PSYC 316 1st Edition Exam 2 Study Guide Lectures 13 21 Lecture 13 February 13 Anxiety Obsessive Compulsive and Related Disorders FEAR ANXIETY Fear the central nervous system s physiological emotional response to a serious threat to one s well being o State of immediate alarm Get me out of here Anxiety the central nervous system s physiological emotional response to a vague sense of threat danger o Anticipatory unproportional or irrational worry BOTH are associated with physiological features Sweating Heavy breathing Muscle tension ETC Anxiety Disorders Most common disorders in US 18 every year experience one of the DSM 5 anxiety disorders 29 lifetime prevalence Only 20 seek treatment Highly comorbid with other disorders but particularly other anxiety disorders Anxiety disorders in the DSM 5 Generalized Anxiety Disorder GAD Specific Phobias Agoraphobia Social Anxiety Disorder SA Panic Disorder Obsessive Compulsive Disorder OCD is now under obsessive compulsive related disorders o Which includes a separate disorder for Hoarding Knowledge of models of abnormality Theories to explain General Anxiety Disorder 1 Sociocultural result of living in dangerous situations Evidence GAD is higher in low Social Economic Status SES groups ethnic minorities o Not everyone in these situations have GAD it can include people with Rundown communities high crime rates Fewer educational job opportunities High risk health problems 2 Psychodynamic result of 3 types of anxiety developed in childhood realistic anxiety face real fear neurotic anxiety prevented from expressing id moral anxiety punished for expressing id 3 Cognitive result of dysfunctional ways of thinking for example Basic irrational assumptions o I must be loved by everyone Metacognitive beliefs about worry o Positive Worry is useful to appraise threats o Negative Repeated worry is a harmful meta worries Intolerance of uncertainty o Worry in an effort to find correct solutions Avoidance theory o Worry reduces high levels of physiological arousal and is experienced therefore as positive 4 Biological Result of genes or GABA inactivity Why GABA Because Benzos e g Xanax and Valium help to reduce anxiety and Benzo receptors ordinarily receive GABA o GABA is usually released to inhibit high neuronal firing this may be dysfunctional in GAD o The causal relationship unclear Long term anxiety might lead to poor GABA reception o Recent evidence suggests multiple neurotransmitters are likely implicated in GAD 5 Behavioral Goes with next disorder Psychotherapy treatments for GAD Less evidence o Humanistic approaches o Psychodynamic approaches Exception short term psychodynamic therapy More evidence o Cognitive approaches Change maladaptive assumptions through cognitive reframing and Socratic questioning Acceptance and mindfulness based approaches Help clients understand the function of worrying Help clients become aware of worry with attempting to control it Help clients use values to direct behavior Biological treatments for GAD Antianxiety drugs o Benzodiazepines 1 Good Provide temp relief modest in effect 2 Bad Sometimes get rebound anxiety and withdrawal many side effects e g drowsiness in a fog mix badly with other drugs especially alcohol 3 Ugly Physical dependence is possible o Newer approaches Antidepressants Antipsychotics Phobias Persistent and unreasonable fears of a particular object activity or situation Differs than regular fears o More intense and persistent o Distress interferes with functioning o Avoidance is the key feature mechanism Most phobias are specific phobias o Specific object or situation o Immediate fear upon presentation of stimulus o Most common specific animals insects heights thunderstorms and blood Some phobias are broad EX Agoraphobia Statistics o 9 of US population each year 12 lifetime o Many have multiple phobias at a time o Women men 2 1 or more o Very few seek treatment because they rather avoid not think about it Behaviorism o Classical conditioning two events occur close together in time become closely associated in a person s mind Ex Fear of running water When the 7yr old girl was at a lake and climbed over rocks got her foot stuck no one heard her she became terrified While being trapped she could hear a waterfall nearby the sound of running water became linked in her mind to the fear of being trapped Unconditioned stimulus entrapment Unconditioned response fear Conditioned stimulus running water Conditioned response fear o Modeling through observation imitation a person may observe others being afraid of certain objects or events and develop fears of the same things Ex Fear of traffic o Maintained through avoidance Ex Fear of fastballs Classical conditioning R Avoidant learning Behavioral evolutionary perspective Preparedness Humans are genetically predisposed to develop certain fears Ex rats disease Treatment of phobias o Behavioral approaches are the gold standard particularly exposure based treatments Desensitization Learning to relax while gradually facing their fear Fear hierarchy relaxation is incompatible with fear In vivo or imaginal sometimes start with latter Flooding Repeatedly intensely exposed to feared objected to be made seen as harmless Forced non gradual exposure Modeling Therapist models interaction with feared stimulus Virtual reality is becoming popular Broad phobias Agoraphobia general fear that you will be in situation from which you cannot escape if one becomes panicked or incapacitated Treatment of agoraphobia o Exposure once again Many same techniques desensitization modeling but also support groups and home based self help 60 80 who receive exposure find it easier to leave home and gains last for years BUT improvement is generally partial and relapse is more common than is desired Lecture 14 February 16 Anxiety Obsessive Compulsive and Related Disorders Social Anxiety Disorder Persistent irrational anxiety about social or performance situations involves fears related to others scrutiny or embarrassment o Can be narrow specific types of situations Ex Public speaking public eating public writing o Can be broad general fear of functioning before others i e nearly all social performance situations Can be very debilitating o We are social beings 7 of US pop each year 60 are women Often begins in childhood early adolescence Low SES about 50 more likely to experience social anxiety Cognitive model is the leading most supported o Sufferers hold social beliefs and expectations that work