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270 Ch 6


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Relatively uncontrollable sequence of negative, emotional thoughts that are concerned with possible future threats or danger
Panic Attack
A sudden, overwhelming experience of terror or fright - Distinguished from anxiety in 4 ways: more focused, less diffuse, more intense, sudden onset * symptoms must develop and reach a peak within 10 minutes
persistent and irrational fears associated with specific objects or situations leading to avoidance
fear of public places in which signals associated with safety or familiarity are not present - anxiety about being in situations from which escape might be either difficult or embarrassing
repetitive, unwanted, or intrusive thoughts, images or impulses - they are unwelcome and often aggressive or nonsensical
repetitive behaviors, rituals used to reduce anxiety that are considered by the person to be senseless or irrational
Panic Disorder
recurrent unexpected panic attacks, one of which is followed by a period of one or more in which patient continues to have problems related to the attack (worry, anxiety, avoidance) - can be with or without agoraphobia (which often occurs as a RESULT of experiencing many panic attacks)
Generalized anxiety disorder
excessive anxiety and worry about a number of distinct events or activities that is debilitating over a period of at least six months - Must be accompanied 3 of the following symptoms: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance
Obsessive-Compulsive Disorder
presence of EITHER obsessions or compulsions - patient must recognize at some point that they are excessive or unreasonable - Obsessions: may be intrusive, unwanted, and unreasonable - Compulsions: must be driven by an obsession or a rigid rule - and must be aimed at reducing or avoiding distress or anxiety
a term used to describe persistent emotional disturbances, such as anxiety and depression, in which the person is aware of the nature of the problem
Social Phobia
a marked persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (specific phobia)... BUT INCLUDES the additional element of performance. - performance anxiety and interpersonal interactions (such as dating and parties)
Preparedness Model
we are biologically prepared to develop phobias selectively to certain stimuli because doing so has evolutionary value - once conditioned, response to fear-relevant stimuli (spiders/snakes) are more resistant to extinction than those to fear-irrelevant stimuli (flowers) - may also explain social phobias: we may be prepared to fear faces that are critical, angry, or rejecting
catastrophic misinterpretation
of bodily sensations or perceived threat can lead to panic and behaviors that are counterproductive (increased HR can be misperceived as evidence of having a heart attack)
Thought suppression
attempting to avoid certain thoughts can make the thoughts more intrusive and increase the distressing emotions associated with the unwanted thoughts
involves exposure to the most frightening stimuli rather than working from least to most frightening; success rates have been excellent using this method
Situational exposure
repeatedly confronting previously avoided situations
Interoceptive exposure
actions that induce the physical sensations (increased HR and respiration rate) that occur in actual panic attacks
Anxiety disorders are:
-highgly prevalent -strikingly disabling -surprisingly treatable
fight or flight response usually experienced in the face of immediate danger
a more general and diffuse emotional rx that is out of proportion to environmental threat - adaptive at low levels - associated with pessimism & negative self-evaluation at higher levels
Developmental Comorbidity
Social phobia leads to MDD + Substance dependence
Dispositional Comorbidity
GAD + MDD share a common diathesis
Probabilistic Comorbidity
Specific phobia + delusional disorder, Somatization + Drug dependence
Arifactual Comorbidity
Double depression, social phobia + avoidant PD
Emotional Disorders
Anxiety disorders + Depression

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