Introduction page 171 Abnormal Psychology Chapter Six Notes Anxiety a general feeling of apprehension about possible future danger Fear an alarm reaction that occurs in response to immediate danger Anxiety disorders affect 25 to 29 of the U S population at some point in their lives and are the most common category of disorders for women and the second most common for men Anxiety disorders are associated with an increased prevalence of a number of medical conditions including asthma chronic pain hypertension arthritis etc Neurotic disorders anxiety with maladaptive and self defeating behaviors The Fear and Anxiety Response Patterns page 171 173 One can specify clearly what the danger is with fear but frequently not with anxiety Fear o Fear is a basic emotion shared by animals that involves activation of the fight or flight response of the autonomic nervous system almost an instantaneous reaction to any imminent threat o Panic attack when a fear response occurs in the absence of any obvious external danger same symptoms of fear except often accompanied by a subjective sense of impending doom o Three components of fear and panic 1 cognitive subjective components 2 physiological components 3 behavioral components loosely coupled i e don t need to show all symptoms Anxiety o Anxiety response is a complex blend of unpleasant emotions and cognitions that is both more oriented to the future and much more diffuse than fear o Has same three components of fear and anxiety shown in negative mood worry self preoccupation unable to predict future threats state of tension chronic over arousal strong tendency to avoid situations where danger might be encountered o Anxiety may be adaptive because it helps us plan and prepare for possible threat o Basic fear and anxiety response patterns are highly conditionable Overview of the Anxiety Disorders and Their Commonalities page 173 174 Anxiety disorders unrealistic irrational fears or anxieties of disabling intensity as their principal and most obvious manifestation Seven primary types of anxiety disorders specific phobia social phobia panic disorder with or without agoraphobia or vice versa generalized anxiety disorder obsessive compulsive disorder acute stress disorder posttraumatic stress disorder Many people with one anxiety disorder will experience at least one more anxiety disorder and or depression either concurrently or at a different point in their lives Specific Phobias page 174 180 Specific phobia when a person shows strong persistent fear that he or she realizes is excessive or unreasonable and is triggered by the presence of a specific object or situation Avoidance is a key characteristic of phobias Phobic behavior tends to be reinforced because every time the person with a phobia avoids a feared situation his or her anxiety decreases Prevalence Age of Onset and Gender Differences o Lifetime prevalence of about 12 Psychological Causal Factors o Among people with one specific phobia over 75 have at least one other specific fear that is excessive o More common in women than men o Age of onset varies animal and blood injection usually begin in childhood while claustrophobia and driving tend to begin in adolescence or early adulthood o Psychoanalytic view phobias represent a defense against anxiety that stems from repressed impulses from the id but because it is too dangerous to know the represses id impulse the anxiety is displaced onto some external object or situation that has symbolic relationship to the real object of the anxiety o Learning theory phobias develop from classical conditioning then are generalized to other similar objects or situations o Phobias can be learned without any direct experience watching people be scared of an object or watching a nonfearful person experience a frightening experience vicarious conditioning o Differences in life experiences among individuals strongly affect whether or not conditioned fears or phobias actually develop o Events that occur during a conditioning experience as well as before it are also important in determining the level of fear that is conditioned Inflation effect suggests that a person who acquired a mild fear from something may develop a full blown phobia of that something if they were assaulted immediately after uncontrollable stress after the event will also produce this effect o Our thoughts cognitions also effect phobias o prepared fears are not inborn or innate but rather are easily acquired or especially resistant to extinction Biological Causal Factors o Genetic and temperamental variables affect the speed and strength of conditioning o Modest genetic contribution to the development of specific phobias of fear Treatments o Exposure therapy is the best treatment for specific phobias o Medication treatments are ineffective by themselves antianxiety medications may interfere with the beneficial effects of exposure therapy Social Phobias page 180 184 Social phobia social anxiety disorder characterized by disabling fears of one or more specific social situations Intense fear of public speaking is the single most common type of social phobia Generalized social phobia people who have significant fears of most social situations rather than just a few and often also have a diagnosis of avoidant personality disorder Prevalence Age of Onset and Gender Differences o 12 lifetime prevalence o More common among women than men o Typically begin during early or middle adolescence or certainly by early adulthood o Nearly two thirds of people with social phobia suffer from one or more additional anxiety disorders at some point in their lives and about 50 also suffer from a depressive disorder at the same time o One third abuse alcohol and on average they have lower employment rates and socioeconomic status and approximately one third have severe impairment in one or more domains of their life o Very persistent Psychological Causal Factors factors o Generally involve learned behaviors that have been shaped by evolutionary o Learned behavior classical conditioning 56 to 58 of people recalled and identified direct traumatic experiences as having been involved in the origin of their social phobias o Especially likely to have grown up with parents who were emotionally cold socially isolated and avoidant o Perceptions of uncontrollability and unpredictability Biological Causal Factors o Behavioral inhibition the most important temperamental variable shares characteristics with both neuroticism and