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chap 14 part 2.docx

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Department
Psychology
Course Code
PSY-0001
Professor
Sam Sommers

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Psychopathology Part 2 04/15/2014 Anxiety Disorders Panic disorder with and without agoraphobia Phobias (specific and social OCD PTSD Generalized anxiety disorder (GAD) Panic Disorder Recurrent, unexpected panic attacks (for no reason/unprovoked) An abrupt, discrete period of intense fear or discomfort, marked by at least four of the following symptoms  (Sx) that peak within 10 mins   Palpitations and/or accelerated heart rate Sweating Trembling Sensations of shortness of breath (hyperventilating) Feeling of choking  Chest pain/discomfort Nausea  Dizzy, lightheaded, faint Derealization & depersonalization (feel like you’re in a dream/things don’t seem real, feel like you’re not in  control of your own movements) Fear of losing control or going crazy Fear of dying  Parenthesis  Paresthesias  Chills or hot flushes  Panic attacks themselves aren’t uncommon – different from panic disorder At least one attack is associated with at least a month of one or more of the following Persistent concern about having additional panic attacks Worry about implication of panic attacks Significant change of behavior related to the attacks (conditioning)  Symptoms cannot be due to general medical condition (e.g., hyperthyroidism) or psychological effects of a  substance (e.g., amphetamine, caffeine, cocaine, etc.) Can exist with or with agoraphobia Avoid public situations, such as airports or malls, where it might be hard to escape May not go out without a trusted friend May not ever leave the house  Statistics Lifetime prevalence = 1­3% in community samples Onset = 20s and 30s Sex ratio (F:M) = 2:1 without agoraphobia and 3:1 with agoraphobia  Familial, with first degree relatives of PD patients being 8 times more likely to develop panic disorder  Twin studies show a genetic component  Neurobiology (according to Jack Gorman & colleagues) The “fear network” is hypersensitive Amygdala, brainstem, hippocampus, thalamus  (Some evidence that especially the amygdala and brainstem are hyperactive and there is more matter in  patients with PD) Frontal cortex fails to inhibit fear network  (Not much evidence for this)  When entire fear network is activated ▯ full blown panic attack  When fear network is partially activated ▯ “limited symptom attack” Treatments Medication treatment: bottom­up desensitization of network Cognitive­behavioral therapy: top­down control (works on frontal cortex) Medication and cognitive treatments work in different ways Specific Phobia Marked and persistent fear that
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