6.2 - Panic Disorder to BDD

Panic Disorder

Occurrence of panic attacks seems to come "out of the blue"

Panic Disorder

Recurrent, unexpected attacks and worry about additional attacks

Panic Disorder

Attacks are brief but intense

3

Panic Disorder:

• Must be abrupt onset of ___ out of 13 symptoms (10 physical, 3 cognitive)

• Unexpected Attacks

• 4+ Symptoms (like heart racing, sweating, dizziness, fear of dying)

• 1 month of Worry

• Not Due to Substance​

• Not Another Disorder

Criteria for Panic Disorder:

• Palpitations, pounding heart, or accelerated heart rate

• ​Sweating

• ​Trembling

• ​Sensations of shortness of breath

• ​Feelings of choking

• ​Chest pain or discomfort

• ​Nausea or abdominal distress

• ​Feeling dizzy, unsteady, lightheaded, or faint

Panic Disorder Symptoms:

Agoraphobia

an anxiety disorder characterized by intense fear and anxiety related to places or situations where escape might be difficult or where help might not be available.

• Fear of 2+ Situations

• Escape Difficult

• Provokes Fear

• Avoidance/Help

• Out of Proportion (Fear is excessive)

• Lasts 6+ Months

• Impairment

Criteria for Agoraphobia:

• Public transport

• Open spaces

• Enclosed spaces

• Standing in line/crowd

• Outside home alone

Situations in Agoraphobia: (5)

Agoraphobia

Anxiety about being in places from which escape might be difficult or embarrassing:

• Crowds

• Theaters

• Malls

Panic disorder without agoraphobia

________ is more common than panic disorder with agoraphobia

Agoraphobia

Twice as prevalent in women than in men

Agoraphobia

Average age onset is 23-34

1st panic attack

often occurs after periods of distress or a highly stressful life circumstance.

True

True or False.

It's important to note that many adults who experience a single panic attack DO NOT develop panic disorder.

The Panic Circle:

• Medications

• Behavioral Treatments

• Cognitive-Behavioral Treatments

Treatments for Agoraphobia:

• Anxiolytics

• Antidepressants

Medications for Agoraphobia:

Generalized Anxiety Disorder (GAD)

Chronic or excessive worry about multiple events and activities

• Duration: Occurs more days than not for a 6-month period.

women

GAD is twice as common in _____

• Excessive Worry (6+ Months)

• Hard to control

• 3+ Symptoms

• Causes Distress/Impairment

Criteria for GAD:

• Restlessness/on edge

• Easily fatigued

• Concentration difficulty

• Irritability

• Muscle tension

• Sleep disturbance

Symptoms for GAD: (6)

• Conflict between id and ego

• Perceptions of uncontrollability and unpredictability

• Worry positive or negative

• Automatic attentional bias toward threatening information in environment

Psychological Causal Factors of GAD:

• Genetics

• Neurotransmitters

• CRH (Corticotropin-Releasing Hormone)

Biological Causal Factors of GAD:

• Anxiolytic drugs

• Buspirone

• Cognitive-behavioral therapy

Treatments for GAD: (ABC)

Anxiolytic Drugs

medications primarily used to reduce anxiety.

• They are also sometimes referred to as minor tranquilizers.

Buspirone

is an anxiolytic medication that belongs to a different class than benzodiazepines.

Obsessive-Compulsive Disorder

Occurrence of unwanted and intrusive obsessive or distressing images

• Usually accompanied by compulsive behaviors

Obsessive-Compulsive and related disorders

New category of disorders in DSM-5:

Obsessive-Compulsive Disorder

Usually accompanied by compulsive behaviors performed to neutralize obsessive thoughts or images and/or prevent some dreaded event or situation

• Contamination fears

• Fears of harming oneself or others

• Lack of symmetry

• Pathological doubt

Obsessions: (CFLP)

• Cleaning

• Checking

• Repeating

• Ordering/arranging

• Counting

Compulsions: (CCROC)

Obsessive-Compulsive Disorder

affects both genders equally

boys

OCD

• Also not uncommon in children: more frequent in ____

Mowrer

______ developed the two-process theory of avoidance learning

Two-Process Theory of Avoidance Learning

Neutral stimuli become associated with fearful thoughts via classical conditioning eliciting anxiety

• Examples: touching doorknob, shaking hands

Two-Process Theory of Avoidance Learning

explains how fears and phobias are learned and maintained.

• It combines classical and operant conditioning processes

• Obsessions AND/OR Compulsions

• Time-Consuming/Impairing (Obsessions/compulsions take up significant time OR cause distress/impairment.)

Criteria for OCD:

• evolutionary

• increase

• Obsessions with contamination and dirt appear to have ________ roots

• Attempting to suppress unwanted thoughts may _______ those thoughts

• Genetics

• Brain function abnormalities

• Serotonin

Biological Causal Factors of OCD:

Serotonin

is strongly implicated in OCD.

• Exposure and response prevention

• Medications that affect neurotransmitter serotonin

Treatments of OCD:

Exposure and response prevention

most effective approach to obsessive compulsive disorder (OCD)

• anxiety-producing obsession

• compulsion

Exposure to ___________, prevention of ________ typically used

Obsessive-Compulsive Disorder

Medications that affect neurotransmitter serotonin have also been found helpful

Body Dysmorphic Disorder

Obsessed with perceived or imagined flaw in appearance

• Causes clinically significant distress

• May focus on any body part

Somatoform disorders

BDD has been moved from _________ to OCD disorders because of its commonalities with it

• skin

• hair

• nose

• eyes

• breasts/chest/nipples

• stomach

• face size/shape

Most common locations of complaints are:

• heritability

• self-schema

Causes of BDD still being researched.

• There is some _________ and some issues with _______.

• Preoccupation with Perceived Defects

• Repetitive Behaviors

• Clinically Significant Distress

• Not Better Explained by Eating Disorder

Criteria for BDD:

• both genders

• adolescence

BDD:

• Gender: BDD affects _____

• Onset: Typically begins in ________.

• similar behaviors and causes

• shares body image distortions with eating disorders

BDD Relationship to OCD and Other Disorders:

• Antidepressants

• Cognitive-behavioral therapy

Treatments for BDD: (2)

Hoarding Disorder

Acquire and fail to discard limited value possessions (10-40% of OCD sufferers)

impulse-control disorders

Trichotillomania

• Moved from ___________ to OCD-related disorders in DSM-5

Trichotillomania

Urge to pull out hair from any body location

• Preceded by tension and followed by pleasure

• Must cause clinically significant distress

• Yoruba Culture of Nigeria

• Koro in China

• Taijin kyofusho in Japan

Cultural differences in Sources of Worry: (3)

Yoruba Culture of Nigeria

Sources of anxiety:

• Creating and maintaining a large family

• Fertility

• Dreams that may indicate bewitchment

• Somatic complaints that are atypical in Western society

Koro

In China, it is an anxiety that a body part is retracting into the body or shrinking

Taijin kyofusho (Japan)

Fear is about offending or embarrassing others, not self.

• Is somewhat like social phobia in Western culture.