Child Psychopathology Chapter 11

Anxiety and Obsessive– Compulsive Disorders

What is anxiety (core concept + body system)?

Future-focused fear involving:

• Worry + lack of control

• Physical tension

• Fight/flight response (sympathetic nervous system)

What is Separation Anxiety Disorder (SAD)?

Excessive fear of separation from caregiver

• Clinginess

• Distress when separated

• Fear of being alone

What is Social Anxiety Disorder?

Fear of judgment/embarrassment

• Symptoms:

  • Avoid social situations

  • Blushing, sweating

  • Freezing/clinging

(More common in girls after puberty)

• Comorbid with:

  • GAD, depression

What is Selective Mutism?

• Child does not speak in certain settings (school)

• Speaks normally at home

• onset ~3–4

• Strongly linked to: Social anxiety disorder

What is Panic Disorder?

• Recurrent unexpected panic attacks

• Symptoms (4+):

  • Heart racing

  • Sweating

  • Dizziness

  • Fear of dying

• Rare in kids

• Common in adolescents (puberty)

What is Agoraphobia?

Fear of situations where Escape is difficult (crowds/public)

What is OCD?

• Obsessions:

  • Intrusive thoughts (unwanted, anxiety-provoking)

• Compulsions:

  • Repetitive behaviors to reduce anxiety

• Time-consuming

What causes anxiety disorders?

• Learning (Two-Factor Theory)

  • Classical conditioning → fear learned

  • Operant conditioning → avoidance reinforced

• Temperament

  • Behavioral inhibition (shy, fearful)

• Cognitive factors

  • Misinterpreting danger

What is Behavioral Inhibition (BI)?

A low threshold for becoming overexcited and to withdrawing in response to novel stimulation.

• Temperament:

  • Shy

  • Fearful

  • Withdrawn

• Risk factor for:
  Social anxiety disorder

What maintains anxiety disorders?

Avoidance

What is the Two-Factor Theory of anxiety?

• Fear is:

  1. Learned (classical conditioning)

  2. Maintained (operant conditioning via avoidance)

What is the main treatment for anxiety disorders?

Exposure therapy

What is graded exposure?

Gradual exposure from least to most feared situation. (SUDS scale)

What is systematic desensitiziation?

1. Relaxation

2. Fear hierarchy

3. Gradual exposure while calm

What is flooding + response prevention?

• Flooding:

  • Intense, prolonged exposure

• Response prevention:

  • Cannot escape/avoid

Forces anxiety to decrease

What is the behavioral lens principle?

• Behavior = Child behavior + cultural interpretation

Culture affects how anxiety is viewed