Lecture 2- Anxiety and Obsessive-Compulsive and related disorders Flashcards
What are the patterns of Fear and Anxiety responses
If the source of danger is less obvious danger leads to ANXIETY
if the source of danger is obvious danger leads to FEAR
What is the response pattern for FEAR or PANIC?
It is the activation of fight-or-flight response
What are the main characteristics of ANXIETY DISORDERS?
Unrealistic fear
Irrational fear
Irrational anxiety
Disabling intensity
What are the main ANXIETY DISORDERS?
- Generalized anxiety disorder
- Specific phobia
- Agoraphobia
- Social anxiety disorder (social phobia)
- Panic disorder
What is the definition of GAD (Generalized Anxiety disorder)?
- Chronic or excessive worry about multiple events and activities
- Free floating anxiety
- Occurs more days than not for 6-month period
- Difficult to control
When GAD appears?
In childhood or adolescence
Who get diagnosed more GAD women or men?
Women - 2:1 ratio than men
What is the percentage of people in treatment for GAD?
Around 1/4 are in treatment
What other disorders are interrelated with GAD?
- Occasional panic attacks
- Other anxiety disorders
- Other mood disorders
Sociocultural perspective of GAD
When is most likely to develop?
- In truly dangerous situations. (Hurricane Katrina)
2. Societal stress and poverty
The Psychodynamic perspective of GAD
What type of anxiety do children experience?
- Realistic anxiety
- Neurotic anxiety
- Moral anxiety
The Humanistic Perspective of GAD
When does GAD appear?
- When people stop looking at themselves honestly and acceptingly
- 1 Lack of unconditional positive regard
- 2 Threatening self-judgments break through and cause anxiety
The Cognitive Perspective of GAD
What therapies can be used to cure GAD?
- RET (Rational Emotive Therapy)
- 1 Point out irrational assumptions
- 2 Suggest more appropriate assumptions
- 3 Assigned related homework
- 4 Studies suggest at least modest relief from treatment
What are the Cognitive causal factors of GAD?
- Perceptions of uncontrollability and unpredictability
- Worry, positive or negative
- Automatic attentional bias toward threatening information in environment
What are the Biological causal factors of GAD?
- Genetics
- Neurotransmitters
- CRH
What are the treatments for GAD?
- Anxiolytic drugs
- Cognitive behavioral therapy
- Relaxation training
- Biofeedback
How is GAD constructed?
Generalized psychological vulnerability - Stress - Anxious apprehension - Worry process- Intense cognitive processing - Inadequate problem-solving skills - Generalised anxiety disorder
Generalized biological vulnerability - Stress - Anxious apprehension - Worry process - Avoidance of imagery - Restricted autonomic response - Generalised anxiety disorder
What are the characteristics of a Phobia?
Strong and persistent fear usually recognized as excessive or unreasonable
Triggered by a specific object or situation
Name the subtypes of Phobias
Animal Natural environment Blood-Injection-injury Situational Other
What is Agoraphobia?
Anxiety about being in places from which escape might be difficult or embarrassing. 2 of the following plus 6 months suffering Public transportation Being in open spaces Malls Being in enclosed places Standing in line or in a crowd Being outside of the home alone
What are the Psychological Causal factors of Phobia?
Psychoanalytic viewpoint Learned behavior/classical conditioning Modelling Individual differences in learning Evolutionary preparedness
What is the Classical Conditioning of Phobia?
Example:
UCS (entrapment) —————UCR (Fear)
Running water + UCS (entrapment)………………….UCR (Fear)
CS (Running water)…………………………CR (Fear)
How are specific phobias treated?
- Systematic desensitization
- 1 In vivo sensitization (live)
- 2 Covert desensitization (imaginal)
- Flooding
- Modelling
What are the Biological causal factors of Phobia?
- Genetics
2. Temperament
What are the Prevalence, age of onset, and gender differences of Phobias?
Common mental disorders
The lifetime prevalence rate of about 12%
More common in women than in men
Blood-injection-injury phobia occurs in about 3-4% of the population
Age of onset for different phobias varies widely
What is Social Anxiety Disorder ?
- It is the disabling fear of one or more specific social situations.
- Fear of exposure to scrutiny and potential negative evaluation of others.
Prevalence, age of onset, and gender differences of Social Anxiety disorder
Common mental disorder
Lifetime prevalence around 12%
Somewhat more common in women (60%) than men
Typically begins during adolescence or early adulthood
Many have comorbid disorders such as other anxiety disorders or depression (50%)
What causes Social Anxiety disorder?
- Social beliefs and expectations that consistently work against them
- 1 Unrealistically high social standards
- 2 Views of themselves as unattractive and socially unskilled
- 3 Believer that inept behaviour in social situations lead to terrible consequences
What are the Psychological causal factors of Social Anxiety disorder?
