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Anxiety Disorders
By Dr seddigh
HUMS
Anxiety Disorders
Primary disturbance is distressing روانی ,رنج persistent anxiety مستمر or اضطراب maladaptive behaviors انطباقی غیر رفتار that reduce anxiety Anxiety - diffuseمنتشر, vague feelings مبهم of fear احساس
and apprehension– everyone experiences it – becomes a problem when it is irrational, uncontrollable, and
disruptive گسیخته هم ودر کنترل قابل منطقی،غیر غیر
Generalized Anxiety Disorder (GAD) منتشر اضطراب اختالل
More or less constant worry about many issues موقعیتها اکثر در مداوم نگرانی
The worry seriously interferes with functioning جدی عملکرد اختالل
Physical symptoms جسمی عالئم– Headaches سردرد – Stomachaches معده ناراحتی– muscle tension تنشعضالنی – Irritability پذیری تحریک
Model of Development of GADGAD has some genetic componentRelated genetically to major depressionChildhood trauma also related to GAD
Genetic predispositionor childhood trauma
GAD following life change or major event
Hypervigilance
Phobias
Intense, irrational fear that may focus on:– category of objects اشیا– event or situation موقعیتها – social setting اجتماعی مسایل
Phobias It is not phobic to simply be anxious about something
Afraid of it Bothers slightly Not at all afraid of it
Beingclosed in,
in a smallplace
Being alone
ina houseat night
Percentageof peoplesurveyed
100
90
80
70
60
50
40
30
20
10
0Snakes Being
in high,exposedplaces
Mice Flyingon an
airplane
Spidersand
insects
Thunderand
lightning
Dogs Drivinga car
Being in
a crowdof people
Cats
Study of normal anxieties
Specific Phobias
Specific phobias - fear of specific object– animals (e.g., snakes)
– substances (e.g., blood)
– situations (e.g., heights)
– more often in females than males
Some Unusual Phobias
Ailurophobia - fear of catsAlgobphobia - fear of painAnthropophobia - fear of menMonophobia - fear of being alonePyrophobia - fear of fire
Social Phobias
Social phobias - fear of failing or being embarrassed زده in public خجالت– public speaking (stage fright) کردن صحبت– fear of crowds, strangers شلوغی از ترس– meeting new people جدید افراد مالقات– eating in public آشامیدن و خوردن
Considered phobic if these fears interfere with normal behavior طبیعی رفتار با تداخل
Equally often in males and females ♂ = ♀
Development of Phobias
Classical conditioning model کالسیک مدل شدن شرطی
– e.g., dog = CS, bite = UCS
– problems: • often no memory of a traumatic experience• traumatic experience may not produce
phobia
Obsessive-Compulsive Disorder (OCD)
Obsessions - irrational, disturbing thoughts that intrude into consciousness
Compulsions - repetitive actions performed to alleviate obsessions
Checking and washing most common compulsions
Heightened neural activity in caudate nucleus
Panic Disorder
Panic attacks - helpless terror, high physiological arousal
Very frightening - sufferers live in fear of having them
Agoraphobia often develops as a result
Posttraumatic Stress Disorder (PTSD)
Follows traumatic event or events such as war, rape, or assault
Symptoms include:– nightmares– flashbacks– sleeplessness– easily startled– depression– irritability
Somatoform Disorders
Bodily ailments in absence of any physical disease
Examples are conversion disorder and somatization disorder
Psychological Influences on Physical Symptoms
and Diseases
Conversion Disorder
Person temporarily loses some bodily function– blindness, deafness,
paralyzed portion of body
– glove anesthesia
No physical damage to cause problems
Conversion Disorder
Rare in western culture now– relatively common 100 years ago– prominent in Freud’s work/clients
Often see examples in non-Western people exposed to traumatic event– e.g., high rate of psychological blindness in
Cambodian women after Khmer Rouge reign of terror in 1970s
Somatization Disorder
Long history of dramatic complaints re: different medical conditions– complaints usually vague, undifferentiated– e.g., heart palpitations, dizziness, nausea
Often difficult to determine whether complaints are somatization or undetectable physical disease
Somatization Disorder
Kleinman’s theory– somatization and depression are different
manifestations of the same problem– cross-cultural research
• pattern of somatoform disorders affected by cultural beliefs