Anxiety disorder specific phobia Learn what an anxiety
Anxiety disorder: specific phobia
• Learn what an anxiety disorder is, focusing on Specific Phobia • Understand the biological contributing factors to phobias and the ways to manage phobias Lesson objectives
• application of a biopsychosocial framework to understanding ONE of the following four types of mental disorder and its management: Anxiety disorder: specific phobia - biological contributing factors: role of the stress response; role of the neurotransmitter gamma aminobutyric acid (GABA) in the management of phobic anxiety Study design dot point
• A state of physiological arousal associated with feelings of apprehension, worry or uneasiness that something is wrong or that something unpleasant is about to happen. Anxiety definition
• Describes a group of disorders that are characterised by chronic feelings of anxiety, distress, nervousness and apprehension or fear about the future, with a negative effect. Anxiety disorder definition
• • • Agoraphobia without history of panic disorder Panic disorder with/without agoraphobia Specific phobia Social phobia Obsessive compulsive disorder Post-traumatic stress disorder Generalised anxiety disorder Acute stress disorder Anxiety disorder due to a general medical condition Substance-induced anxiety disorder DSM-IV-TR anxiety disorders
• An excessive or unreasonable fear directed towards a particular object, situation or event that causes significant distress or interferes with everyday functioning. Phobia definition
• A disorder characterised by significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behaviour. • The specific object/situation producing the fear is called the phobic stimulus. Specific phobia definition
• Anunptaphobia: fear of staying single • Arachibutyrophobia: fear of peanut butter sticking to the roof of the mouth • Hippopotomonstrosesquipped-aphiliophobia: fear of long words • Keraunophobia: fear of lighting • Ornithophobia: fear of birds • Papaphobia: fear of the Pope • Pentheraphobia: fear of mother-in-laws • Quadrataphobia: fear of quadratic equations • Vuteuthindon: fear of picnics Phobia activity
• People with a specific phobia know that their level of fear is excessive or unreasonable. • The fear is in excess of any real danger posed by the phobic stimulus. http: //www. youtube. co m/watch? v=9 rl 7 Lr 6 e. DL c
• Elevated heart rate & blood pressure • Hand tremors • Diarrhoea • Sweating • Shortness of breath • Dizziness • Feel like they have no control over the situation Symptoms Exposure to phobic stimulus Triggers involuntary anxiety response (similar to stress response) Can lead to panic attacks (unexpected onset of intense anxiety that can last a few mins > an hour)
Categories Examples Animal type Situation type Blood, injections and injury type Natural environments type Other phobias Choking, vomiting, loud noises, dying, costumed characters DSM specific phobia categories
Biological factors Specific phobia Social factors Psychological factors Contributing factors: • Role of stress response • Dysfunctional GABA system Management: • Benzodiazepines • GABA supplement • Relaxation response Biopsychosocial framework applied to specific phobia and its management
• Genetic predisposition – moderate level of heritability of anxiety disorders • Role of the stress response • Role of the brain’s neurochemistry Biological contributing factors
• Fight-fight response activated • Accounts for phobic symptoms such as sweating & palpitations • Dizziness due to increase in ANS arousal then sudden drop in blood pressure How does the stress response contribute to phobic anxiety?
• Becomes problematic when the anxiety response is triggered when there is no real threat or danger • For example, objects/situations that have little potential for harm • flowers (anthophobia) or clouds (nephophobia) • Anxiety remains until the exposure to the phobic stimulus is gone
• Gamma-amino butyric acid (GABA) • = Primary inhibitory neurotransmitter • Inhibits firing of neurons • Maintains optimal level of neurotransmission • Low levels of GABA leads to higher levels of anxiety • Neurons are not stopped from firing Role of GABA NOT THAT GABBA…
• Glutamate = primary excitatory neurotransmitter • Makes neurons more likely to fire • Both GABA and glutamate have important roles in arousal and therefore anxiety Role of glutamate (GABA’s mate)
• Benzodiazepines: a group of drugs which are referred to as minor tranquillisers • ADVANTAGE: Calm down the body by reducing physiological arousal and promoting relaxation • DISADVANTAGE: induce drowsiness and are addictive • Eg: Valium, Temazepam, Xanax etc Management of phobias
Agonists Antagonists • Imitate therefore stimulate a neurotransmitter’s activity • Benzos are GABA agonists • Benzos have inhibitory effects on neurons which reduce the symptoms of anxiety • Inhibit a neurotransmitter’s activity • Reduce GABA function and increase anxiety symptoms How do ‘benzos’ work?
• Researchers believe that some people develop anxiety because they have a dysfunctional GABA system • The result of failure to produce, release or receive the correct amount of GABA that is needed to regulate neuronal transmission in the brain GABA/anxiety connection
GABA may be affected by: • Genetic inheritance • Socio-cultural factors • Exposure to prolonged stress • Exposure to environmental toxins • Nutritional deficiencies (vitamin B 6 and citric acid, and high caffeine intake) What can you do? • Proposals that GABA levels can be increased “naturally” by: • Drinking green tea • Eating foods “high in GABA” (e. g. beans, dairy foods, eggs, seafoods and wholegrains) • GABA supplements (although there is no significant research evidence that this works)
• Draw a flow chart to describe and explain how the stress response contributes to a phobic reaction Review!
- Slides: 23