Anxiety disorders

 Adaptive fear—

 Maladaptive anxiety

Anxiety is a feature of many disorders

Symptoms of anxiety—4 categories

 Panic

Attacks vs. Disorder

 Etiological Factors/theories

Bio—

 Cognitive-

Hyperfocused on bodily sensations

Treatments:

Biological

Tricyclic antidepressants—
SSRIs
Benzodiazepines—

 

Cognitive-behavioral therapy-
Confronting thoughts/situations that arouse anxiety
Systematic desensitization
Exposure therapy

 

Phobias

Agoraphobia—fear of being away from help or in situations they can’t escape from. 

Specific phobias

One situation or object—4 basic categories

Social phobia
—three types

Etiological Factors/theories

Behavioral—
Classical cond
Avoidance learning
Prepared conditioning (evolutionary)

Cognitive—
high standards
biases in attention

Biological
Genes—
Temperament--

 Treatments:

Behavioral:
Systematic desensitization
Modeling (by therapist)
Flooding—

Cognitive Behavioral:
Modify thoughts—

Biological
Benzodiazepine situationally
Antidepressants—

 

Generalized anxiety disorder-
Anxious all the time
Worries shift
 Physiological symptoms

 

Etiological Factors/theories

Psycho/social
Humanists:
    Harsh conditions of worth
Existentialists:
    Fear of death
Cognitive:
Focus on threat, irrational beliefs…
automatic thoughts/reactive

Bio:
GABA deficiency or fewer receptors in limbic system

 

Treatment:

Cognitive behavioral

Bio—
Buspirone (blocks serotonin receptors)
Tricyclics & SSRIs

 

Obsessive-compulsive disorder

Obsessions & compulsions exist on a continuum—everyone has them

Obsessions
Commonly sex, aggression, symmetry, pathological doubt

Compulsions
Cleaning, checking, repeating, arranging, counting

Gradual, often early onset.

Tends to be chronic if untreated.

Prevalence similar across cultures, 1-3% lifetime prevalence

Magical thinking—
Compulsive behaviors will prevent bad things, or acting on obsessions.
Ritualized behaviors
Thoughts=actual occurences

 

Etiological Factors/Theories

 Bio:

Brain
orbital frontal cortex—
Caudate nucleus
      

Genes—moderate influence

Serotonin deficit involved…not clear.

 Psychological—
Freud et al (id impulses, anxiety)
Inability to turn off intrusive thoughts, attempts to control the intrusive thoughts seem to increase them.
Negative reinforcement—

Treatments:

Bio:
SSRIs
Surgery-
Anterior cingulotomy—sever connections
Anterior capsulotomy--lesions

Cognitive behavioral:

Exposure therapy