CRM 200 Lecture Notes - Lecture 5: Obsessive–Compulsive Disorder, Social Anxiety Disorder, Autonomic Nervous System
3 May 2018
School
Department
Course
Professor
CHAPTER 5 - Anxiety, Trauma‐ Related, and
Obsessive‐ Compulsive Disorders
Anxiety Disorders in the DSM‐5
1. Anxiety Disorders
2. Trauma and Stressor‐ related disorders
3. Obsessive‐Compulsive and related disorders
Lecture Outline
• Anxiety disorders
• Trauma and stressor‐related disorders
• Obsessive‐compulsive and related disorders
• Etiological factors
• Treatment considerations
Difference between anxiety and fear: main in time
focus
Anxiety:
• is a negative mood state characterized by bodily symptoms of physical tension and by
apprehension about the future
o future oriented (what happens in future), negative affect feelings that one cannot
predict or control upcoming events
o physiological response originating in the brain and reflected in elevated heart rate
and muscle tension.
o Anxiety most closely related to depression
Fear:
• immediate alarm reaction to danger
• It protects us by activating a massive response from the autonomic nervous system
(increased heart rate and blood pressure, for example), along with our subjective sense
of terror = motivates us to escape (flee) or attack (fight).
• When feels intense fear = autonomic nervous system will activate to cause surge of
energy
o Hypothalamus sends a message to your adrenal glands to release adrenaline
o Central nervous system
• Brain and spinal cord
o Peripheral nervous system (have 2 sub sections)
• Somatic nervous system
• All voluntary actions (speak and walk)
• Autonomic nervous system
• Governs automatic functions
• Something we don’t have control over
• Breathing, heart rate, sweating
o Sympathetic nervous system (SNS)
• Rises up
• When we are in fear, our system gets in state of
ready to flight or flight
o Parasympathetic nervous system (PNS)
• Bring back down, calm us down.
• Body cant be in that state all the time.
• When fearful, the SNS goes into overdrive
• The PNS returns your body to its normal resting state
find more resources at oneclass.com
find more resources at oneclass.com
The Elements of Anxiety
Physiological Components
• Heightened level of arousal and physiological activation
• Higher heart rate
• Shortness of breath
• Dry mouth
Cognitive Components
• Subjective perception of the arousal
• Worry
• Rumination – don’t see this in fear response. this is you thinking about what happened in
the past. Negative thoughts about what happened in our lives.
• Future‐focus – worry about what will happen
Behavioral Components
• Avoidance
• Safety behaviors – behaviour that are designed to reduce the the feelings
o Ex.. Practicing before interview, control breathing exercises.
How “Normal” Anxiety Differs from Abnormal Anxiety
• Most anxieties are transient and can be adaptive.
o Don’t last a long time = normal.
• They can also become excessive and inappropriate.
o This is where you start to see there might be a problem
When does anxiety become a disorder?
• Functional impairment
o If anxiety is getting into our daily life. Cant go to work, problem with relationships
etc.
• Developmental considerations
• Sociodemographic factors
o Social or demographic factors
o Affects women more. Twice as many women affect than man
o Why??
• Females report more fears and anxiety disorders than do males.
However, when placed in anxiety
‐
provoking situations, both sexes
show equal physiological reactions.
• Which societal factors might explain this difference?
o Socialization
• Social views on masculinity vs women talk more
o Men are less likely to report/seek help with mental/ anxiety
disorders than women
o Man might not have the social network to encourage them to seek
help when need to.
Anxiety Disorders
a. In Canada and the US: 31% lifetime prevalence
• 31% of us will likely to experience anxiety
b. One of the most common types of psychological disorders
c. Prevalence in youth: 8.6% ‐ 15.7%
d. Early onset; average age of 11
e. Have lots of functional impairment:
• Personal suffering,
• compromised quality of life and social functioning,
• lower educational attainment,
find more resources at oneclass.com
find more resources at oneclass.com
• increased professional help seeking and medication use.
• Substantial financial costs.
• Calling in sick a lot, business need to find new and train new
• On our Health care system
The Complexity of Anxiety Disorders
Anxiety, fear, and panic Panic attacks
• abrupt experience of intense fear (usually for younger ppl) or discomfort
accompanied by physical symptoms (usually for older ppl)
o Expected (cued)
▪ Cued by something
▪ Stimuli causes the attack
o Unexpected (uncued)
▪ All of a sudden comes out of the blue
• Comorbidity – approx. 57%
• Suicide - greater risk of suicide
• Anxiety attack = just feeling anxious about something
• Panic attack = more physical symptoms
Biological contributions:
• can be genetic predisposition
• Behavioral inhibition system (BIS):
o activated by signals that arise from the brain stem or descend from the
cortex = our tendency is to frees, experience anxiety and evaluate the
situation to confirm the danger is present
o activated when there is fear producing event. We freeze!!!
o Other systems are disrupted while cognition is trying to sence about fear
• Fight/flight system (FFS):
o sympathetic nervous system arousal.
o Original from brain stem = immediate alarm and escape response that
looks very much like panic
o FFS might be activated by deficiencies in serotonin
• Both systems can be changed by the environment by becoming more or less
sensitive
Psychological contributions:
• how do we perceive the world? How is our cognitive style? Do I think I’m
worthless if I do this?
• How children were raised and treated by parents affect reaction –
o whether taught they have control over their environment and their
response.
o overprotective parents = never let child to experience = wont be able to
cope to stress
• Involves cognition and conditioning explanation
Social contributions:
• Stressful life events trigger our biological and psychological vulnerabilities to
anxiety.
• Most are social and interpersonal in nature
o marriage, divorce, work, death, school, illness or injury
• way we react to stress seems to run in families.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Anxiety disorders in the dsm 5: trauma and stressor related disorders, obsessive compulsive and related disorders, trauma and stressor related disorders, obsessive compulsive and related disorders, etiological factors, treatment considerations. Difference between anxiety and fear: main in time focus. Physiological components: heightened level of arousal and physiological activation, higher heart rate, shortness of breath, dry mouth. Cognitive components: subjective perception of the arousal, worry, rumination don"t see this in fear response. this is you thinking about what happened in the past. Negative thoughts about what happened in our lives: future focus worry about what will happen. Behavioral components: avoidance, safety behaviors behaviour that are designed to reduce the the feelings, ex When does anxiety become a disorder: functional impairment. If anxiety is getting into our daily life. Cant go to work, problem with relationships etc: developmental considerations, sociodemographic factors, social or demographic factors, affects women more.
