Chapter 5: Anxiety, Obsessive-Compulsive, and Related Disorders

generalized anxiety disorder (GAD)

experience excessive anxiety under most circumstances and worry about practically anything (“free-floating” anxiety)

symptoms of GAD

must be present for at least 6 months. feel restless, or on edge; tire easily; have difficulty concentrating; suffer from muscle tension; and sleep problems

how many people in US have GAD

3% of population. 43% get treatment

basic irrational assumptions

the inaccurate and inappropriate beliefs held by people with various psychological problems, according to Albert Ellis

examples of basic irrational assumptions in people with anxiety

if something is dangerous or fearsome, one should be terribly concerned. it is always best to assume the worst

Freud’s explanation of GAD

all children experience some degree of anxiety due to their parents, id impulses, etc. many develop ego defense mechanisms to control it. those who experienced high levels of anxiety or have inadequate defense mechanisms develop general anxiety disorder

humanistic perspective of GAD

arises when people stop looking at themselves honestly. repeated denials of their true thoughts, emotions, and behavior make people anxious and unable to fulfill their potential as human beings. Rogers believed children who did not receive unconditional positive regard become overcritical and develop harsh self standards, causing intense anxiety

metacognitive theory (Adrian Wells)

cognitive-behavioral explanation of GAD. people with the disorder hold positive and negative beliefs about worrying.

Positive: worrying is useful for coping with threats of life

Negative: society teaches me worrying is bad so I worry about my worrying

intolerance of uncertainty theory

cognitive behavioral theory of GAD. some people cannot tolerate the knowledge that negative events may occur. feel uncertain and think about every possible unacceptable outcome all the time

avoidance theory (Thomas Barkovec)

behavioral cognitive explanation of GAD. people worry repeatedly in order to reduce or avoid uncomfortable states of bodily arousal

rational-emotive therapy

a cognitive therapy, developed by Albert Ellis, that helps clients identify and change the irrational assumptions and thinking that contribute to their psychological disorder. points out the irrational assumptions and suggest more appropriate ones.

mindfulness-based therapy

treatment for GAD. helps clients become aware of their thoughts and worries and help them accept such thoughts as mere events of the mind

benzodiazepines

most common group of antianxiety drugs. act like GABA

biological explanation of GAD

neurotransmitter GABA is deficient in people with anxiety disorder. also found deficiency in the fear circuit

phobia

persistent and unreasonable fear of a particular object, activity, or situation

specific phobias

fear of a specific object or situation. most phobias are this and 9% of people have one

agoraphobia

fear of venturing into public places or situations in which escape might be difficult if one were to become panicky or incapacitated. 1% of population has this

cognitive-behavioral explanation for phobias

learned through classical conditioning and modeling

preparedness

behavioral-evolutionary explanation of phobias: a predisposition to develop certain fears (passed on through evolutionary processes)

exposure treatment

overarching umbrella of certain therapies that expose to what they dread

systematic desensitization

an exposure treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects/situations they dread (in vivo is actual confrontation and covert is imagined confrontation)

fear hierarchy

list of feared objects/situations ordered from mildly to extremely upsetting. clients gradually more up this ladder

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. can be either in vivo or covert

social anxiety disorder

severe, persistent and irrational anxiety about social or performance situations in which they may face scrutiny by others and/or be embarrassed. 7% of people in US have it and 40% get treatment

treatments for social anxiety disorder

medication, exposure therapy, discussions about maladaptive thoughts, social skills training

social skills training

cognitive-behavioral therapy approach that helps people learn or improve social skills and assertiveness through role-playing and rehearsing of desirable behaviors. therapist usually models and reinforces with praise

panic attacks

periodic, short bouts of panic that occur suddenly, reach a peak within minutes, and gradually pass. 1/3 of people experience this at least once in their lives

panic attacks feature at least 4 of these symptoms

heart palpitations, tingling of hands or feet, shortness of breath, hot/cold flashes, trembling, chest pains, choking sensations, faintness, dizziness, and a feeling of unreality

panic disorder

an anxiety disorder marked by recurrent and unpredictable panic attacks. 3% of population has it and 59% get treatment. typically sets the stage for agoraphobia

the biological perspective of panic disorder

panic reactions are produced by the panic circuit. hyperactivity of this circuit creates the disorder. Antidepressants (especially ones that increase serotonin) and benzodiazepine helps

cognitive behavioral perspective of panic disorder

panic reactions are experienced by people who further misinterpret the physiological events taking place within their bodies. treatments aim at correcting those misinterpretations

biological challenge tests

a cognitive-behavioral procedure used to produce panic in participants/clients by having them exercise vigorously or perform some other potentially panic-inducing task in the presence of a researcher/therapist

anxiety sensitivity

tendency to focus on one’s bodily sensations, assess them illogically, and interpret them as harmful

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 in order to prevent or reduce anxiety

obsessive-compulsive disorder (OCD)

a disorder in which a person has recurrent obsessions, compulsions, or both (they are excessive or unreasonable and cause great stress and can interfere with daily functions). 1.2% have it and 40% get treatment

psychodynamic perspective of OCD

believe id impulses take form in obsessive thoughts and ego defenses are the counterthoughts and/or compulsive actions (not supported by research)

cognitive-behavioral perspective of OCD

everyone has repetitive intrusive but the ones that develop the disorder blame themselves for such thoughts and expect terrible things will happen

neutralize

a person’s attempt to eliminate unwanted thoughts by thinking or behaving in ways that put matters right internally, making up for unacceptable thoughts. usually turns into an obsession or compulsion

exposure and response prevention

cognitive behavioral treatment which exposes clients to anxiety-arousing thoughts or situations and then prevents them from performing their compulsive acts

biological perspective of OCD

gene anomalies, hyperactive cortico-striato-thalamo-cortical circuit

OCD related disorders

disorders in which obsessive-like concerns drive people to repeatedly and excessively perform certain pathological patterns of behavior (hoarding disorder, trichotillomania, excoriation disorder, body dysmorphic disorder)

hoarding disorder

a disorder in which individuals feel compelled to save items and become very distressed if they try to discard them, resulting in an excessive accumulation of items

trichotillomania

a disorder in which people repeatedly pull out their hair from their scalp, eyebrows, eyelashes, or other parts of the body. aka hair-pulling disorder

excoriation (skin-picking) disorder

people repeatedly pick at their skin, resulting in significant sores or wounds

body dysmorphic disorder

individuals become preoccupied with the belief that they have certain defects or flaws imagined or greatly exaggerated