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Psych 257 Chap 5 Psych 257 Psychopathology Barlow et Al: Abnormal Psychology 2nd CDN edition Chapter 5

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Uzma Rehman

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Anxiety Disorders
-anxiety: specific disorder; Panic: fear that occurs as an inappropriate time
Anxiety, Fear, And Panic
-Anxiety: negative mood state; bodily symptoms of physical tension & apprehension of future
-eg. fidgeting, trembling, high heart rate, muscle tension
-usu. doesn’t go away despite reassurance etc.
-fear: immediate alarm reaction to danger; strong escapist action tendencies
-panic attack: abrupt intense fear/discomfort: heart palpitations, chest pain, shortness of breath
-3 types: situationally bound (cued); unexpected (uncued) and situationally predisposed
-biological contributions: inherit tendency to be tense, uptight; eg. depleted levels of GABA -> ^ anxiety;
-behavioural inhibition system: unexpected signals from brain stem of danger;
-freeze, ^ anxiety, and evaluate situation to confirm danger is present
-fight-flight system(FFS); alarm and escape response; possibly due to serotonin deficiencies
-environmental factors change sensitivity to these circuits
-psychological contributions: eg. childhood: parents can foster child’s sense of control, prevent anxiety
-secure home base, positive predictable parental reactions, ability to explore their world
-social contributions: stressful life events can trigger bio/psych vulnerabilities to anxiety
-reaction to stress linked to family; eg. panic attacks can be familial
-an integrated perspective: can be biologically vulnerable to anxiety w/o having it; stressors can activate
-panic: familial patterns; reactions associated to certain cues; anxiety + panic can occur together
Comorbidity of Anxiety Disorders
-co-occurrence of 2 disorders; high rates of comorbidity among anxiety disorders (and depression)
-most common additional diagnosis is major depression
Panic Disorder with and without Agoraphobia
-PDA: severe unexpected panic attacks that lead to fear of leaving home;
Clinical Description
-anxiety + panic + phobic avoidance; must experience unexpected P.A. -> anxiety over additional ones
-panic disorder without agoraphobia (PD)
-see attacks as sign of impending death/incapacitation
-development of agoraphobia: P.A. makes one want to stay in safe place in case of a second one
-can still have agoraphobia w/o having a panic attack for years; thus method of coping w/ P.A.’s
-some w/ agoraphobia go outside but experience major distress while doing so
-interoceptive avoidance: avoid physiological arousal that’s similar to P.A.’s (eg. exercising)
-3.5% of pop. 2/3rd women(higher in more severe cases); onset in early adult life (15-40yrs);
-lower in men: possibly due to cultural disapproval; cope via alcohol use
Cultural Influences
-panic disorder exists worldwide, diff. in prevalence; somatic symptoms emphasized in dev. Countries
-Nocturnal Panic: no P.A. with nightmare, caused by transition to delta (slow-wave) sleep; “letting go”
-isolated sleep paralysis: caused by REM sleep (lack of body movement) spilling into waking
-suicide: 20% of P.A. attempt it; more when assoc’d with mood disorder; but less if no comorbidity
-bio: inherit vulnerability to stress that creates unexpected P.A.; partly heritable
-psych: must be susceptible to developing anxiety over possibility of another P.A.
-anxiety sensitivity index: examine psych vulnerability to panic disorder
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