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ANXIETY DISORDERS
Anxiety vs. Fearanxiety: (future oriented)
negative affect, bodily tension, and apprehension about the future
fear: (reaction to current danger) immediate alarm in response to danger – initiates flight or fight response
Phobiasunrealistic fear of a specific situation, activity, or object
Types of specific phobiasBlood-Injection-Injury
Situational Phobia
Natural Environment Phobia
Animal Phobia
Other phobias
Common Phobia Treatments
systematic desensitization: combines relaxation with exposure
• invivo• imaginal• virtual reality http://www.youtube.com/watch?v=JK-vVMMN43Y
flooding: expose individual directly to feared stimulus
Social PhobiaDSM criteria:
Extreme shyness and fear in social situations focus is on situation in which the person is
exposed to unfamiliar people or to possible scrutiny by others
person fears will be humiliated or embarrassed
Avoidance or endure with extreme distress Impairment Rule out cause by other disorder
Social Phobia: Treatment
Social Phobia: Treatment (cont.)
Psychological• Cognitive-behavioral treatment
Exposure Skill buildingGroup settings
PANIC
Panic Disorder At least one of the panic attacks is
followed by at least a month of (a) persistent fear of having another attack, or (b) a significant maladaptive change in behavior following the attacks.
The disturbance is not better understood by the physiological effects of a substance or medical condition.
The disturbance is not better understood by another psychological condition.
Panic Disorder with Agoraphobia (PDA)
agoraphobia: fear of being away from a safe place
Development of Panic DisorderStep 1
Real Stressor
Step 2
Step 3Fear of Having Another Attack
Step 4Increased Attention to Body
Step 5More Fear
SummaryThe fear of having another panic attack just makes you more frightened.
This “fear of your fear” increases the chances of future attacks.
Solution1. Accept, don’t fear your fear.
2. Actively put your self in situations that cause fear. This is the only way to eventually get over it.
3. Use relaxation techniques such as deep breathing and visualization. These work because one can not be very relaxed and very tense at the same time.
Treatment for Panic Disorder:
1) Imipramine (tricyclic antidepressant)
2) SSRIs
3) Exposure and relaxation training
4) Panic control treatment
Example Interoceptive Exposure Exercises
generalized anxiety disorder
GAD Symptoms
continuous feelings of anxiety; experienced across situations
continues for at least 6 months and
is uncontrollable more days than not
involves muscle tension, fatigue, irritability, difficulty sleeping
GAD Treatmentanxiolytics: drugs that reduce anxiety
Benzodiazepines
anti-depressants
cognitive-behavioral treatment
relaxation training
Obsessive Compulsive Disorder and Related Disorders
DSM-V Criteria for OCD Presence of obsessions or compulsions (or
both) the person recognizes that the obsessions or
compulsions are excessive or unreasonable (not required for children)
they cause marked distress, are time-consuming (more than 1 hour per day), or interfere with the person’s functioning
DSM-V Criteria for Obsessions
recurrent and persistent thoughts, impulses, or images
experienced as intrusive and inappropriate cause marked anxiety or distress the thoughts are not simply excessive worries
about real-life problems the person attempts to ignore or suppress the
thoughts the person recognizes that the thoughts are a
product of his or her own mind (not imposed from outside)
DSM-V Criteria for Compulsions
Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
Behaviors are aimed at preventing or reducing distress, or preventing some dreaded event or situation. However, behaviors not connected in a realistic way with what they are designed to prevent, or are clearly excessive
OCD : Compulsions
Four major categories• Checking• Ordering• Arranging• Washing/cleaning
http://www.youtube.com/watch?v=zC2G6lf9fCs&list=PLYL4hYoJA9GcHQt1Cf1owyPUbs-L2QOjN&index=9
Treatment of OCD
SSRI’s
Exposure and response prevention How does it compare to medication?
Psychosurgery (cingulotomy)
Obsessive Compulsive Related Disorders Hoarding Disorder.
Hair-Pulling Disorder.
Excoriation Disorder.
Body Dysmorphic Disorder.
Post Traumatic Stress Disorder
PTSD exposure to traumatic event
traumatic event is reexperienced (e.g., recollections, dreams, flashbacks)
try to avoid stimuli associated with the trauma
symptoms of increased arousal (e.g., problems sleeping, concentrating)
negative alterations of cognitions or mood
PTSDacute stress disorder – PTSD symptoms
have lasted less than one month
acute PTSD – symptoms last between 1 and 3 months after event
chronic PTSD – symptoms last longer than 3 months
delayed onset – few immediate symptoms – years later
Treatment of PTSDCognitive-behavioral treatment
• Exposure• Identify and correct cognitive
distortions.
SSRI’s (Prozac, Paxil)