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Chapter 4  anxiety disorders Chapter 4 anxiety disorders Presentation Transcript

  • Anxiety and the Anxiety Disorders Chapter 4
  • Defining Anxiety And Anxiety Disorders
    • Anxiety
    • An unpleasant emotion characterized by a general sense of danger, dread, and physiological arousal
  • Common Components of Anxiety
  • Anxiety Disorders
    • Trait Anxiety
    • An individual’s tendency to respond to a variety of situations with more or less anxiety
    • State Anxiety
    • An individual’s level of anxiety at a specific time
  • Classifying Anxiety Disorders ( DSM-IV-TR)
  • Anxiety Disorders
    • Generalized Anxiety Disorder
    • Chronic, pervasive, and debilitating nervousness
    • Chronic (>6 months), pervasive anxiety
      • Difficulty controlling the anxiety
      • The anxiety includes three or more of the following:
      • Restlessness
      • Fatigue
      • Difficulty concentrating
      • Irritability
      • Muscle Tension
      • Sleep disturbance
  • Anxiety Disorders
    • Panic Disorder
    • Panic attacks that cause ongoing distress or impairment
    • Panic attack
    • Discrete episode of acute terror in the absence of real danger
    • Criteria for Panic Disorder
    • Episodes of intense panic (panic attacks)
    • Persistent concern about having additional attacks, worry about the consequences of an attack, or changes in behavior because of the attack
  • Anxiety Disorders
    • A Panic Attack Cycle
  • Anxiety Disorders
    • Criteria for Panic Disorder
  • Anxiety Disorders
    • Phobias
    • An intense, persistent, and irrational fear and avoidance of a specific object or situation
  • Anxiety Disorders
    • Types of Phobias
    • Social phobia
    • Agoraphobia
    • Specific phobia
  • Anxiety Disorders
    • Social Phobia
    • A phobia in which fears are focused on social situations or other activities where there is a possibility of being observed and judged
    • Example:
    • Stage Fright
  • Anxiety Disorders
    • Agoraphobia
    • A fear of wide open spaces or crowded places
  • Anxiety Disorders
    • Specific phobias
    • Any phobia that is not a social phobia or agoraphobia
    • Four common types:
    • animals
    • natural environment
    • blood/injection/injury
    • situational
  • Anxiety Disorders
    • Obsessive-Compulsive Disorder
    • An anxiety disorder in which distressing and unwanted thoughts lead to compulsive rituals that significantly interfere with daily functioning
    • Obsessions
    • Unwanted and upsetting thoughts or impulses
    • Compulsions
    • Irrational rituals that are repeated in an effort to control or neutralize the anxiety brought on by obsessional thoughts
  • Anxiety Disorders
    • Criteria for Phobias
  • Anxiety Disorders
    • Obsessive-Compulsive Disorder
  • Anxiety Disorders
  • Anxiety Disorders
    • Postraumatic and Acute Stress Disorders
    • Trauma
    • An emotionally overwhelming experience in which there is a real or perceived possibility of death or serious injury to oneself or a loved one
  • Anxiety Disorders
    • Acute stress disorder
    • Significant posttraumatic anxiety symptoms that occur within one month of a traumatic experience.
    • Posttraumatic stress disorder
    • Significant posttraumatic anxiety symptoms occurring more than one month after a traumatic experience
  • Anxiety Disorders
  • Anxiety Disorders Diagnostic Criteria for Posttraumatic Stress Disorder (continued)
  • Anxiety Disorders
  • Anxiety Disorders
    • Advantages and Limitations of the DSM-IV-TR Anxiety Disorder Diagnoses
      • Comorbidity
    The presence of two or more disorders in one person, or a general association between two or more different disorders.
  • Anxiety Disorders
  • Anxiety Disorders
    • Classification in Demographic Context
    • Age
    • Separation Anxiety Disorder (SAD)
    • Gender
    • Disproportionate rates of anxiety disorders in women have noted that traditional female gender roles have not typically emphasized assertion and self-sufficiency — skills that are important for overcoming anxiety.
    • Class
    • People living in poor urban environments are at increased risk for developing PTSD.
  • Anxiety Disorders
    • Cultural and Historical Relativism
    • Latinos
    • nervios = GAD
    • ataque de nervios = panic attack
    • Chinese
    • Shenjing shuairuo is similar to anxiety and mood disorders symptoms.
