PSYB32H3 Chapter Notes - Chapter 6: Posttraumatic Stress Disorder, Generalized Anxiety Disorder, Panic Disorder

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14 Dec 2010
Chapter 6: Anxiety Disorders
Anxiety is an unpleasant feeling of fear and apprehension
It can occur in many psychopathologies
An anxiety disorder is diagnosed when feelings of anxiety are clearly present
DSM proposes 6 categories
Fear & avoidance of objects or situations that do not present any real
oPanic disorder
Recurrent 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 places
oGeneralized anxiety disorder
Persistent, uncontrollable worry, often about minor things
oObsessive-compulsive disorder
Experience of uncontrollable thoughts, impulses, or images (obsessions)
and repetitive behaviours or mental acts (compulsions)
oPosttraumatic stress disorder
Aftermath of traumatic experience in which the person experiences
increased arousal, avoidance of stimuli associated with the event, and
anxiety in recalling the event
oAcute stress disorder
Symptoms are the same as those of posttraumatic stress disorder, but last
for 4 weeks or less
Often someone with one anxiety disorder meets the diagnostic criteria for another
disorder as well (co-morbidity) because...
oSymptoms of the various anxiety disorders are not entirely disorder specific
oThe etiological factors that give rise to various anxiety disorders may be
applicable to more than one disorder
16% and 9% of men suffer from anxiety disorders (mostly women 15-24 years)
Phobia: a disrupting, fear mediated avoidance that is out of proportion to the danger
actually posed and is recognized by the sufferer as groundless
Examples: fear of heights, closed spaces, snakes or spiders
The person suffers intense distress and social or occupational impairment because of the
For other phobia disorders, the suffix phobia is preceded by a Greek word for the feared
object or situation
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oClaustrophobia: fear of closed spaces
oAgoraphobia: fear of public places
oAcrophobia: fear of heights
oErgasiophobia: fear of writing
oPnigophobia: fear of choking
oTaphenphobia: fear of being buried alive
oAnglophobia: fear of England
Psychoanalysts believe that the content of the phobias has important symbolic value
Behaviourist ignore the content of the phobia and focus on its function instead
There are 2 types of phobias: Specific & Social Phobias
Specific Phobias
Social Phobia: unwarranted fears caused by the presence or anticipation of a specific
object or situation
DSM-IV subdivides these phobias according to the source of the fear
oInjuries & Injections
oNatural Environment
Recent empirical research involving a national representative sample suggests that fear
can be grouped into 1 of 5 factors
oFears of heights of water
oThreat fear (blood/needle, storms/thunder)
oFear or being observed
oSpeaking fears
oBut then these were classified under the higher-order categories – specific &
social fears
Specific fear focused on in a phobia can vary cross culturally
oPa-leng: fear of the cold
They worry that loss of body heat may be life threatening
oTaijinkyofu-sho: fear of other people
Fear of embarrassing others
Social Phobias
Social Phobia: persistent, irrational fears linked generally to the presence of other people
They try to avoid particular situations where they might be evaluated, fearing they will
reveal signs of anxiousness or behave in an embarrassing way
People with generalized type have an earlier age of onset, more co-morbidity with other
disorders (depression, alcohol abuse, and more severe impairments)
Social phobias are fairly common
11% in men and 15% in women
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Often occur in conjunction with generalized anxiety disorder, specific phobias, panic
disorder, avoidant personality disorder, and mood disorders
Onset is usually during adolescent when social awareness and interaction with others is
There was a link between social phobia and dropping out of school
Etiology of Phobias
Psychoanalytic Theories
oPhobias are against the anxiety produced by repressed id impulses
oAnxiety is deplaced from the feared id impulse and moved to an object or
situation that has some symbolic connection to it
oRepression stems from a particular interpersonal problem of childhood rather than
from an id impulse
Behavioural Theories
Learning is the way in which phobias are acquired
Types of learning (3)
Avoidance Conditioning
oPhobias reactions are learned avoidance responses
o(Watson & Rayner) Phobias develop from 2 related sets of learning:
Via classical conditioning (a person learns to fear a neutral stimulus when
it’s paired with a painful or frightening event). The person learns to reduce
the conditioned fear by avoiding/escaping it
Via operant conditioning (response is maintained by its reinforcing
consequence of reducing the fear)
oThe evidence is very little in the laboratory (because you can’t apply aversive
stimuli to people) and mixed outside (some people do produce a phobia through
bad experiences)
oA person can learn a fear through imitating the reaction of others
oViscarious learning: learning of fear by observing others
oViscarious learning can also be accomplished through verbal instructions
oAnxious-rearing model: anxiety disorders in children are due to constant parental
warnings that increase anxiety in the child
Prepared Learning
oPrepared stimuli: certain neutral stimuli
oCertain prepared stimuli are more likely that others to become classically
conditioned stimuli
oPeople tend to fear only certain objects and events; spiders, snakes and heights
oIt is also relevant to learning fear by modelling
So why do some people have this fear and others don’t?
oCognitive diathesis (a tendency to believe that a similar situation will happen in
the future) is important in developing a phobia
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