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Anxiety Disorders. WEB. Anxiety as a Normal and an Abnormal Response. Some amount of anxiety is “normal” and is associated with optimal levels of functioning. Only when anxiety begins to interfere with social or occupational functioning is it considered “abnormal.”.

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Anxiety as a Normal and an Abnormal Response

  • Some amount of anxiety is “normal” and is associated with optimal levels of functioning.

  • Only when anxiety begins to interfere with social or occupational functioning is it considered “abnormal.”


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The Fear and Anxiety Response Patterns

  • Fear

  • Panic

  • Anxiety

  • Anxiety Disorder



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An Important Law- The Yerkes Dodson Law


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Another Bell Curve- Courtesy of Our Good Buddies Yerkes-Dodsen


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Phobic Disorders

  • Phobias

  • Specific phobias

  • Social phobia

  • Agoraphobia



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Specific Phobias

  • Psychosocial causal factors

  • Genetic and temperamental causal factors

  • Preparedness and the nonrandom distribution of fears and phobias

  • Treating specific phobias


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Social Phobia

  • General characteristics

    Fear of being in social situations in which one will be embarrassed or humiliated


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Social Phobia

  • Interaction of psychosocial and biological causal factors

    • Social phobias as learned behavior

    • Social fears and phobias in an evolutionary context

    • Preparedness and social phobia


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Social Phobia

  • Interaction of psychosocial and biological causal factors

    • Genetic and temperamental factors

    • Perceptions of uncontrollability

    • Cognitive variables


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Panic Disorder With and Without Agoraphobia

  • Panic disorder

  • Panic versus anxiety

  • Agoraphobia

  • Agoraphobia without panic


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Panic Disorder

  • Prevalence and age of onset

  • Comorbidity with other disorders

  • Biological causal factors

  • The role of Norepinephrine and Serotonin



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Panic Disorder

  • Genetic factors

  • Cognitive and behavioral causal factors

  • Interoceptive fears



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Panic Disorder: The Cognitive Theory of Panic

  • Perceived control and safety

  • Anxiety sensitivity as a vulnerability factor for panic

  • Safety behaviors and the persistence of panic

  • Cognitive biases and the maintenance of panic


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Treating Panic Disorder and Agoraphobia

  • Medications

  • Behavioral and cognitive-behavioral treatments


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Generalized Anxiety Disorder

  • General characteristics

  • Prevalence and age of onset

  • Comorbidity with other disorders


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Generalized Anxiety Disorder:Psychosocial Causal Factors

  • The psychoanalytic viewpoint

  • Classical conditioning to many stimuli

  • The role of unpredictable and uncontrollable events

  • A sense of mastery: immunizing against anxiety


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Generalized Anxiety Disorder:Biological Causal Factors

  • Genetic factors

  • A functional deficiency of GABA

  • Neurobiological differences between anxiety and panic


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Obsessive-Compulsive Disorder

  • Obsessions- repetitive unwanted ideas that the person recognizes are irrational

  • Compulsions- repetitive, often ritualized behavior whose behavior serves to diminish anxiety caused by obsessions


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Obsessive-Compulsive Disorder

  • Prevalence and age of onset

  • Characteristics of OCD

  • Types of compulsions

  • Comorbidity with other disorders


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Obsessive-Compulsive Disorder:Psychosocial Causal Factors

  • Psychoanalytic viewpoint

  • Behavioral viewpoint

  • The role of memory

  • Attempting to suppress obsessive thoughts


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Obsessive-Compulsive Disorder:Biological Causal Factors

  • Genetic influences

  • Abnormalities in brain function

  • The role of serotonin


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Post-Traumatic Stress Disorder

  • Critical Component

    • Symptoms occurs AFTER a traumatic stressor


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Symptoms Categories

  • Intrusive

    • distressing recollections

    • dreams

    • flashbacks

    • psychological trigger reactions

    • physiological trigger reactions


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Symptoms Categories

  • Avoidance

    • avoid thoughts, feelings or discussions

    • avoid activities, places

    • memory blocks

    • anhedonia (without pleasure)

    • numb

    • alexithymia (emotions unknown)

    • feeling of doom


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Symptom Categories

  • Hyperarousal Symptoms

    • sleep disturbance

    • anger problems

    • concentration

    • startle response

    • “on guard” hypervigilence


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Diagnoses

  • Acute Stress Disorder

    • new to DSM-IV (1994)

    • symptoms 2 days to 4 weeks following traumatic event

  • PTSD

    • new to DSM-III (1980)

    • symptoms beyond 4 weeks

    • delayed onset


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Who Is Vulnerable?

  • All ages

  • Both genders

  • Across Cultures and ethnic groups


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Some StatsAndrews, Wahlberg, Montgomery (1993)




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Types of Traumas

  • Natural

    • earthquakes

    • floods

    • fires

  • Human induces

    • war

    • crimes of violence


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Co-Morbid Diagnoses

  • Alcoholism

    • 75% for Vietnam Veterans with PTSD

  • Depression

    • 77% of firefighters with PTSD also have depression

  • Generalized Anxiety

  • Panic Attacks


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