    • Japanese
    • Taijin kyofusho is an anxiety disorder recognized in Japan characterized by worry that one’s body or aspects of one’s body will be displeasing or offensive to others
  • Explaining and Treating Anxiety Disorders
    • Biological Components
    • The Autonomic Nervous System
    • sympathetic nervous system
    • parasympathetic nervous system
    • flight-or-fight response
  • Explaining and Treating Anxiety Disorders
    • Limbic System
    • amygdala
    • hippocampus
    • hypothalamus
  • Explaining and Treating Anxiety Disorders
    • Neurotransmission
    • Gamma-aminobutyric acid (GABA)
    • Norepinephrine
    • locus coeruleus
    • Serotonin
  • Explaining and Treating Anxiety Disorders
    • Autoimmune Disorders
    • basal ganglia
    • Genetic factors
  • Explaining and Treating Anxiety Disorders
    • Biological Interventions
    • Barbiturates
    Benzodiazepines
  • Anxiety Disorders
    • Biological Interventions
    • Panic Disorder and Agoraphobia
    • SSRIs
    • prozac, zoloft, paxil
    • Tricyclics
    • tofranil, elavil, and sinequan
  • Anxiety Disorders
    • Biological Interventions
    • Obsessive-Compulsive Disorder
    • SSRIs
    • benzodiazepines and neuroleptics to augment
    neuroleptic
  • Anxiety Disorders
    • Biological Interventions
    • Post Traumatic Stress Disorder
    • SSRIs
    • Wellbutrin (bupropion)
  • Anxiety Disorders
    • Biological Interventions
    • Social Phobias
    • SSRIs
    • Beta-blockers
  • Anxiety Disorders
    • Biological Interventions
    • Generalized Anxiety Disorder
    • Paxil
    • Azaspirones
    Effexor BuSpar
  • Anxiety Disorders
    • Behavioral Components
    • Classical conditioning
    • Little Albert (Watson & Raynor)
  • Anxiety Disorders
    • Behavioral Components
    • Classical conditioning
    • temporal contiguity
    • negative reinforcement
    • extinction
    • prepared conditioning
  • Anxiety Disorders
    • Behavioral Components
    • Operant conditioning
    • Modeling
  • Anxiety Disorders
    • Behavioral Components
    • principle of multiple causality
    • preceding variables
    • latent inhibition
    • accompanying variables
    • postevent variables
  • Anxiety Disorders
    • Behavioral Interventions
    • Phobias
    • systematic desensitization
    • in vivo desensitization
    • covert desensitization
    • relaxation training
    • fear hierarchy
    • flooding
  • Anxiety Disorders
    • Behavioral Interventions
    • Panic Disorder
    • systematic desensitization
    • in vivo desensitization
    • covert desensitization
    • interoceptive exposure
  • Anxiety Disorders
    • Behavioral Interventions
    • Obsessive-Compulsive Disorder
    exposure and response prevention covert response prevention
  • Anxiety Disorders
    • Behavioral Interventions
    • Post Traumatic Stress Disorder
    • prolonged imaginal exposure
  • Anxiety Disorders
    • Cognitive Components
    • Cognitive schemas
  • Anxiety Disorders
    • Cognitive Components
  • Anxiety Disorders
    • Cognitive Interventions
  • Anxiety Disorders
    • Psychodynamic Components
    • Freud
    • repression
  • Anxiety Disorders
    • Psychodynamic Components
    • Phobias
    • displacement
    • Oedipus complex
    • projection
  • Anxiety Disorders
    • Psychodynamic Components
    • isolation of affect
    • undoing
    Cheat on wife Buy wife a mink coat
  • Anxiety Disorders
    • Psychodynamic Interventions
    • resistance
    • transference
  • Anxiety Disorders
    • Humanistic and Existential Components
    • maladaptive emotional scheme
    • A humanistic term for patterns of thought and feeling that emerge around salient emotional experiences (usually in childhood) and are activated in similar situations during adulthood.
  • Anxiety Disorders
    • Humanistic and Existential Interventions
    • development of a strong therapeutic alliance that allows for the recognition and exploration of painful emotional experiences
  • Anxiety Disorders
    • Multiple Causality in Anxiety Disorders
    • Integrated cognitive and behavioral approaches
    • Cognitive-psychodynamic overlap
    • Combined behavioral-biological
  • Anxiety Disorders
    • Connection Between Mind and Body
    • HPA axis
    • Brain changes in PTSD
    • Brain changes after behavioral interventions for OCD
  • Anxiety Disorders
    • Case Vignettes
    • Arthur (panic disorder)
    • Greg (obsessive-compulsive disorder)