Abnormal Psychology

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Anxiety

Anx·i·e·ty (n.)1. A state of uneasiness and

apprehension2. A state of intense apprehension,

uncertainty, and fear3. A condition of heightened and

often disruptive tension

Anxiety Disorders

Generalized Anxiety Disorder (GAD) Social Phobia (or Social Anxiety

Disorder) Specific Phobias Post-Traumatic Stress Disorder Obsessive-Compulsive Disorder

(OCD)

Generalized Anxiety Disorder

Anxiety is an unsettling feeling of worry, being unsure, and fear

When anxiety lasts for long periods of time, it is a disorder

18% of American adults have anxiety disorders

Symptoms of GAD

Constant worrying about everyday things (lasting for 6 mos.)

Can’t control worries Know they worry more than they should Can’t relax Can’t concentrate Trouble sleeping or falling asleep Easily startled

Physiological Symptoms

Fatigue Muscle aches Headaches Trembling Irritable Sweating

Difficulty swallowing

Feeling light-headed

Out of breath Hot flashes

Treatment of Anxiety

Medications Anti-anxiety medicine Antidepressants Beta-blockers

Therapy Individual Group

Evolutionary Theory of Anxiety

Anxieties are natural Help people be aware of potentially

harmful situations Help prepare people for these

situations When anxiety occurs without a

stressor, and for long periods of time it harms instead of helps

Phobias

Pho·bia (n.)

1. A persistent, irrational, intense fear of a specific object, activity, or situation

Types of Phobias

Social Phobia Specific Phobia Agoraphobia

Social Phobia

A strong fear or being judged and embarrassed

Fear gets in the way of everyday life, school, and work

Recognize fear is unreasonable Can’t control fear

Common Symptoms

Anxious about being with people Extremely self-conscious Afraid of being embarrassed Afraid of being judged Worry days or weeks before an event Stay away from social settings Difficulty making and keeping friends

Physiological Symptoms

Blushing Heavy sweating Trembling Nausea Difficulty talking

Specific Phobias

11.5 million adults suffer from phobias 3 main types

Situational flying, driving, tunnels, enclosed spaces, elevators

Object Animal, natural environment, blood-injection-injury

Animal – animals/insects Natural – storms, water, heights Blood, injury, and injection

Other vomiting, choking, clowns, becoming ill, falling down

Common Specific Phobias

Public speaking Mice Snakes and other reptiles Spiders and insects Heights Death Clinically, animal fears are found to

be most common

Agoraphobia

Fear of unfamiliar places Includes wide open spaces, crowds,

traveling, and anywhere from which escape may be difficult

Suffer from panic attacks when they feel they aren’t in control

About 3.2 million Americans have agoraphobia

Treatment of Phobias

Medications Anti-anxiety medicine Antidepressants Beta-blockers

Therapy Individual Group Behavior Virtual

Evolutionary Theory of Phobias

Fear alerts people to danger and prepares their bodies to handle the situation, hopefully keeping them safe

Fear which occurs without a stimulus impedes life without being helpful

Constant fear interrupts people’s normal lives

PTSD

Posttraumatic Stress Disorder is an anxiety disorder that develops after exposure to a terrifying or traumatic event where severe physical harm was inflicted or threatened

Traumatic events include: assault, rape, car accidents, child abuse, kidnapping, bombing, natural disasters, military combat, etc.

One can suffer from PTSD after witnessing, being the victim, or being close to the victim

Symptoms of PTSD

Startle easy Become emotionally numb, with family

and friends Irritable Become aggressive or violent Have trouble being affectionate Avoid situations that may remind them of

the traumatic incident Reliving the trauma in flashbacks, during

the day or in nightmares

PTSD Onset of symptoms is usually within three

months of the trauma, but it can be as late as a year after the trauma The symptoms must last at least a month to be

diagnosed as PTSD Recovery can happen in six months with proper

treatment but can last a lot longer, or even become chronic

7.7 million Americans suffer from PTSD PTSD can affect children and adults

PTSD patients may also suffer from depression, substance abuse, or another anxiety disorder

