Abnormal psych lecture 2

Abnormal Psychology Lecture 2: Anxiety Disorders/PTSD

Overview

• Date and Venue: 26/02/2025, Curtin University

• Instructor: Associate Professor David Garratt-Reed (He/Him)

• CRICOS Code: 003011

Acknowledgment of Land

• Recognition of the Whadjuk Noongar people, acknowledging their strength and resilience.

Lecture Content Overview

• What is Anxiety?

• Anxious Cycle

• Anxiety Disorders

  • Specific Phobias

  • Panic Disorder

  • Agoraphobia

  • Social Phobia

  • Generalized Anxiety Disorder (GAD)

  • Post-Traumatic Stress Disorder (PTSD)

• Transdiagnostic Factors

Defining Anxiety

• Common Feelings: Anxiety is a common experience, felt by many, indicating levels of stress that are a normal part of life.

• Triggers: Anxiety is often triggered by perceived threats, influenced by classical conditioning.

• Normal vs. Abnormal: While anxiety is normal and has its purpose, the threshold for when it becomes a disorder is crucial to understand.

The Continuum of Anxiety

• Anxiety exists on a continuum, being normal in various situations to becoming a debilitating disorder. It is essential to distinguish when anxiety shifts from normal to problematic.

The Triple Vulnerability Model of Anxiety

1. General Biological Vulnerability: Natural reactivity to stress.

2. General Psychological Factors: Including negative perceptions of events.

3. Specific Psychological Factors: Classical conditioning responses, negative reinforcement, and expectations influencing reactions in specific situations.

Anxiety Disorders Explained

• Nature of the Problem: Anxiety itself isn't the primary issue; rather, the problem lies in consistently overestimating threats. This results in anxiety that is disproportionate to the actual danger.

• Situational Factors: Different anxiety disorders are characterized by their unique situations and triggers.

• Dysfunction and Duration: To classify as a disorder, the anxiety must interfere significantly with an individual’s daily life over a considerable time.

Common Characteristics of Anxiety Disorders

• Excessive Fear: Overwhelming fear in certain scenarios, often perpetuated by classical conditioning.

• Maladaptive Behaviors: Behaviors aimed at avoiding or escaping anxiety-inducing situations, which only reinforce the fear.

• Diagnostic Criteria: Symptoms must not be better explained by other mental health conditions or the physical effects of substances.

Cognitive-Behavioural Therapy (CBT) Connection

• Anxiety Perpetuation Cycle: Thoughts influence emotions, which in turn dictate behaviors, sustaining the cycle of anxiety.

Overview of Anxiety Disorders in DSM-5-TR

1. Separation Anxiety Disorder

2. Selective Mutism

3. Specific Phobia

4. Social Anxiety Disorder

5. Panic Disorder

6. Agoraphobia

7. Generalized Anxiety Disorder (GAD)

8. Medication-induced Anxiety Disorder

9. Anxiety Disorder Due to Medical Conditions

10. Other Specified Anxiety Disorder

Epidemiology of Anxiety Disorders

• Prevalence Rates: Lifetime prevalence of anxiety disorders is between 20-30%, with a notable increase in health service use reported.

• Demographics: Higher prevalence in females and commonly co-morbid with conditions like depression and alcohol use disorders.

Aetiology of Anxiety Disorders

• Vulnerability Models: Many anxiety disorders stem from a mix of life stressors and genetic vulnerability. Cognitive-behavioral approaches focus on shared processes across disorders, such as rumination.

Specific Phobia

• Defined as an intense fear or anxiety related to specific objects or situations, leading to significant distress or avoidance. Common types include fears of heights, animals, and blood.

• Prevalence: About 10% of the population has a specific phobia, although many do not seek treatment.

• Avoidance Behavior: Avoiding triggers often reinforces fears, leading to catastrophic misinterpretations of threats.

Panic Attacks and Panic Disorder

Definitions

• Panic Attack: Characterized by an abrupt surge of fear or discomfort, peaking within minutes and includes physical and cognitive symptoms.

• Panic Disorder: Diagnosed based on recurrent unexpected panic attacks and associated behaviors that lead to significant changes in functioning.

Perpetuating Factors in Panic Disorder

• Misinterpretation of bodily sensations, which causes increased anxiety and avoidance responses, complicates recovery.

Agoraphobia

• Involves fear of specific situations where escape may be difficult, often related to panic attacks, resulting in avoidance behavior that drastically limits activities.

Social Anxiety Disorder (SAD)

• Definition: Fear of social situations where scrutiny is expected; avoidance may occur due to fear of negative evaluation.

• Link to CBT: Cognitive-behavioral therapy aims to target faulty beliefs and correct misconceptions about social evaluation.

Generalized Anxiety Disorder (GAD)

• Diagnostic Criteria: Persistent worry about various topics affecting daily function, leading to distress and physical symptoms.

• Cognitive Model: Worrying typically acts as a coping mechanism but often results in heightened anxiety and further cognitive distortion.

Post-Traumatic Stress Disorder (PTSD)

• Defined through exposure to traumatic events, alongside symptoms such as avoidance behaviors, negative changes in mood, and arousal.

• Prevalence & Impact: Lifetime prevalence of PTSD is about 8.7%; significant implications on social and occupational functioning are reported.

Treatment Approaches

• Cognitive Behavioral Therapy: Effective across various anxiety disorders with emphasis placed on addressing cognitive distortions and behavior management strategies aimed at reducing threat perceptions.

• Transdiagnostic Approaches: Emphasize shared processes and facilitate a broader understanding across different anxiety disorders for effective treatment.

Key References for Study

• Rieger Ch 2 and Ch 4 for foundational understanding.

• Scholarly articles emphasizing cognitive-behavioral treatments across various contexts.

Example Exam Question

• Question: Explain how the cognitive-behavioral model accounts for the maintenance of symptoms in an individual with a specific phobia.

This lecture emphasizes that understanding anxiety disorders involves recognizing their physiological, psychological, and behavioral complexities, and employing comprehensive treatment strategies focused on both symptom management and underlying cognitive processes.