CHAPTER 7& 9
• Anxiety – a state of fear and apprehension that affects many areas of functioning. Involves 3
Subjective reports of tension, apprehension, dread and expectations of inability to
Behavioral responses such as avoidance of the feared situation, impaired speech and
motor functioning, and impaired performance on complex cognitive tasks.
Physiological responses including muscle tension, increased heart rate and blood
pressure, rapid breathing, dry mouth, nausea, diarrhea, and dizziness.
• Anxiety is experienced in 3 basic patterns: A) Panic disorder [generalized anxiety disorder],
C) Obsessive-Compulsive disorder.
• Anxiety Disorders – characterized either by manifest anxiety or by behavior patterns aimed
at warding off anxiety.
• Panic Disorder – anxiety begins suddenly and unexpectedly and soon mounts to an almost
unbearable level. Derealization – world seems unreal. Depersonalization – people seem
unreal to themselves. A person has panic disorder when he or she has had recurrent
unexpected panic attacks, followed by psychological or behavioral problems, such as
persistent fear of future attacks.
2 kinds: A) Unexpected (uncued) – attack seems to come out of the blue.
B) Situationally Bound (cued)–attack occurs in response to some situational
Agoraphobia – fear of the marketplace. Fear of being in any situation from which escape
might be difficult.
General Anxiety Disorder – main feature is a chronic state of diffuse anxiety. Excessive worry, over a
period of at least six months, about several life circumstances. (Usually over family, money, work and
health). The ‘resting state’ of panic disorder. 3 major differences between:
1) Their symptom profiles differ.
2) GAD usually has a more gradual onset and a more chronic course than PD.
3) When these disorders run in the family, they tend to run separately.
Phobias – involves 2 factors: A) an intense and persistent fear of some object or situation which, as the
person realizes, actually poses no real threat. B) avoidance of the phobic stimulus.
1) Specific Phobia – fairly common. Ex: Acrophobia-fear of heights; Claustrophobia-fear of
enclosed places; phobias of body injury; and animal phobias (most common).
2) Social Phobia – avoid performing certain actions in front of other people, for fear of
embarrassing or humiliating themselves. Ex: public speaking, eating in public, and
using public bathrooms.
Obsessive-Compulsive Disorder - people suffering from either obsession or compulsion
(and usually, both).
Obsession – thought or image that keeps intruding into a person’s consciousness;
the person finds the thought inappropriate and distressing and tries to suppress it,
but it still returns.
Compulsion – an action that a person feels compelled to repeat again and again, in
a stereotyped fashion, though he or she has no conscious desire to do so. Tend to
1 have more natural content. 2 main categories: A) Cleaning Rituals – usually
involve responses to obsessions about harm to loved ones; B) Checking Rituals –
often accompany obsessions about contamination.
Trichotillomania – the compulsive pulling out of one’s own hair.
• Posttraumatic Stress Disorder – a severe psychological reaction, lasting at least one month,
to intensely traumatic events – events involving actual or threatened death or serious injury to
oneself or others. The person may go on for weeks, months, or years re-experiencing the
traumatic event, either in painful recollection or in nightmares. The disorder depends on the
relationship with the trauma (how close to death, etc), psychological background, and the
nature of the trauma (rape vs. earthquake).
Disaster Syndrome – victims of physical trauma show a definite pattern of response
known as DS. In the first phase, shock stage, they are stunned and dazed. In the
second stage, suggestibility stage, they become more passive and are willing to take
orders from almost anyone. The final stage, recovery stage, they begin to pull
themselves together and to approach their situation in a more rational way.
Problems with PST diagnosis: First, currently, non-life threatening events (such as a
miscarriage or discovering a spouse’s affair) are classified as adjustment disorder,
when they could actually be classified as PSD. Second, is whether it should be grouped
with the anxiety disorders.
• Neurosis – anxiety disorders. Freud argued that anxiety stemmed not just from external
threats but also from internal ones, in the form of id impulses attempting to break through into
consciousness. To psychodynamic theorists, the anxiety disorders really differ only in the
choice of defense. The nature of the disorder points to the defense, and the nature of the
defense points to the underlying conflict. Use free association and dream interpretation to
Humanistic-Existential Perspective – conceptualizes anxiety not simply as an individual
problem but as the predictable outcome of conflicts between the individual and society. The seat
of anxiety is the self-concept. Neurotics are simply people who are not as successful as others in
being inauthentic. Client-Centered Therapy. Paradoxical Intention – patients are told to indulge
their symptoms, even exaggerate them.
Behavioral Perspective – anxiety arises from faulty learning. We are endangered through
avoidance learning. Problems with the avoidance learning theory:
1) Many features of the anxiety disorders are simply not explainable by the theory.
2) Traditional learning theory is hard put to explain why only very select, nonrandom
types of stimuli typically become phobic objects.
3) It focuses entirely on concrete stimuli and observable responses without concern for
the thoughts that may be involved in anxiety.
• Efficacy expectations – people’s expectations based on past performance, as to how well
they will be able to cope with the situation.
• Fear-of-Fear – physiological changes that accompany the panic attack, become
conditioned stimuli for further panic attacks.
• Systematic Desensitization – patients draw up a “hierarchy of fears”, a list of increasing
anxiety-arousing situations culminating n the situation they most fear. Then they are to
relax, and imagine the situations.
• In Vivo Desensitization – leading patients through their hierarchies in real life. Dog phobic
person will first look at pictures of dogs, then hold a dog collar, etc.
Cognitive Perspective – people with anxiety disorders misperceive or misinterpret internal and
external stimuli. Evens and sensations that are not really threatening are interpreted at
2 threatening, and anxiety results. Cognitive therapy aims at helpings the patient to interpret bodily
sensations in a non-catastrophic way.
Biological Perspective – seeks genetic and biochemical links to anxiety. Some anxiety disorders,
especially panic disorder, appear to have a genetic component. Recent evidence also suggests that
brain chemistry and neurotransmitters influence some forms of anxiety.
• General Adaptation Syndrome – divides the body’s reaction in to 3 successive stages
described by Hans Seyle.
Alarm and Mobilization – a state of rapid, general arousal in which the body’s defenses are
Resistance – the state of optimal biological adaptation