CH 5 Anxiety, Obsessive-Compulsive, and Related Disorders

fear

body reads as if ir is in danger when a feared stimulus is present; threatening well being

axiety

state of alarm in response to vague sense of being in danger

what are the similarities between anxiety and fear?

physiological features—-sweating, heart papiationons, muscle tensing, heaving breathing

what are the most common mental disorders in the U.S.?

anxiety disorders

comorbidity

one or more diagnoses at the same time

how many people with anxiety disorders actually seek treatment?

42%

what are some disorders associated with anxiety?

GAD, phobias, panic disorder, ocd, acute stress disorder, posttraumatic stress disorder

seperation anxiety disorder

-most common childhood disorder (up to 4%)

-can develop in adults

-up to 2% of adults

generalized anxiety disorder

-common in western societies

-as many as 4% of the us population have symptoms in any given year

-usually first appears in childhood or adolescense

-edginess, fatigue, poor concentration, irritability, muscle tension

GAD: sociocultural perspective

theory: truly dangerous social conditions or highly threatened environment

-poverty and residing in crime area

GAD: psychodynamic perspective

all children experience anxiety

-may develop if child faces particularly high levels of anxiety or has inadequate defense mechanisms

realistic anxiety

in reaction to actual danger

neurotic anxiety

anxiety we feel when prevented from expressing our impulsesmo

moral anxiety

arises when people are punished for expressing impulses

GAD: psychodynamic perspective treatments

free association

therapist interpretations

-freudians focus less on fear and more on helping the person gain control of their id

ORT

short term psychodynamic therapy

ORT

attempt to help others identify and settle early relationship problems

Short term psychodynamic therapies

focus on current relationship patterns with idea to play out old relationship patterns

GAD: Humanistic Perspective

theory: lack of honest and accepting view of oneself—-people not looking at themself in accepting way

Carl Rogers: lack of unconditional positive regard

GAD: Humanistic Treatments

client centered approach

unconditional positive regard, empathy, genuineness

GAD: Cognitive Perspective

rational emotive behavior therapy

-caused by maladaptive assumptions—-if applied to everyday lives, and more events becomes GAD

Aaron Beck

-father of cognitive therapy

-those with GAD constantly hold silent assumptions that imply immediate danger

-”always best to assume the worst”

metacognitive theory

developed by Wells

-suggests that most problematic assumptions in GAD are actually the persons worry about worrying

intolerance of uncertainty theory

certain individual more likely to find it unacceptable that any negative event could possibly occur even if small

avoidance theory

worrying serves as positive function—helps alleviate some level of anxiety

rational emotive therapy

point out irrational assumptions

suggest more appropriate assumptions

assign related HW

some research evidencem

mindfulness based cognitive therapy

ways to calm the mind

if they focus on worry, it enhances cognitive therapy

acceptance and commitment theory

accept thought that arise and commit that you wont act on them

mindfulness meditation

educate clients about their bodily arousal when anxious and what they are thinking

GAD: biological perspective

-biological relatives more likely to have GAD (15%) than general population (6%)

-GABA carries inhibitory message

-malfunctions cause GAD

-feedback system turns on to reduce anxiety and fear after it has passed.

biological: issue of causal relationships

if we find GABA deficit, it does not mean that it is the cause of anxiety

barbituates

sedative hypnotics, cause inhibitory messages to be sent so the body calms down

Benzodiazepines

provide modest temporary relief

relaxation training

physical relaxation will lead to psychological relaxation

more effective than placebo or no treatment

best in combination with CT or biofeedback

phobias

persistent and unreasonable fears of particular objects, activities, or situations

avoid objects or thoughts about it

creates distress that interferes with functioning

specific phobias

a persistent fear of a specific object or situation

12% each year

many have comorbid phobias

vast majority do not seek treatment

agoraphobia

·       Afraid of being in public places or situations in which escape might be difficult or help unavailable if they experience panic or become incapacitated

what causes specific phobias?

fear learned through classical conditioning

avoid situation to permit fear to be more entrenched

unconditoned stimulus

causes response

not learned—built within us

neutral stimulus

paired with something that causes fear

conditioned stimulus

learned reseponse

systematic desensitization

·       learn to relax while gradually facing the objects or situations they fear

in vivo (live)

live with fear

covert desensitization

ask client to imagine themselves in fearful situation

flooding

face the feared stimulus all at once—non-gradual exposure

modeling

how to regulate during the feared stimulus

panic attack 

extreme and sudden explosion of fear

treatments or agoraphobia

exposure therapy

support group

home based self-help

social anxiety

fear of functioning poorly infront of others

-often begins in late childhood/adolescence

symptoms begin in 7% of population every year

what type of medication is commonly used to treat social anxiety?

antidepressants

panic

extreme anxiety reaction

panic attack

occur suddenly, reach a peak, and pass

suffers often fear they will die, go crazy, or lose control

absence of a real threat

panic disorder

unforeseen panic attacks occur repeatedly

What biological factors contribute to panic disorder?

initial theory and more recent theory

initial theory

abnormal norepinephrine activity in locus ceruleus

more recent theory

brain circuits and amygdala are more complex root

antidepressants

preventing or reducing panic attacks

function on norepinephrine receptors

panic disorder: cognitive perspective

cognitive theorists: misinterpretation of bodily event 

cognitive treatment: works to correct such misinterpretations

high degree of anxiety sensitivity

obsessions

persistent thoughts, idea, or image that happens consistently

if try to ignore, causes an anxiety response

feels intense and feoreign

compulsions

repetitive and rigid behavior or mental act that the person feels that they have to perform

feel that they are mandatory or unstoppable

performance of behavior causes a reduction in anxirty

ocd: cognitive behavioral perspective

attempt to neutralize thoughts and reactions

reductions in anxiety after neutralizing streategies

exceptionally high standard of conduct; thought-action fusion

ocd: exposure and response prevention

expose person to stimulus that causes obsession to prevent the compusion

ocd: biological perspective

hyperactive corticostriato-thalamo-cortical circuit

seretonin based antidepressants

clomipramine (Anafranil)

Fuloxetine (Prozac)

Fluvoxamine (Luvox)

combination therapy

treatment in which a patient is given two or more drugs (or other therapeutic agents) for a single disease

hoarding disorder

a mental health condition characterized by the persistent difficulty in discarding or parting with possessions, regardless of their value or usefulness

trichotilomania

hair pulling disorder

excoriation

skinpicking disorderb

body dismorphic disorder

a mental health condition where a person spends a lot of time worrying about flaws in their appearance