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Anxiety Notes.docx

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 6 Anxiety Disorders to fear a neutral object) and operant conditioning (reduce the fear by escaping the CS) General Knowledge:  Modelling – imitation or vicarious learning  Anxious-Rearing Model Anxiety- unpleasant feeling of fear and apprehension  Prepared Learning – ppl tend to only fear certain Anxiety Disorder – diagnosed when subjectively experienced objects (prepared stimuli) feelings of anxiety are clearly present  Diathesis is needed – not everybody exposed to traumatic experience develops phobia Six Categories – Phobias, Panic Disorder, Generalized  Social Skills Deficits in Social Phobias Anxiety Disorder, Obsessive-Compulsive Disorder, Post- Traumatic Stress Disorder, Acute-Stress Disorder Cognitive  Thoughts serve as a predisposition for phobia Comorbidity – Symptoms are applicable across different categories, and etiological factors are similar across categories  Socially anxious ppl are more aware of the image they present to others, more concerned with Anxiety Disorders = most common psychological disorder evaluation, and are preoccupied with hiding (more common in women) imperfections  Social Phobia linked to: Phobias – a disrupting, fear-mediated avoidance that is out of o An attentional bias to negative social info proportion to the danger actually posed and is recognized by o Perfectionistic standards the sufferer as groundless o High degree of public self consciousness Freud – thought phobias were symbolic Biological Behaviourists – looked at function of the phobia (how were  Autonomic lability, ppl with aroused autonomic they acquired) nervous systems  Some phobias have strong genetic link Specific Phobias – fear due to presence or anticipation of a specific object or situation Therapies for Phobias:  blood, injuries, and injections Psychoanalytical – attempt to uncover the repressed conflicts  situations(enclosed spaces) believed to cause fear and avoidance  animals  the natural environment (heights) Behavioural Five fear factors: can be specific or social  Systematic desensitization o Exposure to (in vivo) or thinking of subject  agoraphobia of fear while in deep relaxation  fear of heights or water o Virtual reality treatments  Blood and injection phobias encouraged to tense  threat fears  fears of being observed muscles to prevent fainting  speaking fears  Social Phobias - role playing  Modelling – demonstrations of people interacting Lifetime Prevalence: Men 7% Women 16% fearlessly  Flooding – full on exposure Social Phobias - fears linked generally to presence of other  One-Session exposure Treatment (OST) people (generalized or specific) Cognitive Lifetime Prevalence: Men 11% Women 15%  Skeptical because phobics already know that their Onset of Phobias – adolescence fear is unfounded Etiology:  CBT attempts to change their appraisal of social situations and to rely less on approval from others Psychoanalytic Theories – phobia is defense against anxiety of  CBT requires `homework` to be successful repressed id impulses. There is symbolism in the type of phobia. Biological  Anxiolytics Behavioural  Barbiturates, Benzodiazepines. Risk of overdose,  Avoidance Conditioning – phobias are learned addictive.  Drugs originally for depression good for anxiety avoidance responses via classical conditioning (learn o MAO and SSRI  May be difficult for patient to stop using drugs and  Antidepressants (SSRI and Tricyclic antidepressants) may relapse and Anxiolytics o Drugs must be used continuously Panic Disorders – a person suffers a sudden inexplicable o Often have side effects that cause people to attack of labored breathing, heart palpitations, nausea, chest stop taking them pain, feelings of choking, smothering, dizziness, sweating,  Self medication is common (8% social phobia, 36% trembling, apprehension, terror, and feelings of impending GAD) doom. Psychological Depersonalization – feeling of being outside of one`s body  Exposure based treatments Derealization – feeling of the world`s not being real, as well as  In-vivo is enhanced when coupled with a spouse (the fear of losing control of going crazy or even dying. spouse should stop enabling) Attacks last for minutes, can occur ~once a week  Barlow’s Panic Control Therapy o Relaxation training o Combo of Ellis and Beck type CB Cued – linked to situation interventions (cognitive restructuring) Situationally Predisposed – somewhat linked to situation o Exposure to internal cues that trigger panic  CBT works too, better than some drugs Uncued – random Generalized Anxiety Disorder – persistently anxious, often Prevalence: Men 3% Women 6% about minor things, chronic uncontrollable worry about everything. Onset – Adolescence associated with stressful life experience Prevalence –Men 4.2% Women 7.1% Comorbidity – Agoraphobia (diagnosed with or without), Major Depression, Generalized Anxiety Disorder Onset – Mid teens, though many ppl have it all their lives. Stressful live event may play a role in onset Etiology: Comorbidity –anxiety and mood disorders Biological DSM definition – if you take out excessive and uncontrollable  Physical sensations caused by illness can lead to worry it increase 40% panic disorder ( mitral valve prolapse, inner ear disease) Etiology  Runs in the family (greater concordance with I-twins) Genetic Diathesis may be invovled Psychoanalytic  Noradrenergic Activity – over activity in the  Unconscious conflict between ego and id impulses noradrenergic system ( noradrenergic drugs can cause attack, but not good at preventing them)  Very similar to phobia except the defense of projecting the anxiety to on object is not present  Cholecystokinin – CCK induces anxiety like therefore they are always anxious! symptoms, panic disorders are a hypersensitivity to CCK Cognitive-Behavioural Psychological  The anxiety is classically conditioned to external  Fear of fear hypothesis – agoraphobia not a fear of stimuli, but with a broader range of conditioned public places but a fear of having a panic attack in stimuli  Perception of not being in control is a central public characteristic of all forms of anxiety  Autonomic nervous system overly active + psychological tendency to become very upset by the
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