Panic disorder, Phobias, Social anxiety - PSYC380 - Exam 2

Panic disorder symptoms

• Recurrent and unexpected panic attacks 

• These panic attacks are followed by either one month or more of either 

  • Concern of future attacks or consequences of attacks (if I have an attack, people will see)

  • Dysfunction behavior changes (no longer going out because you are scared of future panic attacks)

Panic attack

Abrupt surge of intense fear or discomfort that peaks within minutes and has four of some of many symptoms

but a few examples of symptoms are: Pounding heart, sweating, feelings of choking, shaking, nausea, and dizziness

Panic disorder: Biological perspective

Locus Coeruleus: Rich in NE; neurons with NE act like an on/off switch for panic attacks

More neurons with NE = More panic

Panic circuit: Increased activity in LC can increase activity in other areas such as the panic circuit

Genetics can also effect panic disorder

Biological treatments for panic disorder 

Medication: Restores proper activity back to panic circuit

Sometimes you can take an anti-depressant for a short period of time and then never have a panic attack again, do not need to be on it for life

Panic disorder and CBT

Panic comes from people who are panic prone and are more sensitive to body sensations and are likely to misinterpret these sensations as serious when they are not

Ex. Stressful interaction at the post office, start breathing heavy, misinterpret as something wrong, leads to panic.

More trauma in life can lead to more misinterpretation

CBT treatments for panic disorder

Biological challenge

Ex. Exposure to sensations: Run up and down the stairs to get out of breath to change the interpretation of the physical sensation.

NOT exposing people to feared situations, just physical sensations

Very effective

Clinical fear (phobias)

Intense, persistent, try to avoid situation, distress to daily life

Phobia symptoms

• Marked as persistent, and disproportionate feat of a particular object or situation; usually lasting at least 6 months 

• Exposure to the object produces immediate fear

• Avoidance of feared situation (avoid going near it or even talking about it)

• Significant distress or impairment 

Agoraphobia

Fear of situations where it would be hard to get help during the symptoms of panic

Agoraphobia checklist

• Pronounced, disproportionate, or repeated fear about being in at least two delineated situations (public transport, parking lots, bridges, open spaces, closed spaces, lines, crowds, going outside by yourself)

• Avoidance of the agoraphobic situation

• Symptoms usually continue for at least 6 months

• Significant distress or impairment

CBT of Phobias (Behavioral dimension)

Proposed that phobias are learned through conditioning like classical conditioning and modeling

Classical conditioning

A simple form of associative learning where an organism learns to connect two different stimuli

CBT treatment for Phobias

Exposure treatment: Have actual or imaginary contact with the phobia to get rid of avoidance

Not getting them to relax, teach to sit with their fear and fear will not cause something bad to happen

Invivo exposure (different types of exposure)

Actual contact with phobia

Imaginal exposure (different types of exposure)

Thinking about contact with the phobia

Just as effective as invivo 

If you have a fear of tsunamis, cannot bring you to one so you have to imagine  

Systematic desensitization (ways to do exposure)

Start from the bottom of the hierarchy and move towards the top, this builds confidence and people are more accepting of treatment

Flooding (ways to do exposure)

Starting right at the top and doing that repeatedly, no buildup, people might hate this and say no to it or do it and never come back

Social anxiety symptoms

• Pronounced, disproportionate, and repeated anxiety about social situations 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 other

• Exposure to social situation almost always produces anxiety

• Avoidance of feared situations

• Significant distress or impairment

SAD cognitive behavioral perspective

Dysfunctional beliefs and expectations of social realm followed by avoidance and safety behaviors

Believing they are not good at being social

Believing that behaviors in social situations can lead to consequences

Safety behavior (CBT of SAD)

Constant need to hold something in order to distract yourself from social situation

Things we do in the middle of a situation to help us deal with it

CBT treatments for SAD

Exposure therapy and systematic therapy discussions to help undo the cycle of negative beliefs

Social skills and assertiveness training (only if lacking)

• May have never had these skills, which develops into social anxiety

• May have lost these skills with social anxiety