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Chapter 6

Chapter 6 - Detailed

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University of Toronto Scarborough
Konstantine Zakzanis

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 o Phobias Fear & avoidance of objects or situations that do not present any real danger o Panic 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 o Generalized anxiety disorder Persistent, uncontrollable worry, often about minor things o Obsessive-compulsive disorder Experience of uncontrollable thoughts, impulses, or images (obsessions) and repetitive behaviours or mental acts (compulsions) o Posttraumatic 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 o Acute 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... o Symptoms of the various anxiety disorders are not entirely disorder specific o The 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) Phobias 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 anxiety For other phobia disorders, the suffix phobia is preceded by a Greek word for the feared object or situation o Claustrophobia: fear of closed spaces o Agoraphobia: fear of public places o Acrophobia: fear of heights o Ergasiophobia: fear of writing o Pnigophobia: fear of choking o Taphenphobia: fear of being buried alive o Anglophobia: 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 C h a p t e r 6 : A n x i e t y D i s o r d e r s Page 12 www.notesolution.comSpecific 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 o Blood o Injuries & Injections o Situations o Animals o Natural Environment Recent empirical research involving a national representative sample suggests that fear can be grouped into 1 of 5 factors o Agoraphobia o Fears of heights of water o Threat fear (bloodneedle, stormsthunder) o Fear or being observed o Speaking fears o But then these were classified under the higher-order categories specific & social fears Specific fear focused on in a phobia can vary cross culturally o Pa-leng: fear of the cold They worry that loss of body heat may be life threatening o Taijinkyofu-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 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 important There was a link between social phobia and dropping out of school Etiology of Phobias Psychoanalytic Theories Freud o Phobias are against the anxiety produced by repressed id impulses o Anxiety is deplaced from the feared id impulse and moved to an object or situation that has some symbolic connection to it Arieti o Repression 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 o Phobias reactions are learned avoidance responses o (Watson & Rayner) Phobias develop from 2 related sets of learning: C h a p t e r 6 : A n x i e t y D i s o r d e r s Page 12 www.notesolution.com
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