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Chapter 5 - Anxiety Disorders PANIC DISORDER Description - with &without Agoraphobia PD w/o Agora - panic attacks - feeling of imminent death - numerous.

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Presentation on theme: "Chapter 5 - Anxiety Disorders PANIC DISORDER Description - with &without Agoraphobia PD w/o Agora - panic attacks - feeling of imminent death - numerous."— Presentation transcript:

1 Chapter 5 - Anxiety Disorders PANIC DISORDER Description - with &without Agoraphobia PD w/o Agora - panic attacks - feeling of imminent death - numerous symptoms (racing heart, sweating, dizziness) - “out of blue” - fear another attack

2 PD w/Agora - avoid certain situations - embarrassment, lack of help - Rare - More in women Tx implications? involve spouse, decrease aid

3 Possible Causes Psychodynamic: - anxiety from sexual/aggressive impulses leaking Cognitive: - Hypersensitive to internal states - Misinterpret symptoms - Perceive danger

4 Behavioral: Classical conditioning Panic attack (US) -> fear (UR) Associate place (CS) with panic attack Public place (CS) -> fear (CR) (embarrassment, lack of assistance) Agoraphobia = stimulus generalization (all places like 1st place)

5 Biological genetic sensitivity– overactive BAS hyperventilation causes symptoms

6 Panic Treatment Psychodynamic Uncover conflict Cognitive Breathing retraining & relaxation Self-statements & reappraisal of fears Biological Mild tranquilizers (Xanax)

7 Behavioral Systematic desensitization Barlow: gradual exposure to panic symptoms until fear decreases

8 Phobias Description Fear specific object or situation No threat or threat is exaggerated Common fears, but heightened Phobia = impairs your life

9 Specific Phobias fear of specific situation/object animal, nature (childhood) blood-injection-injury ~11%

10 Social Phobia fear of being judged/embarrassed in social situations 3-13%

11 Agoraphobia fear situations/public places something bad might happen fear panic but no actual attacks avoid situation

12 Possible Causes Psychodynamic Projection of own impulses onto object Avoid object to reduce anxiety & keep impulse out of awareness Cognitive Catastrophize

13 Behavioral: Mowrer’s 2-Factor Theory 1st = fear is classically conditioned 2nd = fear maintained by operant conditioning - avoid situation = avoid punishment (negative reinforcement)

14 Preparedness - biologically prepared to fear certain stimuli harmful to ancestors - harder to unlearn these phobias

15 Treatment Best is behavioral (esp. specific phobia) - Exposure to feared situation/object - Learn that it is not so frightening - Extinguish link of CS -> CR - Imaginal vs. in vivo exposure - Gradual (systematic) or flooding - Relax vs. not during exposure

16 Obsessive-Compulsive Disorder (OCD) Description Anxiety if do not perform certain actions Anxiety from certain thoughts Actions are pointless, often embarrassing

17 Obsessions - meaningless, troublesome thoughts that cannot stop Compulsions - meaningless acts person feels forced to repeat

18 Possible Causes Psychodynamic Obsessions = unconscious impulses Compulsions = behaviors that keep impulses unconscious Cognitive Irrational beliefs: perfectionism & seeking approval of others

19 Behavioral Obsessions -> anxiety compulsions reduce anxiety Modeling

20 Treatment Systematic desensitization + response prevention - Expose to thoughts and prevent behavior - Tolerate thoughts until anxiety decreases Medication — SSRIs

21 Post-Traumatic Stress Disorder (PTSD) Description Extreme anxiety related to specific trauma Trauma is “outside the normal range of human experience”

22 Symptoms Intrusive thoughts: reliving event Avoid reminders Emotional numbness Hypervigilance Dissociation - detachment from self & surroundings

23 1.Acute Stress Disorder - lasts a few weeks 2.Post-Traumatic Stress Disorder >1 month

24 Possible Causes Cognitive Appraising threat as extremely traumatic Biological Sympathetic NS

25 Behavioral Classical conditioning - environment becomes conditioned stimuli for PTSD response Stimulus generalization - cues that resemble original situation trigger PTSD

26 Treatment Systematic Desensitization - progressive exposure, imaginal or in vivo Flooding - imagine worst-case scene - multiple times until anxiety decreases Disagreement about flooding for trauma

27 Generalized Anxiety Disorder (GAD) Description continual anxiety over everything “catch-all” vs. true disorder

28 Possible Causes Cognitive General tendency to catastrophize, perceive threat Behavioral Worrying modeled/reinforced

29 Biological Genetic predisposition + decreased GABA GABA = inhibits firing Less GABA=more firing

30 Treatment Behavioral Relaxation exercises (deep breathing, progressive muscle) Cognitive Discover & retrain automatic thoughts Biological Medications to stimulate GABA

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