Download Myers Module Forty Eight

Anxiety Disorders
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Anxiety disorders are marked by distressing, persistent
anxiety or dysfunctional anxiety-producing behaviours.
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Generalized anxiety disorder
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Panic disorder
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Phobias
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Obsessive-compulsive disorder
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Post-traumatic disorder.
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2/3 of GAD sufferers are women (McLean & Anderson,
2009)
Generalized anxiety disorder is often accompanied by
depressed mood, but even without depression it tends to be
disabling. (Hunt et al., 2004). Correlated to maltreatment and
inhibition as children (Moffitt et al., 2007).
Panic Disorder
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is an anxiety disorder marked by unpredictable, minuteslong episodes of intense dread in which a person
experiences terror and accompanying chest pain, choking or
other frightening sensation.
It may be misperceived as a heart attack; smokers have a
doubled risk of panic disorder. (Zvolensky & Bernstein,
2005).
Phobia: an anxiety disorder marked by a persistent, irrational
fear or avoidance of a specific object, activity, or situation.
Fig. 48.1(m638 c615 15.2): some common and uncommon
specific phobias.
Social phobia (non-specific) is shyness taken to an
extreme,as opposed to agoraphobia.
Fearing another anxiety or phobia attack can amplify anxiety
symptoms. (Olatunji & Wolitsky-Taylor, 2009).
Obsessive Compulsive Disorder
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Obsessive thoughts and compulsive behaviours cross the
fine line between normality and disorder when they
persistently interfere with everyday living and cause distress.
Table 48.1 (m639 c616 15.2) will be on the next exam.
2% to 3% of the population will cross that line at some time
in their lives (Karno et al., 1988).
OCD is more common among teens and young adults than
among older people. (Samuels & Nestadt, 1997).
A 40-year follow-up study of 144 Swedish people diagnosed
with the disorder found that, for most, obsessions and
compulsions had gradually lessened, though only 1 in 5
completely recovered. (Skoog & Skoog, 1999).
Post-Traumatic Stress Disorder
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There is biological wisdom in not being able to forget our
most emotional and traumatic experiences.
What defines PTSD is less the event itself than the severity
of the trauma memory--our capacity to experience.(Rubin
et al., 2008).
PTSD symptoms have also been reported by survivors of
sexual assualts, including 2/3 of prostitutes. (Brewin et al.,
1999).
Of those living near the Trade Center in 9/11/2001, 20%
reported such telltale signs as nightmares, severe anxiety,
and fear of public places. (Susser et al., 2002).
A sensitive limbic system seems to increase vulnerability,
by flooding the body with stress hormones. Brain scans of
PTSD patients reveal an aberrant and persistent right
temporal lobe activation. (Engdahl et al., 2010).
Understanding Anxiety Disorders
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Fear Conditioning: uncontrollable bad events help develop
anxieties. (Mineka & Oehlberg, 2008).
Using classical conditioning, one can create chronically
anxious, ulcer-prone rats. (Schwartz, 1984).
Panic-prone people come to associate anxiety with certain
cues (Bar-Haim et al., 2001).
Stimulus generalization has occurred, followed by
reinforcement.
Avoiding or escaping the feared situation reduces anxiety,
thus reinforcing the phobic behaviour.
We may also learn fear through observation learning--by
observing others' fears. Tame children of wild monkeys
learned to fear snakes this way. (Mineka, 2002).
Cognition & Anxiety
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People with an anxiety disorder tend to be hypervigilant.
Anxiety is especially common when people cannot switch off
such intrusive thoughts and perceive a loss of control and a
sense of helplessness. (Franklin & Foa, 2011).
We are biologically hard-wired for some fears. Preschool
children more speedily detect snakes in a scene than
flowers, caterpillars, or frogs. (LoBue & DeLoache, 2008).
It is easy to condition and hard to extinguish evolutionary
relevant stimuli.
If you wonder why we are still some fascinated by monsters
such as vampires and werewolves, the latest theory is that
this the true face of Neanderthals, not the happy cavemen of
science programs. Visit http://www.themandus.org to see for
yourself.
Monsters From The Id!
Genetics & Brain Structure
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Genes matter. Pair a traumatic event with a sensitive, highstrung temperament and the result may be a new phobia.
(Belsky & Pluess, 2009).
In humans, vulnerability to anxiety disorders rises when an
afflicted relative is an identical twin. (Kendler, 2002).
Identical twins also develop similar phobias, even when
raised separately. (Carey, 1990).
Hovatta et al., 2005 has identified 17 genes that appear to
be expressed with typical anxiety disorder symptoms.
Canli, 2008, point to an anxiety gene that affects brain levels
of serotonin (too little of a good thing).
Welch et al., 2007 implicated genes that regulate the
neurotransmitter glutamate (too much of a good thing).
Brain Structure and Function
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Fig. 48.2 (m643 c620 15.3)will be on the next exam.
Ursu et al., 2003 used functional magnetic resonance
imaging scans to compare the brains of those with and
without OCD as they engaged in a challenging cognitive
task.
The scans of those with OCD showed elevated activity in the
anteriro cingulate cortex in the brain's frontal area. This area
of the brain monitors our actions and checks for errors.
When the disordered brain detects that something is amiss,
it seems to generate a mental hiccup of repeating thoughts
or actions (Gehring et al., 2000)
Fear-learing experiences also create fear circuits within the
amygdala (Etkin & Wagner, 2007).
Propanolol in therapy can help by reconsolidation. (Kindt el
al., 2009).