Anxiety Disorders Panic Disorder - PowerPoint Presentation

Slide1

Slide2

Anxiety Disorders

Panic DisorderAgoraphobiaSocial PhobiaSpecific PhobiaObsessive Compulsive DisorderGeneralized Anxiety Disorder(PTSD & Acute Stress Disorder)

Slide3

Panic Attack (not a diagnosis)

A. Discrete period of intense fear or discomfort, in which 4 or more of the following develop abruptly and reach a peak within 10 minutes

Palpitations

Sweating

Trembling/aching

Sensations of shortness of breath or smothering

Feeling of choking

Chest pain/discomfort

Nausea/abdominal distress

Feeling dizzy/unsteady/lightheaded/faint

Derealization/depersonalization

Fear of losing control/going crazy

Fear of dying

Paresthesias (numbness or tingling sensation)

Chills/hot flushes

Slide4

Agoraphobia (not a diagnosis)

A

. Anxiety about being in places or situations from which escape might be difficult

or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms.

B. The situations are avoided or are endured with marked distress

C. Not better accounted for by another mental disorder

Slide5

Specific Phobia

A. Marked,

persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation

B. Exposure to the phobic stimulus almost always provokes an immediate anxiety response

C. The person recognizes that the fear is excessive or unreasonable

D. The phobic stimulus is avoided or endured with intense anxiety or distress

E. There is significant distress or an impairment in functioning due to the phobia

F. The phobia is not better accounted for by another mental disorder

Slide6

Subtypes of Specific Phobia

Animal type

Natural environment type

Blood-Injection-Injury type

Situational type

Other type

Slide7

Phobia

Marked by a persistent and irrational fear of an object or situation that disrupts behavior.

Slide8

Kinds of Phobias

Phobia of blood.

Hemophobia

Phobia of closed spaces.

Claustrophobia

Phobia of heights.

Acrophobia

Phobia of open places.

Agoraphobia

Slide9

Just FYI….

Acrophobia: Heights

Aquaphobia

: Water

Gephyrophobia

: Bridges

Ophidiophobia

: Snakes

Aerophobia: Flying Arachnophobia: Spiders

Herpetophobia

: Reptiles

Ornithophobia

: Birds

Agoraphobia: Open spaces Astraphobia: Lightning

Mikrophobia

: Germs

Phonophobia

: Speaking aloud

Ailurophobia

: Cats

Brontophobia

: Thunder

Murophobia

: Mice

Pyrophobia

: Fire

Amaxophobia

: Vehicles, driving Claustrophobia: Closed spaces

Numerophobia

: Numbers

Thanatophobia

: Death

Anthophobia

: Flowers

Cynophobia

: Dogs

Slide10

Good Question…

If phobias are learned behaviors,

why don’t they extinguish on their own???

Slide11

Answer to the Good Question…

Avoidance works!

Fear is never tested

Slide12

Obsessive-Compulsive Disorder

Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress.

Slide13

Slide14

OCD

Obsession = thoughtsCompulsion = actions

Slide15

Obsessive-Compulsive Disorder

A. Either

obsessions

or compulsions:

Obsessions as defined by 1, 2, 3, and 4

Recurrent, persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

The thoughts, impulses, or images are not simply excessive worries about real-life problems

The person attempts to ignore or suppress such thoughts, impulses, or images or tries to neutralize them with some other thought or action

The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind

Slide16

Typical Obsessions

Doubts (e.g. Did I turn off the stove? Did I lock the door? Did I hurt someone?)

Fears that someone else has been hurt or killed

Fears that one has done something criminal

Fears that one may accidentally injure someone

Worry that one has become dirty or contaminated

Blasphemous or obscene thoughts

NOT just excessive worries about real-life problems

Slide17

Obsessive-Compulsive Disorder

Compulsions as defined by 1 and 2

Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly

The compulsions are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

Slide18

Typical Compulsions

Checking

Cleaning/washing

Doing things a certain number of times in a row

Doing and then undoing things

Doing things in a certain order, with symmetry

Mental acts such as praying, counting, etc.

