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Lecture 11

PSYC 235 Lecture Notes - Lecture 11: Panic Disorder, Panic Attack, Palpitations

Course Code
PSYC 235
Meredith Chivers

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Obsessive-compulsive disorder is no longer an Anxiety Disorder but Obsessive Compulsive
and related Disorders
Posttraumatic stress dis is no longer an Anxiety Dis but a Trauma and stressor related dis.
A number of disorders previous called somatoform and & Disorders& First Diagnosed in
)nfancy/Childhood are now categorized as Anxiety, or Obsessive Compulsive and Related
Subtypes of Panic Attacks:
Situationally bound (cued) Expected panic in a specific situation over another. These are
common in people suffering from specific & social phobias
Unexpected (uncued) This is when people do not not come to the conclusion that their
symptoms are the result of a actual stimulus or one is not found. This is common in panic
Yerkes Dodson Law -
Performance is optimized by
anxiety in a low to high
range, when anxiety passes
the high range and goes into
excessive that is when it
becomes antiproductive
(bell curve).
Panic Attack
It is abrupt experience of intense
fear or acute discomfort
accompanied by physical
symptoms that usually include:
- Heart palpitations Sweating
- Trembling or shaking
- Shortness of breath/smothering
- Feeling of choking Chest pain
- Nausea Feeling dizzy or faint
- Numbing or tingling sensation
- Chills or hot flashes
- Depersonalization
- Fear or losing control/ or dying
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Factors associated w/ first panic attack
Biological Contributions
- We inherit a tendency to be tense or uptight (no single gene seems to cause anxiety).
- Depleted levels of GABA, part of the GABA-benzodiazepine system, are associated with increased
- Corticotropin releasing factor (CRF) system, which is central to the expression of anxiety
- Behavioural inhibition system (BIS) is activated by signals of unexpected events from the brain
stem such as major changes in body functioning that might signal danger. When the BIS is activated
by signals from the brain (amygdala), our tendency is to freeze, experience anxiety, and
apprehensively evaluate the situation.
- Fight-Flight system (FFS).
Psychological Contributions
- Behavioural theorist view anxiety as a product of early classical conditioning.
- A general sense of uncontrollability may develop early due to environmental factors (actions of
parents fostering a sense of control/uncontrolled).
Social Contributions
- Most are interpersonal in nature - marriage, divorce, diff at work, and death of a loved one.
- Physical ailments; injury or illness.
- Social Pressure form peers ect can cause distress and stress.
- These psychological stressors to anxiety can trigger actual physical reactions; headaches or
hypertension, and panic attacks.
Those w/ psychological vulnerability view the world as a dangerous place and out of their
control are often unable to cope with stressors. A given stressor could activate your biological
tendencies to anxiety and your psychological predisposed tendencies.
Because an individual assoc. the panic attacks with internal or external cues (conditioning is one
form of learning) the attacks are called learned alarms, also in the absence of any real danger.
Comorbidity or Anxiety disorders
Specific anxiety disorders often co-occur. Comorbidity among anxiety disorders (and depression) is
high. They share the same vulnerabilities, biological and psychological bases for developing anxiety
and panic.
Most common additional diagnosis for all anxiety disorders is major depression. 50% of individuals
with these disorders will also present with one or more additional anxiety or depressive disorders
and substance use disorders (for coping).
The Anxiety Disorders
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Panic Disorder Etiology/Diathesis
Consequences of Panic Disorder
They often engage in safety
- taking along a friend who knows
your procedures
- having a companion (small dog)
with you
- carrying a bottle of anti anxiety
meds whether you will use them
all not
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