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Psych 509 ch 4

generalized anxiety disorder general and persistent feelins of worry and anxiety
6 types of anxiety disorders generalized, phobias, panic disorder, OCD, acute stress, OCD
free floating anxiety another name for generalized anx dis
ratio of women to men w/ gen anx disorder 2 to 1
length of symptoms for diagnosis of gen anx dis 6 months
% of pop with symptoms in any given year of gen anx dis 3%
% of people who develop gen anx dis in lifetime 6%
onset of gen anx dis childhood/adolescence
% of people with gen anx currently in treatment 25%
number of times more likely low SES develop gen anx dis as high SES 2x
after 3 mile island: ratio of moms of preschoolers with anxiety/depression as elsewhere 5 to 1
anx/dep ratio after hurricane katrina as elsewhere 2 to 1
% of af ams who suffer from gen anx dis 6%
% of whites who suffer from gen anx dis 3.1%
% of af am women who suffer from gen anx dis 6.6%
% of people w/ anxiety who suffer from multiple disorders 80%
% of anxiety people with 1 disorder 19%
% people with 2+ anxiety disorders independent of each other 26%
two or more anxiety disorders one caused by the other 55%
vauge sense of being in danger anxiety
most common mental disorders in US anixety
% people who suffer in any given year 18%
% who have anxiety disorder in lifetime 29%
% who seek treatment for anxiety disorder 20%
generalized anx dis: psychodynamic perspective happens when child overrun by neurotic or moral anxiety, stage is set for generalized anx dis
realistic anxiety freud: when children face actual danger
neurotic anxiety freud: experienced when children are repeatedly prevented by parents or circumstance from expressing their id impulses
moral anxiety freud: experienced when children punished or threatened for expressing id impulses
defense mechanism development: gen anx dis prevented when child overprotected
modern psychodynamic theory: gen anx dis believe traced to inadequacies in early relationship b/w children and parents
psychodynamic therapies used to treat gen anx dis free association, transference, resistance, dreams (only of modest help to persons with gen anx dis)
short term psychodynamic effect on gen anx dis in some cases significantly reduces anxiety, worry and social difficulty
humanistic theory: gen anx dis arises when people stop looking at themselves honestly and acceptingly and repeatedly deny their true thoughts, emotions and behavior= makes anxious and unable to fulfill their potential as human beings. develop conditions of worth (only limited support)
% of college students who say spend less than 10 minutes at at ime worrying about something 62% (20% worry for more than an hour)
gen anx dis: cognitive perspective caused by dysfunctional ways of thinking
maladaptive assumptions COGNITIVE: cause of anxiety disorder
basic irrational assumptions Albert ellis COGNITIVE. claim that people with gen anx dis believe "dire necessity for an adult to be loved by every single person in community..." etc. (interpret stressful event as dangerous)
aaron beck on gen anx dis hold silent assumptions (situation or person unsafe until proven safe) or always best to assume the worst (researchers found both beck and ellis to be true)
new wave cognitive explanations metacognitive theory, intolerance of uncertainty theory, avoidance theory
metacognitive theory developed by adrian wells: people with gen anx dis implicity hold both positive and negative beliefs about worrying +: believe worrying is a useful way of appraising and coping with threats of life -: come to believe that their repeated worrying is harmfu
metaworries worries about worrying (net effect of this and positive feelings about worrying = gen anx dis. Powerful predictor of developing gen anx dis
intolerance of uncertainty theory gen anx dis: certain individuals believe that any possibility of negative event occuring means likely to occur, and worry in efforts to find "correct solutions" and to restore sanity (research shows support)
avoidance theory thomas berkovec: people with generalized anxiety disorer worry repeatedly in order to reduce or avoid uncomfortable states of bodily arousal (actually reduces arousal for these people) supported by research
gen anx dis: cognitive therapies 2 kinds: 1. change maladaptive assumptions 2. help client understand special role that worrying plays in disorder to change views
gen anx dis: rational emotive therapy in RET, therapists point out the irrational assumptions held by clients, suggest more appropriate assumptions, assign hw to give practice (modest relief)
