ABNORMAL PSYCHOLOGY NOTES

Prepared and screened by:

Prof. Erickson Amion, RPm

ANXIETY DISORDERS
Anxiety vs. Fear
✓ Anxiety is defined as apprehension over
an anticipated problem
✓ Fear is a reaction to immediate
danger.
✓ Both involve physiological arousal
● Sympathetic nervous system
✓ Both can be adaptive
● Fear triggers “flight or fight”
o May save life
● Anxiety increases preparedness
o Moderate levels improve
performance

Nature of Anxiety, Fear, and Panic

✓ Panic attacks –abrupt experience of
intense fear
● Symptoms: palpitations, chest
pain, dizziness, labored
breathing

Anxiety Disorders

✓ Most common psychiatric disorder

✓ 28% report anxiety symptom
✓ Most common are phobias

General Criteria
✓ Symptoms must interfere with important areas
of functioning or cause marked distress.
✓ Symptoms are not caused by a drug or a
medical condition.
✓ The fears and anxieties are distinct from the
Summary of Anxiety Disorders
symptoms of another anxiety disorder.
Specific Phobia ● Women are at least twice as likely as
✓ Marked and disproportionate fear consistently men to be diagnosed with an anxiety
triggered by specific objects or situations disorder
✓ The object or situation is avoided or else ● Possible Explanations:
endured with o Women may be more likely to
intense anxiety report their symptoms.
✓ Symptoms persist for at least 6 months. o Women are much more likely
Social Anxiety Disorder than men to be sexually
✓ persistent, unrealistically intense fear of social assaulted during childhood and
situations adulthood
✓ That involves being scrutinized by, or even just o Women show more biological
exposed to, unfamiliar people reactivity to stress than do men
✓ Symptoms persist for at least 6 months. ✓ Socio-cultural Factors
Panic Disorder ● Focus of these problems appears to
✓ Recurrent uncued panic attacks vary by culture.
✓ At least 1 month of concern about the o Taijin kyofusho (Japan)
possibility of more attacks, worry about the o Kayak-angst (North America
consequences of an attack, or maladaptive and Greenland)
behavioral changes because of the attacks. o Shenkui (South and East Asia)
● Panic Attacks o Factors that May Increase for
o Uncued More than One Anxiety Disorder
▪ Occurred unexpectedly
without warning
o Cued Risk Factors
▪ Triggered by specific ✓ Genetic
situation ● Twin Studies
Panic Attack o 20–40 percent for specific
✓ is a sudden attack of intense apprehension, phobias, social anxiety disorder,
terror, and feelings of impending doom, GAD and PTSD
accompanied by at least four other symptoms. o about 50 percent for panic
✓ Physical symptoms disorder
● labored breathing, heart palpitations, o genes may elevate risk for
nausea, upset stomach, chest pain, several different types of anxiety
feelings of choking and smothering, disorder
dizziness, lightheadedness, sweating, ✓ Neurobiological
chills, heat sensations, and trembling. ● Fear Circuit Activity
✓ Other symptoms include: o Amygdala (Active)
● Depersonalization o Medial prefrontal cortex (Less
● Derealization Active)
Agoraphobia ● Neurotransmitters
✓ Greek agora, meaning (“marketplace”) o Serotonin, GABA (Poor
anxiety about situations situations are those Functioning)
that are difficult to escape from, such as trains, o Norepinephrine (Higher than
bridges, or long road trips. Symptoms last at Normal)
least 6 months
Generalized Anxiety Disorder ✓ Psychological Contributions
✓ Worry refers to the cognitive tendency to chew ● Freud
on a problem and to be unable to let go of it o Anxiety = psychic reaction to
✓ They worry about relationships, health, danger
finances, and daily hassles o Reactivation of infantile fear
✓ GAD typically begins in adolescence, situation
● Behaviorists
Comorbidity of Anxiety Disorders o Classical and operant
✓ ¾ of those anxiety disorder meet criteria for conditioning
another disorder o Modeling
● 60% meet criteria for major depression ● Integrated psychological model
● Other disorders commonly comorbid o Early experiences and
with anxiety perceptions
o Substance Abuse ▪ Controllability
o Personality Disorders ▪ Dangerousness
o Medical Disorders e.g. coronary o Parental actions/modeling
heart diseases o Associations or cues to stimuli

