Thursday, February 20, 2014Abnormal Psychology Chapter 5: Anxiety Disorders -Generalized Anxiety Disorder •People with generalized anxiety disorder experience anxiety and worry about a wide range of events and activities. The various explanations and treatments for this anxiety disorder have received only limited research support, although recent cognitive and biological approaches seem to be promising. •According to the sociocultural view, societal dangers, economic stress, or related racial and cultural pressures may create a climate in which cases of generalized anxiety disorder are more likely to develop. •In the original psychodymanic explanation, Freud said that generalized anxiety disorder may develop when anxiety is excessive and defense mechanisms break down and function poorly. Psychodynamic therapists use free association, interpretation, and related psychodynamic techniques to help people overcome this problem. •Carl Rogers, the leading humanistic theorist, believed that people with generalized anxiety disorder fail to receive unconditional positive regard from significant others during their childhood and so become overly critical of themselves. He treated such individuals with client-centered therapy. •Cognitive theorists believe that generalized anxiety disorder is caused by maladaptive assumptions and beliefs that lead people to view most life situations as dangerous. Many cognitive theorists further believe that implicit beliefs about the power and value of worrying are particularly important in the development and maintenance of this disorder. Cognitive therapists help their clients to change such thinking and to find more effective ways of coping during stressful situations. 1Thursday, February 20, 2014•Biological theorists hold that generalized anxiety disorder results from low activity of the neurotransmitter GABA. Common biological treatments are anti anxiety drugs, particularly benzodiazepines, and serotonin-enhancing antidepressant drugs. Relaxation training and biofeedback are also applied in many cases. -Phobias •A phobia is a severe, persistent, and unreasonable fear of a particular object, activity, or situation. There are three main categories of phobias: specific phobias, social phobia, and agoraphobia. Behaviorists believe that specific phobias are learned from the environment through classical conditioning or through modeling, and then are maintained by avoidance behaviors. Cognitive theorists believe that social phobia is particularly likely to develop among people who hold and act on certain dysfunctional social cognitions. •Specific phobias have been treated most successfully with behavioral exposure techniques by which people are led to confront the objects they fear. The exposure may be gradual and relaxed (desensitization), intense (flooding), or vicarious (modeling). •Therapists who treat social phobia typically distinguish two components of this disorder: social fears and poor social skills. They try to reduce social fears by drug therapy, exposure techniques, group therapy, various cognitive approaches, or a combination of these interventions. They may try to improve social skills by social skills training. -Panic Disorder •Panic attacks are periodic, discrete bouts of panic that occur suddenly. Sufferers of panic disorder experience panic attacks repeated and unexpectedly and without apparent reason. When panic disorder leads to agoraphobia, it is termed panic disorder with agoraphobia. 2Thursday, February 20, 2014•Some biological theorists believe that abnormal norepinephrine activity in the brain’s locus ceruleus may be the key to panic disorder. Others believe that related neurotransmitters and brain regions may also play key roles. Biological therapists use certain antidepressant drugs or powerful benzodiazepines to treat people with this disorder. Patients whose panic disorder is accompanied by agoraphobia may need a combination of drug therapy and behavioral exposure treatment. •Cognitive theorists suggest that panic-prone people become preoccupied with some of their bodily sensations, misinterpret them as signs of medical catastrophe, panic, and in some cases develop panic disorder. Such people have a high degree of anxiety sensitivity and also experience greater anxiety during biological challenge tests. Cognitive therapists teach patients to interpret their physical sensations more accurately and to cope better with anxiety. In cases of panic disorder with agoraphobia, practitioners may combine a cognitive approach with behavioral exposure techniques. -Obsessive-Compulsive Disorder •People with obsessive-compulsive disorder are beset by obsessions, perform compulsions, or display both. Common themes in obsessions are contamination and violence. Compulsions commonly center on cleaning or checking. Other common compulsions involve touching, verbal rituals, or counting. Compulsions are often a response to a person’s obsessive thoughts. •According to the psychodynamic view, obsessive-compulsive disorder arises out of a battle between id impulses, which appear as obsessive thoughts, and ego defense mechanisms, which take the form of counter thoughts or compulsive actions. Behaviorists believe that compulsive behaviors develop through chance associations. The leading behavioral treatment combines prolonged exposure with response prevention. Cognitive theorists believe that obsessive-3Thursday, February 20, 2014compulsive disorder grows from a normal human tendency to have unwanted and unpleasant thoughts. The efforts of some people to understand, eliminate, or avoid such thoughts actually lead to to obsessions and compulsions. Cognitive therapy for this disorder includes psychoeducation and, at times, habituation training. While the behavioral and cognitive therapies are each helpful to clients with obsessive-compulsive disorder, research