PS101 Lecture Notes - Lecture 15: Natural Disaster, Obsessive–Compulsive Disorder, Agoraphobia
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Michael Matthews November 8, 2011
Free floating anxiety:
Panic attacks- people have this overwhelming feeling of dread. 1/3 of university students admit to having
panic attacks. Very sudden, perspiration, repertory implications, cardiac changes. The trigger is usually a
perceived threat of physiological changes that are interpreted as extremely catastrophic. The solution to this
is to be with someone who can calm the person and keep them comfortable, reassure them they are not
going to die. Reassure them with some sense of safety. One of the key symptoms of anxiety is
uncontrollability. 2% female, 1% male. If you have 4 panic attacks in a month, you have a panic disorder.
Physiological changes can happen through exercise or sexual activity.
Only about 9% of panic attacks happen in the house (associated with a social phobia) –agoraphobia
Another form of free floating is called generalized anxiety disorder (GAD). Some argue that this is the pre-
state of panic disorders, low level chronic anxiety. An unrealistic worry of two or more of life’s
circumstances (health, money, family, work). This disorder gives link to a secondary anxiety, this this
worrying will cause sickness, family start to resent your behaviour…They do see the world as a fairly
dangerous place. Lots of anti-anxiety medication.
Post-traumatic stress reaction- happens after the event. 10% are women, usually from sexual assault. 5% of
men. Response to an event that is outside the use of human experience that would be marketable depressing
to any individual. The act of being assaulted sexually, or being violated by another human being, outdoes
any natural disaster. Three stages of this: shock, suggestibility (they will do virtually anything you suggest),
recovery. Vietnam War had a massive jump when soldiers came back.
If you is anxious, it leads to further depression because of peoples’ awareness of their anxiety.
DSM’s biggest issue is how they “label” particular things.
About 1/3 of people who experience post-traumatic stress still experience parts of these years later.
Phobias- a persistent fear of a particular situation or object. Many would say this fear is still very
unrealistic, or out of proportion. Second piece is you spend your whole life avoiding your phobia. Finally,
the fear is isolated.
Simple phobias- claustrophobia, acrophobia (heights), zoophobia (snakes, dogs, spiders). Non-random
nature. Most of our phobias are from what our ancient ancestors feared most.
We come into the world conditioned to being able to scare of such basic fears such as spiders.
Social Phobias- agoraphobia. Some people become absolutely house bound because they cannot leave their
front porch. Some people are scared of public speaking, eating in public, going to the washroom in public.
2% of people have social phobias. An important aspect is that the person has a realistic basis of fear from
reality. E.g. worrying that we will stumble again, making the same mistakes can increase the vicious cycle.
Some people use such things as tranquilizers or alcohol in order in order to feel better about their phobias.
OCD- obsessive compulsive disorder. Anxiety rises if people are prevented of ding the ritualistic things
people want to pursue. Change makes people very anxious; they are helped by performing their rituals.
Checking and cleaning rituals are very common.
Roughly 2-3% suffers from OCD. It is quite rare, and there is no gender difference. Usually beings in late
adolescence. About ½ of OCD happens after a very stressful event. The compulsion is just a means to an
end, as opposed to an actual end like drinking or gambling. It is possible to have obsession, but not have it
as compulsion (love affairs).
Body dimorphic disorder- anxiety surrounds a particular piece of the body that we really dislike. Average
age of onset in 19. 28% of the student population have some level of this disorder. /where is the line
between what is normal and what is obsessive?
Prozac is usually used to treat OCD and body dimorphic disorder.
Munchhausen syndrome – great liars, lie about extreme terms of illness in order to be admitted into a
hospital. Largely about the secondary attention they receive.