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Lecture 13

PSY 105 Lecture 13: 10:16 Notes

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PSY 105

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10416 Notes Treatments GAD treatment normally happens at primary care units > give pill (probably antidepressants or benzodiazepines) because dont have time to do a behavioral therapy Pharmacological o Benzodiazepines > fast acting antianxiety agents; quickly take the edge off of anxiety, but do not last very long Risks versus benefits Risks might be slow, might be at risk of abuse of benzos, might be numb, potential for ABUSE and DEPENDENCE, possible memory effects; Rebound effects (anxiety decreases with benzo, but when benzo wears off, your anxiety comes back stronger) Benefits fast acting o Antidepressants Psychological a lot of these are not unique to GADs, they apply to other disorders to o Cognitivebehavioral treatments (CBTs)collection of behavioral interventions that have similar principles Family of interventions that are Cognitive (CbT) [focus on changing cognition] and Behavioral (cBT) [about changing how you behave as a driver to change cognition, emotion, or internal experiences] Behavioral, B > identifying and changing patterns of behavior Doing differently Cognitive; C > identify patterns of thinking that are dysfunctional and changing them Thinking differently Cognitive Distortion maladaptive patterns of thinking Content based CBT interventions Some are very change focused (changing CONTENT of how you think) EX. Julias fearworry of failing is a catastrophizing pattern; cognitive intervention would change her maladaptive pattern of thinking called COGNITIVE DISTRORTIONS where we look at her thoughts and look at evidence for why her thoughts are true or false and rationally think it through to change her appraisal of the future and her future thought patterns Reappraisal of what is true is end goal Acceptance based CBT interventions try to change the process of HOW you think, or the context of how you think; process of how you think about what you think Would help Julia learn experientially through metaphors or practices, that the thoughts are just thoughts to notice, they are neither true nor untrue The observation of the thinking process and a new way to relate to her thoughts as jus simply thoughts Content of catastrophizing thoughts is still there, but she is able to stand back and observe my mind is spinning, telling me this, and that < distance perspective Interventions often include mindfulness and meditation CBT: Exposure to worry process CBTs expose people to their fears! Because all the worrying that patients have might function as a way to avoid more difficult decisions, life concerns, living (constantly worried about minor things keeps me from worrying about the BIG stuff Tom Borkeveck)! Retrain patient how to worry effectively and functionally Confronting anxietyprovoking images Coping strategies Push worries off until a designated worry time > trains you to worry at a later time to train you to be in the present moment o Acceptance Being present in the moment in which you come into contact with what is in the moment with you and your worry Teaches experientially how to be in your skin o Meditations Same general goal as acceptance just a different way to get there o Similar benefits o Better longterm results GAD is a chronic course disorder that is REALLY hard to treat o Acceptance based CBTs for GAD are the most contemporary and used today 2. Panic Disorder and Agoraphobia Clinical description o Unexpected panic attacks o Anxiety, worry, or fear of another attack o Persists for 1 month of more o Agoraphobia Fear or avoidance of situationsevents Excessive fears about dangers out there in the world Classic: being homebound
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