© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Abnormal Psychology, Eighth Edition by Gerald C. Davison and John M. Neale Lecture notes created by Paul J. Wellman, Texas A&M University PowerPoint  Lecture Notes Presentation Chapter 6: Anxiety Disorders Ch 6

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Anxiety Disorders Anxiety refers to an unpleasant feeling of fear and apprehension –Neuroses is a former term that refers to a group of disorders involving unrealistic anxiety, assumed to be due to unconscious conflicts Anxiety disorders reflect the clear presence of symptoms of anxiety –Anxiety is not specific to anxiety disorders –Comorbidity: A person may be diagnosed with more than one disorder Ch 6.1

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Phobias A phobia is a fear-mediated avoidance that is out of proportion to the object or situation –Phobias involve intense distress –Phobias are disruptive –Person recognizes that the fear is groundless Ch 6.2

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Examples of Phobias AgoraphobiaEnclosed Places AcrophobiaHeights PnigophobiaChoking TaphephobiaBeing Buried Alive HellenologophobiaPseudoscientific Terms PhobiaInvolves Fear of: Ch 6.3

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Classes of Phobias Specific phobias are unwarranted fears caused by the presence of a specific object or situation –Blood, injuries, or injections –Situations (planes, elevators) –Animals –Natural environment (water, heights) Social phobia involves a persistent fear linked to the presence of other people Ch 6.4

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Etiology of Phobias Psychoanalytic theory: phobias result from anxiety produced by repressed id impulses Behavioral theories: focus on learning as the etiological basis of phobias –Phobias are learned avoidance responses –Phobias may be acquired through modeling –We are biologically prepared to learn certain fears (e.g. taste with nausea) Cognitive theory: Thought processes result in high levels of anxiety Ch 6.5

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Treating Phobias Psychoanalytic therapy attempts to uncover repressed conflicts using free association Behavioral approaches use systematic desensitization to reduce anxiety responses to phobic stimuli and situations –Flooding: exposure to a phobic stimulus at full intensity Cognitive approaches focus on altering irrational beliefs Ch 6.6a

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Treating Phobias Biological approach uses drugs to eliminate anxiety symptoms –Anxiolytic drugs such as the benzodiazepines (Valium) can reduce anxiety but are also addictive and give rise to withdrawal symptoms upon termination –MAO inhibitors such as phenelzine reduce the degradation of norepinephrine and serotonin MAO inhibitors can have adverse side effects –Selective serotonin reuptake inhibitors (SSRI’s) (fluoxetine) increase brain serotonin Ch 6.6b

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Panic Disorder Panic disorder involves –an attack of labored breathing, nausea, chest pain, dizziness and intense apprehension (terror) –Depersonalization: the feeling of being outside of one’s body –Derealization: the feeling that the world is not real Lifetime prevalence for panic disorder is 2% for men and 5% for women Ch 6.7

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Etiology of Panic Disorder Biological theories focus on the observations –that panic disorder runs in families –that panic disorder can be induced experimentally using Hyperventilation may activate the autonomic nervous system Infusions of lactate can induce panic attack Panic attack may result from an exaggerated central response to arousal Ch 6.8

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Etiology of Panic Disorder The Fear-of-fear hypothesis of panic disorder suggests that some people have an overly aroused nervous system and a tendency to be upset by the sensations generated by their nervous system –Eventually, worry about a panic attack makes a future attack more likely (vicious circle) Ch 6.9

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Panic Disorder Treatments Biological treatments include use of antidepressant and anxiolytic drugs –Require long-term use, symptoms return upon drug cessation Psychological treatments emphasize exposure to stimuli that accompany panic –Barlow’s therapy includes a combination of relaxation training, cognitive interventions and exposure to the internal cues that elicit panic Ch 6.10

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Generalized Anxiety Disorder (GAD) involves persistent anxiety and chronic (uncontrollable) worry The lifetime prevalence of GAD is 5% Women are twice as likely to develop GAD as are men Generalized Anxiety Disorder Ch 6.11

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Etiology of GAD Psychoanalytic view: generalized anxiety results from unconscious conflicts between ego and id impulses Cognitive behavioral view: anxiety results from conditioning of anxiety to external stimuli Biological view: the transmitter GABA inhibits anxiety, anxiolytic drugs enhance the release of GABA in brain Ch 6.12

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Therapies for GAD Psychoanalytic therapy for GAD is similar to that of phobia (reveal sources of conflict) Behavioral therapy involves a combination of relaxation training and cognitive intervention Biological therapy uses administration of anxiolytic drugs to reduce anxiety –Drug therapy is effective while the drugs are taken Ch 6.13

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Obsessive-Compulsive Disorder (OCD) Obsessions are intrusive and recurring thoughts Compulsions are repetitive behaviors or mental actions that are repeated over and over in order to reduce anxiety The lifetime prevalence of OCD is 1-2 % –Women are more likely than men to develop OCD Ch 6.14

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Common Compulsions Pursuing cleanliness Avoiding particular objects (e.g. cracks in a sidewalk) Performing repetitive, magical, protective practices Checking (e.g. “is the gas off?”) Performing a particular act (e.g. chewing slowly) Ch 6.15

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Etiology of OCD The psychoanalytic view is that OCD reflects arrest of personality development at the anal stage Behavioral accounts of OCD point to learned behaviors reinforced by fear reduction The biological view of OCD has focused on activation of the frontal lobes and basal ganglia Ch 6.16

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e The Basal Ganglia Ch 6.17

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e OCD Therapy Psychoanalytic procedures are not effective ERP: Exposure and Response Prevention involves exposing the OCD client to situations that elicit a compulsion and then restraining the client from performing the compulsion Biological treatment involves drugs that increase brain serotonin activity (Prozac) Ch 6.18

© 2000 John Wiley & Sons, Inc. Davison and Neale: Abnormal Psychology, 8e Posttraumatic Stress Disorder Posttraumatic Stress Disorder (PTSD) refers to an extreme response to an extreme stressor PTSD symptoms may include: –Increased anxiety and arousal –Reexperiencing the traumatic event –Avoidance of stimuli associated with the trauma Ch 6.19

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