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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
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.
panic disorder2
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
panic disorder3
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….
models of abnormality
Models of Abnormality

Biological model

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

models of abnormality5
Models of Abnormality

Biological model: Anatomy (structures)


Corpus callosum


Locus ceruleus

models of abnormality6
Models of Abnormality

Biological model: Physiology (processes)

Nerve impulse

panic disorder7
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
panic disorder8
Panic Disorder


  • 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
obsessive compulsive disorder
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.”

obsessive compulsive disorder10
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.
obsessive compulsive disorder11
Obsessive-Compulsive Disorder

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

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

obsessive compulsive disorder12
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.

obsessive compulsive disorder13
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?
obsessive compulsive disorder14
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
obsessive compulsive disorder15
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
obsessive compulsive disorder16
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
obsessive compulsive disorder17
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
obsessive compulsive disorder18
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

Caudate nucleus

Orbital frontal cortex