Lecture 23: Anxiety and Depression Flashcards
What causes disorders?
• Biopsychosocial model – Biology – Individual psychology – Social and environmental risk factors • Diathesis-stress model: disorder may develop when an underlying vulnerability is coupled w/ a precipitating event
Biological factors
• Genetics
• Prenatal risk factors
– E.g. Malnutrition, toxin exposure, maternal illness
• Exposure to environmental toxins and malnutrition during childhood and adolescence
• Neural differences associated w/ psychological disorders
Cognitive-behavioral factors
- Cognitive behavioral approach: abnormal behavior is learned
- Revised cognitive-behavioral perspective: thoughts & beliefs are types of behavior and can be studied empirically
- The premise: thoughts can become distorted, and produce maladaptive behaviors & maladaptive emotions
Internalizing disorders
characterized by negative emotions
externalizing disorders
characterized by disinhibition
Psychological disorders: treatment
• Depends on: – Diagnosis – Type and severity of symptoms • Most disorders can be treated in more than one way: – Biological – Psychological – Often both are used for best effect!
Psychotherapy
• Goal: change patterns of thoughts, behaviors
• Estimated > 400 different approaches
• Many therapists use a variety of techniques
• “Talking therapy”
– Talking or writing about emotionally charged
events reduces blood pressure, muscle tension, and skin conduction during the disclosure and immediately thereafter
– Improves immune function via reduced stress response
Behavior therapy
Behavior is learned; hence can be unlearned
– Uses classical, operant conditioning
Cognitive therapy
Distorted thoughts -> maladaptive behaviors and emotions; treatment strategies attempt to modify thought patterns. Cognitive behavior therapy can include:
• A-B-C model (Consequences of Adversity or Activating event mediated by Beliefs)
• Cognitive restructuring
• Mindfulness-based therapy
Cognitive restructuring
- Identify thoughts/beliefs influencing the disturbing emotion
- Evaluating them for accuracy & usefulness using logic and evidence, and if warranted, modifying/replacing thoughts w/ one that are more accurate & useful
Beware of programs w/o scientific evidence
- Many available therapies have no scientific basis
* Empirical research (treatment vs. control/placebo) to show treatment is effective (e.g. randomized clinical trials)
Anxiety disorders
- Most common psychiatric disorder: lifetime prevalence ~28%
- Excessive, debilitating anxiety in absence of true danger
- Panic disorder, GAD, social anxiety, OCD
- All share some emotional, cognitive, somatic and motor symptoms, even though behavioral manifestations of these disorders are quite different
General anxiety disorder
- Excessive, difficult to control anxiety & worry not associated w/ specific object or event
- LIfetime rates under 6%; 2x more likely in women than men
- Clinically significant signs of distress & disruption of daily life
- Hypervigilance -> distractibility, fatigue, irritability, and sleep problems; as well as headaches, restlessness, light-headedness, muscle pain
Panic disorder
• Episodic attacks of acute anxiety
– Few secs to few hours
• Prevalence 3-5%; women 2x more likely than men
• Physical symptoms
– Shortness of breath, irregular heartbeat, faintness, dizziness
• Anticipatory anxiety of a panic attack
– Can -> agoraphobia
Biological causes?
• Panic attacks can be triggered by ANS activation: injections of lactic acid, breathing C02 (increased HR and respiration)
• ANS (sympathetic), central (emotional)
• Heritable (heritability ~30-60%)
– No specific gene emerging, but:
– Gene encoding BDNF: regulates neuronal
development, survival; role in LTP
– Val66Met allele of BDNF gene
• Impairs extinction of conditioned fear response
• Yields atypical activity in frontal-amygdala circuit
