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Chapter 6

PSYB32_Chapter 6

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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 6-Anxiety Disorders Anxiety is a unpleasant fear or apprehension There is comorbidity among anxiety disorders for two reasons: o Symptoms of the various anxiety disorders are not disorder specific o The factors that cause the anxiety disorders may be applicable to more than one disorder Anxiety disorders are the most common psychological disorders More prevalence in women Those with anxiety disorders are less likely to seek help than mood disorders Work stress is associated with anxiety disorders PTSD and GAD have more in common with major depression than any other anxiety disorder Phobias A phobia is a fear-mediated avoidance that is out of proportion of the danger actually posed Many specific fears or phobias do not create enough hardship to compel someone to seek treatmentneed to feel personal distress Psychologists focus on different aspects of phobias depending on the paradigm they adopt Specific Phobias Specific phobias are fears caused by the presence of a specific object or situation Fears can be classified into five factors: o Agoraphobia o Fear of heights or water o Threatening fears o Fear of being observed o Speaking fears These are then made into two main categories of phobias: Specific phobias and social phobias The specific fear focused on in a phobia vary cross culturally o Ex. China has pa-lengfear of losing body heat Social Phobias Social phobias are fears linked to the presence of other people. Try to avoid situations in which they can reveal their anxiety or where they can be evaluated by others Can be specific or generalized People with generalized social phobia have an earlier age of onset, more comorbidity with other disorders, and severe impairment Onset of social phobia typically takes place in adolescence when social awareness and interaction become important in a persons life People with social phobia also have lower self esteem and distorted body image Etiology of Phobias Psychoanalytical Theories According to Freud, phobias are a defence against the anxiety produced by repressed id impulses. The anxiety is displaced from the feared id impulse and moved to an object or situation that has a symbolic connection to it Phobia is the egos way to avoid dealing with repressed conflicts (caused by id impulses) Most of the evidence is restricted to case reports Behavioural Theories Behavioural theories focus on how phobias are acquired through learningtheir function Avoidance Conditioning Phobias develop from two related sets of learning: o Via classical conditioninga person learns to fear neutral stimulus if it is paired with an unpleasant event o Via operant conditioningthe avoidance response it maintained by the reinforcing consequence of reducing fear All fears and phobias are not acquired through classical conditioning Some phobias are reported after a painful experience (neutral stimulus paired with unpleasant event) and some are not (below) Modelling In addition to learning to fear something as a result of an unpleasant experience with it, a person can also fear through imitating the reactions of others Vicarious learning is learning of fear responses by observing others Can be accomplished through verbal instructions o Ex. A child may come to fear something after parents repeatedly warn of dire consequences (anxious-rearing model) Prepared Learning The original avoidance conditioning model fails to address is that people tend to fear only certain objects/events This is because certain neutral stimuli called prepared stimuli are more likely than others to become classically conditioned Prepared learning is also true in modelling. Observing fear responses only operate for certain prepared stimuli A Diathesis is Needed A diathesis or predisposition for believing that similar traumatic/unpleasant experiences will occur in the future is needed to develop a phobia Another possible diathesis is the belief that they are unable to control the environment Social Skills Deficits in Social Phobias A behavioural model of social phobia considers inappropriate behaviour or a lack of social skills as the cause of social anxiety/phobia A lack of social skills in an adult with social phobia tells little about the etiological nature of it Cognitive Theories Cognitive views of phobias see peoples thought processes as a diathesis and how thoughts can maintain a phobia Anxiety is related to being more likely to attend to negative stimuli, to interpret ambiguous info as threatening, and to believe that negative events are more likely than positive events to occur in the future Social phobia has certain cognitive characteristics o An attention bias to focus on negative social info o Perfectionistic standards for social performances o High degree of self consciousness Social phobia is also linked with high self criticism They also engage in extensive post event processing of the negative social experiences that they focus on. This sometimes leads to intrusive thoughts associated with OCD Predisposing Biological Factors Autonomic Nervous System People with phobic behaviour have autonomic liability in which their autonomic systems are readily aroused by a wide range of stimuli
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