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Lecture 5

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Western University
Psychology 2310A/B
Rod Martin

Anxiety Disorders: Panic Disorder & Obsessive-Compulsive Disorder DSM-IV criteria for Panic Attack Period of intense fear or discomfort- Develops abruptly, peaks within 10 minutes 4 of 13 symptoms must be present to be diagnosed - Laboured breathing, heart palpitations, nausea, chest pain, feelings of choking and smothering, dizziness, sweating, trembling, feelings of impending doom, depersonalization, derealization, etc. DSM-IV Diagnosis of Panic Disorder Recurrent unexpected panic attacks At least one month of: Persistent concern about having other attacks Or worry about the implications of the attacks Or significant change in behavior related to attacks. Panic Disorder (cont’d) Isolated panic attacks are common- 50% of reg pop have symptoms of panic attack Lifetime prevalence: 3-5% of the population 2X as common in women as men Onset in early adult life (teens to 40) Bimodal: late teens, 30’s can start at two diff times, teens or 30s. Two peaks Chronic course – waxing and waning – doesn’t go away by itself. Can get worse then be gone for some time. If agoraphobia develops, usually within 1 yr Comorbidity with agoraphobia, major depression 50-65%, GAD, phobias, alcohol dependency, personality disorders. Agoraphobia Agora = marketplace (today: shopping malls) Anxiety about being in places where escape would be difficult E.g., away from home alone, shopping mall, in a crowd, on a bus, standing in line Usually involves fear of having a panic attack Person stays home to avoid these situations Clarks Cog model of panic - vicious cycle - fear or fear - trigger, perceived threat, apprehension, bodily sensations, catastrophic misinterpretation, back to perceived threat…. Obsessive-Compulsive Disorder (OCD) Obsessions Recurring, persistent thoughts, images, or impulses Experienced as intrusive, inappropriate, cause marked distress or anxiety (“ego-dystonic”) things that you experience that don’t fit with who you are that annoy and bother you but you can’t stop feeling them. Not simply excessive worries about problems Person recognizes they are product of own mind Doubts (e.g. "Did I lock the door?“) Impulses (e.g. jump off building, killing someone) Contamination - fear of germs Need to have things in order. Compulsions Repetitive behaviours or mental acts that the person feels driven to perform to reduce the distress caused by the obsessions Excessive, irrational The person recognizes irrationality of behavior Behaviours – e.g., hand-washing, ordering, checking Mental acts – e.g., praying, counting, repeating words silently Don’t enjoy compulsions, gambling not a compulsion… Obsessions and/or compulsions cause marked
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