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Chapter 6

Chapter 6 Notes

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University of Toronto Scarborough
Konstantine Zakzanis

CHAPTER 6 Anxiety: Unpleasant feeling of fear and apprehension. DSM-IV poses 6 categories of anxiety: phobias, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, PTSD and acute stress disorder. Comorbidity is when you have more than 1 disorder at any given time and can arise from: - symptoms of anxiety are not disorder specific. Signs of anxiety such as perspiration, heart rate etc. can be diagnosed for panic disorder, phobias, PTSD etc. - etiological factors that give rise to anxiety disorders may be applicable to more than 1 disordor - anxiety disorders are more prevalent in woman and the likelihood decreases with age. Phobias - It is an irrational fear-mediated avoidance of an object that is out of proportion to the danger it poses, and is recognized by the sufferer as groundless. - Each term ends with phobia derived from Phobos, a greek god that would scare enemies - Psychoanalysts focus on content of phobias and regard their origins as symbolic (boy who is afraid of horses sees black lining around mouth and eyes that resemble his dads glasses and mustache, thus turning his fear for his father into a fear for horses) - Behaviourists see acquisition of fear and reduction of fear, they ignore the content of the phobia. Specific Phobias - unwarranted fears caused by presence or anticipiation of an object - DSM-IV subdivides into: blood, injuries and injections, situations (plane, small spaces etc.), animals and natural environments (height, water etc.) - Recent empirical evidence suggests that fear can be grouped into the following categories: - [1] Agoraphobia - [2] fear or heights or water - [3] threat fears (bloodneedles, stormsthunder) - [4] fears of being observed - [5] speaking fears - Fears then classified into 2 categories: specific and social fears. - Prevelance at 7% men and 16% women - Fear focused on in a phobia can very cross-culturally (Chinese men scared of cold and japs scared of causing embarrasement) Social Phobias www.notesolution.com - irrational fears linked to presence of others - try to avoid situations in which they are judgedevaluated - ex. Speaking in public, eating, using the bathroom etc. - social phobias can be general or specific - General: involve many different situations and display comorbidity with things such as alcohol abuse and depression. This type leads to more impairment - Specific: a single fear such as public speaking - Prevalence 11% men 15% women - Diagnosed social phobia linked to marked dissatisfaction and low functioning in terms of quality of life. - Positive link between social phobia and school dropouts. Etiology of Phobias Proposals for the cause of phobias has been made from psychoanalytic, behavioural and cognitive points of view as well as in terms of the biological paradigm. Psychoanalytic Theories - Freud said phobias were a defense against anxiety caused by repressed id impulses - Response moved from a feared id impulse to an object that has a connection to it ex: elevators or closed spaces become the phobic stimuli - Phobia is egos way of dealing with a repressed childhood conflict - Arieti said repression stems from problem of childhood, not id impulse. Behavioural Theories Focus on learning to acquire phobias. These are types of learning that lead to phobias: Avoidance conditioning (lil albert and the mouse) - phobic reactions are learned avoidance responses - avoidance conditioning theory is based on 2 factors - [1] person can learn to fear neutral stimulus (cs) if it is paired with painful event (the ucs) - [2] this fear can be reduced by escaping the CS. This leads to positive reinforcement by the reduction of fear, thus repetition of activity. - Phobia of a specific object or situation has been reported after a stressful incident - Also known that fears can develop with people that have had no prior interaction with that object. How can this be explained? Maybe modeling? Modelling - learning of fears by imitating the reaction of others - this method I of learning fear by observation is called vicarious learning - various learning may be accomplished through verbal interactions. - The anxious-rearing model states that children develop anxiety due to constant parental warning that increases anxiety at childhood www.notesolution.com
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