phobias, involving a conditioned association between social cues and unpleasant or embarrassing events or social defeats. o There is no information that establishes a relationship between the disorder and childhood maltreatment or adversity. • Psychodynamic models tend to emphasize internal conflicts that produce anxiety (as in the other phobias) as the probable cause of social anxiety disorder.
Specific Phobias: Biological Causal Factors
• Specific phobias are more common in families in which other members have phobias. • Monozygotic twins show higher concordance rates for specific phobias than dizygotic twins. • There seems to be an innate preparedness to fear certain stimuli evolutionarily associated with real dangers - animals, the dark, heights
Social Anxiety Disorder 2
• This is one of the most common anxiety disorders, with an estimated 12.1% lifetime prevalence. o The 12-month prevalence rate is higher in the USA (7%) than for the rest of the world (0.5% - 2.3%) . • Age of onset is between 8 and 15 years in 75% of the cases. • Although it is more commonly diagnosed among women, men are represented equally in treatment settings.
