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Panic Disorder. Anxiety that turns the corner into terror Bouts of panic that come on suddenly, often with little or no warning

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Panic Disorder

  • Anxiety that turns the corner into terror

  • Bouts of panic that come on suddenly, often with little or no warning

  • Include some of the following: heart palpitations; tingling in hands, feet; shortness of breath, sweating, hot & cold flashes; trembling; chest pains; faintness; dizziness; feeling of unreality.


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Panic Disorder

  • Recurring bouts of panic  dysfunctional changes in thinking & behavior

  • Fears of “losing my mind”

  • Avoidance of increasing # of places/things

  • Panic Disorder can lead to agoraphobia


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Panic Disorder

  • What Causes Panic Disorder?

    • We don’t really know; many factors.

  • But: Strong evidence that norepinephrine is involved.

  • Norepinephrine: neurotransmitter especially active in Locus ceruleus part of the brain.

  • Digression….


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Models of Abnormality

Biological model

How the brain’s anatomy & physiology affect emotions, cognitions & behavior


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Models of Abnormality

Biological model: Anatomy (structures)

Neo-Cortex

Corpus callosum

Amygdala

Locus ceruleus


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Models of Abnormality

Biological model: Physiology (processes)

Nerve impulse


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Panic Disorder

  • Anti-depressant drugs that regulate norepinephrine successful in treating panic

  • When Locus ceruleus stimulated in monkeys  panic like behavior

  • Locus ceruleus rich in norepinephrine carrying neurons

  • Hypothesis: Norepinephrine dysregulation may well be implicated in Panic Disorder


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Panic Disorder

Treatment

  • Anti-depressant drugs

  • Exposure-based treatment

  • Support groups to venture out & gradually reduce avoidance behaviors

  • Cognitive treatments to reduce focus on, and misinterpretation of bodily signals


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Obsessive-Compulsive Disorder

Obsession: Uncontrollable thoughts, ideas, impulses

Compulsion: Rigid, repetitive acts used to reduce anxiety

Example: “Germs are everywhere. I know they are. I better go wash my hands 53 times one more time.”


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Obsessive-Compulsive Disorder

  • We all harbor some O-C behaviors – can you think of any?

  • O-C Disorder: When they become excessive and interfere with daily functioning.

  • Equally common in men and women.

  • Often associated with depression.


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Obsessive-Compulsive Disorder

Obsessions: Can take the form of wishes, impulses, images, ideas, or doubts.

Common Obsessions: Dirt & germs; violence; inappropriate vocalizations; sexuality.


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Obsessive-Compulsive Disorder

Compulsions: Usually recognized as unreasonable; yet cannot be ignored or avoided.

Suffer dreads horrible consequences if they abandon the compulsive behavior.

Common Compulsions: Hand washing; cleaning; “checking”; “ordering”; my friend & his backpack.


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Obsessive-Compulsive Disorder

Psychodynamic Perspective

  • Anxiety rooted in repressed ID impulses

  • Impulses = obsessive thoughts

  • Compulsions = ego defenses against them

  • E.g.: Lady Macbeth: Anxiety/guilt over her part in a murder  compulsive hand washing to get rid of the imagined blood.

  • How would you treat Lady Macbeth?


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Obsessive-Compulsive Disorder

Behavioral Perspective

  • Focus on compulsions, not obsessions

  • Theory: association forms randomly between fear/anxiety reduction and the compulsive behavior

  • Compulsive behavior becomes reinforcing because it reduces anxiety

  • Therefore compulsion increases in frequency


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Obsessive-Compulsive Disorder

Behavioral Perspective

  • Behavioral treatment: break the link between anxiety & compulsive behavior

  • Induce anxiety, prevent the compulsive behavior

  • Eventually, the link is broken

  • However, treatment does not address the underlying obsessions


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Obsessive-Compulsive Disorder

Cognitive Perspective

  • Focus on OCD as a mental phenomenon

  • Compulsive thoughts/acts are those that reduce “bad” thoughts & are therefore reinforced, becoming compulsions

  • CBT researchers have demonstrated strong link between OCD & depression


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Obsessive-Compulsive Disorder

Cognitive Perspective

  • CBT Treatment: Habituation Training, a form of exposure

  • Elicit anxiety-provoking thoughts repeatedly to diminish their power

  • Then, use distraction to prevent use of compulsions to alleviate anxiety


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Obsessive-Compulsive Disorder

Biological Perspective

  • Drugs that increase Serotonin activity are somewhat effective in treating OCD

  • Serotonin is also active in 2 brain areas that have been associated with OCD: the orbital region of the frontal cortex and caudate nucleus


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Caudate nucleus

Orbital frontal cortex