User:Atcovi/Psychopathology/Chapter 5


 * Fear: Alarm in the central nervous system that goes off when your well-being is under attack. (evolutionary)
 * Anxiety: CNS physiological/emotional response to a vague sense of threat.

The ANS (Autonomic Nervous System) wants balance. PNS (peripheral nervous system) seeks relaxation, while the SNS (sympathetic nervous system) produces stress.

Anxiety is good because it prepares us for action. Though, 19% of US adult population suffer from at least 1 of the 6 DMS-5-TR anxiety disorders (slide 8 for more info).

Generalized Anxiety Disorder (GAD)

 * 6+ months, person is really worried about multiple matters (or anything). Huge reduction in life quality is necessary.
 * Sociocultural perspective: GAD is associated with dangerous social conditions/threatening environments, including poverty, prejudice, and illness.
 * Psychodynamic perspective: GAD occurs when the degree of anxiety/ego mechanisms naturally used to control anxiety is overwhelming. Today, psychodynamic theorists believe that GAD can come back to early parent-child relationships... for example, repression and suffering extreme punishments (id impulses are to the max). Therapies include free asscoation, interpretations of transference, resistance, and dreams to remove fear of id impulses and control. Focus more on control of id than fear.
 * Humanistic perspective: When people reject their honest self, that's when GAD comes up. Lack of 'unconditional positive regard' during childhood leads to conditions of worth (harsh standards for oneself). Bad judgements of one's self leads to anxiety, where GAD develops. Client-centered therapy shows UPR (unconditional positive regard), although optimistic and positive, there is a considerable lack of empirical support.
 * Cognitive-behavioral perspective: Anxiety is from awkward thinking, treatment focuses on nature of behavior/thoughts. Ellis beloves some people have basic irrational assumptions (for example, "I have to be loved by everyone!") [Ellis's rational-emotive therapy (RET)]. Beck believes GAD people hold horrible assumptions/pessimistic. Breaking down the worry and scheduling "worry time" (as seen in mindfulness-based cognitive-behavioral therapy) is essential.
 * Biological perspective: Based mainly off of separation of parents and that fear reactions are tied to brain circuits. Improper functioning by neurons could lead to issues with benzodiazepines being recieved by GABA receptors. For example, LOW GABA produce excess brain circuits, which may lead to GAD (see slide 32). Drug therapies are also an option, where prescriptions for antidepressants that increase serotonin/norepinephrine are common. Antipsychotics are used as well.

Some More Theories

 * 1) Adrian Wells, Metacognitive theory: GAD people do worry in a good way (coping with threats in life), but worrying about worrying isn't good either.
 * 2) Koerner, intolerance of uncertainty theory: I'm worrying about finding the correct answers in life, but I'm unable to... so I just worry more.
 * 3) Avoidance theory, Borkovec: Worrying is good, it reduces bodily arousal.

Phobias
Phobias are more intense, immediate, and persistent than fear. They are scared of an object/situation, and even creates severe distress that causes deviance in regular functioning. Being scared of heights (to a reasonable extent) is not a phobia. See slide 37 for statistics. Agoraphobia is found in 1% of US population. It is the obvious, unreasonable, or persistent fear of being in at least two specific situations, such as crowds or public transportation. They may have panic attacks in public places.

Cause?
Cognitive-behavioral theories suggest that once a fear of something develops, the more the fear is asserted, the worse it gets. Fear reactions don't always go back to conditioning, since despite classical conditioning examples (like Little Albert), several studies can't seem to trace phobias to classical conditioning/modeling.

Behavioral-evolutionary explanation: Certain biological predisposition to develop fears, gets you prepared for IRL action. Exposure treatment (like support groups and home-based programs) is key, includes systematic desensitization, flooding, and modeling.

Social Anxiety Disorder
Fear of talking or functioning properly in front of others.

Cognitive-behavioral perspective: poor expectations, anticipation of bad scenarios and a hatred for social situations. Can come from genes, traits, biological abnormaltieis, trauma during childhood, and overprotective parents. Treatments address 1) overhwleming social fears (medication, exposure therapy, systematic therapy needed) and 2) lack of social skills (social skills training).

Social media sucks!

Panic Disorder
Short spurs of pure panic that are horrible for a minute, then die out. Experience at least sweating, chest pains, dizziness, and faintness.

Biological perspective: Initially, people thought panic attacks were caused by off-the-charts norepinephrine activity in the locus ceruleus, but now, we think that the amygdala is just going off all the time. May be inherited. Caused by hyperactive panic circuit, involving the aymgdala, hippocampus, locus coeruleus, etc. Drug therapies, such as the usage of benzodiazepines, have been implemented.

Cognitive-behavioral perspective: Biological factors + see odd body sensations, then go into panic mode. Leads to anxiety sensitivity. Assess using biological challenge test. Therapy in this field seeks to correct the way people think of their bodily sensations, so this includes education about panic attacks and teaching skills for how to cope with such anxiety.

Obsessive-Compulsive Disorder
Obsessions: Persistent thoughts that seem to contaiminate a person's mind. This includes urges to clean dirt and when they try to ignore it, it doesn't work (their anxiety gets worse).

Compulsions: Consistent urges that some people do to reduce anxiety. They feel like they can't control it. This includes cleaning a billion times.

Psychodynamic perspective: Id vs. ego defense mechanisms is being played out. OCD is related to the anal stage of development. Treatment consists of classical techniques (free association and therapist interpretation) and short-term psychodynamic therapies.

Cognitive-behavioral perspective: Humans tend to have bad thoughts. To prevent these thoughts from becoming reality, they neutralize them. Therapy includes exposure and response prevention excersises. Expose, but resist, with an emphasis on cognitive processes that help produce/maintain obsessive thoughts to just thoughts.

Biological perspective: Brain circuit mad hyperactive, includes odd serotonin activity + brain structure and functioning. Treatment? Serotonin-enhancing antidepressants, including Anafranil.

Medication and C-B therapy is the best.

Separation Anxiety Disorder
Anyone, not just kids, can suffer from separation anxiety disorder. It is the most common disorder in young children.

SUMMARY


 * Biological model: Genetic variations, bad fear cricuits, behavioral inhibitions.
 * Cognitive-behavioral and psychodynamic models: Overprotective parents
 * Sociocultural model: Life stress, poverty, school difficultues, bad family, bad friends, danger in the community.

May be different from person to person.