PSY240H1 Lecture Notes - Lecture 3: Panic Attack, Hypervigilance, Diarrhea
Week 3 – Wednesday January 27th, 2016
Definitions
• Anxiety
o Negative affect
o Somatic symptoms of tension
• Muscle tension
o Apprehensive anticipation of future danger
• Fear
o Immediate alarm reaction to present danger
o "fight or flight"
Adaptive versus Maladaptive Fear
• Anxiety and fear are normal emotions
o Everyone experiences them to a certain amount
o Not cause for alarm
• Becomes maladaptive when it affects your functioning and relationships
• Adaptive
o Realistic concerns
o Proportional to threat
o Subsides upon removal of threat
• Maladaptive
o Unrealistic concerns
• Out of proportion to the situation
• The source of anxiety is unlikely to occur or it won't hurt you
o Disproportional
o Persists after threat
o Also, anticipatory anxiety
• Being in a really agitated state, expecting the threat to happen
Common Symptoms of Anxiety
• Physical
o Goosebumps
o Sweat
o Heartrate increases
o Nausea
o Diarrhea
• Cognitive/emotional
o Cognitive
• Hypervigilance
• Fear losing control
• Sense of unreality
o Emotional
• Sense of dread
• Terror
• Irritability
• Behavioural
o Escape
find more resources at oneclass.com
find more resources at oneclass.com
• Running away (flight)
o Avoidance
o Freeze
o Aggression
• Lash out, can't regulate emotional experience
Anxiety Disorders
• Commonalities
o Basic biological causes
o Basic psychological causes
o Effective treatments
• Classical conditioning
o Severe
o Impact quality of life
o Chronicity and frequency
o Interfere with functioning
o Disproportion to real dangers
DSM-5 Anxiety Disorders
• Some changes in DSM-5 for anxiety disorders
• Social phobia changed to social anxiety disorder
• Added some diagnostic labels
o Separation anxiety (used to be categorized as a developmental disorder)
o Agoraphobia
• OCD and PTSD are no longer listed as anxiety disorders
Panic Attacks (PAs)
• Not a disorder
o Characteristics that might come up in several anxiety disorders
• Intense fear/discomfort
• Sudden onset and peaks and subsides rapidly (<10 minutes)
• Accompanied by 4+ physical symptoms
o Example: increased heart rate, muscle tension, etc.
• Cued versus uncued
o Cued
• Symptoms come on very suddenly in response to some specific stimulus
o Uncued
• Symptoms come up out of the blue (nothing around you to make you feel
anxious or nervous)
• Can become cued over time
Panic Disorder (PD)
• Recurrent, unexpected panic attacks (PAs)
o Two or more uncued PAs
• Followed by 1+ month of (at least one):
o Persistent concern about having another PA
o Persistent concern about implications of PAs
o Significant change in behaviour
find more resources at oneclass.com
find more resources at oneclass.com
Agoraphobia
• It used to be just an add-on but DSM-5 now categorizes it as its own disorder
• Anxiety about places / situations where escape might be difficult or help is unavailable
• Many people with panic disorder also have agoraphobia
• Situations avoided or endured with distress
• Examples
o Being in crowds, standing in line, train station, being in the house alone, leaving the
house alone, etc.
Separation Anxiety Disorder
• Excessive anxiety concerning separation from the home or primary caregiver(s)
o Usually starts when children first start going to school
• Complain about a physical symptom so they can go home to their parents
• 4+ weeks (6 months in adults)
o Most adults don't recall having the anxiety in childhood
• Going to college for first time
o Even older adults might have the anxiety towards their offspring and/or spouse
• It's hard to understand because children might have a hard time communicating
Selective Mutism (DSM-5)
• Consistent failure to speak in social situations
• Interferes with achievement
• Duration: at least 1 month
• Not due to lack of knowledge of language
• Not better accounted for by other disorders
o Not a speech disorder
Specific Phobia
• Cued panic attacks
• Marked and persistent fear
• Exposure almost invariably provokes fear / anxiety*
o *In children, the threshold might be different
• Different behaviours/symptoms
• Situation avoided / endured with distress
• Fear / anxiety =/= actual danger posed
o Example: tin foil
• Subtypes
o Animal
• Fear of dogs, insects, spiders
o Natural / environment
• Heights, closed spaces, sky diving
o Blood-injection-injury
• Getting needles, seeing blood
o Situational
• Closed spaces, elevators (claustrophobia)
o Other
• Clowns
find more resources at oneclass.com
find more resources at oneclass.com
1
PSY240H1 Full Course Notes
Verified Note
1 document