Gender and Sociocultural Factors in the Anxiety ✓ Social Contributions

Disorders ● Biological vulnerabilities triggered by
stressful life events
✓ Gender o Familial
 o Interpersonal ✓ Mowrer’s two-factor model
o Occupational 1. Through classical conditioning, a person
o Educational learns to fear a neutral stimulus (the CS) that is
paired with an intrinsically aversive stimulus (the
✓ An Integrated Model UCS).
Triple Vulnerability 2. Through operant conditioning, a person
● Generalized biological vulnerability gains relief by avoiding the CS. This avoidant
o Diathesis response is maintained because it is reinforcing
● Generalized psychological vulnerability (it reduces fear).
o Beliefs/perceptions
● Specific psychological vulnerability Etiology of Panic
o Learning/modeling ✓ Neurobiological Factors
● Locus Ceruleus
✓ Cognitive Factors ● Major source of norepinephrine
● Sustained Negative Beliefs about the ● A trigger for nervous activity
Future ✓ Interoceptive Conditioning
o People with anxiety disorders ● Classical Conditioning of panic in
often report believing that bad response to bodily sensations
things are likely to happen. ✓ People with panic disorder sustain classically
● Perceived Control conditioned fears longer
o People who think that they lack ✓ Cognitive Factors
control over their environment ● Lack of perceived control can trigger
appear to be at greater risk for panic
a broad range of anxiety ● Fear of bodily changes
disorders than people who do
not have that belief.
● Attention to signs of threat
o People with anxiety disorders
have been found to pay more
attention to negative cues in
their environment than do
people without anxiety disorders
✓ Personality
● Behavioral Inhibition
o a tendency to become
agitated and cry when faced
with novel or unfamiliar settings
o strong predictor of anxiety in
childhood and social anxiety
disorder in adolescents
▪ Observed in infants as
young as 4 months old
▪ May be inherited
● Neuroticism
o Tendency to react to events
with greater than-average
negative affect.
o Linked to anxiety and
depression
o Twice as likely to develop an Etiology of Agoraphobia
anxiety disorder ✓ Fear-of-fear hypothesis
● Expectations about the catastrophic
Other Etiological Factors consequences of experiencing anxiety
Etiology of GAD in public after a panic attack.
✓ GABA System Deficit
● Worry reinforcing because it distracts Psychological Treatment
from negative emotions and images ✓ Cognitive Approaches
● Allows avoidance of more disturbing ● Increase belief in ability to cope with
emotions the anxiety trigger
o Distress of previous trauma ● Challenge expectations about
● Avoidance prevents extinction of cognitive outcomes
underlying anxiety Psychological Treatment for Phobia and Social
● Individuals with GAD less able to Anxiety Disorder
identify their own negative feelings ✓ Exposure
● Exposure
Etiology of Social Phobia ● Role playing or small group
✓ Conditioning interaction
 ● Social Skills training
● Reducing safety behaviors
● In Vivo Exposure
● Real life exposure
● Systematic desensitization
Psychological Treatment for Panic Disorder
✓ Panic Control Therapy
● Exposure to somatic sensations
associated with panic attack in a safe
setting
● Increased heart rate, rapid
breathing, dizziness
● Use of coping strategies to control
symptoms
● Relaxation
● Deep breathing
Psychological Treatment of Agoraphobia
● Systematic exposure to feared
situations.
● Self-guided treatment

Psychological Treatment of Generalized Anxiety

Disorder
✓ Relaxation training
✓ Cognitive Behavioral Methods
● Challenge and modify negative
thoughts
● Increase ability to tolerate uncertainty
● Worry only during scheduled times
● Focus on present moment