Abnormal Psychology: Anxiety Disorders

Published by admin on

anxiety
apprehension about a future threat; increases preparedness and can improve performance
fear
response to an immediate threat; triggers “fight or flight”; may save life
phobias
disruptive fear of a specific object or situation; fear out of proportion to actual threat; awareness that fear is excessive; types: specific or social
specific phobia
unwarranted, excessive fear of specific object or situation; most specific phobias cluster around a few feared objects and situations; high comorbidty
social phobia
persistent, intense fear of social situations; fear of negative evaluation and scrutiny; onset often adolescence; either generalized or specific; 1/3 also have Avoidant Personality Disorder
panic disorder
frequent panic attacks unrelated to specific situations; sudden, intense episode of apprehension, terror, feelings of impending doom; other symptoms include depersonalization, derealization, and phsyiological symptoms like sweating and nausea
uncued attacks
occur unexpectedly without warning; panic disorder diagnosis requires recurrent uncued attacks
cued attacks
triggered by specific situations (e.g. tunnel); more like a phobia
generalized anxiety disorder (GAD)
involves excessive, uncontrollable worry; lasts at least 6 months; worries about relationships, health, money and daily hassles; often begins in adolescence or earlier; early onset common in men, while cleaning compulsions and late onset are more common in women
obsessive-compulsive disorder (OCD)
obsessions: intrusive, persistent, and uncontrollable thoughts or urges; experienced as irrational; compulsions: impulse to repeat certain behaviors or mental acts to avoid distress (may involve elaborate behavior rituals)
post-traumatic disorder (PTSD)
extreme response to severe stressor; anxiety, avoidance of stimuli associated with trauma, emotional numbing; exposure to a traumatic event that involves actual or threatened death or injury; symptoms present for more than a month
PTSD symptom categories
1. re-experiencing the traumatic event-nightmares, intrusive thoughts, or images; 2. avoidance of stimuli (ex. refuse to walk on street where rape occurred); 3. increased arousal-insomnia, irritability, hypervigilance
acute stress disorder
symptoms similar to PTSD; duration varies: short term reaction, with symptoms occurring between 2 days and 1 month after trauma; 90% of rape victims experience ASD
comorbidity
3/4 of those with anxiety disorder meet criteria for another disorder; 60% meet criteria for major depression; other disorders commonly comorbid with anxiety: substance abuse, personality disorders, medical disorders
factors that may increase the risk for more than one anxiety disorder
genetic vulnerability, increased activity in the fear circuit of the brain, negative life events, neuroticism
anxiety: genetic risk factors
twin studies suggest heritability; 20-40% for phobias, GAD, PTSD; about 50% for panic disorder
anxiety: neurobiological risk factors
fear circuit overactivity; amygdala; medial prefrontal cortex deficits; neurotransmitters: serotonin, GABA, norephinephrine (similar to depression)
anxiety: social risk factors
negative life events: job loss, relationship break-up, etc.
anxiety: personality risk factors
behavioral inhibition: tendency to be agitated, distressed, and cry in unfamiliar novel settings; predicts anxiety in childhood and social anxiety in adolescence
anxiety: cognitive risk factors
belief that one lacks control over environment; attention to threat
etiology of specific phobias: Mowrer’s 2-factor model
pairing of stimulus with aversive UCS leads to fear (classical conditioning); avoidance maintained through negative reinforcement (operant conditioning)
etiology of specific phobias: problems with 2-factor model
many people never experience aversive interaction with phobic object; people with phobias tend to fear only certain types of objects (prepared learning)
etiology of social phobia: 2-factor model
avoidance of safety behaviors; avoid eye contact, appear aloof, stand apart from others in social settings; cognitive factors: negative self-evaluation, excessive attention to internal cues
neurobiological etiology of panic
neurobiological factors: locus ceruleus (major source of norepinephrine)–a trigger for nervous system activity; multiple drugs can induce panic attacks
etiology of panic: interoceptive conditioning
classical conditioning of panic in response to bodily sensations; people with panic disorder sustain classically conditioned fears longer
cognitive etiology of panic
lack of perceived control can trigger panic; fear of bodily changes–>interpreted as impending doom–> beliefs increase arousal and anxiety–> vicious cycle
etiology of agoraphobia
fear-of-fear hypothesis: expectations about the catastrophic consequences of having a public panic attack: “what will people think of me??”
neurological etiology of GAD
GABA system deficits
cognitive etiology of GAD
Borkovec’s model: worry reinofrcing because it distracts from negative emotions and images (e.g. distress from trauma); avoidance prevents extinction of underlying anxiety; individuals with GAD less able to identify their own negative feelings
neurobiological etiology of OCD
symptoms common in neurological disorders like Huntington’s chorea; hyperactive brain regions: orbitofrontal cortex, caudate nucleus, anterior cingulate; loss of neuronal function and underlying biochemical abnormality
behavioral and cognitive etiology of OCD
operant reinforcement: compulsions negatively reinforced by the reduction of anxiety; cognitive factors: lack of a satiety signal
yadasentience
subjective feeling of completion; knowing that you have though enough, or cleaned enough–> individuals with OCD have a yadasentience deficit
neurobiological etiology of PTSD
smaller hippocamal volume linked to PTSD; disruption of verbal vs. nonverbal memory; supersensitivity to cortisol
psychological etiology of PTSD
perception of control; avoidance coping, dissociation, memory suppression–> intelligence and ability to grow from the experience enhance coping
psychological treatments for anxiety disorders
exposure: face the situation or object that triggers anxiety–> should include as many features of the stimulus as possible; should be conducted in as many settings as possible; systematic desensitization: relaxiation plus marginal exposure
psychological treatment of specific phobias
in vivo exposure more effective than systematic desensitization–> virtual reality as effective as in vivo
psychological treatment of social phobia
role playing or small group interaction; social skills training (reduce use of safety behaviors); cognitive therapy: enhances treatment for social but not specific phobias
psychological treatment of panic and agoraphobia
cognitive behavior therapy (CBT): increase patient’s awareness of thoughts that make physical sensations threatening; patient learns to challenge and change maladaptive beliefs; also effective for agoraphobia
psychological treatment of OCD
exposure plus ritual prevention; most widely used treatment; cognitive therapY: challenge beliefs about anticipated consequences of not engaging in compulsions
psychological treatment of PTSD
exposure to memories and reminders of original trauma; either direct or imaginal; treatment may increase symptoms initially; more effective than medication or supportive therapy; cognitive therapy: enhance beliefs about coping abilities
drug treatments for anxiety
benzodiazepenes: valium, xanax; antidepressants: tricyclics, SSRIs and SRIs
Categories: Abnormal Psychology