Anxiety Disorders. Phobias. Panic Disorder. Phobias Panic and Agoraphobia GAD OCD PTSD
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1 Anxiety Disorders Phobias Panic and Agoraphobia GAD OCD PTSD Phobias Unrealistic fear; person knows not realistic Two-factor theory (cc plus oc); Mowrer Specific phobias: 2x F vs M; snakes, animals, heights, storms, bridges Social phobia: social anxiety disorder; anxiety of being evaluated in social situations; common = public speaking; 2x in women vs. men; Adolescence generalized social phobia = allencompassing, lifetime rate = 1-2% Panic Disorder Panic = palpitations, sweating, shaking, shortness of breath, choking feeling, chest pain, nausea, dizzy, derealization, depersonalization, fear of going crazy, fear of dying, numbness, chills/hot flashes During day usually Heart evaluation first is common referral Uncued (out of the blue) Lifetime rate = 2-3% 3x in F vs. M Late adolescence/early adult Anti-depressants (panic not same as anxiety) 1
2 Agoraphobia Fear of fear (fear of panic attacks) Early onset, female Loss, depression Treatment Generalized Anxiety Disorder Chronic worry (6+ months, lot of issues) Free-floating anxiety Female (2x) Adolescence/early adult; chronic problem Lifetime rate = 5% Worry without arousal: avoid visualizing the source, limited exposure therefore Obsessive-Compulsive Disorder An obsession is a persistent thought that cannot be controlled Did I lock the door? A compulsion is an intentional behavior (ritual) that occurs in response to a thought Check the door (22 times) Key aspect is that OC persons experience anxiety if they are unable to complete their ritual 2
3 Obsessive-Compulsive Disorder Common obsessions: doubt, contamination Common compulsions: checking, washing No sex differences Lifetime rate = 2-3% Early onset Ego dystonic Tourette s and OCD: common genetics? Response prevention Anti-depressants Schizophrenia Schizophrenia refers to a profound disturbance in human function including: Thought: Illogical thought systems (delusions) and loosening of associations Perception: Presence of hallucinations (hearing) Language: Word salad, disconnected ideas neologism, clang Affect: Emotion (often flat or absent); inappropriate Symptoms can be viewed as: Positive: Delusions are an added function Negative: Signal the absence of a function (flat affect) Schizophrenia Kraepelin Lifetime rate = 1% No sex difference Late adolescence/early adult earlier onset in men Lowest social class (why?): stress vs drift Prodromal, acute, residual Medication (dopamine) Hospitalization 3
4 Major Types of Schizophrenia Paranoid: delusions (can be better functioning) Catatonic: waxy flexibility; echolalia Disorganized: bizarre, inappropriate Undifferentiated Residual Biological Basis of Schizophrenia Diathesis-stress model proposes that some persons develop schizophrenia because of a underlying biological vulnerability(diathesis) that is compounded by stress The heritability of schizophrenia is 50-83% Risk of schizophrenia is 48% in monozygotic, 17% in dizygotic twins, and 9% in siblings Dopamine hypothesis: schizophrenia reflects elevated levels of dopamine in brain Paranoid schizophrenia is induced by chronic treatment with amphetamine, a drug that releases dopamine Neural Atrophy in Schizophrenia Neuron loss in brain results in a diminished volume of brain tissue The fluid-filled ventricles enlarge to take up the volume Enlarged ventricles are a common finding in schizophrenia Atrophy of the frontal, temporal, and prefrontal cortex has been noted in schizophrenic patients: reflects brain damage Note that negative symptoms induced by brain cell loss may not respond to drug treatment 4
5 Schizophrenia Neurodevelopmental problems: subtle, which is why don t manifest until later in life. Virus, flu, delivery; Mixed handedness during childhood Expressed emotion: course of disorder Personality Disorders Borderline Personality Disorder relationships, self-mutilating, suicide, F more than M Antisocial Personality Disorder M more than F Schizoid (detachment) Schizotypal (discomfort in relationships) Narcissistic: grandiose, need for admiration 5
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