Treatment of PTSD

Medications Psychotherapy

Exposure therapy – exposed to the trigger and desensitize the patient

Virtual reality treatments – similar to the technology used with phobias

Evolutionary Theory of PTSD Flight is a common symptom in PTSD

leaving a situation that is thought to be threatening this is an adaptation– predator avoidance is less dangerous

than predator confrontation Vigilance is one of the symptoms of PTSD

this is just being wary and watchful of different situations and their potential threats

Re-experiencing the memory is going to promote the flight reflex to avoid the previously traumatic experience Although memories may intensify over time, the

phenomenon of re-experiencing events seems to fade once the avoidance/defense behavior is reinforced

PTSD is based on fear, rather than emotion – thus motivates action

How can PTSD be adaptive

A small dose of vigilance, avoidance, flight, etc. is always going to promote survival there are varying degrees of PTSD

Maladaptations are always adaptations at some point for example aggression is favorable during wartime

but not so much during peacetime PTSD and being overly cautious is favorable in times

of high risk and danger In war-time or during a natural disaster your kin will be

safer by keeping them more protected using avoidance, flight, etc.

Video Clip of PTSD

Posttraumatic Stress Disorder – Clip 2 - 2:17 minutes

PTSD

Video Clip of OCD

OCD – As OCD As It Gets – 1:06 minutes

OCD

Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder or OCD is

an anxiety disorder characterized by frequent, unwanted thoughts, obsessions, and/or repeating specific behaviors, compulsions Repeated behaviors can include: hand washing,

counting, checking, cleaning, etc. These behaviors are performed with the

hope of relieving or alleviating the obsessive thoughts Not performing these rituals causes intense

anxiety

Obsessive-Compulsive Disorder It affects approximately 2.2 million American

adults Can and frequently is coupled with another

mental disorder such as an eating disorder, another anxiety disorder,

or depression Onset during adolescence or early adulthood

The disease can come and go over time It can get better or worsen as a person gets older Severe OCD can keep people from functioning in

their daily lives Research indicates that OCD runs in families

Symptoms of OCD Symptoms are

Obsessions – frequent, unwelcome thoughts that will not go away Obsession: germs or dirt Obsession: security

Compulsions – repetitive behavior that is thought to relieve the anxiety and/or obsessions Compulsion: excessive and repetitive hand

washing Compulsion: checking many times to make sure

the door is locked

Treatment of OCD

Personal treatments People with OCD are likely to try to self-

medicate with drugs or alcohol They will try to avoid situations that trigger their

obsession or compulsions Clinical treatments

Medication Exposure-based psychotherapy – desensitizing

them to the anxiety-producing situation New treatments – deep brain stimulation

Evolutionary Theory of OCD

Most symptoms of OCD revolve around safety, security, and/or preservation of self and/or others

OCD as a symptom of a security motivational system – although security is not officially recognized as one of the five motivations it is an intrinsic need Security is a “special motivation” – motivation

based on a biologically primitive need

Evolutionary Theory of OCD OCD sufferers are constantly assessing and

processing potential danger – with a slight threat the defense system is activated and is slow to deactivate Favors action – being proactive to avoid the predator –

predators rely on the element of surprise – so gathering information and being constantly alert diminishes or eliminates this element

Prevention – being prepared and avoiding the threatening situations

Most of the symptoms of OCD are security behaviors – like cleansing, checking, or hoarding Cleansing – teratogens, spice hypothesis, germs, etc. Checking – security, safety of kin Hoarding – in case of food shortage, famine, or natural

disaster

Evolutionary Theory of OCD

Overexposure and Protection Childhood – two extremes

Highly protected during their childhood, seen the world from a distance, hold onto their parents, fear, a lot of restrictions Taught to fear the outside world and thus they do not feel

like they are in a safe environment, OCD develops Very permissive experience – parents allowed them to

do a lot of things very early in life, over stimulated, were not equipped to handle all their experiences Lack of a safe and secure environment – thus the

obsessive and compulsive behavior creates a sense of security

DISSOCIATIVE DISORDERS

What are Dissociative Disorders?