Slide19

Obsessive-Compulsive Disorder

B. The person has recognized that the obsessions or compulsions are excessive or unreasonable

C. There is significant distress or an impairment in functioning due to the obsessions or compulsions

D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to the other Axis I disorder

E. The disturbance is not due to a GMC or substance

Slide20

OCD in Children

Children have an average of 4 obsessions and 4 compulsions at any given time

Often comorbid with Tourette’s syndrome and/or ADHD

Slide21

Generalized Anxiety Disorder (GAD)

Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events

The person finds it difficult to control the worry

The anxiety and worry are associated with 3 or more of the following symptoms

Restlessness or feeling keyed up or on edge

Being easily fatigued

Difficulty concentrating or mind going blank

Irritability

Muscle tension

Sleep Disturbance

Slide22

Generalized Anxiety Disorder (GAD)

D. The focus of the anxiety and worry is not confined to features of another disorder and do not occur exclusively during PTSD

E. There is clinically significant distress or impairment in functioning

F. Not due to a GMC or substance

Slide23

Post-Traumatic Stress Disorder (PTSD)

The person has been exposed to a traumatic event and have experienced four or more weeks of one or more of the following symptoms:

1. Haunting memories

2. Nightmares

3. Social withdrawal

4. Jumpy anxiety

5. Sleep problems

Slide24

Slide25

Resilience to PTSD

Only about 10% of women and 20% of men react to traumatic situations and develop PTSD.

Holocaust survivors show remarkable resilience against traumatic situations.

All major religions of the world suggest that surviving a trauma leads to the growth of an individual.

Slide26

“It is not always true that ‘What doesn’t kill you makes you stronger,’ but it is often true,” he reports. And “what doesn’t kill you may reveal to you just how strong you really are.”

Posttraumatic Growth

Slide27

Explaining Anxiety Disorders

Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.

Slide28

The Learning Perspective

Learning theorists suggest that fear conditioning leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced.

John Coletti/ Stock, Boston

Slide29

The Learning Perspective

Investigators believe that fear responses are inculcated through observational learning. Young monkeys develop fear when they watch other monkeys who are afraid of snakes.

Slide30

The Biological Perspective

Natural Selection has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species.

Twin studies suggest that our

genes

may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias.

Slide31

The Biological Perspective

Generalized anxiety, panic attacks, and even OCD are linked with brain circuits like the anterior cingulate cortex.

Anterior Cingulate Cortex

of an OCD patient.

S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action

monitoring in obsessive-compulsive disorder.

Psychological Science, 14,

347-353.

Slide32

Panic Disorder

What Causes Panic Disorder

?

We don’t really know; many factors.

But:

Strong evidence that norepinephrine is involved.

Norepinephrine: neurotransmitter especially active in Locus

ceruleus

part of the brain.

Slide33

Models of Abnormality

Biological model: Anatomy (structures)

Neo-Cortex

Corpus callosum

Amygdala

Locus ceruleus (Pons)

Slide34

Panic Disorder

Anti-depressant drugs that regulate

norepinephrine

successful in treating panic

When Locus ceruleus stimulated in monkeys

 panic like behavior

Locus ceruleus rich in norepinephrine carrying neurons

Hypothesis: Norepinephrine dysregulation may well be implicated in Panic Disorder

Slide35

Obsessive-Compulsive Disorder

Anxiety rooted in repressed ID impulsesImpulses = obsessive thoughtsCompulsions = ego defenses against themE.g.: Lady Macbeth: Anxiety/guilt over her part in a murder  compulsive hand washing to get rid of the imagined blood.How would you treat Lady Macbeth?

Psychodynamic Perspective

Slide36

Obsessive-Compulsive Disorder

Focus on compulsions, not obsessionsTheory: association forms randomly between fear/anxiety reduction and the compulsive behaviorCompulsive behavior becomes reinforcing because it reduces anxietyTherefore compulsion increases in frequency

Behavioral Perspective

Slide37

Obsessive-Compulsive Disorder

Drugs that increase Serotonin activity are somewhat effective in treating OCDSerotonin is also active in 2 brain areas that have been associated with OCD: the orbital region of the frontal cortex and caudate nucleus

Biological Perspective

Slide38

Caudate nucleus

Orbital frontal cortex

Slide39

Please take the remainder of class to work on your Reading Guides!