Anxiety Disorders, Panic Disorder, and OCD Lecture

Vocabulary practice flashcards covering diagnostic criteria, psychological theories, conditioning models, symptoms, and treatments for Social Anxiety Disorder, Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, and Obsessive-Compulsive Disorder.

Exposure Simulations for SAD

Behavioral treatment exercises simulating feared social situations in Social Anxiety Disorder, such as initiating conversations, public speaking, writing in front of others, eating or drinking in front of others, making mistakes in front of others, and interacting with authority figures.

Cognitive Restructuring

A therapeutic technique that involves identifying automatic negative thoughts (e.g., 'Everyone can tell I’m nervous'), examining the evidence for and against them, and reframing them to be less biased and more accurate (e.g., 'Feeling nervous isn’t the same thing as looking nervous').

Safety Behaviors

Maladaptive coping strategies used to reduce anxiety or prevent feared outcomes—such as over-preparing for a speech, wearing makeup to hide blushing, avoiding eye contact, or using alcohol—which must be assessed and eliminated during treatment.

Panic Disorder

An anxiety disorder characterized by recurrent panic attacks that 'come out of the blue' accompanied by persistent fears of having additional panic attacks.

Core Fear of Panic Disorder

Fear itself, commonly known as 'the fear of fear.'

Panic Attack

A discrete period of intense fear in which at least $4$ somatic or cognitive symptoms develop abruptly and reach a peak within $10\,\text{minutes}$.

Panic Attack Symptoms

Thirteen physical and cognitive symptoms including palpitations or pounding heart, sweating, trembling or shaking, shortness of breath, feelings of choking, chest pain or discomfort, nausea or abdominal distress, dizziness/lightheadedness/faintness, derealization or depersonalization, fear of losing control or going crazy, fear of dying, numbness or tingling sensations, and chills or hot flashes.

Lifetime Prevalence of Panic Attacks

Approximately $25\%$ of individuals will experience a panic attack at some point during their lifetime (Kessler et al., 2006).

Panic Disorder (DSM-5-TR Diagnostic Criteria)

Recurrent unexpected panic attacks, where at least one attack has been followed by $1\,\text{month}$ (or more) of persistent worry about additional attacks/consequences or a significant maladaptive change in behavior related to the attacks, not due to substances or another disorder.

Agoraphobia

Anxiety lasting at least $6\,\text{months}$ about being in places or situations from which escape might be difficult or embarrassing, or where help may not be available in the event of a panic attack or panic-like symptoms.

Agoraphobia without Panic Disorder

A condition in which a person experiences limited symptom panic attacks and avoids public situations due to specific fears, such as fearing they will get dizzy and fall over.

Common Agoraphobia Situations

Settings frequently avoided or endured with distress, including crowds, theaters, malls, parking lots, cars, bridges, standing in line, elevators, airplanes, and being home alone.

Comprehensive Theory of Learning (Panic Disorder)

A psychological causal model of panic disorder based on classical conditioning, explaining how both internal somatic cues and external environments become conditioned stimuli that trigger anxiety and panic responses.

Interoceptive Conditioning

A classical conditioning process in panic disorder where previously neutral internal bodily sensations (e.g., an increased heart rate) become conditioned stimuli that trigger an anxiety rush or panic response after being paired with panic.

Exteroceptive Conditioning

A classical conditioning process where external environmental locations (such as highways or shopping malls) become conditioned stimuli evoking anxiety or panic after being paired with a panic attack.

Anxiety Sensitivity

A psychological causal factor consisting of a person's belief that bodily sensations associated with autonomic arousal are harmful or dangerous.

Perceived Control

A psychological protective factor that buffers against the development and severity of anxiety and panic disorder.

Cognitive Theory of Panic

A psychological causal model stating that panic disorder arises from cognitive biases, specifically hypervigilance and greater attention directed toward threat and bodily sensations.

Benzodiazepines

Fast-acting anti-anxiety medications (such as Xanax and Klonopin) whose primary clinical drawback and concern is addiction.

Panic Control Treatment (PCT)

A cognitive-behavioral therapy protocol for panic disorder that incorporates interoceptive exposure targeting panic attacks, exposure to external stimuli, education, breathing retraining, and cognitive restructuring.

Interoceptive Exposure

A CBT technique that deliberately induces feared internal physical sensations (e.g., hyperventilating through a straw or spinning in a chair) to reduce panic-related anxiety and show that sensations are harmless.

Generalized Anxiety Disorder (GAD)

An anxiety disorder characterized by excessive and unreasonable anxiety or worry about many different aspects of life lasting at least $6\,\text{months}$.

Core Fear of Generalized Anxiety Disorder

'Everything,' specifically characterized by pervasive and uncontrollable worry.

GAD Worry (Dupuy et al., 2001)

A distinct form of pathological worry in GAD that significantly differs in excessiveness, uncontrollability, and focus on minor matters compared to 'normal' worry.

Belief that Worry is Good

A psychological causal factor in GAD where individuals hold positive beliefs about worrying, such as believing it helps prepare for threats, avoid catastrophe, and prevent negative emotions.

Negative Reinforcement of Worry

The mechanism maintaining GAD in which worrying temporarily suppresses physical anxiety symptoms or emotional processing, thereby reinforcing and maintaining the worrying behavior.

Neuroticism

A major personality vulnerability factor that serves as a shared risk factor across all anxiety disorders.

Obsessive-Compulsive Disorder (OCD)

A mental disorder characterized by recurrent, unwanted, and intrusive obsessive thoughts or distressing images, often accompanied by compulsive behaviors performed to cope with or neutralize such thoughts.

Obsessions

Recurrent and persistent thoughts, impulses, or images that are intrusive, inappropriate, cause marked anxiety or distress, last more than $1\,\text{hour}$ per day, and are recognized by the individual as products of their own mind that are irrational.

Common Obsessions

Frequent obsessional themes in OCD, including contamination fears, fears of harming oneself or others, pathological doubt, need for symmetry, sexual obsessions, and religious obsessions.

Compulsions

Repetitive behaviors or mental acts performed in response to an obsession, aimed at preventing or reducing distress or a dreaded event or situation, and taking up more than $1\,\text{hour}$ per day.

Common Compulsions

Frequent compulsive actions seen in OCD, specifically cleaning, checking, repeating, ordering/arranging, and counting.

Primary DSM-5-TR Criteria for OCD

The presence of obsessions, compulsions, or both that are time-consuming (taking more than $1\,\text{hour}$ per day) or cause clinically significant distress or functional impairment.