ANXIETY DISORDERS Anxiety vs Fear anxiety future oriented

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ANXIETY DISORDERS

ANXIETY DISORDERS

Anxiety vs. Fear anxiety: (future oriented) negative affect, bodily tension, and apprehension about the

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

Phobias unrealistic fear of a specific situation, activity, or object

Phobias unrealistic fear of a specific situation, activity, or object

Types of specific phobias Blood-Injection-Injury Situational Phobia Natural Environment Phobia Animal Phobia Other phobias

Types of specific phobias Blood-Injection-Injury Situational Phobia Natural Environment Phobia Animal Phobia Other phobias

Common Phobia Treatments systematic desensitization: combines relaxation with exposure • • • invivo imaginal

Common Phobia Treatments systematic desensitization: combines relaxation with exposure • • • invivo imaginal virtual reality http: //www. youtube. com/watch? v=JK-v. VMMN 43 Y flooding: expose individual directly to feared stimulus

Social Phobia DSM criteria: Extreme shyness and fear in social situations focus is on

Social Phobia DSM 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

Social Phobia: Treatment

Social Phobia: Treatment

Social Phobia: Treatment (cont. ) Psychological • Cognitive-behavioral treatment Exposure Skill building Group settings

Social Phobia: Treatment (cont. ) Psychological • Cognitive-behavioral treatment Exposure Skill building Group settings

PANIC

PANIC

Panic Disorder At least one of the panic attacks is followed by at least

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.

Panic Disorder with Agoraphobia (PDA) agoraphobia: place fear of being away from a safe

Panic Disorder with Agoraphobia (PDA) agoraphobia: place fear of being away from a safe

Development of Panic Disorder Step 1 Real Stressor Step 2 Step 3 Fear of

Development of Panic Disorder Step 1 Real Stressor Step 2 Step 3 Fear of Having Another Attack Step 4 Increased Attention to Body Step 5 More Fear

Summary The fear of having another panic attack just makes you more frightened. This

Summary The fear of having another panic attack just makes you more frightened. This “fear of your fear” increases the chances of future attacks. Solution

Treatment for Panic Disorder: 1) Imipramine (tricyclic antidepressant) 2) SSRIs 3) Exposure and relaxation

Treatment for Panic Disorder: 1) Imipramine (tricyclic antidepressant) 2) SSRIs 3) Exposure and relaxation training 4) Panic control treatment

Example Interoceptive Exposure Exercises

Example Interoceptive Exposure Exercises

generalized anxiety disorder

generalized anxiety disorder

GAD Symptoms continuous feelings of anxiety; experienced across situations continues for at least 6

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

GAD Treatment anxiolytics: drugs that reduce anxiety Benzodiazepines anti-depressants cognitive-behavioral relaxation training treatment

GAD Treatment anxiolytics: drugs that reduce anxiety Benzodiazepines anti-depressants cognitive-behavioral relaxation training treatment

Obsessive Compulsive Disorder and Related Disorders

Obsessive Compulsive Disorder and Related Disorders

DSM-V Criteria for OCD Presence of obsessions or compulsions (or both) the person recognizes

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

DSM-V Criteria for Obsessions recurrent and persistent thoughts, impulses, or images experienced as intrusive

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)

DSM-V Criteria for Compulsions Repetitive behaviors or mental acts that the person feels driven

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

OCD : Compulsions Four • • major categories Checking Ordering Arranging Washing/cleaning http: //www.

OCD : Compulsions Four • • major categories Checking Ordering Arranging Washing/cleaning http: //www. youtube. com/watch? v=z. C 2 G 6 lf 9 f. Cs&list=PLYL 4 h. Yo. JA 9 Gc. HQt 1 Cf 1 o wy. PUbs-L 2 QOj. N&index=9

Treatment of OCD SSRI’s Exposure and response prevention How does it compare to medication?

Treatment of OCD SSRI’s Exposure and response prevention How does it compare to medication? Psychosurgery (cingulotomy)

Obsessive Compulsive Related Disorders Hoarding Disorder. Hair-Pulling Disorder. Excoriation Disorder. Body Dysmorphic Disorder.

Obsessive Compulsive Related Disorders Hoarding Disorder. Hair-Pulling Disorder. Excoriation Disorder. Body Dysmorphic Disorder.

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder

PTSD exposure to traumatic event is reexperienced (e. g. , recollections, dreams, flashbacks) try

PTSD exposure to 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

PTSD acute stress disorder – PTSD symptoms have lasted less than one month acute

PTSD acute 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 delayed onset – few immediate symptoms – years months later

Treatment of PTSD Cognitive-behavioral • • treatment Exposure Identify and correct cognitive distortions. SSRI’s

Treatment of PTSD Cognitive-behavioral • • treatment Exposure Identify and correct cognitive distortions. SSRI’s (Prozac, Paxil)