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Scope of Study
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Introduction to anxiety Panic Disorders Phobic disorders Obsessive-Compulsive disorders Generalized anxiety disorders Acute stress disorder and posttraumatic stress disorders Ethnic differences in anxiety disorders Case Study of anxiety disorders
Scope of Study
Anxiety disorders
Panic disorders Phobic disorders
Obsessivecompulsive disorders Generalized anxiety disorders
Scope of Study
Treatment approaches DSM-IV-TR criteria
Thereotical perspectives
TYPES OF ANXIETY DISORDERS
One casestudy
INTRODUCTION
Introduction
Meaning of Anxiety Anxiety is generalized state of apprehension or foreboding.
Meaning of anxiety disorders Anxiety disorders is the kind of maladaptive anxiety reaction, which can cause significant emotional distress or impair the persons ability to function.
Introduction
Symptoms of anxiety 1) Physical domain *external appearance 2) Behavioral domain *avoidance behavior *dependent behavior *agitated behavior 3) Cognitive domain *thinking pattern
1) PANIC DISORDERS
1.1 Definition The occurrence of repeated, unexpected panic attacks. Panic attacks are intense anxiety reactions accompanied by physical symptoms pressing heart, rapid respiration, shortness of breath, and difficulty breathing Physical symptoms are accompanied by feelings of sheer terror, sense of imminent danger, and faulty thought. *Panic attacks symptoms are akin to heart attacks
Role of nerotransmitter
Anxiety sensitivity(AS)
Gammaaminobutyric acid(GABA)
Serotonin
1.3.1
Biological Factors
1. Suffocation False alarm theory alarm model occur defect in the brains alarm Kleins model- involve respiratory sensations which triggers respiratory alarm 2. The role of neurotransmitter Gamma-aminobutyric acid (GABA) - low level of GABA lead to panic disorders Serotonin - role in regulating anxiety
1.3.2
Cognitive Factor
ANXIETY SENSITIVITY o Examining the role of fear of fear o Appears to magnify fear reactions to cues of bodily arousal o AS, their emotions or associated bodily states of arousal will get out of control, leading to harmful consequences o Avoidance of situations in which anxiety is experienced In the cognitive factor, the main root cause is faulty interpretations of bodily sensations
Drug theraphy
Medication
1.4.1
Cognitive-Behavioral Therapy
Elements of Cognitive-Behavioral Programs for treatment of Panic Disorder Self-monitoring Exposure Development of Coping Responses
1.4.2
Drug Therapy
Clomipra mine (Anafranil)
Anti depressan ts
Alprazolam (Xanax)
Sertraline (Zoloft)
2) PHOBIC DISORDERS
2.1 Definition is a fear of an object or situation that is
Phobia
particular threat.
Example: driving a car
Phobia Phobia
involve fears of the ordinary events of life is disabling when it interfere daily tasks life of
individuals.
Types
Specific disorders Social phobia Agoraphobia
2.2.1
situations.
Specific Phobias
excessive fear of a specific object or
Persistent,
2.2.2
o
Social Phobias
An intense fear of social situations that they may avoid altogether or endure them only with great distress. o Common forms of social phobia like o stage fright, speech anxiety, dating fears o Anxiety lead them to escape the situations they encounters with. o Relief acts as negatively reinforces to the situation. o Social phobias will lead to several implications.
2.2.3
Agoraphobia
a fear of being out in open, busy areas. e:g, fear shopping in crowded place, crossing a bridge, using public transports, eating in restaurants and leaving home fear of places or situations that they cannot be escape if panicky symptoms or panic attacks arise in themselves two types of agoraphobia:
panic disorders with agoraphobia (PDA) - Fear of recurrent panic attacks and avoid public places agoraphobia. - Mild panicky symptoms
Biological perspectives
Cognitive perspectives
2.3.1
Anxiety
Psychodynamic
is a danger signals arise as a result of impulses nature that are nearing the level of conscious mind. Defense Mechanism take actionprojection. Phobic reaction as a result of projection. e:g specific phobias Phobic objects represents these
2.3.2
Learning Perspectives
Mowrers two-factor model
1)
2)
Classical Conditioning - neutral objects and situations gain the capacity to evoke fear by being paired with dangerous stimuli. - unconditioned stimulus and conditioned stimulus Operant Conditioning - negative reinforcement as a result of avoidance component of phobias - strengthen the avoidance response. - avoidance works to relieve anxiety but at a significant cost. Observational Learning - through observation from parents or significant others. - through hearing from others such as friends.
