PSY 242 - Anxiety, OCD + Related Disorders

Anxiety

• CNS’s physiological and emotional response to a vague sense of threat or danger

• mood characterized by apprehension & worry

3 Components of Anxiety

• Physiological

• Cognitive

• Behavioral

Fear

• CNS’s physiological and emotional response to a serios threat to one’s well being

• immediate alarm reaction

Anxiety Disorder: Common Feature

presence of extreme or disabling anxiety in the absence of a real threat or danger

Anxiety Disorders

• Generalized Anxiety Disorder

• Social Phobia

• Specific Phobia

• Agoraphobia

• Obsessive Compulsive Disorder

• Out of Proportion Anxiety

Generalized Anxiety Disorder

excessive anxiety across most situations and about most things (for over 6 months)

Separation Anxiety Disorder

individuals feel extreme anxiety, often panic, whenever they are separated from key people in their lives

Specific Phobia: Criteria

• fear of specific object or situation

• object/situation almost always provokes immediate fear

• avoid stimulus or endured with intense distress and anxiety

• lasts over 6 months

• interferes with normal routine or functioning

Social Anxiety Disorder

• marked fear/anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others

• distress, impairment

• avoidance of the social situations

Agoraphopbia

• concern/fear that the individual cannot escape or get help

• situations almost always provoke fear/anxiety

• lasts more than 6 months

• significant distress and impairment

Panic

experience of in intense fear accompanied by physical symptoms which occurs in the absence of real danger

Panic Attack: Criteria

• abrupt surge of intense fear (peaks within mins)

• >= 4 symptoms:

  • palpitations/accelerated heart rate

  • sweating

  • trembling/shaking

  • shortness of breath

  • dizziness/faintness

  • chills/hot flushes

  • paresthesia (numbing/tingling)

  • derealization/depersonalizatino

  • fear of losing control

• can be unexpected or expected

• can be added as a specifier for other disorders

Obsessions

persistent, intrusive, and nonsensical thoughts, images, or urges

Compulsions

repetitive and rigid behaviors or mental acts that people may feel they MUST do to prevent or reduce anxiety

Obsessive and Compulsive Disorder (OCD)

• time-consuming

• causes significant distress/impairment

• tic-related - has a current or past history of a tic disorder

Triple Vulnerability Theory (Barlow, 2000, 2002)

• Biological Factors

• Psychological Factors

• Social Factors

Generalized Anxiety Disorder: Etiology

• Psychodynamic - high anxiety experiences in childhood, poor defense mechanisms

• Humanistic - lack of unconditional positive regard, overly self critical of self

• Cognitive-Behavioral - problematic behaviors and dysfunctional thinking

• Biological

Conditioning of Phobias: Mowrer’s Conditioning Model

• Direct Experience

• Vicarious Experience

• False Alarm/Unexpected Panic Attack

Social Phobia: Development

• Behavioral Conditioning

• Cognitive Errors

• Inhibited (shy temperament)

  • biological factor

Panic Disorder: Development

• Biological Factors

• Cognitive Factors

OCD: Etiology

• Psychodynamic: obsessions (id), compulsions (ego)

• Behavioral: operant conditioning of compulsive behavior

• Cognitive: predisposition to repetitive thoughts, act to neutralize the thoughts

• Biological

Treatment of Anxiety

• Pharmacological (Benzodiazepines + SSRIS)

• Behavioral Therapy - Exposure

• Cognitive Behavioral Therapy

• Relaxation Training

Treatment for Phobias

• Exposure Treatment

  • Systematic Desensitization

  • Flooding Modeling

Systematic Desensitization

• Fear Hierarchy

• Relaxation Training

• In Vivo Desensitization

• Overt Desensitization

• Virtual Reality

Treatment of OCD

• Cognitive-Behavioral

• Exposure and Response Prevention

• Biological Perspective

  • Serotonin-Enhancing Antidepressants (Clomipramine/Anafranil)

Treatment of Social Phobia

• Medications (Benzodiazepine or antidepressant drugs)

• Cognitive-Behavioral Therapy

• Social Skills and Assertiveness Training

Treatment of Panic Disorder

• Psychoeducation

• Promote accurate interpretation

• Interoceptive Exposure

• Drug Therapies

• CBT Therapies

Developmental Psychopathology Perspective

examination of how key factors emerge and intersect at points throughout the life span