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Psychology (9,699)
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Chapter 6

Chapter 6 notes - anxiety disorders

9 Pages
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Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

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Chapter6- Anxiety disorders November-06-11 9:19PM Comorbidityamonganxietydisordershappensfr2reasons- 1) Symptomsoftheanxietydisorderarenotcompletelydisorderspecific. 2) Etiologicalfactorsthatgiverisetoanxietydisordersareapplicabletootherdisorders Anxietydisrodersthemostcommon Earlyageof onset---->durringchildhood Higherprevalanceinwmen(16%)thanmen(9%)andwomenagd15 - 24 yearsold Socialanxietydisorderwasthemostcommon--->majorityofcanadiansbelieveditinterruptedthere everydaylife Peoplewithanxietydisorderswerelesslikelytoseakhelpthanpeoplewithmooddisorders Strongestcomorbitityiswithdepression Showsimilaritiesatthephenotypicandgenotypiclevel Studiesfoundthatsocialphobiawasamajorpredictorofdepression Phobias Phobia=disrupting,fearmediated,avoidancethatisoutofproportiontodangerthat isactuallyposed. Personexperiencesintenseditressandoccupationalimpairment. SpecificPhobias-unwarrantedfearscausedbythepresenceoranticilationofaspecificobjector situation Highinprevalence---->lifetimeprvlenceinUSalmost1in10 Specificfearfocusedinaphobiacanvarycross culturally Eg.China= fearoflosingbodyheat Eg.Japan= extremefearsofembarrasingothers SocialPhobias- persistantirrationalfearlinkedtopresenceofotherpeople Canbegeneralzed(fearofmanyinterpersonallrelations) orspecific(fearofaspecificrelation- speakinginpublic)dependingonsituation. Peoplewithgeneral=haveearlieronset,morecomorbidityandalcoholabuse Onsetisusuallyadolescent-13yo average Studentswithithadlowerselfesteemanddistortedbodyimage Etiology Behaviouraltheories-phobiasaquiredthroughlearning Avoidanceconditioning- Phobiasdecvelopefrm2setsoflearning 1) Viaclassicalconditioning=personlearnstofearneutralstim.Ifitspairedwitha painful/scaryevent 2) Personreducestheconditionedfearbyescapingfrmtheconditionedstimulus----> operantconditioningb/cresponsemaintainedbythereinforcingeventwhichthe reductionoffear Modelling- Explanationofphobiasthatarenotaquiredthroughpasttraumaticexperiences Personlearnstofearthroughtheimitationofresponseofothers---->VACARIOUS LEARNING Canbelearnedthroughverbalintruction----->childfearinganactivityafterparenthas warnedagainstorbadthingsaregonnahappen Preparedlearning Certainstimuli(preparedstimuli)aremorelikelytobeclassiclyconditioned Monkeyswillonlybeafraidoftapeswithcrocadilesandsnakes(relativetofloweresand rabbits)------>somefearswillclassicalyconditiontostimulithatthbodyisphysiologicaly preparedtobesensitiveto. preparedtobesensitiveto. Diathesisisneeded- Whydopeoplewhodohavetraumaticexperiencedontdevelopaphobia Cognitivediathisis=tendancytobelievethatthesamething(traumaticexoerience)isgonna happeninthefuture. SocialSkilldeficitsinPhobias-inappropriatebehavioursandalackofsocialskills=socialanxiety Personhasntlearnedtobehaveassuchthattheyfealcomfortablewithothers Lackof interpersonalskillsinanadultcanbesignificantinplannigtherupeuticinterventions. CognitiveTheories Howpeoplesthoughtprocessescanserveasdiathesisandhowtheymaintainaphobia Anxiety=attendto-stimuli,ambiguouseinfoisseenthreatening,negativeeventsaremorelikely tooccurethan posotive. Moreconcernedaboutevaluationsofothers---->viewthemselvesnegetivelyeventhoughthey didfine Theyareworriedaboutcausingdiscomforttootherpeople Cognitivebehaviouraltheorieslinksocialphobiaswith 1) Focusonnegativesocialinfoandinterpretothersasnegative 2) Perfectioniststandardsforsocialperformances 3) Highdegreeofpublicselfconciousness Peoplerecalleventsashavinganegative Studentswhoaresociallyanxiousealsodoposteventprocessingfthenegativeexperience Predesposingbiologicalfactors - Explainswhysomepeopleacquirefearswhenothersdont. - Thosewhodohavea predispositontodevelopingaphobiafollowingastressfullevent. AutonomicNervousesystem- PeopledifferintheirreactiontotheenvirenmentistheeaseatwhichtheANSbecomes aroused. JUMPYpeople=ANSbecomesmorearousedbystimuli. ---->AUTONOMICLABILITY Maybe gebeticallydetermined-heredityhasaroleinphobias GeneticFactors Bloodandinjectionphoviarunsinthefamily 64% withphobiahaveafirstdegreefamilymemberwiththesamething. Inadditiontogenticpredisposition---->closefamilymembershavealotofoppurtunitiesto observeeachotherbehaviour Problems- 1) Geneticcomplexity-disrodersreflectinteractiveandadditiveforcesofmanyloci 2) Phenootipiccomplexity-transcendstheDSMcategories. PsychoanalyticTheories- Freud =phobiasaredefencemechanismsagainstanxietyproducedbytheidimpulses. Anxietyfrmtheidimpulseismovedtoanobjectorsituation----->wayofdealingwithrepressed issues TherapiesforPhobias Behaviouralapproaches- Systemcdesensatizationwasthefirsttreatmenttobeused Personimaginesanxiusesituationswhilebeingdeeplyrelaxed----->reducesanxiety. Somecliniciansusereallifesituations=INVIVOEXPOSURE Considerdsuperiortoimaginingthesituation BUTdidseea highdropout rate VIRTUALREALITYEXPOSURE- Justaseffectiveasinvivoexposure Learningsocialskillscanhelppeoplewithsocialphobia CBTthearapistencourageroleplaying Canusemodelling ---->otherpeopleinteractingnormallywiththefearedsituation FLOODING-personexposedtofearedobjectin Operanttechniques=overtavoidanceofphobicobjectandapproachbehaviourthatmustreplace it.it. Ost'sone-sessionexposuretreatmenttophobias- Intensiveandlastsmanyhours Cognitiveapproaches- PeoplewithsocailphobiasbenefitfrmtreatmentsbyBeckandEllis Clientstrainedtoappraisepeoplesreactionstothem Alsorelylessonapprovalofothers CBTmorebeneficialthandrugsor exposuretophobicobjectorappliedrelaxation "homeowrk"orbtwnseesionlearningisessentialtorecovery. Cognitivebehaviouralcaseformulation Framworkcontainssasual&maintainingfactorshatareoutlinedinasimpleframwork. Approachbehaviour Contactwiththephobicobjectoccursthroughpersonbehaviour(enteringamall)-----> xposurebasedinterventionincreasesthis Stimulus- Fearedstimulibroughtfrmexternalobjects/situations(theperceptionthatsomeones watchingyou) Hypervigalencetostimulus- Peopleattendtothreatneningstimuli PerceptionofDanger Perceptionofthreatorganger(notthefearedstimulus)---->elicitsanxiety Fixedthrouhgcognitiverestructuring. Neuroticism- Persuasivepersonnalitydimensionthatpredisposespeopletoexperiencenegativeaffective states. Informationorexperience- Stimulicanbecomethreateningthroughdirectexperience,observation,andverbal aqquisition. Increasedanxiety Anxietyexperiencedthroughphysicalcognitive,andbehaviouralsymptoms
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