Chapter 5 Flashcards
Anxiety
a generalized state of apprehension or foreboding
Anxiety Disorder
- 3 domains of symptoms
- Prevalence
- DSM 3 major types
a maladaptive anxiety reaction which causes significant emotional distress or impairment of ability to function.
1) physical features- jumpiness jitteriness trembling tightness in stomach or chest, sweating, cold fingers, nausea
2) behavioral- avoidance behavior, clinging behavior. agitation
3) Cognitive- worry, nagging sense of dread or apprehension about future, preoccupation with bodily senses and over awareness
- affect nearly 1 in 5 adults in the US or 40 million people
1. panic disorder 2. phobic disorder 3. GAD
neurosis
means an abnormal or diseased condition of the NS. Described anxiety disorders in the 19th century. Will Cullen termed it in 18th century.
Freud’s definition of anxiety disorders
At beginning of 20th century Freud replaced Cullen’s organic assumption. Anxiety represents easy in which ego attempts to defend against anxiety. Concepts featured in DSM until 1980.
Panic disorder
- prevalence of panic attacks
- prevalence of panic disorder
repeated unexpected panic attacks; panic attacks are intense anxiety reactions that are accompanied by physical symptoms like pounding heart, shortness of breath, dizziness. People tend to be keenly aware of changes in their heart rates. Attack builds to peak of intensity within 10 to 15 minutes.
For a diagnois to be made there must be presence of recurrent panic attacks that begin unexpectedly and at least one of them followed by a period of at least one onto by either of following symptoms: Persistent fear of attacks & significant maaldaptive change in behavior.
- 10% of population may experience an isolated attack
- 5.1% of the general population develop disorder, usually begins in late adolescence thru mid 30s and occurs twice as often in women.
Theoretical perspective of panic disorder
Combination of cognitive (misattributions) and biological factors (physic symptoms).
Panic prone ppl tend to misattribute minor changes in internal bodily sensations to underlying dire causes; this triggers anxiety which activates sympathetic NS which activates adrenal glands to release epinephrine and norepinphrine.
Changes in body sensations that trigger a panic attack may result from many factors such as unrecognized hyperventilation, exertion, changes in temp, or reactions to drugs.
Biological factors of panic disorder
3
1) May involve an unusually sensitive internal alarm system. Donal klein proposed suffocation false alarm theory: A defect in brains respiratory alarm triggers a false alarm in response to minor cues of suffocation. Small changes in CO2 produces sensations of suffocation.
2) Gamma aminobutryic acid (GABA) a inhibitory neuroT. People with panic disorder ten to have low levels of GABA. Benzodiazepines act to make receiving stations more sensitive to GABA.
3) responses of people with panic disorder to bio challenges like dizziness (by infusing sodium lactate) or manipulation of CO2 in blood.
Cognitive factors of panic disorder
Anxiety sensitivity (AS) means fear of fear itself and involves fear of one’s emotions and bodily sensations getting out of control. Ppl with high levels of AS experience anxiety they perceive it as signs of impending catastrophe. These thoughts intensify their anxiety reactions making them vulnerable to a vicious cycle.
Treatment approaches to panic disorder (2)
- rates of success
Two most used are drug therapy and CBT.
1) Antidepressants used are Tofranil, Anafranil, Paxil, Zoloft. (however many side effects such as heart palpitations)
2) CBT therapists use a variety of techniques like coping skills for handling attacks, breathing retraining and relaxation training. Help clients recognize that bodily cues are fleeting sensations. Learn to place catastrophizing thoughts with calming ones.
Breathing retraining aims at restoring a normal level of CO2 in blood by breathing from abdom.
- average response rates to CBT of more than 60% of cases.
Phobia
Derives from phobos meaning fear. A fear of an object or situations that is disproportionate to the threat it poses. Fear exceeds any reasonable appraisal of danger. Many recognize their fears are excessive. DSM recognizes three types: specific, social and agoraphobia.
Fear
is anxiety experienced in response to a particular threat.
Specific Phobia
- to diagnose?
- Prevelance
a persistent, excessive fear of a specific object or situation that is our of proportion to the actual danger. Includes fear of animals, natural environments, blood injection. To diagnose: phobia must significantly affect the persons lifestyle or functioning or cause significant distress. Fear and anxiety assoc with phobia persists for 6 months of longer before treated.
- Most common phobic disorder; affects 9% More common in women.
Social anxiety disorder
- Prevelance
- Diathesis stress model
AKA social phobia; intense fear of social situations, excessive fear of negative evaluations from others. Include stage fright, speech anxiety, and dating fears. Relief from anxiety negatively reinforces escape behavior but escape prevents learning how to cope.
- 5% affected, more common in women. Avg age of onset is 15 and about 80% of affected ppl develop it by 20. Usually don’t receive help until age 27
- Shyness may represent a diathesis that makes a person more vulnerable to developing social anxiety in face of stress.
Agoraphobia
- Prevelance
Has potential to become one of the most incapacitating type of phobia. Women more likely to develop. Frequently begins in late adolescence and may occur without panic disorder.
Psychodynamic perspective of Phobic disorder
Anxiety is a danger signal that threatening impulses of sexual or aggressive nature are nearing level of awareness. Ego mobilizes defense mechanisms to fend off threatening impulses. Defense mechanism in phobias is projection of persons own threatening impulses onto the phobic object. Phobic object symbolizes these unconscious wishes or desires.
