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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 6 Anxiety DisordersAnxiety is an unpleasant feeling of fear and apprehension It can occur in many psychopathologiesAn anxiety disorder is diagnosed when feelings of anxiety are clearly presentDSM proposes 6 categoriesoPhobiasFearavoidance of objects or situations that do not present any real dangeroPanic disorderRecurrent panic attacks involving a sudden onset of physiological symptoms dizziness rapid heart rate etc accompanied by terror and feeling of impending doom sometimes accompanied with agoraphobia a fear of being in public placesoGeneralized anxiety disorderPersistent uncontrollable worry often about minor thingsoObsessivecompulsive disorderExperience of uncontrollable thoughts impulses or images obsessions and repetitive behaviours or mental acts compulsionsoPosttraumatic stress disorderAftermath of traumatic experience in which the person experiences increased arousal avoidance of stimuli associated with the event and anxiety in recalling the eventoAcute stress disorderSymptoms are the same as those of posttraumatic stress disorder but last for 4 weeks or lessOften someone with one anxiety disorder meets the diagnostic criteria for another disorder as well comorbidity becauseoSymptoms of the various anxiety disorders are not entirely disorder specificoThe etiological factors that give rise to various anxiety disorders may be applicable to more than one disorder16 of women and 9 of men suffer from anxiety disorders mostly women 1524 yearsPhobiasPhobia a disrupting fear mediated avoidance that is out of proportion to the danger actually posed and is recognized by the sufferer as groundlessExamples fear of heights closed spaces snakes or spidersThe person suffers intense distress and social or occupational impairment because of the anxietyFor other phobia disorders the suffix phobia is preceded by a Greek word for the feared object or situationoClaustrophobia fear of closed spacesoAgoraphobia fear of public placesoAcrophobia fear of heightsoErgasiophobia fear of writingoPnigophobia fear of chokingoTaphenphobia fear of being buried aliveoAnglophobia fear of EnglandoMysophobia fear of contamination and dirt that plagues many ppl eg Howie mandelPsychoanalysts believe that the content of the phobias has important symbolic valueBehaviouristignore the content of the phobia and focus on its function insteadThere are 2 types of phobias SpecificSocial PhobiasPSYB32 MIDTERM 2 CHAPTER NOTES1Specific PhobiasSpecific Phobia unwarranted fears caused by the presence or anticipation of a specific object or situation DSMIV subdivides these phobias according to the source of the fearoBloodoInjuriesInjectionsoSituationsoAnimalsoNatural EnvironmentRecent empirical research involving a national representative sample suggests that fear can be grouped into 1 of 5 factorsoAgoraphobiaoFears of heights of wateroThreat fear bloodneedle stormsthunderoFear or being observedoSpeaking fearsThese fears were then classified under the 2 higherorder categoriesspecificsocial fearsSpecific fear focused on in a phobia can vary cross culturallyoPaleng fear of the coldThey worry that loss of body heat may be life threateningIn Chinese cultureoTaijinkyofusho fear of other peopleFear of embarrassing others Social PhobiasSocial Phobia persistent irrational fears linked generally to the presence of other peopleThey try to avoid particular situations where they might be evaluated fearing they will reveal signs of anxiousness or behave in an embarrassing waySocial phobias can be either generalized or specific depending on the range of situations that are feared and avoidedGeneralized social phobia involve many different interpersonal situationsSpecific social phobias involve intense fear of one particular situation public speakingPeople with generalized type have an earlier age of onset more comorbidity with other disorders depression alcohol abuse and more severe impairmentsSocial phobias are fairly commonLifetime prevalence of 11 in men and 15 in womenOften occur in conjunction with generalized anxiety disorder specific phobias panic disorder avoidant personality disorder and mood disordersOnset is usually during adolescent when social awareness and interaction with others is importantThere was a link between social phobia and dropping out of schoolEtiology of PhobiasPsychoanalytic TheoriesFreud first to attempt to account systematically for the development of phobic behaviouroPhobias are a defence against the anxiety produced by repressed id impulses oAnxiety is displaced from the feared id impulse and moved to an object or situation that has some symbolic connection to itArietioHe proposed that Repression stems from a particular interpersonal problem of childhood rather than from an id impulseBehavioural TheoriesLearning is the way in which phobias are acquiredTypes of learning 3PSYB32 MIDTERM 2 CHAPTER NOTES2Avoidance Conditioning oPhobias reactions are learned avoidance responsesoWatsonRayner Phobias develop from 2 related sets of learningVia classical conditioning a person learns to fear a neutral stimulus when its paired with a painful or frightening event The person learns to reduce the conditioned fear by avoidingescaping itVia operant conditioning response is maintained by its reinforcing consequence of reducing the fearoThe evidence is very little in the laboratory because you cant apply aversive stimuli to peopleethical considerations and mixed outside the laboratory some people do produce a phobia through bad experiencesModellingoA person can learn a fear through imitating the reaction of othersoVicarious learning learning of fear by observing othersoVicarious learning can also be accomplished through verbal instructionsoAnxiousrearing model anxiety disorders in children are due to constant parental warnings that increase anxiety in the childPrepared LearningoPrepared stimuli certain neutral stimulioprepared stimuli are more likely than others to become classically conditioned stimulioPeople tend to fear only certain objects and events spiders snakes and heightsoIt is also relevant to learning fear by modellingA diathesis is neededSo why do some people have this fear and others dontoCognitive diathesispredisposition a tendency to believe that a similar situation will happen in the future is important in developing a phobiaIn sum some phobias are developed through avoidance conditioning other are notSocial Skills Deficits in Social PhobiasThis view says that a person develops social phobias because the individual has not learned how to behave so that heshe feels comfortable with others OR the person repeatedly commits faux pas is awkward and socially unskilled and is often criticized by social companionsBehaviourists say its caused by inappropriate behaviour or lack of social skillsCognitive TheoriesHow peoples thought processes can serve as a diathesis and how thoughts can maintain a phobiaPeople are more likely to attend to negative stimuli and believe that negative events are more likely than positive ones to occur in the futureSocially anxious people are more concerned of what others think of them and are preoccupied with hiding imperfectionscognitive behavioural models of social phobia link social phobia with certain cognitive characteristicsoAttention on negative social informationoPerfectionistic standards for accepted social performancesoHigh degree of public selfconsciousnessResearch has shown social phobia is linked with high self criticismPredisposing Biological FactorsMaybe there is a biological malfunction diathesis that predisposes someone to develop a phobia to a stressful eventAutonomic nervous systemoPeople differ in how easily their ANS become arousedoAutonomic lability extent to which the ANS is involved in fear and phobic behaviouroAutonomic lability may be genetically determined Genetic FactorsoBloodandinjection phobia is strongly related in firstdegree relativesPSYB32 MIDTERM 2 CHAPTER NOTES3
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