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Lecture 4

PSY240H1 Lecture Notes - Lecture 4: Panic Attack, Panic Disorder, Specific Phobia

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Theone Patterson

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Lecture 4: Trauma Disorder & Anxiety Disorder
Background on anxiety disorders
Anxiety: emotional state in response to perceived threat in the future (real or imagined)
Fear: The intense emotional state which is activated in response to a real, imminent, and objective danger,
which threatens life and survival
o The fight-or-flight response is activated in response to fear
Threat → amygdala → hypothalamus → activates sympathetic nervous system and adrenal
glands secrete cortisol
Cortisol helps to prevent continued elevated response therefore it serves a negative feedback on the
hypothalamus and pituitary
Anxiety Disorders
Anxiety disorders are characterized by;
o Pervasive, persistent anxiety/fear
o Excessive avoidance/escape
o Significant distress/impairment
There are 3 theories about vulnerabilities of anxiety disorders;
o Biological: Genetic tendency to be tense, uptight, anxious, or to panic or overly sensitive or dysfunction
fight-or-flight system (NT imbalance)
o Cognitive: thoughts that may stem from childhood about the world being a dangerous place
e.g. children raised by overprotective or overly emotional parents how may not have allowed
children to explore world resulting in adults unable to cope with novel information
o Behavioral: people learn to fear or worry about certain things from modeling or other types of condition
Specific phobias
Phobias are split into two broad categories:
o Specific: unreasonable or irrational fears of specific objects or situations
o Agoraphobia: a fear places where they might have trouble escaping or getting help if they become
In addition, specific phobias can be further broken down into 3 subtypes; animal, natural environment, and
blood-injection injury
There are two major theories for phobias:
o Mowrer's two Factor Theory: phobias develop via classical conditioning (CC) and are maintained via
operant conditioning
o Prepared classical conditioning: Evolution has prepared us to more easily develop conditioned fear in
response to dangerous stimuli
Panic disorder
Panic attacks are short but intense periods of anxiety symptoms
o When panic attacks become reoccurring and unexpected the person is said to have a panic disorder
o About 28% of the pop. Of suffered from a panic attack but only 4% of the pop. Meets the criteria to be
diagnosed with a panic disorder
Panic disorders seem to have a strong genetic component (43-58%)
o fight-or-flight response appears to be poorly regulated in people who develop panic disorder. In addition,
Neuroimaging studies show differences between people with panic disorder and those without panic
disorder in several areas of the limbic system involved in the stress response, including the amygdala,
hypothalamus, and hippocampus
The reason panic attacks endure is because people use avoidance conditioning - learning to avoid situations
o Overtime this avoidance becomes a negative reinforcement from a CBT perspective therefore panic
symptoms won't get better just worse
Panic Disorder Treatments
Certain antidepressant drugs treat panic attacks and agrohobia
Exposure therapy is also used to help get weaken the association between the CR (freaking out) and CS (the
mall or whatever gives the person anxiety)
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