CRM 200 Lecture Notes - Lecture 5: Generalized Anxiety Disorder, Social Anxiety Disorder, Anxiety Disorder
3 May 2018
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Chapter 5 – part 2
Lecture Outline
Etiology
◦ Biological Perspective
◦ Psychological Perspective
◦ An Integrated Model
Treatment
◦ Biological Treatments
◦ Psychological Treatments
The Etiology of Anxiety, Trauma‐ and Stressor‐
Related Disorders, and OCD
Biological Perspective
o Family and Genetic Studies
• Are these disorders inherited?
o Relatives with anxiety disorder = more likely to have an anxiety disorder
▪ Not just that certain disorder but disorders in general
o parents have an anxiety disorder, the child is likely to have one, too.
• Twin studies
o Concordance rates for monozygotic vs. dizygotic: 34% vs 17%
o monozygotic = Look at identical twins. If one had what is the
likelihood of the other having it = higher rate
o dizygotic = Do the same with fraternal twins
o Heritability – the strength of genetic influences on psychiatric disorders
▪ ‐4% BUT ot %
▪ Tells us that there are other factors that are not due to genetics
▪ The extend that which genetics have variation
• What is inherited: general vulnerability factor – trait anxiety
o We are not inheriting the disorder but the general vulnerability factor – the
diathesis (prone to).
o Its going to differ depending on life situations
o Neuroanatomy
• When stressed, amygdala and hippocampus become more active
o play a part in the development of anxiety disorders
o If these 2 parts are overly sensitive that it has correlation but not causation.
• Different areas of the brain – different disorders
o Amygdala, insula – social anxiety disorder
o Orbital prefrontal cortex, caudate nucleus – OCD
▪ Do’t have to know details
• To fully answer questions about neuroanatomy causing disorders, we need longitudinal
studies.
o take ppl and do brain scan throughout whole life. Not done.
• Differences in brain functioning (more or less active) i aiet s. o‐aiet disodes,
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but no differences in brain structure (how it looks, amp etc)
o Its about brain function and not brain structure
• Neurotransmitters
o Serotonin – regulates mood, thoughts, behaviour, and plays a key role in anxiety
disorders
o GABA – inhibits postsynaptic activity; reducing postsynaptic activity inhibits
anxiety emotions
• Brain imaging
o CT, fMRI, SPECT, PET
o This research is still in its early days
o Temperament and Behavioural Inhibition
• Temperament: individual behavioural differences that are present from an early age
(baby)
o Some babies are fuzzy, happy etc
o Predetermine future personality
o Its too early for external influences therefore likely born that way
• Behavioural Inhibition: temperamental feature
o 20% of children, identifiable at 4 months
o Withdraw from new people, objects, situations
▪ Seems to be correlated to social disorders
▪ But not ever. Not perfect correlation but strong
Psychological Perspective
1. Psychodynamic Theories of Fear Acquisition
• Sigmund Freud
o Geealized fee‐floatig aiet esulted fo a oflit etee the id and
the ego.
▪ Id = I want it now. Pleasure principle
▪ Ego = more concern about rules
o He believed that defense mechanisms were causal factors for specific phobias.
2. Behavioural Theories of Fear Acquisition
• Direct conditioning theory
o Little Albert – created phobia on him. Presenting with white rat. John bang pipe
together behind him and albert created. He did this repeatly to condition a
phobia.
o He generalized that phobia to other furry things: He is also scared of rabbits
o Not just phobia; can be applied to other things
• Observational learning/vicarious conditioning
o Previous positive experiences may be protective
▪ If you enjoy dogs in the first place, someone telling you wont cause that
phobia. Because you already have a positive experience about it
o How do we develop anxiety by watching others?
▪ Parents, friends, others
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o Watching parents try to save money
o The reaction they show in stressful situations. We learn about how to approach
situations by watching our caregivers
• Information transmission
o Another person instructs someone that a situation or object should be feared
o Just othe tellig us aout soethig a eate a phoia. If ou’e soeoe
who has that genetic vulnerability, you are able to develop that disorder.
▪ Do’t talk to stages, do’t walk near the microwave etc
▪ If we are prone to a disorder: can cause us to develop
3. Cognitive Theories of Fear Acquisition
• A. Maladaptive Thoughts
▪ Thoughts that are auto and not controlled
▪ Not interrupting reality correctly
o Inaccurate interpretations of internal events
▪ M heat is aig, so I ust e haig a heat attak
▪ When in reality you just walked up the stairs
o Inaccurate interpretations of external events
▪ I a giig a speeh ad oss is aig – I ust eall e oig
o Anxiety results from maladaptive thoughts that automatically interpret an
ambiguous situation in a negative fashion.
▪ When show someone a neutral face, they will see it as they are mad etc.
they see things negative
o Because they never attempt to determine if their thoughts are true, the
negative thoughts maintain the disorder.
▪ They don’t get to disconfirm their beliefs/ thoughts
▪ Etc. you think someone going to think you’e aoig, so the aoid
goig to a pat. B doig this the a’t dispoe this.
• B. The fear of fear model
o After one panic attack, a person becomes sensitive to any bodily symptom and
interprets any change as a signal of a panic attack
o They become so worried that any change in their body = panic attack = therefore
something small = think its them having an attack which can lead to an actual
attack.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Etiology: biological perspective, psychological perspective, an integrated model. Its going to differ depending on life situations: neuroanatomy, when stressed, amygdala and hippocampus become more active, play a part in the development of anxiety disorders. Not done: differences in brain functioning (more or less active) i(cid:374) a(cid:374)(cid:454)iet(cid:455) (cid:448)s. (cid:374)o(cid:374) a(cid:374)(cid:454)iet(cid:455) diso(cid:396)de(cid:396)s, but no differences in brain structure (how it looks, amp etc) Its too early for external influences therefore likely born that way: behavioural inhibition: temperamental feature, 20% of children, identifiable at 4 months, withdraw from new people, objects, situations, seems to be correlated to social disorders, but not ever. Psychological perspective: psychodynamic theories of fear acquisition, sigmund freud, ge(cid:374)e(cid:396)alized (cid:894)f(cid:396)ee floati(cid:374)g(cid:895) a(cid:374)(cid:454)iet(cid:455) (cid:396)esulted f(cid:396)o(cid:373) a (cid:272)o(cid:374)fli(cid:272)t (cid:271)et(cid:449)ee(cid:374) the id and the ego. Pleasure principle: ego = more concern about rules, he believed that defense mechanisms were causal factors for specific phobias, behavioural theories of fear acquisition, direct conditioning theory, little albert created phobia on him.
