Download Anxiety and Mood Disorders

Anxiety and Mood
Disorders
Anxiety Disorders
Primary disturbance is distressing,
persistent anxiety or maladaptive
behaviors that reduce anxiety
Anxiety - diffuse, vague feelings of fear
and apprehension
everyone experiences it
becomes a problem when it is irrational,
uncontrollable, and disruptive
Generalized Anxiety
Disorder (GAD)
More or less constant worry about
many issues
The worry seriously interferes with
functioning
Physical symptoms
headaches
stomachaches
muscle tension
irritability
Model of Development
of GAD
GAD has some genetic component
Related genetically to major depression
Childhood trauma also related to GAD
Genetic predisposition
or childhood trauma
Hypervigilance
GAD following life
change or major event
Phobias
Intense, irrational fear that may
focus on:
category of objects
event or situation
social setting
Phobias
 It is not phobic to simply be anxious about something
Study of normal anxieties
100
Percentage 90
of people 80
surveyed 70
60
50
40
30
20
10
0
Snakes Being Mice Flying Being Spiders Thunder Being Dogs Driving Being Cats
in high,
on an closed in, and
and
alone
a car
in
exposed
airplane in a
insects lightning in
a crowd
places
small
a house
of people
place
at night
Afraid of it
Bothers slightly
Not at all afraid of it
Specific Phobias
Specific phobias - fear of specific
object
animals (e.g., snakes)
substances (e.g., blood)
situations (e.g., heights)
more often in females than males
Some Unusual Phobias
Ailurophobia - fear of cats
Algobphobia - fear of pain
Anthropophobia - fear of men
Monophobia - fear of being alone
Pyrophobia - fear of fire
Social Phobias
Social phobias - fear of failing or being
embarrassed in public
public speaking (stage fright)
fear of crowds, strangers
meeting new people
eating in public
Considered phobic if these fears
interfere with normal behavior
Equally often in males and females
Development of Phobias
Classical conditioning model
e.g., dog = CS, bite = UCS
problems:
often no memory of a traumatic
experience
traumatic experience may not produce
phobia
Seligman’s preparedness theory
Obsessive-Compulsive
Disorder (OCD)
 Obsessions - irrational, disturbing thoughts
that intrude into consciousness
 Compulsions - repetitive actions performed to
alleviate obsessions
 Checking and washing most common
compulsions
 Heightened neural activity in caudate
nucleus
Panic Disorder
Panic attacks - helpless terror, high
physiological arousal
Very frightening - sufferers live in
fear of having them
Agoraphobia often develops as a
result
Posttraumatic Stress
Disorder (PTSD)
Follows traumatic event or events such
as war, rape, or assault
Symptoms include:
nightmares
flashbacks
sleeplessness
easily startled
depression
irritability
Mood Disorders
Depressive disorders
depression of mood
Bipolar disorders
cycling between depression and
mania (extreme euphoria)
Depression
Symptoms include:
sadness
feelings of worthlessness
changes in sleep
changes in eating
anhedonia
suicidal behavior
Depression
Major Depression
prolonged, very severe depression
lasts without remission for at least 2 weeks
Dysthymia
less severe, but long-lasting depression
lasts for at least 2 years
Can have both at the same time
Women diagnosed far more often than
men
Biological Bases for
Depression
Neurotransmitter theories
dopamine
norepinephrine
serotonin
Genetic component
more closely related people show
similar histories of depression
Situational Bases for
Depression
Positive correlation between stressful
life events and onset of depression
Is life stress causal of depression?
Most depressogenic life events are
losses
spouse or companion
long-term job
health
income
Cognitive Bases for
Depression
A.T. Beck: depressed people hold
pessimistic views of
themselves
the world
the future
Depressed people distort their
experiences in negative ways
exaggerate bad experiences
minimize good experiences
Cognitive Bases for
Depression
Hopelessness theory
depression results from a pattern of
thinking
person loses hope that life will get better
negative experiences are due to stable,
global reasons
e.g., “I didn’t get the job because I’m stupid
and inept” vs. “I didn’t get the job because the
interview didn’t go well”
Seasonal Affective
Disorder
Cyclic severe depression and elevated
mood
Seasonal regularity
Unique cluster of symptoms
intense hunger
gain weight in winter
sleep more than usual
depressed more in evening than morning
Bipolar Disorders
 Cyclic disorders
 Mood levels swing from severe depression to
extreme euphoria (mania)
 No regular relationship to time of year (like
SAD)
 Bipolar disorder is severe form
 Cyclothymia is less severe form
 Strong heritable component
 Bipolar disorder often treated with lithium
Somatoform Disorders
Bodily ailments in absence of any
physical disease
Examples are conversion disorder
and somatization disorder
Psychological
Influences on
Physical Symptoms
and Diseases
Conversion Disorder
Person temporarily
loses some bodily
function
blindness,
deafness, paralyzed
portion of body
glove anesthesia
No physical
damage to cause
problems
Conversion Disorder
Rare in western culture now
relatively common 100 years ago
prominent in Freud’s work/clients
Often see examples in non-Western
people exposed to traumatic event
e.g., high rate of psychological blindness
in Cambodian women after Khmer Rouge
reign of terror in 1970s
Somatization Disorder
Long history of dramatic complaints re:
different medical conditions
complaints usually vague, undifferentiated
e.g., heart palpitations, dizziness, nausea
Often difficult to determine whether
complaints are somatization or
undetectable physical disease
Somatization Disorder
Kleinman’s theory
somatization and depression are
different manifestations of the
same problem
cross-cultural research
pattern of somatoform disorders
affected by cultural beliefs
Psychological factors and
medical condition
Traumatic Grief
studied people’s health before
and after death of spouse
25 months following death of a
spouse
surviving spouses had increased
incidences of flu, heart disease,
cancer
Psychological factors and
cardiovascular disease
Friedman & Rosenman’s studies
type A personality
competitive, aggressive, easily irritated,
impatient, workaholic
have shown increased risk for heart
attack
biggest personality risks are the
irritability and hostility, not the hurried
life-style
Friedman & Rosenman’s
studies
Type B personality
opposite of type A, more relaxed
Have shown low risk for heart attack
Anxiety and depression also predictive
of heart disease
Conclusion
prolonged, frequent negative emotions
increase risk of heart disease
hard working people who enjoy what
they’re doing not at higher risk
Immune function &
emotional distress
Emotional distress shuts down some
bodily defenses against pathogens
makes person more vulnerable to
infectious diseases
Some studies
temporary decrease in T-cells following
frustrating cognitive task
only in people who also showed other
signs of physiological distress to task
 Exposed group of
people to cold virus
 Quarantined for 6 days
 Distressed develop
cold more easily
 Not due to other risk
factors like:
smoking
diet
sleep
Percentage who developed colds
Cohen, et al. (1991)
50
45
40
35
30
25
3-4
5-6
7-8
9-10
11-12
Score on psychological distress scale