Outline of Current LecturePanic disorder*Panic attackEmotion: intense fearPhysiological componentsHeartbeat changes - Chest pain or discomfortSweating - Nausea or abdominal distressTrembling, shaking -Dizzy, lightheaded, faintShortness of breath - Chills or hot flushesFeeling of choking - ParasthesiasCognitive componentsFear of losing control or going crazyFear of dyingDe-realization or depersonalizationWhat makes panic attack worse?Self-talk: I am gonna die blah blahHyperventilation(over-breathing)Trauma and stress related disordersFormerly part of anxiety disorders in DSM-IV, now a separate category (PTSD)PTSD: posttraumatic stress disorderPeople report having numbness; emotional numbing, Anhedonia (is defined as the inability to experience pleasure from activities usually found enjoyable)Usually have flashbackObsessive compulsive and related disordersOCDPreviously part of the anxiety disordersHoarding disorderBody Dysmorphia Disorder (BDD)OCD symptoms (negative reinforcement helps worsening OCD)ObsessionsRecurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate and cause anxiety or distressNot just excessive worries about real-life problemsPerson attempts to ignore, suppress or neutralize themPerson may or may not recognize that obsessions are product of their own mindCompulsionRepetitive behaviors or mental acts person feels driven to perform in response to obsession or according to rigid rulesAimed at preventing or reducing distress or preventing some dreaded event or situation, but not realistically connected or clearly excessiveClass clip: OCD girl thinks everything is contaminated and so she washed her 100 times a day and not touch anything with any thingObsessive-Compulsive Disorder (强迫症)General types of obsessions(想的)ContaminationSymmetryDoubtsAggressive, sexual, religious imagesGeneral types of compulsions （行为上的）Cleaning and washing“Evening-up” and “just-right”Checking, repeatingHoarding disorder (A person with hoarding disorder experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs)Moved from being a subtype of OCD to its own diagnosis in DSM 5Obsessive compulsive and related disorders: Body dysmorphic disorder(involves belief that one's own appearance is unusually defective (worthy of hiding or fixing), while one's thoughts about it are pervasive and intrusive (at least one hour per day), although the perceived flaw might be nonexistent)CheckingReassurance seeking: looking at the mirror, asking othersFormerly part of “somatoform disorders” in DSM IVBDD by proxyApplying BDD to somebody else, involves magnification of somethingintrusive concerns about another person’s appearanceEtiology (of anxiety disorders)Genetics (concordance rate) –in the bookCognitive factorsPeople interpret information in a biased mannerPeople with anxiety disorder will interpret ambiguous info as threateningAnxiety sensitivityStroop testInterference to naming colors also occurs when the words involve some kind of threat: (seeking out threat information)Social phobia: lonelyPanic: doctor; hospital; doctor; breatheOCD: germsParanoia: followPreparednessThe things we are afraid are not random and we are biologically prepared based on evolutionary history to develop fear of certain thingsConditioningA) classical conditioning: acquisition of phobic fearMowrer’s two factor theoryOperant conditioning: maintenance of phobic fearMood disordersMajor depression disorder and persistent depressive disorder (formerly dysthymia—low level of depression and last a long time)Major depressive disorder (don’t need to rmb all)At least 2 weeks: most of the day, nearly every daySymptoms (5 or more for MDD):Depressed moodLoss of interest/pleasureChange in appetite (usually ¯)Change in sleep (usually ¯)Change in psychomotor activity (agitation or retardation)Fatigue/loss of energyWorthlessness, excessive/inappropriate guiltDecreased ability to concentrate/think, indecisivenessThoughts of deathDistress/ImpairmentPersistent depressive disorderSimilar to major depressive disorder, but less severe and very lastingBipolar disorderManic Episode (under mood disorder)Presence of abnormally elevated, expansive or irritable mood (for at least one week, 3 or more of the following criteria must be met)Inflated self-esteem/grandiosityDecreased need for sleepPressured speech (talking so quickly)Flight of ideasDistractibilityIncrease in goal directed activity or psychomotor agitationExcessive involvement in pleasurable activities that have a high potential for painful consequences (gambling, substances use)May be manifest only as a manic state or alternate with periods of depressionPsychosis can occurNot attributed to a substanceMood disorder: EtiologyGeneticsIf one identical twin has a bipolar disorder, the other twin has a 70% risk of getting a bipolar disorder.NeurotransmittersCertain role for neurotransmitter, the primary neurotransmitter related to depression: serotoninCognitive biasesAutomatic thought: situation- specific thought, relate to core belief about yourselfInterpersonal factorsAn interpersonal or social activity theory of depression. This is the theory of why people STAY depressed.When one is less active, he is less likely to have positive reinforcementOne of the treatment involve increasing activities level, behavioral activationMajor life stressorsPanic disorder*Panic attackEmotion: intense fearPhysiological componentsHeartbeat changes - Chest pain or discomfortSweating - Nausea or abdominal distressTrembling, shaking -Dizzy, lightheaded, faintShortness of breath - Chills or hot flushesFeeling of choking - ParasthesiasCognitive componentsFear of losing control or going crazyFear of dyingDe-realization or depersonalizationWhat makes panic attack worse?Self-talk: I am gonna die blah blahHyperventilation(over-breathing)Trauma and stress related disordersFormerly part of anxiety disorders in DSM-IV, now a separate category (PTSD)PTSD: posttraumatic stress disorderPeople report having numbness; emotional numbing, Anhedonia (is defined as the inability to experience pleasure from activities usually found enjoyable)Usually have flashbackObsessive compulsive and related disordersOCDPreviously part of the anxiety disordersHoarding disorderBody Dysmorphia Disorder (BDD)OCD symptoms (negative reinforcement helps worsening OCD)ObsessionsRecurrent and persistent