Involuntary escape from reality Ranges from suppressing memories to

complete alternate identities 7% of Americans experience a

dissociative disorder in their lifetime

Four Types of Disorders

Dissociative Amnesia Dissociative Identity

Disorder (DID) Dissociative Fugue Depersonalization

Disorder

Signs and Symptoms

Memory loss (amnesia) of certain time periods, events and people

Mental health problems, including depression and anxiety

A sense of being detached from yourself (depersonalization)

A perception of the people and things around you as distorted and unreal (derealization)

A blurred sense of identity

Dissociative Amnesia

Memory loss that's more extensive than normal forgetfulness and can't be explained by a physical or neurological condition.

Sudden-onset amnesia following a traumatic event, such as a car accident, happens infrequently.

More commonly, conscious recall of traumatic periods, events or people in your life — especially from childhood — is simply absent from your memory.

Dissociative Identity Disorder

Formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress.

You may feel the presence of one or more other people talking or living inside your head.

Each of these identities may have their own name, personal history and characteristics, including marked differences in manner, voice, gender and even such physical qualities as the need for corrective eyewear.

Dissociative Identity Disorder

Considerable variation in each alternate personality's familiarity with the others.

People with DID typically also have dissociative amnesia.

Edward Norton in Primal Fear Martin meets Roy (DID)

Dissociative Fugue

People with this condition dissociate by putting real distance between themselves and their identity.

For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location.

Typically retain all their faculties and may be very capable of blending in wherever they end up.

Dissociative Fugue

A fugue episode may last only a few hours or, rarely, as long as many months.

Ends as abruptly as it begins. May feel intensely disoriented,

depressed and angry, with no recollection of what happened

Depersonalization Disorder

Characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie.

Distortion of the size and shape of your body or of other people and objects around you.

Time may seem to slow down, and the world may seem unreal.

Symptoms may last only a few moments or may last over many years.

Causes

Develop as a mechanism for coping with trauma.

Often form in children subjected to chronic physical, sexual or emotional abuse or a home environment that is otherwise frightening or highly unpredictable.

A child is more able than is an adult to step outside herself or himself and observe trauma as though it's happening to a different person.

More Causes

A child who learns to dissociate in order to endure an extended period of his or her youth may reflexively use this coping mechanism in response to stressful situations throughout life.

Adults rarely develop dissociative disorders in response to severe trauma

Risks

People who experience chronic physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.

Children and adults who experience other traumatic events, including war, natural disasters, kidnapping, torture and invasive medical procedures also may develop these conditions.

Prevention

If stress or other personal issues are affecting the way you treat your child, seek help.

Talk to a trusted person such as a friend, your doctor or a leader in your faith community.

Ask for help locating resources such as parenting support groups and family therapists.

Parenting classes may help you learn a healthier parenting style.

If your child has been abused or has experienced another traumatic event, see a doctor immediately.

Your doctor can refer you to mental health professionals who can help your child recover and adopt healthy coping skills.

Diagnosis

Doctors diagnose dissociative disorders based on a review of your symptoms and your personal history.

Perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality.

If your doctor rules out physical causes, he or she will likely refer you to a mental health professional for an in-depth interview.

To help diagnose dissociative identity disorder, some doctors use medication or hypnosis.

Helps identify alternate personalities or may help you describe repressed memories

Treatment

Psychotherapy is the primary treatment for dissociative disorders.

Involves talking about your disorder and related issues with a mental health professional.

Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances.

Psychotherapy often involves techniques, such as hypnosis, that help you remember and work through the trauma

The course of your psychotherapy may be long and painful, but this treatment approach often is very effective in treating dissociative disorders.

More Treatment Creative art therapy.

Uses the creative process to help people who might have difficulty expressing their thoughts and feelings.

Helps you increase self-awareness, cope with symptoms and traumatic experiences, and foster positive changes.

Includes art, dance and movement, drama, music and poetry. Cognitive therapy.

Helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

It's based on the idea that your own thoughts — not other people or situations — determine how you behave.

Even if an unwanted situation has not changed, you can change the way you think and behave in a positive way.

Medication. Your doctor may prescribe antidepressants, anti-anxiety

medications or tranquilizers to help control the mental health symptoms