Social Factors

1
Social Factors

• Stressful life events
• Childhood adversity
• Attachment relationships and separation anxiety

2
Psychological Factors

• Learning
• Classical conditioning
• Preparedness model
• Observational learning
• Cognitive factors
• Perception of lack of control
• Catastrophic misinterpretation
• Attention to threat and shifts in attention
• Thought suppression

3
Biological Factors

• Genetic Contributions
• Panic disorder and GAD seem to run in families
• Generalized form of social phobia is linked to
  genetics, but not non-generalized form
• OCD not specifically linked to genetics, but to
  anxiety disorders in general

4
Biological Factors

• Neuroanatomy
• Phobias and Panic Disorder two pathways
• Without Cortex thalamus ? amygdala
• With Cortex thalamus ? frontal lobe ? amygdala
• Panic Disorder
• Locus ceruleus (brain stem) norepinephrine
• OCD
• Basal ganglia (caudate nucleus and putamen)
• Orbital prefrontal cortex
• Anterior cingulate cortex

5
Biological Factors

• Neurochemistry
• Pharmacological challenge
• Lactic acid
• 50-90 with panic, 0-25 without
• Caffeine
• Carbon dioxide

6
Treatment

• Psychological interventions
• Systematic desensitization
• Flooding
• Exposure
• Situational exposure
• Interoceptive exposure (panic disorder)
• Prolonged exposure, plus response prevention
  (OCD)

7
Psychological Interventions

• Relaxation training (GAD)
• Breathing retraining (Panic Disorder)
• Cognitive therapy
• Recognize faulty logic
• Decatastrophizing

8
Biological Interventions

• Benzodiazepines
• For example Valium Buspar
• Selective Serotonin Reuptake Inhibitors (SSRIs)
• For example Paxil
• Tricyclic Antidepressants
• Imipramine agoraphobia with panic attacks
• Clomipramine OCD