Abnormal Psychology Chapter 6: Panic, Anxiety, Obsessions,
and Their Disorders
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1. agoraphobia literally "fear of the marketplace." A fairly
consistent group of places and
situations are [1] avoided or [2] tolerated only
with great discomfort. Usually a
complication of having panic attacks in various
situations. The places become
conditioned fear stimuli and the person, of
course, avoids the situation.
2. amygdala a collection of nuclei that are almond shaped
and that lie in front of the hippocampus in the
limbic sysem of the brain. Involved in the
regulation of emotion and is critically involved
in the emotion of fear. critical role in panic
attacks
3. anxiety A general feeling of apprehensinon about
possible danger.
1. cognitive/subjective - negative mood, worry,
self-preoccupation, sense of being unable to
predict or control future threat
2. physiological - creates state of tension and
chronic overarousal. no activation of fight or
flight response
3. behavioral - strong tendency to avoid
dangerous situations
4. anxiety disorders that share an unrealistic, irrational
disorders fear or anxiety of diabling intensity. DSM 5
recognizes 5 types of anxiety disorders:
specific phobia, social anxiety disorder (social
phobia), panic disorder, agoraphobia, and
generalized anxiety disorder
5. annxiety A trait-like belief that certain bodily symptoms
sensitivity may have harmful consequences.
6. blood- Persistent and disproportionate fear and
injection- disgust at the sight of blood or injury, or the
injury possibility of having an injection. Afflicted
phobia persons likely to experience initial increase
then rapid drop in blood pressure and
accompanied by nausea, dizziness or fainting;
it tends to run strongly in families; fainting may
have evolved as an adaptive mechanism to
avoid further attack (i.e., play dead). In the case
of the phobic person, this automatic response
is excessive.
7. body Obsession with some perceived flaw or flaws
dysmorphic in one's appearance.
disorder
(BDD)
8. cognitive cognitive-behavioral therapy techniques that
restructuring aim to change a person's negative or
unrealistic thoughts and attributions.
9. compulsions repetitive behaviors that a person feels
driven to perform in response to an
obsession; Most common are washing and
checking. Also common are rituals (counting)
and a need for symmetry (lining things up).
Compulsions are very difficult to resist
because they are "operantly
reinforced." The behaviors lead to a reduction
in anxiety making them more likely to
occur in the future.
10. exposure and Method of treatment for OCD disorder that
response combines intense exposure of the patient to
prevention feared conditions and then they are asked
not to respond by engaging in their usual
rituals to the feared stimuli.
11. exposure Technique in psychological treatment of
therapy anxiety disorders that involves exposing the
patient to the feared object or context w/o
any danger in order to overcome the anxiety.
12. exteroceptive modifying the perception of environmental
conditioning stimuli acting on the body. theory is that initial
panic attacks become associated with initially
external cues through this type of
conditioning - sets stage for two of three
components of panic disorder = anticipatory
anxiety and sometimes agoraphobic fears
13. generalized Chronic excessive worry about a number of
anxiety events or activities, w/ no specific threat
disorder present, accompanied by at least 3 of the
(GAD) following symptoms: restlessness, fatigue,
difficulty concentrating, irrability, muscle
tension, sleep disturbance
14. hoarding A new DSM 5 diagnosis characterized by
idsorder long-standing difficulties discarding
possessions, even those of little value.
15. interoceptive Refers to a learning process similar to classic
conditioning conditioning. 2 conditioned stimuli and one
unconditioned response. theory is that initial
panic attacks become associated with initially
internal cues through this type of
conditioning - sets stage for two of three
components of panic disorder = anticipatory
anxiety and sometimes agoraphobic fears
16. obsessions Persistent and recurrent intrusive thoughts, 25. specific phobia Strong and persistent fear that is triggered
images, or impulses that a person experiences by the presence of a specific object or
as disturbing and inappropriate but has situation
difficulty supressing.;Common themes include often originate in childhood
contamination, guilt, and fear of doing harm cannot be treated by medication (formerly
(aggressive/sexual impulses) simple phobia)
17. obsessive- moved to its own category in DSM 5
criteria:
compulsive (obsessive-compulsive and related disorders)
A. marked fear or anxiety about specific
disorder
object or situation
(OCD) ****characterized by the persistent intrusion of
B. object or situation provokes immediate
unwanted and intrusive thoughts or distressing
fear or anxiety
images; these are usually accompanied by
C. phobic object actively avoided
compulsive behaviors designed to neutralize
D. fear/anxiety out of proportion to the
the obsessive thoughts or images or to prevent
actual danger
some dreaded event or situation.
