1 / 34

From Last Class

Anxiety Disorders, Part IV (Chapter 5) February 28, 2014 PSYC 2340: Abnormal Psychology Brett Deacon, Ph.D. From Last Class. Panic disorder PTSD. Specific Phobias. Defining features Extreme and irrational fear of a specific object or situation

aneko
Download Presentation

From Last Class

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Anxiety Disorders, Part IV(Chapter 5)February 28, 2014PSYC 2340: Abnormal PsychologyBrett Deacon, Ph.D.

  2. From Last Class • Panic disorder • PTSD

  3. Specific Phobias • Defining features • Extreme and irrational fear of a specific object or situation • Interferes with one's ability to function and/or is highly distressing • Feared stimulus is avoided or endured with great distress

  4. Specific Phobias • Facts and statistics • Affects 12.5% of the general population • Sex ratio = 4:1 female to male • Chronic course • Onset usually between age 15-20

  5. Types of Specific Phobias • Situational phobias • Claustrophobia • Flying • Driving • Natural environment phobia • Heights • Storms • Water (swimming)

  6. Types of Specific Phobias • Animal phobias • Snakes • Spiders • Mice • Blood-injection-injury phobia • With or without vasovagal (fainting) reaction

  7. Specific Phobias I’ve Treated • Unusual fears • Vomiting • Own navel • Food allergy • Aliens • Demons • Common Fears • Injections • Snakes • Spiders • Insects • Enclosed spaces • Driving • Flying

  8. Treating Specific Phobias • Cognitive-behavioral therapy: exposure • Applied muscle tension for blood-injection-injury phobias involving fainting • Modeling helps • Medications? Not for phobias.

  9. Case Examples • Series of real examples of how exposure therapy was used to treat specific phobias…

  10. Treating Specific Phobias • Lisa, 33-year-old woman with fear of vomiting • History • Current symptoms

  11. Lisa’s Fear Hierarchy Exposure Situation 1. Vomiting 2. Watching people vomit 3. Drinking alcohol 4. Overeating 5. Eating undercooked meat

  12. Treating Specific Phobias • Exposure hierarchy for a 28-year-old pregnant woman in her 2nd trimester with Needle Phobia • Each of the following were done in a 3-hour session… Exposure Situation Giving blood in inside of elbow Having finger pricked Watching others give blood in inside of elbow Watching others get finger pricked Touching and feeling and examining different types of needles

  13. Social Phobia • Fear of social or performance situation(s) involving exposure to scrutiny by others • Fear of embarrassment/humiliation • Interferes with functioning or highly distressing • Situation is avoided or endured with great distress • Generalized subtype (fear most social situations)

  14. Fear-Evoking Stimuli in Social Phobia • Social settings • Performance situations (any context in which one’s behavior can be evaluated by others) • Being the center of attention • Experiencing observable body sensations or anxiety reactions • Blushing, trembling, sweating

  15. Safety Behaviors in Social Phobia • Avoidance of social situations • Escape from social situations when one’s anxiety gets too high • In-situation safety behaviors • Avoiding eye contact, prematurely terminating conversations, excessive rehearsal, wearing hat/beard/sunglasses, drinking alcohol, requiring presence of “safe persons”

  16. Maladaptive Beliefs in Social Phobia • Feared outcomes: • 1. Making a mistake, appearing foolish • 2. Having this be observed by others • 3. Being negatively evaluated by others • Socially phobic people overestimate the probability and cost (badness) of these outcomes

  17. Maladaptive Beliefs in Social Phobia • Social phobia is unique in that people fear outcomes that are objectively less severe that in most other anxiety disorders • Embarrassment vs. death/illness/assault • Treatment implications….

  18. Study conducted with undergraduates at UW:Nelson, E. O., Deacon, B. J., Lickel, J. J., & Sy, J. T. (2010). Targeting the probability versus cost of feared outcomes in public speaking anxiety. Behaviour Research and Therapy, 48, 282-289.

  19. Participants • 926 undergraduate students completed Speech Anxiety Thoughts Inventory (SATI; Cho et al., 2004) • Recruited those with scores > 1 SD above published mean (n = 154) • Final N = 37 (75.7% women)

  20. Procedure • Assessments at pre, post, and 1-week follow-up • Treatment: • Procedures common to both conditions • Probability exposure condition • Cost exposure condition • Stuttering, hand shaking, mumbling, pausing, making foolish statements

  21. Fear of Public Speaking Time x Condition Interaction: F (2, 70) = 3.22, p < .05; between-group d = 1.57

  22. Cost of Feared Social Outcomes Time x Condition Interaction: F (2, 70) = 3.15, p < .05; between-group d = .56

  23. “Social Cost” Exposures in the Clinic • Treatment examples: • Dropping change • Shaking hands • Asking others to open the door for you…

  24. “Social Cost” Exposures • Why would committing social mishaps be therapeutic?

  25. Social Cost Exposures on TV • Impractical Jokers on TruTV • Example social cost exposure: http://www.youtube.com/watch?v=g_MlKGujZ_I

  26. Rejection Therapy • Jia Jiang’s 100 days of rejection therapy: http://www.entresting.com/blog/100-days-of-rejection-therapy/ • TED talk: http://rejectiontherapy.com/

  27. Treating Social Phobia • Antidepressant medications: • As effective as CBT (depending on the study) while medication is being taken • Rate of improvement somewhat more rapid • Moderate relapse rates upon drug discontinuation

  28. Treating Social Phobia • Exposure-based CBT • Facing feared social situations and eliminating safety behaviors • As effective as medication in short-term • More effective in long-term after treatment is done • Addition of medication conveys no benefit beyond CBT alone (generally true for all anxiety disorders)

  29. Andrea’s Exposure Hierarchy Exposure Situation Estimated Anxiety Giving a speech at work 100 Making mistakes around other people 95 Having others notice my sweaty armpits 95 Making conversation with strangers 85 Going dancing with boyfriend 70 Getting together with classmates on weekend 65 Eating lunch alone in crowded place 60 Asking people for the time 50 Making eye contact with strangers 45

  30. Obsessive-Compulsive Disorder • Obsessions • Compulsions • What is OCD and what is not

  31. Obsessions • Obsessions – unwanted, distressing, intrusive thoughts, images, or urges • Obsessions cause anxiety

  32. Obsessions • Common types of obsessions • Contamination • Aggressive • Symmetry/order • Religious/morality • Somatic • Hoarding/saving

  33. Obsessions: A Case Example On leaving work at the end of the day… “Have I left anything? Do I have my wallet? Do I have my pager? Have I left any notes out? Should I look under the chair? Should I look under the table? Is the phone on the hook? Touch it. Did you knock it off the hook? Should I touch it again? Will somebody know that I’ve been touching my phone compulsively? Turn the light off. Did I leave any lights on? Did I leave the light switch in an “in-between” position that could cause a short and cause a fire? Should I go back and check? Did I step on anything? Will I ever get out of here?” -Patient with OCD

  34. Obsessions • Not obsessions • Any thought that is not distressing or inconsistent with your beliefs/values • Being “obsessed” with sex, grades, high performance, perfection, morality, etc.

More Related