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Chapter 5
Anxiety Disorders
Abnormal Psychology, 11th Edition
by
Anxiety
Apprehension about a future threat
Fear
Response to an immediate threat
Anxiety Disorders
DSM-IV-TR
Specific and social phobias
Panic disorder and agoraphobia
Generalized anxiety disorder
Obsessive compulsive disorder
Posttraumatic stress disorder
Phobias
Two types:
Specific
Social
Copyright 2009 John Wiley & Sons, NY
Specific Phobia
Fear
Phobia
Anything new
Neophobia
Asymmetrical things
Asymmetriphobia
Books
Bibliophobia
Children
Pedophobia
Dancing
Chorophobia
Englishness
Anglophobia
Garlic
Alliumphobia
Arachibutyrophobia
Technology
Technophobia
Mice
Musophobia
Pseudoscientific terms
Hellenophobia
Source of Fear
Associated Characteristics
Animal
Natural environment
Situational
mid-20s.
Other
Social Phobia
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Panic Disorder
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Panic Disorder
Uncued attacks
Occur unexpectedly without warning
Panic disorder diagnosis requires recurrent uncued
attacks.
Cued attacks
Triggered by specific situations (e.g., tunnel)
More likely a phobia
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Panic Disorder
Often begins in adolescence
25% unemployed for more than 5 years
because of symptoms (Leon et al., 1995)
Prognosis worse when agoraphobia is
present
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Generalized Anxiety
Disorder (GAD)
Other symptoms:
Common worries:
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Obsessive-Compulsive
Disorder (OCD)
Obsessions
Compulsions
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Obsessive-Compulsive
Disorder (OCD)
Women
Cleaning compulsions and later onset more
common
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2.
Avoidance of stimuli
3.
Increased arousal
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Comorbidity
(Brown et
Avoidant
Dependent
Histrionic
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Gender &
Sociocultural Factors
Possible explanations
Women may be more likely to report symptoms
Women more likely to experience childhood sexual abuse
Women show more biological stress reactivity
Sociocultural factors
Focus of anxiety varies
Taijin kyofusho
Kayak-angst
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Genetic vulnerability
Increased activity in the fear circuit of the brain
Decreased functioning of GABA and serotonin;
increased norepinephrine activity
Negative Life Events
Behavioral inhibition
Neuroticism
Cognitive factors, including attention to cues of
threat and low perception of control
Copyright 2009 John Wiley & Sons, NY
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Risk Factors
Genetic
Neurobiological
Amygdala
Medial prefrontal cortex deficits
Neurotransmitters
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Behavioral inhibition
Tendency to be agitated, distressed, and cry in
unfamilar or novel settings
Observed in infants as young as 4 months
May be inherited
Neuroticism
React with negative affect
Linked to anxiety and depression (deGraaf et a., 2002)
Psychophysiological reactivity in firefighters predicted
development of PTSD (Guthrie & Bryant, 2005)
Copyright 2009 John Wiley & Sons, NY
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Attention to threat
Tendency to notice negative environmental cues
Selective attention to signs of threat
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Conditioning
Mowrers two-factor
model
Pairing of stimulus with
aversive UCS leads to
fear (Classical
Conditioning)
Avoidance maintained
though negative
reinforcement (Operant
Conditioning)
Copyright 2009 John Wiley & Sons, NY
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Cognitive factors
Negative self evaluation
Harsh, punitive self-judgment
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Etiology of Panic
Neurobiological
factors
Locus ceruleus
Major source of
norepinephrine
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Etiology of Panic
Interoceptive
conditioning
Classical conditioning
of panic in response to
bodily sensations
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Etiology of Panic
Cognitive factors
Lack of perceived
control can trigger panic
Fear of bodily changes
Interpreted as impending
doom
I must be having a
heart attack!
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Etiology of Agoraphobia
Fear-of-fear hypothesis
(Goldstein &
Chambless, 1978)
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Etiology of GAD
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Etiology of OCD:
Neurobiological Factors
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Etiology of OCD:
Behavioral & Cognitive Factors
Operant reinforcement
Compulsions negatively reinforced by the reduction
of anxiety
Cognitive factors
Lack of a satiety signal
Yadasentience
Subjective feeling of completion
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Etiology of PTSD
Supersensitivity to cortisol
Behavioral
Psychological
Perception of control
Avoidance coping, dissociation, memory suppression
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Common Aspects of
Psychological Treatment
Systematic desensitization
Relaxation plus imaginal exposure
Copyright 2009 John Wiley & Sons, NY
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Common Aspects of
Psychological Treatment
Cognitive approaches
Increase belief in ability to cope with the
anxiety trigger
Challenge expectations about negative
outcomes
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Psychological Treatment of
Phobias
Exposure
Social phobia
Exposure
Cognitive therapy
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Psychological Treatment of
Panic and Agoraphobia
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Psychological Treatment of
Panic and Agoraphobia
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Psychological Treatment of
GAD
Relaxation training
Cognitive Behavioral methods
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Psychological Treatment of
OCD
Cognitive therapy
Challenge beliefs about anticipated consequences
of not engaging in compulsions
Usually also involves exposure
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Psychological Treatment of
PTSD
Cognitive therapy
Enhance beliefs about coping abilities
Adding CT to exposure does not improve treatment
response
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Medications
Anxiolytics
Drugs that reduce anxiety
Antidepressants
Tricyclics,Selective Serotonin Reuptake Inhibitors (SSRIs), and
Serotonin Reuptake Inhibitors (SRIs)
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Medications
Side effects
Withdrawal from benzodiazepenes
Weight gain, nervousness, high blood pressure from SSRIs
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