Week 10-chapter 8: anxiety disorder and OCD

intellectual disability

• delay in sensory-motor skills

  • motor coordination

  • movement of arms

  • ex catching ball

receptive

• stronger skill set

• understanding

expressive

• communicative

the anxiety cycle

1. thought

2. physical sensations

3. feelings

4. beahviours

5. outcome

anxiety

• complex

• presentational of anxiety and depression

• a hypothetical case

• social anxiety disorder (SOC) or social phobia

when does social anxiety occur?

• early to mid adolescence

• evidence base treatment

  • CBT (psychoeducation)

  • psychoeducation: learning that it is a part of me but it doesn’t define me

  • most of the time 2 treatments are used together in the case of anxiety

  • individualized to the client

specific phobia

• a fear that is not age appropriate, persists, is irrational or exaggerated, leads to avoidance of the object or event and causes functional impairment

• becomes an issue if it affects/interferes in your everyday life

role of the insular cortex

• looking at specific phobias we look at the insular cortex

• researchers believe the anxiety associated with specific phobias relate to abnormalities in the anterior insular cortex

graduated exposure vs. in vivo flooding

• graduated exposure: client initially confronts situations that causes minor anxiety, then gradually progresses to situations that cause more anxiety

• in vivo: A procedure in which clients gradually expose themselves to increasingly challenging anxiety-provoking situations.

generalized anxiety disorder

• worrying about multiple things at once

• types of worries (minor events and bigger ones)

• ex, could be worrying about it raining tmrw

• diagnosed if you have 6 months of worrying for more days than not worrying

• typical age onset is in adolescence

• evidence-bsased treatment is CBT and medication such as SSRIs

Dr. Ali Mattu explains agoraphobia video

• fear or avoidance of situations and fear of not being able to escape

• can experience in the subway, large open spaces, plane, elevator

• people will avoid a situation that will make them distressed

• some may not leave their home because of this fear

• often accompanied by panic attacks

obsessive compulsive cycle

• anxiety→ compulsion → reinforcement → obsession

• ex. handwashing

  • Anxiety: hands aren’t clean

  • Compulsion: washing hands

  • Reinforcement: needing to wash hands

  • Obsession: thinking hands still aren’t clean so continual washing occurs

what is OCD

• persistent thoughts, images and or impulses

• repetitive behaviours are performed to neutralize the thoughts

how much time does it take up?

• at least one hour per day to meet clinical criteria

• discussion of interference

age of onset

• first onset 9-12 years and most likely to be in males

• ex. kid packing all of their belongings in a backpack bc of the fear of loosing things

family accomodation

• actively participating in compulsions and rituals

• facilitating escape from certain distressing situations

• providing excessive reassurance

• adhering to child-assigned rules and modifying family routines

what medication is often prescribed for OCD?

• SSRIs

• bringing in the biopsychosocial model

case: scenario-hoarding: Rachel

• 12 yr old with ASD, ID and ADHD

• target obsession: worries about loosing things

• related compulsion: hoarding, extensie packing of items

• treatment completed in home and community setting

• acceptable interobserver agreement and treatment integrity

• CBT treatment for her

overcoming anxiety: Jonas Kolker

• 3rd grade was bad form him when he started to have panic attacks and he could not comprehend the feelings he was having

• he would leave the home feeling fine but then once he got to school his body overloaded and shut down '

• therapist said to get through it you have to force yourself to become uncomfortable with this

  2 main methods that was taught was CBT and exposure therapy

• CBT: work with your mind to better how you feel

  • collection of methods

  • imagine waves crashing over you

• exposure therapy: if you are scared of something the best way to get over the fear is to do it

  • exposure therapy works better than medications

flooding

• a behavioural in which the client is immersed in the sensation of anxiety by being exposed to the feared situation in its entirety

in vivo flooding

• a behavioural technique in which the client is immersed in the actual feared situation

imaginal flooding

• a behavioral technique in which the client is immersed through imagination into the feared situation

gradual in vivo

• a procedure in which clients gradually expose themselves to increasingly challenging anxiety-provoking situations

systematic desensitization

• for treating specific phobias, which method suggests the client learn to substitute relaxation for fear through a series of graduated steps

behaviourist view of specific phobias

• a person generalizes an appropriate fear reaction to all stimuli in the category, even harmless one

agoraphobia

• intense anxiety triggered by the real or anticipated exposure to situations in which individuals may be unable to get help should they become incapacitated

acute stress disorder

• an anxiety disorder that develops after a traumatic event and lasts 1 month with symptoms such as depersonalization, numbing, dissociative amnesia, intense anxiety, hypervigilance and impairment of everyday functioning

body dysmorphic disorder (BDD)

• a disorder in which individuals are preoccupied with the idea that a part of their body is ugly or defective

complex post-traumatic disorder

• diagnostic in ICD-11 used to apply to individuals who suffer prolonged exposure to severe stressors or multiple and repeated adverse events from which they cannot escape

disinhibited social engagement disorder

• diagnosis given to children who engage in culturally inappropriate, overly familiar behaviour with people who are relative strangers

excoriation (skin-picking) disorder

• recurrent picking at ones own skin

anxiety sensitivity theory

• people who have this disorder have heightened responsiveness to the presence of carbon dioxide in the blood

diagnosis of a panic disorder

• for a clinician to assign a diagnosis of panic disorder, the individual would have to experience panic attacks on a repeated basis and be bothered by the fear of having another one

acute stress disorder

• An anxiety disorder that develops after a traumatic event, and lasts for up to 1 month with symptoms such as depersonalization, numbing, dissociative amnesia, intense anxiety, hypervigilance, and impairment of everyday functioning.

disinhibited social engagement disorder

• Diagnosis given to children who engage in culturally inappropriate, overly familiar behavior with people who are relative strangers.

reactive attachment disorder (RAD)

• A diagnosis given to children involving a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers along with minimal responsiveness to others and limited positive affect.

trichotillomania (hair-pulling disorder)

• An impulse-control disorder involving the compulsive, persistent urge to pull out one’s own hair