gen anx dis: new wave therapies COGNITIVE: guide clients wit gen anx dis to recognize and change dysfunctional USE of worrying (look for triggers, misguided efforts to control through worrying,
mindfulness based cognitive therapy steven hayes: part of acceptance and commitment therapy: teaches clients to become aware of streams of thought and to ACCEPT (not eliminate) such thoughts as mere events of the mind. promising results
gen anx dis: biological perspective believe that caused chiefly by biological factors: supported by family pedigree studies, show more likely to have it if relatives have it
% of relatives of people with gen anx dis 15% (closer the relationship the more likely)
benzodiazepines family of drugs that researchers 1950s found to provide relief from anxiety- certain neurons have receptors that receive benz
GABA gamma aminobutyric acid: common neurotransmitter . benz receptors ordinarily receive GABA, and GABA is an inhibitory message (stops firing neurons) *SEE TEXTBOOK p 104*
drug therapy leading biological treatment for gen anx dis
sedative-hypnotic drugs drugs that calm people in low dose and help fall asleep in high doses, benz marketed as these in 1950s. less addictive than barbituates
relaxation training theory physical relaxation will lead to a state of psyhological relaxation - best when combined with cognitive therapy or biofeedback
EMG electromyograph - provides feedback at level of muscular tension (best when plays adjunct roles in treatment)
% of people in us w/ specific phobia symptoms 9% (12% lifetime prevalence) most dont seek treatment
women : men specific phobias 2 to 1
narrow vs broad social phobia social phobia related to limited events vs general fear of funtioning in front of people (judge worse than they are)
% of people w/ social phobia in western countires 7.1 % (12% lifetime prevalence)
women to men ratio: social phobias 3 to 2
af am and asian am social phobia higher than whites according to surveys
taijn kyofusho culture bound disorder in asia- fear of making other ppl feel uncomfortable
social phobia: behaviorists conditioning classical conditioning - two events occur together modeling - through observation and imitation also believe that specifc learned fears can become gen anx dis if have many of them
stimulus generalization responses to one stimulus are also elicited by similar stimuli (i.e water fear extends to milk in a glass, bubbly music) research shows support, but not ordinary way
baby albert taught to fear white mice via conditioning
prepardness humans are prepared to acquire some phobias not others (i.e. ones that are evolutionarily advantageous) -- supported by studies using GSRs for high fears vs low fears
galvanic skin responses measures of fear using skin reactions
% of people in treatment for specific phobias; % in treatment for social phobia 19%; 25% (behavioral used most widely)
behavioral treatments for phobias desensitization, flooding, modeling = exposure treatment
systematic desensitization behavioral technique: joseph Wolpe: learn to relax gradually facing objects they fear (first receive relaxation training)
covert desensitization imagined exposure for desensitization (vs in vivo)
flooding belief that people will stop fearing things when exposed frequently - without relaxation training. in covert desensitization, might exaggerate the description so client experiences intense emotional arousal
modeling behavioral technique for desensitization, therapist shows fear is groundless
social phobia treatment principles usually behavioral: 1. people with social phobias may have overwhelming social fears 2. may lack skils for starting conversations, communicating needs or meeting others needs (skill training
biological solutions for phobias antidepressants (more than anti-anxieties)
psychotherapy solutions for phobias as effective as mediaction; less likely to relapse; some use of exposure therapy, gropu therapy (cognitive therapy used, too, esp RET) reductions typically persist for years
panic disorder unexpected panic attacks, month+ of concern about panic attacks, significant change in behavior related to attacks
% of people who have a panic attack in life 25%
agoraphobia fear of having panic attacks in public places (not developed by all ppl with panic disorder)
panic disorder onset late adolescence early adulthood
panic disorder women : men 2 :1
% of ppl in us w/ panic disorder ea year 2.8%
% get panic disorder in lifetime 5%
panic disoder: biological perspective helped by antidepressant drugs which change activity of norepnephrine; norepinephrine activity is irregular in poeple who suffer with panic attacks
