PSCY300 #2.docx

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PSYC 300
Lawrence Walker

10/31/2011 4:12:00 PM Cognitive: “worry: concern about negative consequence Behavior avoidance Anxiety vs. fear Fear: -more intense, present oriented Anxiety: future oriented, more diffuse Function of anxiety Keep away from harm Increases attention and focus Energy Motivation Panic disorder General anxiety disorder POST Most commonphobia More women with the exception of OCD High rates of comorbidity Common= pattern of avoidance Panic attack Trembling and dizzy Hot flushes/ cold spells Increase heart rate/ palpitations Sweating Inspiration (e.g. choking) Shortness of breath Numbness or tingling Tightness in chest Fear of: losing control, dying, going crazy Unreality (sense of) Nausea (This not fun) (4 or more, peak quickly, brief and intense) Single attack doesn‟t mean disorder. Most people will experience a panic attack at some point. Panic attack can occur in many anxiety disorders. (Not just panic disorder) Type of attack Situationally bound (cued) Police, bad news Unexpected uncued out of blue. Panic disorder  Recurrent unexpected panic attack (2 or more)  Plus or more > 1 month A. Persistent concern about having another attack B. Worry about the implication (heart problem, losing my mind) C. Significant change in behavior avoidance agoraphobia Panic attack with agoraphobia Panic attack with agoraphobia Agoraphobia DSM criteria  Anxiety about being in places from which escape might be difficult (or embarrassing) or help may not be available in the event of having a panic attack or panic- like symptoms  Situations are avoided or endured with significant distress. Causes Some evidence runs in families (true of anxiety in general) Neurotransmitters = norepinephrine increase, GABA decrease  Brain areas= amygdala Two competing theory 1. CO2 dioxide hypersensitivity Theory (suffocation alarm) Panic disorder CO2 panic attack No Panic CO2 no panic attack 2. Cognitive theory Disclose of information Benign physiological changes misinterpreted Catastrophic Treatment CBT cognitive restructuring  Relaxation  Introspective exposure  Decrease relapse rates Antidepressants (Esp. SSRIs)  Relapse often when discontinued Benzos short term only With Agoraphobia SSRIs and exposure therapy Phobia disorder 1) Agoraphobia 2) Social phobia 3) Specific phobia - Fear of social or performance situation - Fear is that they will embarrass or humiliate themselves - Intense anxiety or even panic attacks when expose  Pattern avoidance 1. Situational- public speaking exposure 2. Generalized all social situations SSRIs and CBT 3. Specific phobia  Fears that are excessive and cued by specific objects or situations 1) Animal Childhood onset, gender equal, 100 boys = 100 girls Adulthood: 10 boys and 90 girls “Socialization” forced exposure 2) Natural environment Storm height water 3) Blood injection injury Dramatic decrease in blood pressure Fainting 4) Situational Diving, elevator. Causes of phobia Conditioned response  Result of traumatic exposure 50% people with a phobia  Traumatic conditioning Preparedness theory  Fear can be learned by modeling CBT- exposure, relaxation Antidepressant limited use Generalized Anxiety disorder (GAD) Worry disorder Worry that is excessive and difficult to control about a whole number of things - Far at least 6 months - Plus 3 of the 6 1) Restless 2) Easily fatigued 3) Difficulty concentrating 4) Irritability 5) Muscle tension 6) Sleep disturbance  Many people with GAP report an early onset and living with it most of their lives  More difficult to treat especially “worry”  Chronic course may be more like a p
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