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Lecture 12

PSYC 3F20 Lecture Notes - Lecture 12: Sympathetic Nervous System, Sensory Cortex, Reuptake

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Andrew Dane

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PSYC 3F20 Abnormal Psychology Section 1 Tuesday, January 10th, 2017.
Lecture 12
w/ = with ppl = people ex., or eg., = example
b/w = between q = question ie., = in other words
w/o = without ps = participant
TEST: January 24th
- next week: review in seminar
- same format as last one: 20 M/C, ¾ 10 mark questions about etiology or treatment
- covers ADHD, CD, ODD, GAD, Panic Disorder, Agoraphobia, Specific Phobia
- dot eed to stud ase ook
GAD (see slide)
- anxiety is atiated hee situatio ist eall uh of a theat, o eal easo to o
- worry about more hypothetical situations
- difficult to control this worry
GAD Etiology (chart on slide)
- 2 parts:
- why are some ppl more likely to become more anxious about everyday life events?
biological, genetic factors more reactive amygdala in threatening situations; less
activity in prefrontal cortex to regulate or control worry
psychological unconscious biased attention to things that are more
threatening/dangerous; intolerance of uncertainty less ok / aiguit
- why is this worrying maladaptive?
- those w/ GAD often think worrying is a good thing
- maladaptive coping strategy
- intense cognitive processing in left lobe; less in right side avoiding imagery to do w/
thing they are worrying about; thinking about it abstractly/verbally = restricted autonomic
response get tense physically but other than that, avoid unpleasant physical aspect of
fight or flight (i.e., negative reinforcement of avoidance)
- inadequate problem solving skills b/c worrying is an end in itself (i.e., alleviates physical
upleasatess; dot ed up doig athig aout the poles
- identifying the problem is only the first step
- effective problem solving involves identifying goal, possible responses, and
consequences of each response
Cognitive-Behavioural Treatment of GAD (Dugas et al., 2003)
1. Psycho-education about recognizing, accepting and dealing w/ uncertainty
- hat if uestios otiute to poleati o ad aiet; uaseale
- have to live w/ a certain amount of uncertainty
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2. Distinguishing worries about current problems from hypothetical situations
- homework assignment: note 3 times a da he oue oig are these situations
hypothetical or current problems you are faced w/?
3. Re-evaluation of positive beliefs about worry
- might think worry keeps them safe
- however, problem-solving is limited; worry is maladaptive
4. Problem-solving training
5. Cognitive exposure
- record major worry and listen to it repeatedly so they become habituated to it
Results (Dugas et al., 2003)
Compared to wait-list controls, treatment group showed greater reductions at post-test
on measures of..
Anxiety Disorder symptoms
Intolerance of Uncertainty
Applied Relaxation Training (Dugas et al., 2010)
1) Psycho-education and tension awareness
- soeties dot elease ou ae tighteig up
- get ppl to notice that they are tensing
- first step in teaching them to relax these muscles
2) Tension-release training
- noticing the difference b/w tension and relaxation
3) Relaxation by recall
4) Relaxation by counting
- count from 10 in your head when in a stressful situation bringing yourself down, relaxing
- counting serves a cue
5) Conditioned relaxation
Compared to wait-list control group at post-test….
CBT showed fewer symptoms of GAD, less worry, less tension and better global clinical
improvement better adjusted in general
AR showed fewer symptoms of GAD
At 6, 12, and 24-month follow-up assessments
Meta-analysis of 5 studies has shown that effect of CBT is greater than AR over follow-up
intervals ranging from 6 to 24 months (Cuijpers et al., 2014).
A‘ doest stop okig ut CBT just shos geate edutio at follo-up
A‘ is effetie ut ist a eplaeet fo CBT
Cognitions are important for long term effectiveness of treatment
Medication Treatment of GAD
Benzodiazepines (minor tranquilizers) are frequently prescribed used more historically,
less now
Benzos keep channel open for chlorine ions to enter channel and increase likelihood of
neural firing
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Affect the neurotransmitter GABA (inhibitory neurotransmitter), which dampens anxious arousal
Seem to impair cognitive and motor functioning (Westra et al., 2004); i.e., less alert at work
Also carry a risk of substance dependence (Westra et al., 2002) feels good to be more relaxed,
so can be addictive
Used more to address acute anxiety, rather than a long-term solution
Benzodiazepines and CBT are approximately equally effective in the treatment of GAD in
the short term, but long-term effects of medication not well established (Barlow &
Durand, 2009).
SSRI and GAD (Katzman, 2009)
Block reuptake of serotonin greater efficiency in neurotransmissions involving
Serotonin receptors, lots on the amygdala can dampen hyperactive amygdala
Serotonin agonist
Serotonin key neurotransmitter in cognitive-control system; could increase ability to
regulate emotions cognitively
Compared to placebo condition in randomized, double blind studies
Remission rates significantly lower 68% vs. 46% at post-test
6-month relapse rates 11% on medication versus 40% placebo
effective and safer option
Panic Disorder and Agoraphobia
Differences between Anxiety and Fear (Sylvers et al., 2010)
Fea is…..
elicited by a specific, actual threat; anxiety is a perceived, future-oriented threat
motivates escape/avoidance or defensive aggression (fight or flight response)
Short-lived response whereas anxiety is longer-lived
Neurobiology of Fear Response
Amygdala detects present threat via sensory cortex and activates emotional response
through hypothalamus and brain stem
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