ABNORMAL PSYCHOLOGY THIRD EDITION Deborah C Beidel Cynthia M Bulik Melinda A Stanley Chapter 4 Anxiety ObsessiveCompulsive and Trauma and Stressor Related Disorders 2014 2012 2010 by Pearson Education Inc All rights reserved Chapter Outline What Is Anxiety What Are the Anxiety Disorders What Are the Obsessive Compulsive and Related Disorders What Are the Trauma and Stressor Related Disorders The Etiology of Anxiety OCD and Trauma and Stressor Related Disorders The Treatment of Anxiety OCD and Traumaand Stressor Related Disorders 2014 2012 2010 by Pearson Education Inc All rights reserved What Is Anxiety A common emotion characterized by physical symptoms future oriented thoughts and escape or avoidance behaviors Occurs when people encounter a new situation or anticipate a life changing event Usually is time limited and ends when the event is over 2014 2012 2010 by Pearson Education Inc All rights reserved Fight or Flight Response Activation of the SNS triggered by fear or stress Sympathetic nervous system SNS increases heart rate and respiration allowing body to perform at peak efficiency Allows you to use all available resources to escape Parasympathetic nervous system PNS slows down the heart rate and respiration thus returning the body to a resting state 2014 2012 2010 by Pearson Education Inc All rights reserved Figure 4 1 The Fight or Flight Response Sympathetic and the Parasympathetic Nervous Systems Adapted from Lilienfeld et al Psychology From Inquiry to Understanding p 121 Pearson Allyn and Bacon Copyright 2009 Pearson Education Inc Reprinted by permission of Pearson Education Inc 2014 2012 2010 by Pearson Education Inc All rights reserved You are walking on a path at a local park and all of a sudden you see a snake slither out in front of you Just how it works As soon as you see the snake your heart starts racing and your breathing increases body s response What if the snake strikes me and it s poisonous Figure 4 2 The Three Components of Anxiety 2014 2012 2010 by Pearson Education Inc All rights reserved You scream for help or run in the other direction Figure 4 3 Negative Reinforcement Increases Avoidance Behavior and Anxiety 2014 2012 2010 by Pearson Education Inc All rights reserved Normal Anxiety vs Abnormal Anxiety Things to consider Feeling anxious occasionally is normal Functional impairment Developmental age Cognitive development not actual chronological age Sociodemographic factors Sex race ethnicity and SES Women and men seek treatment at equal rates if fear is severe 2014 2012 2010 by Pearson Education Inc All rights reserved Table 4 1 Common Fears at Various Developmental Ages 2014 2012 2010 by Pearson Education Inc All rights reserved What Are the Anxiety Disorders Group of disorders characterized by heightened physical arousal cognitive distress and behavioral avoidance of feared objects situations events 57 of people diagnosed with one anxiety disorder also have another anxiety disorder or depression Panic Attacks Panic Disorder Agoraphobia Generalized Anxiety Disorder Social Anxiety Disorder Specific Phobia Obsessive Compulsive Disorder OCD Posttraumatic Stress Disorder PTSD Separation Anxiety Disorder 2014 2012 2010 by Pearson Education Inc All rights reserved The Facts about Anxiety Disorders 31 2 of American adults will suffer at some point in their lives Most common disorder among all age groups Onset is around age 11 years old Equally distributed among Hispanics nonHispanic blacks and non Hispanic whites Significant economic burden 42 3 billion Frequent comorbidity issues 2014 2012 2010 by Pearson Education Inc All rights reserved Fact Or Fiction Panic attacks tend to only occur in people diagnosed with a panic disorder Generalized Anxiety Disorder GAD is found to be more common in individuals from lower socioeconomic status SES Fact or fiction 2014 2012 2010 by Pearson Education Inc All rights reserved Fact or fiction Panic Attacks Discrete period of intense fear and physical arousal which develops abruptly Symptoms peak in about ten minutes Somatic and cognitive symptoms Common occurrence Two types of attacks Expected panic attacks Unexpected attacks 2014 2012 2010 by Pearson Education Inc All rights reserved Remember as many as 28 of adults report having had a panic attack although only 4 7 of adults have panic disorder Panic Attack Symptoms Pounding heart increased heart rate Sweating Trembling or shaking Shortness of breath of smothering feeling Feelings of choking Chest pain or discomfort Nausea or abdominal distress Feeling dizzy light headed Chills or heat sensations Numbness or tingling sensations Feelings of unreality or detached from oneself Fear of losing control or going crazy Fear of dying 2014 2012 2010 by Pearson Education Inc All rights reserved Panic Disorder 300 01 Recurrent unexpected panic attacks 4 or more symptoms Persistent concern about future attacks and or Avoid situations that lead to attack 1 month or more Not due to substances drug side effects or medical conditions Not better Dx as social anxiety disorder specific phobia etc Typically starts at age 20 24 rarely starts in kids Impact highest of medical visits among anxiety disorders 2014 2012 2010 by Pearson Education Inc All rights reserved Agoraphobia 300 22 Fear of the marketplace 2 or more below Public transportation open spaces enclosed spaces standing in line or being in crowd being outside home alone Fears avoids situations b c escape might be difficult or help may not come if they have a panic attack or other embarrassing symptom Situations almost always provoke fear anxiety Actively avoid but can sometimes enter fear situations with trusted companions or with intense fear Fear is out of proportion to actual danger Lasts 6 months or more Causes significant distress or impairment Usually begins in early adulthood and often follows panic disorder Women are more likely to experience agoraphobia than men 2014 2012 2010 by Pearson Education Inc All rights reserved Generalized Anxiety Disorder GAD 300 02 Excessive worry about future events past transgressions financial status and the health of oneself and loved ones is the worry uncontrollable Lasts at least six months and associated with Three of the following restless or keyed up easily fatigued difficulty concentrating irritability muscle tension and sleep disturbance 1 for children Onset late teens early adulthood 20s Account for 12 of PCP visits Common in lower SES difficult to treat More likely to occur in