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Chapter 5

CHAPTER 5 Psych 257

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Uzma Rehman

CHAPTER 5: ANXIETY DISORDERS ANXIETY, FEAR, AND PANIC  Is anxiety a functional or adaptive disorder? - 1. Characteristics of Anxiety disorders  Psychological disorders – Pervasive and persistent symptoms of anxiety and fear  Involve excessive avoidance and escapist tendencies  Symptoms and avoidance causes clinically significant distress and impairment  3 characteristics/ trademarks: - Behavioral – uneasiness, discomfort - Physiological – muscle tension - Cognitive – continuous worry  Anxiety is a future oriented disorder and characterized by tension while fear is more concern on the present and is more likely has a strong avoidance tendencies 2. The Anxiety Disorders: An Overview  Panic Disorder with and without agoraphobia  Generalized anxiety disorder  Specific phobias  Social phobia  Posttraumatic stress disorder  Obsessive-compulsive disorder 3. Panic Attacks  What Is a Panic Attack? o Abrupt experience of intense fear or discomfort o Accompanied by several physical symptoms (e.g., breathlessness, chest pain, like a heart attack) o Must obtain 4 out of 12 symptoms o You don’t have a panic disorder when you don’t worry having another panic attack  DSM-IV Subtypes of Panic Attacks o Situationally bound (cued) panic: e.g.: “ I panic when I go to parties.”; “I panic when I cross a bridge.” o Unexpected (uncued) panic : e.g.: “I don’t know when will I have a panic attack.” o Situationally predisposed panic: e.g.: 4. Panic Disorder with and without Agoraphobia  Overview and Defining Features o Experience of unexpected panic attack (i.e., a false alarm) o Develop anxiety, worry, or fear about having another attack or its implications o Agoraphobia o Symptoms and concern about another attack persists for 1 month or more  Facts and Statistics o 3.5% of the general population meet diagnostic criteria for panic disorder o Two thirds with panic disorder are female 5. Treatment  Medication Treatment of Panic Disorder o SSRIs (e.g., Prozac and Paxil) are currently the preferred drugs o Relapse rates are high following medication discontinuation o Benzodiazopine – high level of panic disorder, if you take it within 20 minutes, your anxiety will be reduced; addictive physiologically and psychologically  Psychological and Combined Treatments of Panic Disorder o Cognitive-behaviour therapies are highly effective o Combined treatments do well in the short term o Best long-term outcome is with cognitive-behaviour therapy alone 6. Generalized Anxiety Disorder: The “Basic” Anxiety Disorder  Overview and Defining Features o Excessive uncontrollable anxious apprehension and worry about life events o Coupled with strong, persistent anxiety o Somatic symptoms differ from panic (e.g., muscle tension, fatigue, irritability) o Persists for 6 months or more  Facts and Statistics o Females outnumber males approximately 2:1 o Onset is often insidious, beginning in early adulthood 7. Generalized Anxiety Disorder: GAD  Primary symptom excessive worry more days than not  Range of worries about daily life, things likely and not (not exclusively physical concerns)  More than 2/3 have co-morbid disorders 8. Generalized Anxiety Disorder: Associated Features and Treatment  Associated Features o Persons with GAD have been called “autonomic restrictors” - o Fail to process emotional component of thoughts and images instead focus on cognitive components (what will happen next?)  Treatment of GAD: Generally Weak o Benzodiazapines – often prescribed o Psychological interventions – cognitive-behavioural therapy 9. Specific Phobias: An Overview  Extreme and irrational fear of a specific object or situation  Markedly interferes with one's abil
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