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Chapter 5

PSYC 235 Chapter 5: Chapter 5 - PSYC235

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PSYC 235
Christopher Bowie

WEEK 6&7 – Chapter 5: Anxiety, Trauma-Related and Obsessive-Compulsive Disorders The Complexity of Anxiety Disorders - Emotion implicated so heavily across the full range of psychopathology - Panic is fear that occurs, perhaps at an inappropriate time Anxiety, Fear and Panic - Anxiety is a negative mood state characterized by bodily symptoms of physical tension and apprehension about the future - Hard to study because of subjective POV - Much research has been done with animals o Ex. Teaching lab rats that light means impending shock and so when it is turned on, they look and act anxious o Is this the same as in humans? - Good for you in moderate amounts – we perform better when a little anxious - When you have too much anxiety: concentration goes down, sick feeling in stomach etc - Severe anxiety usually doesn’t go away - Most people know they have little to fear in those situations, but cannot seem to shake those feelings - Fear is an immediate alarm reaction to danger o Can be good because it protects us with response by ANS that can motivate us to escape or attack - Fear and anxiety differ psychologically and physiologically o Anxiety is future orientated mood state whereas fear is immediate emotional response - Panic is a sudden overwhelming reaction and in psychopathology - A panic attack is defined as an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms usually including heart palpitations, shortness of breath, dizziness o Expected (cued) panic attack: if you know you are afraid; specific phobia or social anxiety disorder o Unexpected (uncued) panic attack: you don’t know when or where the next attack will happen; more important in panic disorder Causes of Anxiety and Related Disorders Biological Contributions - We inherit a tendency to be tense, uptight and anxious - Panic also seems to run in families - No single gene seems to determine anxiety or panic; instead contributions from a collection of genes in several areas on chromosomes - Anxiety related to depleted levels of GABA, although not so direct - Recent studies focusing on corticotropin-releasing factor (CRF) system as central to anxiety and groups of genes involved are turned on here o Activates hypothalamic-pituitary-adrenocortical (HPA) that has effects on areas of the brain involved in anxiety including: limbic system, hippocampus, WEEK 6&7 – Chapter 5: Anxiety, Trauma-Related and Obsessive-Compulsive Disorders amygdala, areas of brain stem, prefrontal cortex, dopaminergic neurotransmitter system - Limbic system is mediator between the brain stem and the cortex; BS relays danger signals to higher cortical levels through the LS - Behavioural inhibition system is activated by signals from the brain stem of unexpected events; danger signals descend from the cortex to the septal hippocampal system o Also activated by the signals from amygdala o Tendency is to freeze, experience anxiety and evaluate situation - Fight/Flight System (FFS) is involved in panic that originates in brain stem and travels through midbrain, including amygdala o Immediately produces alarm and escape response in animals that looks a lot like panic in humans o Think partially due to deficiencies in serotonin - Complex interaction between smoking and panic disorder has been confirmed in more recent research confirming that factors in your environment can change sensitivity in your brain circuits o Chronic exposure to nicotine increases somatic symptoms and triggers anxiety symptoms - For people with anxiety, limbic system including is overly responsive to stimulation or new information (bottom-up processing) o Functions of cortex that would down regulate hyperexcitable amygdala are deficient Psychological Contributions - Freud thought anxiety was a psychic reaction to danger surrounding reactivation of infantile fearful situation - Behavioural theorists thought it was due to early classical conditioning or learning - Range of confidence may go from confident to deep uncertainty about ourselves and ability to deal with upcoming events - Sense of uncontrollability may arise due to upbringing or other traumatic environmental factors - Parents who respond appropriately, positively and predictably to children teach them that they have control in their environments - Providing “home base” allow children to explore world and develop necessary skills o Parents who are overprotective don’t allow their children to learn how to cope with adversity o Makes us more vulnerable to anxiety later in life - For panic, strong fear response initially occurs during extreme stress or due to dangerous situation o Then, gets associated with many different cues that will be evoked at assumption of danger, even if not actually present - Internal cues are increases in HR etc that even if your heart is beating fast, you are more likely to think of and perhaps experience a panic attack WEEK 6&7 – Chapter 5: Anxiety, Trauma-Related and Obsessive-Compulsive Disorders Social Contributions - Most stressful life events that trigger anxiety are interpersonal and social in nature o Divorce, marriage, work problems, death, pressures to exceed in school - Can trigger physical reactions o Hypertension, emotional reactions (ex. Panic attacks) An Integrated Model - Triple vulnerability theory: one component is not enough to develop anxiety - Generalized biological vulnerability: tendency to be uptight or high string can be inherited - Generalized psychological vulnerability: strong perception of not being able to control things in life and being out of control - Specific psychological vulnerability: learn from early on; taught by parents that some situations are to be feared more than others - Your anxiety responses may become so strong that they remain present even after the particular life stressor has passed - Panic may have a separate genetic component than anxiety as it is also seen to run in families; anxiety increases likelihood of panic Comorbidity of Anxiety and Related Disorders - Disorders can often co-occur - High occurrence of comorbidity shows that all of these share common features of anxiety and panic and similar vulnerabilities - Differ in focus of anxiety - Study done for the DSM-IV on 1127 patients show comorbidity of 55% at time of assessment o Had at least one more additional anxiety or depressive disorder at this time o If you consider at any other point in their life, this goes to 76% - Most common additive disorder is depression, which happened in 50% of cases - Also important that finding of depression or alcohol or drug abuse makes it less likely that you will recover from an anxiety disorder and more likely to relapse WEEK 6&7 – Ch
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