anxiety disorders

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ANXIETY DISORDERS

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ANXIETY DISORDERS. Anxiety vs. Fear. anxiety: (future oriented) negative affect, bodily tension, and apprehension about the future fear: (reaction to current danger) immediate alarm in response to danger – initiates flight or fight response. Causes of Anxiety - Biological Contributions. - PowerPoint PPT Presentation

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Page 1: ANXIETY DISORDERS

ANXIETY DISORDERS

Page 2: ANXIETY DISORDERS

Anxiety vs. Fearanxiety: (future oriented)

negative affect, bodily tension, and apprehension about the future

fear: (reaction to current danger) immediate alarm in response to danger – initiates flight or fight response

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Phobiasunrealistic fear of a specific situation, activity, or object

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Types of specific phobiasBlood-Injection-Injury

Situational Phobia

Natural Environment Phobia

Animal Phobia

Other phobias

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Common Phobia Treatments

systematic desensitization: combines relaxation with exposure

• invivo• imaginal• virtual reality http://www.youtube.com/watch?v=JK-vVMMN43Y

flooding: expose individual directly to feared stimulus

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Social PhobiaDSM criteria:

Extreme shyness and fear in social situations focus is on situation in which the person is

exposed to unfamiliar people or to possible scrutiny by others

person fears will be humiliated or embarrassed

Avoidance or endure with extreme distress Impairment Rule out cause by other disorder

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Social Phobia: Treatment

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Social Phobia: Treatment (cont.)

Psychological• Cognitive-behavioral treatment

Exposure Skill buildingGroup settings

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PANIC

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Panic Disorder At least one of the panic attacks is

followed by at least a month of (a) persistent fear of having another attack, or (b) a significant maladaptive change in behavior following the attacks.

The disturbance is not better understood by the physiological effects of a substance or medical condition.

The disturbance is not better understood by another psychological condition.

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Panic Disorder with Agoraphobia (PDA)

agoraphobia: fear of being away from a safe place

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Development of Panic DisorderStep 1

Real Stressor

Step 2

Step 3Fear of Having Another Attack

Step 4Increased Attention to Body

Step 5More Fear

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SummaryThe fear of having another panic attack just makes you more frightened.

This “fear of your fear” increases the chances of future attacks.

Solution1. Accept, don’t fear your fear.

2. Actively put your self in situations that cause fear. This is the only way to eventually get over it.

3. Use relaxation techniques such as deep breathing and visualization. These work because one can not be very relaxed and very tense at the same time.

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Treatment for Panic Disorder:

1) Imipramine (tricyclic antidepressant)

2) SSRIs

3) Exposure and relaxation training

4) Panic control treatment

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Example Interoceptive Exposure Exercises

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generalized anxiety disorder

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GAD Symptoms

continuous feelings of anxiety; experienced across situations

continues for at least 6 months and

is uncontrollable more days than not

involves muscle tension, fatigue, irritability, difficulty sleeping

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GAD Treatmentanxiolytics: drugs that reduce anxiety

Benzodiazepines

anti-depressants

cognitive-behavioral treatment

relaxation training

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Obsessive Compulsive Disorder and Related Disorders

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DSM-V Criteria for OCD Presence of obsessions or compulsions (or

both) the person recognizes that the obsessions or

compulsions are excessive or unreasonable (not required for children)

they cause marked distress, are time-consuming (more than 1 hour per day), or interfere with the person’s functioning

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DSM-V Criteria for Obsessions

recurrent and persistent thoughts, impulses, or images

experienced as intrusive and inappropriate cause marked anxiety or distress the thoughts are not simply excessive worries

about real-life problems the person attempts to ignore or suppress the

thoughts the person recognizes that the thoughts are a

product of his or her own mind (not imposed from outside)

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DSM-V Criteria for Compulsions

Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly

Behaviors are aimed at preventing or reducing distress, or preventing some dreaded event or situation. However, behaviors not connected in a realistic way with what they are designed to prevent, or are clearly excessive

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OCD : Compulsions

Four major categories• Checking• Ordering• Arranging• Washing/cleaning

http://www.youtube.com/watch?v=zC2G6lf9fCs&list=PLYL4hYoJA9GcHQt1Cf1owyPUbs-L2QOjN&index=9

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Treatment of OCD

SSRI’s

Exposure and response prevention How does it compare to medication?

Psychosurgery (cingulotomy)

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Obsessive Compulsive Related Disorders Hoarding Disorder.

Hair-Pulling Disorder.

Excoriation Disorder.

Body Dysmorphic Disorder.

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Post Traumatic Stress Disorder

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PTSD exposure to traumatic event

traumatic event is reexperienced (e.g., recollections, dreams, flashbacks)

try to avoid stimuli associated with the trauma

symptoms of increased arousal (e.g., problems sleeping, concentrating)

negative alterations of cognitions or mood

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PTSDacute stress disorder – PTSD symptoms

have lasted less than one month

acute PTSD – symptoms last between 1 and 3 months after event

chronic PTSD – symptoms last longer than 3 months

delayed onset – few immediate symptoms – years later

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Treatment of PTSDCognitive-behavioral treatment

• Exposure• Identify and correct cognitive

distortions.

SSRI’s (Prozac, Paxil)