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Lecture 13

Psychology 46-322 Lecture 13: Notes on Anxiety Disorders

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Lecture 13 on Anxiety Disorders Anxiety  Definition of fear: Normal adaptive response to danger in the environment  Fear is normative starting in childhood  Mostly fear of novelty (new people, new food; peak around age 8; around age 10 these fears decline)  Infants exhibit separate anxiety once they have identified preferred caregiver  Pre-school  Fear shift to imagery things (ex. ghost, monsters, dinosaurs)  School age  fears are more about real events (ex. injury, physical danger)  Adolescence  abstract and socially motivated (ex. being judged, failing, fear of war)  Transitional objects (ex. blanket)  to cope with their fears  Anxiety disorder  a failure in adaptive response; different from normative fears due to their intensity, maladaptiveness, persistence (across multiple environment and time), voluntary control (less control over their sense of fear)  Anxiety responses o Behavioural response (ex. crying, hiding, covering eyes)  the behaviours we can see o Physiological response (fight or flight response) o Cognitive response (in adolescence)  both adaptive and maladaptive Predisposing/risk factors  Genes  increase risk in all anxiety disorders; parents should know if children carry "a gene for anxiety"  Biology  only for PANDAS  significant factor for OCD  Temperament  probably related to the gene risk factors  kids are more anxious, highly self-control or over controlled, more likely to develop an anxiety disorder  **Early exposure to fear, separation, or traumatic events change how the brain behaves itself (changes how the HPA access works)  enhanced levels of anxiety  Attachment  kids who experience significant threats are less likely to develop secure attachment; attachment is laid in early relationships; create an unstable foundation for attachment  Cognitive biases o Intentional bias  increased sensitivity to cue of threats o Unrealistic cognitive set  child with anxiety disorder believes the world is a danger place  Reinforcement  the child exhibit symptoms of anxiety by ex. going to the closet and hiding behind mom, the teacher/parents or the attachment figure comfort, praising them for positive reaction  Avoidance  child experiences fear and move away from it and they feel better  Competence  as the child avoid the fear, they do not develop coping strategies  Parental behaviour  how the parent responds to the child's fear; parents who are over- protecting or over controlling might cue the child that the fear is something to avoid in the future (child does not develop coping strategies, confidence and competence to cope fear because parents are too loving and over-protective)  Transactional processes  child and parent relationship in coping fear Across Anxiety Disorders  Symptoms: Intense, persistent, anxiety, and worry  Symptoms are enduring (persistent even when the threat is over)  Middle-childhood  person can tell you the fear when the fear isn't present; that it is not as scary as the person describe  10-20% will go on to develop anxiety disorders  More common in females; difference gets bigger as age increases  High comorbidities for those who have anxiety disorder than those who do not (depressive disorder)  Anxiogenetic  Parents have anxiety disorder often anticipate their children to have an anxiety disorder (due to parenting strategy, environmental events) Specific Anxiety Disorders Generalized Anxiety Disorder (GAD)  Aka over-anxious disorder of childhood  Symptoms: Generalized worry (disruptive to the individual)  3-6% of kids meets diagnostic of GAD  Mostly in school period  They focus on performance and drives for perfection; they have catastrophic thinking episodes (spiral/endless worrying)  Start to develop: Headaches, stomach aches, nervous habits (ex. chewing hair, biting nails)  More common in girls than boys always; most obvious in adolescence  **Similar in childhood, and over time, girls in all anxiety disorders go up  Common comorbidity: another anxiety disorder, major mood disorder (ex. depression  developing worrying into hopelessness and then depression); chronic perfectionism (high levels of self-criticism)  Best intervention: CBT, kindle's coping cat (the kids generalize the cat to themselves) o CBT: Reinterpret the meaning of physical symptoms and teach them coping strategies o Teach them to identify maladaptive thoughts o Cognitive reappraisal o Graduated exposure  approach the thing that makes them anxious Specific Phobia  Marked and persistent fears that are cued by the presence of the fear stimuli  2-4% of kids have a specific phobia  Categories: 1. Blood, injuries, and injection 2. Animal phobias (ex. dogs, snakes) 3. Natural environment (ex. heights, storms, water) 4. Situational phobias (ex. being in small space, in an elevator) 5. Other category  Different on
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