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Chapter 5

Psychology 46-228 Chapter 5: Notes on Anxiety Introduction and Panic

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University of Windsor

Chapter 5 (P. 126-141)  Anxiety  a negative mood state characterized by bodily symptoms of physical tension and apprehension about the future o Can be good and bad for us o Anxiety doesn't go away  makes the situation worse  Fear  immediate alarm reaction to anger (can be good for us) o Protects us by activating ANS, motivates us to escape (flight) or to attack (fight)  Panic attack  an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms (ex. increased heart rate, chest pain, shortness of breath, and possibly dizziness o Situationally bound (cued) o Unexpected (uncued) o Situationally predisposed (in between) Causes  Biological contributions o Tendency to panic seems to run in families and may have a genetic component o Jeffrey Gray identified a brain circuit in limbic system of animals that seems heavily involved in anxiety and may be relevant to humans  Circuit leads from septal and hippocampal area to frontal cortex  Named it behavioural inhibition system (BIS)  Activated by signals of unexpected events from brain stem, ex. major changes in body functioning that signal danger  Psychological contributions o Sense of uncontrollability o Parents who provide secure environment and allow their children to explore enable their children to develop a healthy sense of control o Parents who are overprotective of their children, they don’t learn that they can control their environment  Social contributions o Stressful life events (ex. marriage, divorce, difficulties at work, death of a loved one) Comorbidity of Anxiety Disorders  Comorbidity  co-occurrence of two or more disorders in a single individual (ex. depression and features of anxiety and panic) Panic Disorder and Agoraphobia  Panic disorder with agoraphobia (PDA)  individuals experience severe unexpected panic attacks; may think they're dying or otherwise losing control  Agoraphobia  fear and avoidance of situations where they would feel unsafe in the event of a panic attack or symptoms  Panic disorder without agoraphobia (PD)  To make the criteria (with or without agoraphobia), one must experience an unexpected panic attack and develop substantial anxiety over the possibility of having another attack or the implications of the attack or its consequences (each attack is a sign of death or incapacitation)  Agoraphobic avoidance is one way to cope with unexpected panic attacks (anxiety is reduced for people with agoraphobia if they think a location/person is "safe")  Other coping methods include alcohol and drugs  Some display interoceptive avoidance (avoidance of internal physical sensations)  involve removing yourself from situations or activities that might produce the arousal  3.5% of the population meet the criteria for panic disorder at some point in their lives (2/3 women); 5.3% for agoraphobia  Usually occurs in early adult life (from mid-teens through about age 40); mean age is between 25 and 29  Taiwan shows lower rates (probably because of a stigma about admitting to psychological problems) Nocturnal attacks  occur more frequently between 1:30AM and 3:30AM (some people  are afraid to go to sleep at night) o Similar to isolated sleep paralysis (awake at night, unable to move, heart pounding, feeling that a presence is in the room)  Risk of someone with panic disorder attempting suicide is comparable to those have major depression  Suicide risk is much greater for people with mood disorders and an anxiety disorder than those with mood disorder alone Causes  Biological, psychological, and social influences  We inherit some vulnerability to stress  Harmless exercise can be a conditioned stimulus (CS) for a panic attack  People have the tendency to expect the worst when they experience strong physical sensations; some focus on their anxiety of possible future panic attacks Treatment  Medication  Benzodiazepines (ex. Xanax) for panic disorder, work very fast (affect cognitive and motor functions to some degree  Psychological Intervention  Panic control treatment (PCT)  exposing patients with panic disorder to remind them of their panic attacks; create "mini" panic attacks by having the patients exercise to elevate their heart rates or spinning them in a chair to make them dizz
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