Chapter 5

Anxiety Disorders

Anxiety vs. fear

• ______ = response to serious, known threat

• ______ = response to vague sense of threat or danger

• same physiological features

Panic Disorder

• “_________”– periodic, short bouts of panic that

occur suddenly, reach a peak, and pass

– no REAL threat…•Unexpected (_______) Attacks• Situationally Bound (______) Attack• ______________________

• Panic Disorder:– panic attacks repeatedly and

unexpectedly and without apparent reason•Worry about having an attack; plan

• Often accompanied by agoraphobia – _______________________

• Panic disorder with (or without) agoraphobia

Biological Perspective

• panic reactions are related to changes in __________________

• Inherited biological predisposition? Drug therapies– Antidepressants and some

benzodiazepines (_____________)

• When drug therapy is stopped, symptoms return– (medications + ____________

therapy) - may be most effective

Cognitive-behavioral Perspective• (____________) overly sensitive to

certain bodily sensations and may misinterpret them (medical catastrophe) – Poor coping skills– Lack of social support– Unpredictable childhoods– Overly-protective parents

• ____________ response – associate bodily sensations with previous panic responses

Treatments

• Panic Control Therapy– correct _________________ of their

bodily sensations– Relaxation training

• “______________” procedures to induce panic sensations

Phobias

• Persistent and unreasonable fears of particular objects, activities, or situations (immediate fear)

• often avoid the object or thoughts about it

Specific Phobias

Hematophobia Blood

Ephidophobia Snakes

Claustrophobia Closed spaces

Acrophobia Heights

Aerophobia Flying

Death-related phobia

Funerals, corpses, and cemeteries

Examples

What Causes Phobias?

• Behavioral – Conditioning– Modeling

(Observation & imitation)

– Phobias may develop into GAD ___________________________________________

• Biological – _________________

•Species-specific biological predisposition to develop certain fears

Treatments for Specific Phobias

• Systematic Desensitization– Since relaxation is incompatible with

fear, the relaxation response is thought to substitute for the fear response

– ___________ desensitization ( Live) ; Covert desensitization – (________)

• Flooding– __________________________

• Modeling• Graduated Exposure – confront small

situations• __________ Stopping

Social Phobias

• Severe, persistent, and unreasonable fears of social or performance situations in which embarrassment may occur

• Behavioral treatments – ______________________________– social skills & __________________

• Cognitive therapies

Generalized Anxiety Disorder (GAD)

• excessive anxiety under most circumstances and constant worrying– Vague, intense concerns and fearfulness

•free-floating” anxiety– “Danger” not a factor– Sleeplessness, irritability, fatigue, muscle

tension

• Symptoms last at least six months

Obsessive-Compulsive Disorder

• ___________– Persistent thoughts, ideas, impulses, or

images • ____________ (rituals)

– Repeated and rigid behaviors or mental acts performed in order to prevent/reduce anxiety

• Diagnosis made when symptoms:– _______________________– cause great distress– consume considerable time– or interfere with daily functions

Obsessive-Compulsive Disorder

• Obsessions associated with checking compulsions.

• Need for ____________________.• Obsessions about cleanliness

associated with washing compulsions.

• Hoarding-related behaviors.

4 Major Dimensions

Obsessive-Compulsive Disorder

treatment with clomipramine or other serotonin reuptake inhibiting medications, such a fluoxetine (Prozac), is the most effective biological treatment available for OCD.

OCD is increasingly being understood as a genetic disorder.

Other approaches to OCD• Behavioral Therapy

– __________________________ (ERP)•repeatedly exposed to anxiety-provoking stimuli and prevented from responding with compulsions

•Therapists often model the behavior

•Cognitive perspective– __________________________

TRAUMAserious accident

violent victimization

life-threatening calamity

firesearthquakes

riots

war

abuse

witnessing tragedy

Photograph copyright © 2002 www.arttoday.com. Used with permission.

Stress Disorders

• Occurs after an event that would be traumatic to anyone

• ____________________– Symptoms begin within 4 weeks of event

and last for less than 1 month

• __________________________– Symptoms can begin at any time following

the event but must last for longer than 1 month

Symptoms

• Depersonalization

• dissociative amnesia

• Hypervigilance

• numbing • intense anxiety• impairment of

everyday functioning

Treatment of Trauma-Induced Disorders

• Medication

• “Covering”

• “Uncovering”

Most studies on obsessions and compulsions indicate that• A. obsessions generally occur in

the absence of compulsions.• B. compulsions generally occur in

the absence of obsessions.• C. obsessions and compulsions

generally occur together.• D. there is no relation between

obsessions and compulsions.

Rita suffers from a panic disorder. After she begins exercising her heart rate increases. A cognitive theorist would predict that Rita would

• A. interpret the increased heart rate in a catastrophic way.

• B. Experience a surge of anxiety after interpreting the heart rate increase as something dangerous.

• C. Be likely to experience a panic attack if she interprets any additional physical sensations as signs of increasing danger.

• D. All of the above

Elliot constantly worries about his health, finances, and his marriage. Often, his worries keep him awake at night, causing extreme daytime fatigue. His wife has become frustrated with him because he is so preoccupied with his worries. His likely diagnosis is:

• A. Panic disorder• B. Simple phobia• C. Social phobia• D. Generalized anxiety disorder