Chapter 14: Psychological Disorders; ANXIETY DISORDERS

Annotations:

• 1. Generalized Anxiety Disorders (GAD) is marked by chronic, high level of anxiety that is not tied to any specific threat 2. sometimes called free-floating anxiety as it is nonspecific 3. Worry about yesterdays mistakes and tomorrow's problems  4. Worry about family related matters, finances, work, & persona illness. Then worry about how much they worry
• 1. Dread making decisions 2. Accompanied by physical symptoms: trembling, muscle tension, diarrhea, dizziness, faintness, sweating, & heart palpitations.  3. Gradual onset, more common in females

Annotations:

• 1. Anxiety has a specific focus. 2. A phobic disorder is marked by a persistent & irrational fear of an object or situation that presents no realistic danger. 3. Fears seriously interfere with everyday behavior 4. Accompanied by physical symptoms like trembling & Palpitations 5. Phobias can be about anything
• 1. Most common phobias: - acrophobia - fear of heights - claustrophobia - fear of small, enclosed places - Brontophobia - fear of storms - Hydrophobia - fear of water - various animal & insect phobias 2. People recognize fears are irrational, but unable to calm themselves 3. Imagining the phobia can sometimes trigger great anxiety

Annotations:

• 1. Panic Disorder is characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly & unexpectedly. 2. Physical Symptoms of anxiety 3. After a number of panic attacks, victims often become apprehensive, anticipating the next attack. 3. Public exhibiting of panic attacks may escalate to the point the victim won't leave their house. 4. Agoraphobia - common complication of panic disorders; fear of going out to public places (literal meaning "fear of the marketplace or open places"
• 1. Agoraphobia - traditionally viewed as a phobic disorder - recent evidence suggests is mainly a complication of panic disorder - about 2/3 of people with this disorder are female. - onset typically occurs during late adolescence or early adulthood. 

Annotations:

• 1. Obsessions - thoughts that repeatedly intrude one's consciousness in a distressing way. 2. Compulsions - actions that one feels force to carry out 3. Obsessive-compulsive disorder (OCD) is marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)
• 1. Howie Mandel - comedian & TV personality is a spokesperson for the Anxiety Disorders Association of America. 2. Mysophobia - contamination of germs 3. Obsessions sometimes center on inflicting harm on others, personal failures, suicide, or sexual acts. 4. Compulsions usually involve stereotyped rituals that temporarily relieve anxiety. Some examples: constant hand-washing, repetitive cleaning of things already clean, & endless rechecking of locks, faucts, and such.
• 1. Specific types of obsessions tend to be associated with specific types of compulsions. Example: obsession about contamination paired with cleaning compulsions; obsessions about symmetry paired with ordering & arranging compulsions.
• Research by Laura Summerfeldt, Martin Antony and their colleagues suggests: - OCD may be heterogeneous disorder - Four Factors underlie the symptoms: a. Obsessions & checking b. Symmetry & order c. Cleanliness & washing d. Hoarding "A comprehensive model of symptom structure has yet to be identified"

Annotations:

• 1. Often elicited by any of a variety of traumatic events, including: rape, assault, severe automobile accident, natural disaster or witnessing someone's death. 2. May not surface for many months or years after exposure 3. Can be tied to a memory of the events 4. Research shows approximately 7-8% of people have suffered from PTSD in their lives; prevalence being higher among women (10%) than men (5%)  5. Used to be more common for military members
• 1. Common Symptoms: - re-experiencing the traumatic event in forms of nightmares & flashbacks - emotional numbing - Alienation - problems in social relationships - increased sens of vulnerability - elevated levels of arousal, anxiety, anger, & guilt 2. Key predictor - intensity of one's reaction at the time of the traumatic event. Immediate intense emotional reactions after the traumatic event show elevated vulnerability to PTSD.  3. These reactions are so intense people report dissociative experiences (sense that things are not real, the is stretching out, one is watching oneself in a movie)
• 1. Frequency & severity of PTSD symptoms usually decline gradually over time. 2. Recovery tends to be gradual & in many cases the symptoms never completely disappear.

Annotations:

• Develop out of complicated interactions among a variety of biological & psychological factors

1. A. Biological Factors

   Annotations:

   • 1.Studies look at heredity on psychological disorders, researchers look at Concordance Rates 2. Concordance rate indicates the percentage of twin pairs or other pairs of relatives who exhibit eht same disorder 3. Research suggests that there is a moderate genetic predisposition to anxiety disorders 4. Inherited differences in temperament make some people more vulnerable than others to anxiety disorders
   • 1. Inhibited temperament - characterized by shyness, timidity, & wariness, appears to have a strong genetic basis. 2. This temperament is a risk factor for the development of anxiety disorders
   • Other research shows: 1. Anxiety Sensitivity may make people vulnerable to anxiety disorders. Highly sensitivity to the internal physiological symptoms of anxiety & prone to overreact with fear when they experience these symptoms. - may fuel an inflationary spiral which indicates that anxiety breeds more anxiety, & eventually spins out of control in the form of an anxiety disorder  2. Possible link between anxiety disorders & neurochemical activity in the brain.  3. Neurotransmitters (chemicals) that carry signals from one neuron to another.  4. Therapeutic drugs that reduce excessive anxiety appear to alter neurotransmitter activity at GABA synapses.
2. B. Conditioning & Learning

   Annotations:

   • 1. Anxiety responses may be acquired through classical conditioning & maintained through operant conditioning. A. phobia appears to be acquired through classical conditioning when a neutral stimulus is paired with an anxiety  arousing stimulus.  B> Once acquired, a phobia may be maintained through operant conditioning. Avoidance of the phobic stimulus reduces anxiety, resulting in negative reinforcement.
   • 1. Preparedness - people are biologically prepared by their evolutionary history to acquire some fears much more easily than others. 2. New name = Evolved module for fear learning. Evolved module is  automatically activated by stimuli relatively resistant to intentional efforts to suppress the resulting fears.  3. Consistent with this view, phobic stimuli associated wtih evolutionary threats tend to produce mroe rapid conditioning of fears & stronger fear responses.
   • 1. Problems with conditioning models of phobias: - many people cannot recall or identify a traumatic conditioning experience that led to their phobia. - Many people that endure extremely traumatic experiences that should create a phobia, but do not.  - Phobic fears can be acquired indirectly, observing another's fear response to a specific stimulus or by absorbing fear-inducing information.
   • 1. The development of phobias may depend on synergistic interactions among a variety of learning processes.
3. C. Cognitive Factors

   Annotations:

   • 1. Certain styles of thinking make some people particularly vulnerable to anxiety disorders because: A. misinterpret harmless situations as threatening B. Focus excessive attention on perceived threats C. Selectively recall information that seems threatening
   • 1. Theme that human experience is highly subjective, the cognitive view holds that some people are prone to anxiety disorders because they see a threat in every corner of their lives.
4. D. Stress

   Annotations:

   • 1. Anxiety disorders are stress-related. 2. High stress often helps to precipitate the onset of anxiety disorders