locus ceruleus area of brain rih in neurons that use norepinephrine (studies on this part of brain)
parts of brain involved in panic disorder amygdala (processes emotional information when a person fonfots a fightening object or situation); ventolmedialnuleus of the hypothalalmus, central gray matter, locus ceruleus *different brain circuit from that responsible for anxiety reactions
anxiety disorder brain circuit amygdala, prefrontal cortex, anterior cingulate cortex (different from panic disorder= two distinct disorders
panic disorder twin studies: identical: if one twin has, other twin has it in 31% of cases fraternal: if one twin has, other 11% has it
biological treatment: panic disorder antidepressants bring some relief to 80% of people; improvement indefinite with drugs
panic disorder: cognitive perspective panic reactions are experienced only by people who further misinterpretthe physiological events that are occuring within their bodies. Cognitive treatment aims at correcting misinterpretations
biological challenge test COGNITIVE: researchers produce hyperventilation or other biological sensations by administering drugs or doing exercises
anxiety sensitivity people who are panic prone have a high degree of focus on their bodily sensations much of the time and are unable to assess them logically and interpret them as potentially harmful
cognitive therapy for panic disorder -correct misinterpretations -educate about nature of panic attacks -teach accurate interpretations during stress -biological challenge test studies: 85% of clients free of panic for 2yrs+ compared to 13% control
obsessions persistent thoughts, ideas, impulese or images that seem to invade a persons consciousness
compulsions repetitive and rigid behaviors or mental acts that peeople perform to prevent or reduce anxiety
OCD diagnosis -excessive or unreasonable obsessions or compulsions -cause great distress/take up time/interfere with daily functions
why OCD anxiety disorder -obsessions cause anxiety -compulsions aimed at preventing/reducing anxiety
% of people with OCD in us/yr 1-2%
% develop OCD in lifetime 3%
% of ppl with OCD who seek treatment 40%
common OCD themes most common: dirt or contamination other: violence, aggression, orderliness, religion, sexuality
common compulsions cleaning, checking, order/balance, touching, verbal, counting
OCD: psychodynamic perspective OCD different from anxiety disorders because defense mechanism not buried in subconscious but played out in overt thoughts and actions (id= O ego=C); use free association, etc to overcome underyling conflicts
OCD: psychodynamic 3 ego defense mechanisms isolation: people simply disown unwantedthoughts and see as foreign intrusions undoing: perform acts meant to cancel out undesireable impulses (i.e. handwashing) reaction formation: take lifestyle that opposes their unacceptable impulses
freud traces OCD to: anal stage - rage and shame cuz of toilet training (other psychodynams see as early rage reactions and insecurity)
OCD behavioralist: in ocd behavioralists explain and treat COMPULSIONS rather than obsessions (learn behaviors through classical conditioning= random behaviors)
exposure and response prevention behaviorlists for OCD: developed by victor meyer, exposed to objects but resist performing behaviors (like dykman did)
% OCD improved by exposure and responses prevention 55-85% improvements (though few cure all symptoms and up to 1/4 dont improve at all
OCD cognitive perspective people with disorder blame selves for intrusive thoughts and expect that terrible things will happen. Try to NEUTRALIZE the thoughts using neutralizing acts that become part of compulsion
OCD traits -higher depression -high standards of conduct and morality -thoughts = actions -need to have perfect control over their thoughts and behaviors (some research shows cognitive-behavioral most effective)
OCD biological perspective -low activity of serotonin in brain -abnormal functioning in key regions of brain (esp in orbioftronal cortexand basal ganglia = parts of brain that convert sensory info into thoughts and actions.
caudate nuceli filter from sensory to thought in brain, sends only most powerful impulses to thalamus for thinking or acting -- more active in people with OCD
OCD: biological treatments antidepressant drugs reduc obsessions AND compulsions; improvement for 50-80% of people -- cut in half within 8 weeks
stress management program combining treatments, like cognitive and biofeedback
Created by: lwstewart