Transcript Ch. 5
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 Examples Hematophobia Blood Ephidophobia Snakes Claustrophobia Closed spaces Acrophobia Heights Aerophobia Flying Death-related phobia Funerals, corpses, and cemeteries What Causes Phobias? • Behavioral • Biological – Conditioning – _________________ – Modeling • Species-specific (Observation & biological imitation) predisposition to develop certain – Phobias may fears develop into GAD _______________ _______________ _____________ 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 4 Major Dimensions • Obsessions associated with checking compulsions. • Need for ____________________. • Obsessions about cleanliness associated with washing compulsions. • Hoarding-related behaviors. Obsessive-Compulsive Disorder OCD is increasingly being understood as a genetic disorder. treatment with clomipramine or other serotonin reuptake inhibiting medications, such a fluoxetine (Prozac), is the most effective biological treatment available for OCD. Other approaches to OCD • Behavioral Therapy – __________________________ (ERP) • repeatedly exposed to anxietyprovoking stimuli and prevented from responding with compulsions • Therapists often model the behavior • Cognitive perspective – __________________________ TRAUMA violent victimization serious accident fires abuse earthquakes life-threatening calamity war riots 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. B. C. D. Panic disorder Simple phobia Social phobia Generalized anxiety disorder