Abnormal Psych Ch 5

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Anxiety

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An emotional state characterized by physiological arousal, unpleasant feelings of tension, and a sense of apprehension or foreboding.

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Anxiety Disorder

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A class of psychological disorders characterized by excessive or maladaptive anxiety reactions.

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Three types of anxiety disorders in the DSM

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Panic Disorder

Phobic Disorders

Generalized Anxiety Disorder

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Panic Disorder

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A type of anxiety disorder characterized by repeated episodes of intense anxiety or panic.

Urge to escape, sheer terror, imminent danger.

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What is required to diagnose Panic Disorder?

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repeated, unexpected panic attacks, and one must be followed by one of the following:

1. at least a month of persistent fear of subsequent attacks.

2. worry about the implications or consequences of the attack.

3. Significant change in behavior.

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Theoretical Perspectives on PANIC DISORDER

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Cognitive and biological.

Perceiving bodily sensations as dire threats inducing anxiety and activation of the sympathetic nervous system.

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Biological factors with Panic Disorder

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Genetic factors.

Unusually sensitive alarm system or fear network in the brain.

Suffocation False Alarm theory (Klein).

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Cognitive Factors with Panic Disorder

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the fear of fear, or AS - anxiety sensitivity.

AS appears to magnify fear reactions to cues of bodily arousal.

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Treatments for Panic Disorder

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Drug therapy - generally antidepressants.

CBT

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Three elements of CBT for Panic Disorder

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Self-monitoring: keeping a journal/log

Exposure: gradual exposure to anxiety inducing situations with relaxation skills.

Development of coping responses: coping skills to interrupt the vicious cycle of overreactions - focus on deep breathing and relaxation training.

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Phobic Disorders - what is a phobia?

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a fear of an object or situation that is disproportionate to the threat it poses.

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Social Anxiety Disorder

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Also called Social Phobia

Excessive fear of social interactions or situations.

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Underlying problem of social phobia

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excessive fear of negative evaluations from others.

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Agoraphobia - greek origin

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fear of the marketplace

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Agoraphobia

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a fear of places and situations from which it might be difficult or embarrassing to escape in the event of panicky symptoms or a full-fledged panic attack, or of situations in which help may be unavailable if such problems should occur.

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Psychodynamic perspective of phobias

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anxiety is a danger signal that threatening impulses of a sexual or aggressive nature are nearing the level of awareness.

ego mobilizes its defense mechanisms: projection.

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Psychodynamic treatment of phobias

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TRADITIONAL: fears symbolize inner conflicts, so the ego can be freed from expending its energy on repression.

MODERN: same, but focus more on exploring sources of anxiety that arise from current rather than past relationships and encourage clients to develop more adaptive behaviors.

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Biological Perspectives of phobias

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genetic factors predispose obvs.

a particular gene is involved according to research.

those with the gene showed greater neuronal activity in response to fearful stimuli in the amygdala.

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What kinds of drugs can be used for phobias?

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antidepressants, zoloft, paxil

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How is classical conditioning related to phobias?

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Previously neutral objects gain the capacity to evoke fear by being paired with noxious or aversive stimuli.

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Learning Based approach for treating phobias: Systematic desensitization

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A behavior therapy technique for overcoming phobias by means of exposure to progressively more fearful stimuli (in imagination or by viewing slides) while remaining deeply relaxed.

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Learning based approach for phobias: Fear-stimulus hierarchy

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An ordered series of increasingly fearful stimuli.

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Learning-Based Approach: Gradual Exposure

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In behavior therapy, a method of overcoming fears through a stepwise process of exposure to increasingly fearful stimuli in imagination or in real-life situations.

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Learning Based Approach: Flooding

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A behavior therapy technique for overcoming fears by means of exposure to high levels of fear-inducing stimuli.

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Learning Based Approach: Virtual Reality Therapy

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A form of exposure therapy involving the presentation of phobic stimuli in a virtual reality environment.

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Cognitive Perspectives with proneness to phobias

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1. Oversensitivity to threatening cues

2. Overprediction of danger

3. Self-defeating thoughts and irrational beliefs

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Cognitive Therapy for social phobias

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REBT: irrational needs for social approval and perfectionism produce unnecessary anxiety in social interactions.

Eliminating exaggerated needs for social approval is a key therapeutic factor.

Cognitive restructuring.

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Generalized Anxiety Disorder

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A type of anxiety disorder characterized by general feelings of dread and foreboding and heightened states of bodily arousal.

Persistent feelings of anxiety that are not triggered by any specific object, situation, or activity, but rather seems to be what Freud labeled “free floating.”

The emotional distress associated with GAD interferes significantly with the person’s daily life.

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Psychodynamic perspective on GENERALIZED ANXIETY DISORDER

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generalized anxiety represents the threatened leakage of unacceptable sexual or aggressive impulses or wishes into conscious awareness.

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GENERALIZED ANXIETY from the learning perspective.

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generalized anxiety is precisely that: generalization of anxiety across many situations.

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GENERALIZED ANXIETY from the Cognitive perspective

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emphasizes the role of exaggerated or distorted thoughts and beliefs, especially beliefs that underlie worry.

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Treatments for Generalized Anxiety Disorder (GAD)

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psychiatric drugs and cognitive-behavioral therapy.

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Cognitive Behavioral Therapy treatments for GAD

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Training in relaxation skills;

learning to substitute calming, adaptive thoughts for intrusive, worrisome thoughts;

and learning skills of de-catastrophizing (avoiding tendencies to think the worst).

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Obsessive–Compulsive and Related Disorders - TYPES (5)

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– obsessive–compulsive disorder

– body dysmorphic disorder

– hoarding disorder

– trichotillomania (hair pulling disorder)

– excoriation (skin picking) disorder

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Obsessive-Compulsive Disorder

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A type of anxiety disorder characterized by recurrent obsessions, compulsions, or both.

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Obsession

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A recurring thought or image that the individual cannot control (e.g. fearing contamination)

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Compulsion

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A repetitive or ritualistic behavior that the person feels compelled to perform (e.g., washing hands, checking doors, avoiding cracks in sidewalk)

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Psychodynamic theory of obsessions

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represent leakage of unconscious impulses into consciousness, and compulsions are acts that help keep these impulses repressed.

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Learning perspective of compulsive behaviors

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These are viewed as operant responses that are negatively reinforced by relief of anxiety engendered by obsessional thoughts.

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Behavior therapist treatments for OCD

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the technique of exposure with response prevention.

The exposure component involves having clients intentionally place themselves in situations.

Through exposure with response prevention (ERP), people with OCD learn to tolerate the anxiety triggered by their obsessive thoughts while they are prevented from performing their compulsive rituals.

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Body Dysmorphic Disorder

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preoccupation with an imagined or exaggerated physical defect in appearance causing individuals to feel they are ugly or even disfigured.

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Treatment for Body Dysmorphic Disorder

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Exposure therapy with response prevention is often used in treating body dysmorphic disorder.

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Hoarding Disorder

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accumulation of and need to retain unnecessary and seemingly useless possessions, causing personal distress or making it difficult to maintain a safe, habitable living space.

not like OCD: Do not experience an urge to perform rituals to control disturbing thoughts related to hoarding.