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5. Anxiety Disorders.pdf

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PSYC 3230
James Alcock

5. Anxiety Disorders Monday, February 4, 20139:00 AM What is fear? • This reflects the fact that we have two separate systems for processing information about the world • Affective/experiential (amygdala, hippocampus, etc.) • Cognitive/intellectual (cortex) • Remember: Fear response is vital to our survival-- allows for fast, energized action ○ Born with fear in response to falling or loud noise or pain ○ Learn other fear stimuli; tendency to fear is often culturally transmitted  E.g., fear of spiders in European cultures not found in many other cultures-- may be related to cultural reaction to the plague • Until about 35 years ago, psychologists believed we could learn a fear response to anything, through classical conditioning • E.g., rats made ill following a particular taste in water or food will avoid it; the conditioning response is poor if noise or bright light is the CS • Yet, taste in water preceding electric shock leads to poor conditioning, while noise/bright light leads to good conditioning What is anxiety? • Anxiety: Affective state involving strong negative emotion, feelings of uncontrollability regarding the future, self-preoccupation, autonomic nervous system arousal • Fear and anxiety are essentially the same physiologically, except that when there is arealistic source of impending danger, we call the reaction "fear" • Anxiety is a more diffuse response than fear, and relates to vague, impending or future threat of danger • Again, remember, fear/anxiety important for survival • However, it can also become maladaptive • "Normal" or "adaptive" experience of anxiety or fear--> "disordered" or "maladaptive" experience of anxiety of fear ○ Determined by situation • Genuine threat/danger: adaptive Models for understandinganxiety • Psychoanalytic model ○ Realistic anxiety-- external danger ○ Neurotic anxiety-- fear of id impulses emerging ○ Moral anxiety-- superego vs. ego • Biopsychosocial model-- various factors interact ○ Hereditary temperament ○ Neurotransmitters ○ Learning ○ Cognition • Learning theory ○ Classical plus operant conditioning ○ Social learning (modelling) • Cognitive theories ○ Research shows phobias often come about through frightening irrational thoughts during exposure to stimulus that becomes object of phobia ○ People become anxious because they feel unable to cope with anticipated averse events ○ Apart from actual physical threat, cognitions typically come first, and shape emotions  Catastrophizing Stress • We experience psychological stress when we are confronted with circumstances that demand change ○ Primary appraisal: Is the situation dangerous or harmless? ○ Secondary appraisal: Do I have the resources to cope? • If we decide that we can indeed cope, then we are more likely to avoid negative emotional reactions • Some people are generally relaxed while others are almost always tense Anxietydisorders • When individuals routinely experience such maladaptive response, or they cannot cope with chronic stress • Comorbidity: many patients with anxiety disorders suffer from multiple disorders Panicdisorder • "Panic" is a very strong anxiety, massive autonomic arousal, coming on suddenly, unexpectedly, uncontrollably, with no apparent source of threat • Experienced by 3 to 4% of the population; about 75% are women • Typical onset in late twenties, but often begins at puberty • If untreated, 20-25% attempt suicide • Runs in families • 60% report panic attacks during sleep-- usually between 1:30 and 3:30am ○ Occurs during delta sleep and not during REM sleep • Symptoms ○ Palpitations ○ Shortness of breath ○ Sweating, shaking ○ Choking sensations Loss of control, fear of dying Lecture Notes Page 1 ○ Loss of control, fear of dying ○ Derealization ○ Usually peak in about 10 minutes • Can produce all the symptoms in the laboratory: ○ Lactate infusion ○ Hyperventilation ○ CO2 inhalation ○ Caffeine injection • Individual comes to have a secondary fear-- the fear of ha
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