Mental Health - Anxiety Disorder/Specific Phobia (Chapter 18) Flashcards
DP5
Applicaiton of a biopsychosocial framework to understanding and managing simple phobia as an example of an anxiety disorder.
Anxiety
A state of aroussal associated with feelings of apprehension, worry or uneasiness that something is wrong or something unpleasant is about to happen.
Anxiety Disorder
Characterised by chronic feelings of anxiety, distresss, nervousness and apprehension or fear about the future, with a negative effect
Phobia Definition
Persistent, irrational and intense fear of a particular object, animal situation, activity or person that causes a significant distress and interferes with daily functinoing
Phobic Disorders - Divided into 3 main categories
1) Specific Phobia - fear of a single object or event that triggers a panic response
2) Social Phobias - social disorder - fear of other people or social situations. Includes feeling scrutinised by others while eating, speaking in public or attending a party.
3) Agoraphobias - fear of leaving a place. Can be worse when accompanied by a panic attack.
DSM Phobia Categories
- Animals
- Situations.
- Blood/Injections
- Natural Environments
- Other
Biological Factors
Genetic Predisposition
Stress Response - Fight or Flight, Heart Palpitations, increased perspiration
Gamma-amino-butyric-acid (GABA)
PRIMARY INHIBITORY neurotransmitter in the CNS
- Inhibits postsynaptic neurons
- Gets in the synapse t block the transmission
Glutamate
EXCITATORY neurotransmitter
- Makes postsynaptic neurons more likely to PASS ON the neural impulse
- Gets the post synaptic neuron excited so it requires less stimulation to make it fire
- Also plays a role in learning and memory, strengthing synaptic connections
GABA and Anxiety
Lack of the neurotransmitter might lead to over stimulation, and thus heightened anxiety Benzodiazepines - a class of drugs that 'calm down' neural activity.
Agonist and Antagonists (DRUGS)
Agonists - mimic the activity of a neurotransmitter
Antagonists - inhibit the activity of a neurotransmitter
Benzodiazepines and Anxiety
Mimic the activity of GABA in inhibiting post synaptic neural activity
CBT
Cognitive behaviour therapy (CBT) is a type of psychotherapy that helps people to change unhelpful or unhealthy thinking habits, feelings and behaviours. CBT may be used to treat problems including anxiety, depression, low self-esteem, uncontrollable anger, substance abuse, eating disorders and other problems.
Psychodynamic Model
- Mental disorders are caused by unresolved conflicts that occur in the subconscious
- Psychosexual Stages ORAL 0-2 ANAL 2-3 PHALLIC 4-5 LATENCY 6-Puberty
- As we progress through these stages different parts of the body become focus of attention and pleasure
- Each stage has a critical development conflict that must be resolved to move onto the next stage
UNRESOLVED CONFLICTS CAUSE ANXIETY
- We use defense mechanisms to protect ourselves from this anxiety
- The ego (conscious part of mind) distorts, denies or falsifies reality unconsciously
Oedipal Complex
Phallic Stage 4-5
Male/female child develops sexual attraction to his/her mother/father
Fears father/mother who is bigger and stronger
Repression of sexual impulses towards opposite sex parent - used as a defense mechanism
Behavioural Model
- Assumes phobias are learned through experience and may acquired, maintained or modified by environmental consequences such as rewards and punishment
Classical Conditioning
- Explains acquisition of a phobia and generalisation
- Fear of a CR through association with CS
Operant Conditioning
- Explains persistence of phobia
- May also explain acquisition
Cognitive Model Definition
Emphasises how the individual processes information about the phobic stimulus and related events
Cognitive Biases
Tendencies for distorted thinking, mistaken judgements, flawed, decision-making
Cognitive Model - attentional bias
selectively attend to threat-related stimuli rather than neutral stimuli
Cognitive Model - memory bias
Recall negative or threatening information rather than positive/neutral information
Cognitive Model - interpretive bias
Interpret or judge ambiguous stimuli and situations in a threatening manner
Cognitive Model - Catastrophic bias
object or event is perceived as intolerable, dangerous, insufferable or resulting in the worst possible outcome when actually none of these is realistic
Overestimate threat and underestimate ability to cope with threat
Cognitive Behavioural Therapy
Assists person to understand interrelationship between thoughts, emotions and behaviour in interpreting and responding to phobic stimuli
Combines cognitive therapy and behavioural therapy
- Cognitive Therapy: thinking therapy, aims to address the problems in cognition that contribute to negative emotions and behaviours
- Behavioural Therapy: application of classical, operant and observational learning to address behavioural aspects of a disorder
CBT and phobias
Switch from unhelpful irrational automatic thoughts to evidence-based rational thoughts
CBT behavioural component
Behavioural component aims to address maladaptive behaviours that are part of the condition
- Make a prediction
- Review the evidence for and against
- Devise an experiment to test it
- Note the results
- Draw conclusions
Socio-cultural factors - Specific environmental triggers
Specific Environmental Triggers: specific objects or situations in the environment that produce (trigger) the fear response
Socio-cultural factors - Parental Modelling
Parental Modelling: learning through observation of a parent model’s fearful response (and consequences) to a specific object or situation
Socio-cultural factors - Transmission of threat information
Transmission of Threat Information: information received directly or indirectly from people or media about potential threat or actual threat/danger of a specific object or situation