2.3.3
1)
Biological Perspectives
Genetic factors
Variations of a particular gene and different patterns of brain activity when people exposed to fearful stimuli.
brain.
Amygdala, function as emotional computer for evaluating stimuli.
Prepared Conditioning
Biological traits to acquire fears on certain types of
objects or situations
2.3.4
Cognitive Perspectives
Factors that lead to phobias: 1) Oversensitivity to threatening cues - inherited an acutely sensitive internal alarm that leads them to become overly sensitive to threatening cues. 2) Over prediction of danger - overpredict how much fear or anxiety they will experience in the fearful situation. 3) Self-defeating thoughts and irrational beliefs - negative thinking about themselves. - irrational hold about themselves towards others.
Biological factors
Learning influences
Operant Observationa Classical l learning conditionin conditioning g
Vulnerability factors
Cognitive Biases
Phobia
2.4
Treatment Approaches
4 approaches in treatment of phobic disorders: 1) Learning-based approaches. - systematic desensitization - gradual exposure - flooding 2) Virtual Therapy - virtual reality therapy (VRT) 3) Cognitive Therapy - cognitive restructuring 4) Drug Therapy
3)
Obsessive-Compulsive Disorders
Troubled by recurrent obsessions, compulsions, or both obsessions and compulsions. It is a period of time or extent that cause marked distress, occupy more than an hour a day or significantly interfere
- cleaning rituals
- checking rituals
4)
-What???? GAD is a type of anxiety disorders involving persistent anxiety that seems to be free floating or not tied to specific situation.
Emotional distress associated with GAD interferes significantly with the people life.
2) Cognitive Perspective
Cognitive
perspective
emphasizes
the
role
of
3) Biological perspective
In ASD and PTSD, traumatic event involve either actual or threatened death or serious physical injury or threat to one own or another physical safety.
Factor relate to personal characteristic, people with a history of childhood sexual abuse those lacking
PTSD in response to
emotions associated with trauma 2) Training in stress management 3) Training in anger management 4) Training with antidepressant drugs (sertaline)
- Anxiety disorder are not unique to our culture. Example, Panic disorder occur in many countries perhaps
even universally. However, specific features of panic attack
such as shortness of breath or fear of dying may vary from culture to culture.
CASE STUDY:
The complete Cognitive Behaviour Therapy audio series on Overcoming Social Anxiety
adapted from 2011, the anxiety network international by Thomas A. Richards, Ph.D., Psychologist
Case Study
Jim is a man in his mid-30s and he was a bright man who had associated great anxiety around these social events in public situations. He could trace his shyness and his social anxiety when in teenager years. He had married a girl he knew well from high school and had almost no other dating history. He and his wife, Lesley, had three children, two girls and a boy. After Jim married, his wife helps him taking over all of the daily and family responsibilities. Jim was able to avoid almost all social responsibility, except his own job. It was his job that bought Jim into this treatment. He had no friends of his own, except for the couples his wife knew from her work.
Years earlier, Jim had worked at a small, locallyowned record and tape store, where he knew the owner and felt a part of the family. The business was slow and manageable and he never found himself on display in front of lines of people. Several years previously, the owner had sold his business to a national record chain, and Jim found himself a lower mid-range manager in a national corporation, a position he did not enjoy because he need to communicate with client through the telephone so every time he make a call he will getting extremely anxious. So when he knew he had to perform, do something in public, or even make phone calls from work. The more time he had to worry about these situations, the more anxious, fearful and uncomfortable he felt.
Treatment
Method: Cognitive behavioral therapy (CBT)- talking Therapy. Jim was cooperative from the beginning and progressed nicely doing therapy. He took each of the practice handouts and spent time each day practicing. After completion of the behavioural group therapy, Jim had an opportunity for advancement in his company, which he now felt comfortable to take and he able to do some public speaking and respond to his employees questions.