- Learned behavior
- Evolutionary factors
- Perceptions of uncontrollability and unpredictability
- Cognitive biases toward “danger schemes”
What are the Biological Causal factors of Social Anxiety disorder?
- Genetics
2. Temperament
What are the treatments for Social Anxiety disorder?
- Cognitive Therapy
- Behaviour therapy and Social skills training
- Medications
What is a Panic Attack?
- Abrupt experience of intense fear or discomfort with no real threat
- Several physical symptoms (breathlessness, chest pain)
- Fear as an alarm response
What are the main features of a Panic Attack?
Intense fear or discomfort in which 4 or more symptoms developed abruptly and reached a peak within minutes.
Palpitations
Sweating
Trembling or shaking
Sensation of shortness of breath or smothering
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded or faint
derealization or depersonalization
fear of losing control or going crazy
fear of dying
paresthesias (numbness or tingling sensations)
chills or hot flushes
What are the main features of Panic Disorder?
Come out of the blue Recurrent, unexpected attacks Worry about additional attacks Must be abrupt onset of 4 out of 13 symptoms Concern about future panic attacks Change in behavior
What are the Prevalence, age of onset, and gender differences for Panic Disorder?
25% of population have had panic disorder at some time in their lives
Twice as prevalent in women as men
Average age of onset is 23-24 years
What is the comorbidity with other disorders for Panic Attacks?
83% of people with panic disorder have at least one comorbid disorder ———–50-70% experience serious depression at some point in their lives
What are the Biological causal factors of Panic Attacks?
Genetics
Biochemical agents
Neural regions
Are the neurobiological factors implicated in panic disorders and GAD are the same?
TRUE OR FALSE?
What are the Psychological Causal factors of a Panic attack?
Comprehensive theory of panic disorders
Cognitive theory of panic
Safety behaviors and persistence of panic
Cognitive biases and maintenance of panic
What is the Panic circle?
Trigger stimulus…………..Perceived threat……………..Apprehension or worry about having a panic attack or about any distressing situation………….Body sensations……………….Interpretations of sensations as catastrophic
What are the treatments for Panic Attack?
Medications
Behavioral treatments
Cognitive behavioral treatments
What is an obsessive-compulsive and related disorder?
Occurrence of unwanted and intrusive obsessive or distressing images usually accompanied by compulsive behaviors.
What are the Obsessions in Obsessive-Compulsive Disorder?
Contamination fears
Fears of harming oneself or others
Lack os symmetry
Pathological doubt
What are the Compulsions in Obsessive-Compulsive disorder?
Cleaning Checking Repeating Ordering/arranging Counting
Prevalence, age of onset, and gender differences in Obsessive-compulsive diisorder
One-year prevalence is 1.2%
Lifetime prevalence is 2.3%
OCD affects both genders about equally
Typically begins in adolescence or early childhood
What is the comorbidity with other disorders of OCD?
Frequently co-occurs with other anxiety disorders and mood disorders
Also co-occurs with body dysmorphic disorder
What is the Psychodynamic perspective of OCD?
The goals are to uncover and overcome underlying conflicts and defenses.
Main techniques are free association and interpretation.
Research has offered little evidence.
What are the Psychological Causal factors of OCD?
Developed by Mowrer
2 process theory of avoidance learning:
- Neutral stimuli become associated with fearful thoughts via classical conditioning
- Compulsion reduces obsessions
What is the Cognitive perspective of OCD?
If everyone has intrusive thoughts, why do only some people develop OCD?
People with OCD tend to:
1. Have exceptionally high standards of conduct and morality
2. Believe thoughts are equal to actions and are capable of bringing harm
3. Believe they can, and should, have perfect control over their thoughts and behaviors.
What are the Biological causal factors of OCD?
- Genetics
- Brain function abnormalities
- Serotonin
What are the treatments for OCD?
- Exposure and response prevention
- Medications that affect neurotransmitter serotonin
- Antidepressants?
- Cognitive behavioral therapy ?
What are the main OCD related disorders?
- Hoarding disorder
- Hair pulling disorder
- Skin-picking disorder
- Body dysmorphic disorder
What is Body Dysmorphic Disorder?
- Obsessed with perceived or imagined flaw in appearance.
- Causes clinically significant distress
- May focus on any body part
What is Hoarding?
- Acquire and fail to discard limited value possessions.
- Disorganization in living space interferes with daily life.
- Poorer prognosis for treatment than OCD
What is Trichotillomania?
- Urge to pull out hair from any body location.
- Preceded by tension and followed by pleasure
- Must cause clinically significant distress
Relationship to OCD and Other disorders
- Similar behaviors and causes as OCD
2. Shares body image distortions with eating disorders
