UNDERSTANDING PSYCHOPATHOLOGY

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UNDERSTANDING PSYCHOPATHOLOGY

• Anxiety Disorders

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OVERVIEW

• Describe the major types of anxiety disorders
  listed in the DSM
• Illustrate several case examples
• Discuss causal models

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ANXIETY DISORDERS

• I. Phobias
• II. Anxiety States
• III. Post-Traumatic Stress Disorder

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ANXIETY DISORDERS

• Fear response is unrealistic
• Fear response is out of proportion to the threat
• Fear response is persistent

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ANXIETY DISORDERS

• I. Phobias
• Anxiety is attached to a discrete set of stimuli

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ANXIETY DISORDERS

• II. Anxiety States
• Pervasive, non-specific anxiety

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ANXIETY DISORDERS

• III. Post-Traumatic Stress Disorder
• A catastrophic event brings on an aftermath in
  difficulties with thinking, relaxation, and
  emotions.

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HOW COMMON ARE ANXIETY DISORDERS?
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BIOPSYCHOSOCIAL MODEL OF PANIC DISORDER

• Biological vulnerability
• neurotransmitter dysfunction in locus ceruleus
• genetic vulnerability
• Psychological factors
• anxiety sensitivity
• beliefs about the controllability of the attacks
• Stress
• precipitants

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FEAR PATHWAY TWO ROUTES

• Auditory or visual stimuli are processed first by
  the thalamus (processing hub for sensory cues)
• Signals travel to the cortex
• If fear response is required, cortex signals the
  amygdala

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FEAR PATHWAY TWO ROUTES

• When startled, the brain automatically engages
  the amygdala
• Smells and touch sensations bypass the thalamus
  altogether
• Once activated, the amygdala sends signals to
  other brain structures (all-points bulletin)

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THALAMUS

• Processes incoming visual signals by size, shape,
  and color
• Processes auditory cues by volume and dissonance
• Signals the appropriate part of the cortex

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CORTEX

• Gives meaning to the raw sounds and sights
• Enables the brain to become conscious of what it
  is seeing or hearing
• Prefrontal cortex may be responsible for turning
  off the anxiety response once threat has passed

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AMYGDALA

• Emotional core of the brain
• Primary role in triggering the fear response
• Information that passes through the amygdala is
  tagged with emotional significance

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BED NUCLEUS OF THE STRIA TERMINALIS

• Perpetuates the fear response, causing the
  longer-term unease typical of anxiety

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LOCUS CERULEUS

• Receives signals from the amygdala
• Responsible for many of the classic anxiety
  responses
• Rapid heartbeat
• Increased blood pressure
• Sweating
• Pupil dilation

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HIPPOCAMPUS

• Memory center, vital for storing the raw
  information that comes in from the senses
• Also stores the emotional meaning attached to the
  sensory memory

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PHOBIASDIATHESES STRESS MODEL

• Biological vulnerability (predisposition to learn
  to fear certain stimuli)
• genetic vulnerability
• preparedness to associate fear with stimulus
• tendency to overreact physiologically to stimuli
• Stressors (frightening experiences with a
  stimulus)
• Traumatic conditioning of fear response
• Vicarious conditioning of fear response
• Vivid information associating fear with the
  stimulus

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PHOBIAS WAYS OF ACQUISITION (Ost, 1987)

• Conditioning
• Modeling
• Instruction

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PHOBIAS WAYS OF ACQUISITION (Ost, 1987)

• Conditioning
• Agoraphobia 81
• Blood phobia 45
• Animal phobias 48
• Modeling
• Animal phobias 26
• Blood phobias 25

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AGE OF ONSET OF ANXIETY DISORDERS

• Varies widely
• Generalized anxiety disorder 0-20 years
• Panic Disorder 15 to 35 years
• Simple Phobias 2-55 years 80 onset occurs.
• dental phobia age 15
• social phobia age 25
• agoraphobia age 35

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MEAN AGE OF ONSET, PHOBIAS