ch. 5: anxiety, obsessive-compulsive, & related disorders

fear

the central nervous system’s physiological & emotional response to a serious threat to one’s well-being

anxiety

the central nervous system’s physiological & emotional response to a vague sense of threat or danger

general symptoms of anxiety

sometimes described as free-floating. disproportionate, uncontrollable, & ongoing worry about multiple matters. feel restless, keyed up, or on edge. have difficulty concentrating, tire easily, suffer from muscle tension, irritable, sleep problems. symptoms last at least 6 months & lead to reduced quality of life.

GAD is common in

western nations. transgender & nonbinary people more likely than cisgender to develop this. women are twice as likely as men to experience this. more prevalent among lesbian, gay, bisexual people than heterosexuals. non-Hispanic white Americans are more likely than POCs to develop this.

separation anxiety

individuals feel extreme anxiety, often panic, whenever they are separated from home or key people in their lives. occurs in children, but adults can experience it as well (however, they may be experiencing another disorder like PTSD or prolonged grief disorder).

children with separation anxiety

children have trouble traveling away from their family and often refuse to visit other people or go to school. many can’t stay alone in a room and cling to their parents around the house. children fear that they will get lost or their parents will meet with an accident or illness. function quite typically as long as they’re near their parents. symptoms must persist for at least 4 weeks.

adults with separation anxiety

occurs particularly after adults have experienced traumas such as death of child or intimate partner, relationship breakup, separation caused by military service, etc. consumed with concern about health, safety, or well-being of significant other: partner, surviving child, or other. extreme anxiety & invasive demands cause severe distress and greatly damage social & occupational life. symptoms must persist for at least 6 months

what causes GAD according to the sociocultural perspective?

high rates in people living in dangerous conditions (high threat environments, high crime rates & violence). poverty: people w/ low incomes more likely to live in underserved communities w/ high crime rates, fewer education/jobs, house/food insecurity, higher risk of health problems, & less adequate healthcare. epidemics. most people in these environments don’t develop this disorder (other factors at play).

where does anxiety come from according to Freud?

all children experience some anxiety as part of growing up and use ego defense mechanisms to help control it. high levels of anxiety means that their self defense mechanisms are inadequate, so they may develop GAD.

what causes GAD according to the psychodynamic perspective?

children who are punished for their id impulses (messing themselves, crying to be fed during infancy) believe that their impulses are dangerous, so they may feel overwhelming anxiety whenever they have them. alternatively, overprotected children have little opportunity to develop effective defense mechanisms, so it’s too weak to cope with resulting anxieties of adult life.

what is right about Freud’s theory of anxiety?

disorder can be traced to difficulties in early relationships between children & their parents. children who experienced harsh punishment and children who had extreme protectiveness by parents had higher levels of anxiety later in life.

what is disagreed upon in Freud’s theory of anxiety?

patients reacted defensively, forget what they had been talking about (repress), & changed the subject/denied negative feelings when asked to discuss upsetting experiences. patients are not necessarily repressing those events, but they may be focusing purposely on positive aspects of their lives or are too embarrassed. need to develop trust in therapist first

Freudian psychodynamic therapists vs. anxiety

use free association and interpretations of transference, resistance, & dreams to treat all psychological problems. use these to help clients become less afraid of their id impulses and be more successful in controlling them

object relation therapists vs. anxiety

psychodynamic therapists that use free association and interpretations of transference, resistance, & dreams to treat all psychological problems. use these to help clients identify & settle the childhood relationship problems that causes them anxiety in adulthood

is psychodynamic therapy effective for people with anxiety?

long-term is only modest help to people with GAD. short-term has in some cases significantly reduced levels of anxiety, worry, & social difficulty of clients with this disorder

what causes GAD according to the humanistic perspective?

arises when people stop looking at themselves honestly & acceptingly. repeated denials of their true, thoughts, emotions, & behavior make people anxious and unable to fulfill their potential as human beings. 

where does anxiety come from according to Carl Rogers?

children who fail to receive unconditional positive regard from others may be overly critical of themselves and develop harsh-self standards (conditions of worth). they try to meet these standards by repeatedly distorting & denying true thoughts & experiences. threatening self-judgements keep breaking through and causing intense anxiety

client-centered therapy

humanistic therapy developed by Carl Rogers in which clinicians try to help clients by conveying acceptance, accurate empathy, & genuineness. it would hopefully help clients feel secure enough to recognize their true needs, thoughts, & emotions.

client-centered therapy vs. anxiety

usually more helpful to anxious clients than no treatment at all. only sometimes superior to placebo therapy or no therapy. only limited support for Roger’s explanation of broad & excess anxiety

what causes GAD according to the cognitive-behavioral perspective?

psychological disorders are often caused by problematic behaviors & dysfunctional ways of thinking. focus largely on cognitive dimension rather than behavior for anxiety. GAD primarily caused by maladaptive assumptions (basic irrational, silent), which are applied to more & more events. overattentive to potentially threatening stimuli

basic irrational assumptions (specifically for anxiety)

inaccurate & inappropriate beliefs help by people with various psychological problems. ex: you have to be loved or approved by everyone in your community, it is awful/catastrophic when things don’t go your way. when faced with a stressful event, people with these are likely to interpret it as dangerous, to overreact, & to feel fear. 

silent assumptions (specifically for anxiety)

in theory, people with GAD constantly hold these. ex: a situation/person is unsafe until proven safe, it’s always best to assume the worst. implies that they are imminent danger. 

metacognitive theory

people with GAD implicitly hold both positive & negative beliefs about worrying. positive: worrying is a useful way of appraising & coping with threats in life. negative: society teaches worrying is bad, so believing repeated worrying is harmful & uncontrollable. worry about the fact that they’re always worrying (meta-worries). net effect: GAD

intolerance of uncertainty theory

some can’t tolerate the knowledge that negative events may occur. worry constantly that such events are about to occur. such intolerance & worry leave them highly vulnerable to development of GAD. research: higher levels of intolerance with people who have more anxiety, may be biologically based, develops in early childhood & can be passed on genetically

proponents of intolerance of uncertainty theory

people with GAD worry as they try to find “correct” solutions & restore certainty, but since it’s never certain that a solution is correct, they are always left to grapple with intolerable levels of uncertainty. triggers new rounds of worrying & new efforts.

avoidance theory

people with GAD have greater bodily arousal, and worrying reduces arousal, perhaps by distracting them from unpleasant physical feelings. research: people with GAD experience fast & intense bodily reactions, find reactions overwhelming, worry more when aroused, and reduce arousal when they worry

rational-emotive therapy

cognitive therapy that helps clients ID & change the irrational assumptions and thinking that contribute to their psychological disorder

CBT breaking down worrying

educate clients about role of worrying and have them observe bodily arousal & cognitive responses across various situations. appreciate the triggers, misconceptions, & misguided efforts to control their lives by worrying. expected to view world as less threatening (& less arousing)

mindfulness-based CBT

therapists help clients become aware of their streams of thoughts, including their worries, as those thoughts are occurring and to accept such thoughts as mere events of the mind. instead of trying to eliminate worries, they are expected to be less upset & influenced by them.

family pedigree study

a research design in which investigators determine how many and which relatives of a person with a disorder have the same disorder

benzodiazepines

the most common group of anti-anxiety drugs, which includes ativan, valium & xanax.

what causes GAD according to the biological perspective?

neuron receptors ordinarily receive GABA (inhibitory), which causes neuron to stop firing & help anxiety subside: GABA may be deficient in people with GAD → benzodiazepines & gabapentinoids.