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Chapter 5
Anxiety Disorders
Anxiety vs. fear
• ______ = response to serious,
known threat
• ______ = response to vague sense
of threat or danger
• same physiological features
Panic Disorder
• “_________”
– periodic, short bouts of panic that occur
suddenly, reach a peak, and pass
– no REAL threat…
• Unexpected (_______) Attacks
• Situationally Bound (______) Attack
• ______________________
• Panic Disorder:
– panic attacks repeatedly and
unexpectedly and without apparent
reason
• Worry about having an attack; plan
• Often accompanied by agoraphobia
– _______________________
• Panic disorder with (or without)
agoraphobia
Biological Perspective
• panic reactions are related to
changes in __________________
• Inherited biological predisposition?
Drug therapies
– Antidepressants and some
benzodiazepines (_____________)
• When drug therapy is stopped,
symptoms return
– (medications + ____________ therapy)
- may be most effective
Cognitive-behavioral Perspective
• (____________) overly sensitive to
certain bodily sensations and may
misinterpret them (medical
catastrophe)
–
–
–
–
Poor coping skills
Lack of social support
Unpredictable childhoods
Overly-protective parents
• ____________ response – associate
bodily sensations with previous panic
responses
Treatments
• Panic Control Therapy
– correct _________________ of their
bodily sensations
– Relaxation training
• “______________” procedures to
induce panic sensations
Phobias
• Persistent and unreasonable fears
of particular objects, activities, or
situations (immediate fear)
• often avoid the object or thoughts
about it
Specific Phobias
Examples
Hematophobia
Blood
Ephidophobia
Snakes
Claustrophobia
Closed spaces
Acrophobia
Heights
Aerophobia
Flying
Death-related phobia
Funerals, corpses, and
cemeteries
What Causes Phobias?
• Behavioral
• Biological
– Conditioning
– _________________
– Modeling
• Species-specific
(Observation &
biological
imitation)
predisposition to
develop certain
– Phobias may
fears
develop into GAD
_______________
_______________
_____________
Treatments for Specific Phobias
• Systematic Desensitization
– Since relaxation is incompatible with fear, the
relaxation response is thought to substitute for
the fear response
– ___________ desensitization ( Live) ; Covert
desensitization – (________)
• Flooding
– __________________________
• Modeling
• Graduated Exposure – confront small
situations
• __________ Stopping
Social Phobias
• Severe, persistent, and unreasonable fears
of social or performance situations in
which embarrassment may occur
• Behavioral treatments
– ______________________________
– social skills & __________________
• Cognitive therapies
Generalized Anxiety Disorder (GAD)
• excessive anxiety under most
circumstances and constant worrying
– Vague, intense concerns and fearfulness
• free-floating” anxiety
– “Danger” not a factor
– Sleeplessness, irritability, fatigue,
muscle tension
• Symptoms last at least six months
Obsessive-Compulsive Disorder
• ___________
– Persistent thoughts, ideas, impulses, or images
• ____________ (rituals)
– Repeated and rigid behaviors or mental acts
performed in order to prevent/reduce anxiety
• Diagnosis made when symptoms:
–
–
–
–
_______________________
cause great distress
consume considerable time
or interfere with daily functions
Obsessive-Compulsive Disorder
4 Major Dimensions
• Obsessions associated with checking
compulsions.
• Need for ____________________.
• Obsessions about cleanliness associated
with washing compulsions.
• Hoarding-related behaviors.
Obsessive-Compulsive Disorder
OCD is increasingly
being understood
as a genetic disorder.
treatment with clomipramine or other
serotonin reuptake inhibiting medications,
such a fluoxetine (Prozac), is the most
effective biological treatment available for
OCD.
Other approaches to OCD
• Behavioral Therapy
– __________________________ (ERP)
• repeatedly exposed to anxietyprovoking stimuli and prevented from
responding with compulsions
• Therapists often model the behavior
• Cognitive perspective
– __________________________
TRAUMA
violent victimization
serious accident
fires
abuse
earthquakes
life-threatening calamity
war
riots
witnessing tragedy
Photograph copyright © 2002 www.arttoday.com. Used with permission.
Stress Disorders
• Occurs after an event that would be
traumatic to anyone
• ____________________
– Symptoms begin within 4 weeks of event and
last for less than 1 month
• __________________________
– Symptoms can begin at any time following the
event but must last for longer than 1 month
Symptoms
• Depersonalization •
• dissociative
•
amnesia
•
• Hypervigilance
numbing
intense anxiety
impairment of
everyday functioning
Treatment of Trauma-Induced
Disorders
• Medication
• “Covering”
• “Uncovering”
Most studies on obsessions and
compulsions indicate that
• A. obsessions generally occur in the
absence of compulsions.
• B. compulsions generally occur in the
absence of obsessions.
• C. obsessions and compulsions generally
occur together.
• D. there is no relation between obsessions
and compulsions.
Rita suffers from a panic disorder.
After she begins exercising her heart
rate increases. A cognitive theorist
would predict that Rita would
• A. interpret the increased heart rate in a
catastrophic way.
• B. Experience a surge of anxiety after interpreting
the heart rate increase as something dangerous.
• C. Be likely to experience a panic attack if she
interprets any additional physical sensations as
signs of increasing danger.
• D. All of the above
Elliot constantly worries about his health, finances,
and his marriage. Often, his worries keep him
awake at night, causing extreme daytime fatigue.
His wife has become frustrated with him because
he is so preoccupied with his worries. His likely
diagnosis is:
•
•
•
•
A.
B.
C.
D.
Panic disorder
Simple phobia
Social phobia
Generalized anxiety disorder