E. fear/anxiety persistent >6 months
F. causes clinically sig. distress or
****tends to be chronic, with symptoms
impairment
lessening or worsening in response to stress.
G. disturbance is not better explained by
18. obsessive- a model of medical classification where various symptoms of another mental disorder
compulsive psychiatric, neurological and/or medical
26. trichotillomania Chronic pulling out of one's own hair.
spectrum conditions are described as existing on a
disorders spectrum of conditions related to obsessive- 27. fear an alarm reaction that occurs in response
compulsive disorder (OCD) to immediate danger
19. panic Severe, intense fear response that occurs in the 28. fear and panic 1, cognitive/subjective components - i feel
attack absence of any obvious external danger; sense similarities afraid
of impending doom 2. physiological components - inc. heart
rate
20. panic occurrence of repeated unexpected panic
3. behavioral components - urge to flee
disorder attacks, often accompanied by intense anxiety
about having another one; diagnosed as "with" 29. specific phobia animal
or "without" agoraphobia. subtypes natural environment
blood-injection-injury
21. panic a variety of biological challenge procedures
situational
provocation that provoke panic attacks at higher rates in
other
procedures people w/ panic disorder than in people w/o
panic disorder. 30. biological temperament
causes of genetics
22. phobia persistent and disproportionate fear of some
specific
specific object or situation that presents little
phobias
or no actual danger.
31. social phobia performance situations, such as public
23. prepared view that people are biologically prepared
subtypes speaking
learning through evolution to more readily acquire fears
nonperformance situations, more general -
of certain objects or situations that may once
eating in public
have posed a threat to our early ancestors. For
example, people more readily dev fear of 32. safety people with panic disorder frequently
snakes and spiders if paired w/ aversive events behaviors engage in these behaviors before or
than they develop fears of knives and guns. during an attack - attribute these behaviors
to lack of catastrophe rather than the idea
24. social Fear of situations in which a person might be
that panic attacks do not lead to a
phobia exposed to the scrutiny of others and fear of
catastrophe
acting in a humiliating or embarrasing way.
also called social anxiety disorder 33. obsessive OCD
originate during early or middle adolescence. compulsive and hoarding disorder
can be treated with MAO inhibitors or SSR related excoriation (skin picking disorder)
inhibitors = antidepressants disorders body dimorphic disorder
CBT > medication trichotillomania
34. Neurotic was an early term for anxiety problems. 45. classical Wolpe and Rachman have a simpler
behavior They were thought conditioning "learning" explanation of Freud's classic
(neurosis) to stem from "neurological malfunctioning." anylysis of phobia. Hans saw an injured
The term "neurotic" is shunned by the DSM horse.
but "NEUROTICISM" is still considered to be Via ____ _____, horses became a conditioned
the "primary personality trait" and probably stimulus for anxiety.
the strongest single predictor of
46. 50 Ost and Hugdahl (1981) found that about
psychopathology.
__% of phobia
35. Neurasthenia is also an early term that referred to a patients could recall a traumatic incident
breakdown in functioning which as the source of their phobia.
resulted from a stress-related depletion of
47. Negative according to operant conditioning theory,
the body's vital fluids. (not in book)
reinforcement each time the phobic object is avoided
36. Freud viewed anxiety as a "signal" of "intrapsychic of avoidance (behavior) avoidance is "reinforced"
conflict." The ego could no longer behaviors (rewarded)
manage id-superego conflict. by reduction in anxiety. Avoidance
behavior is more likely to occur in the
37. David Barlow a prominent anxiety researcher who
future. (not in
distinguishes between fear/panic and
book)
anxiety.
48. Vicarious Fear can be learned by watching others
38. Fear/Panic results from activation of the sympathetic
(observational) behaving
nervous system in response to
conditioning fearfully. Mineka and Cook demonstrated
danger. The "fight or flight response."
that lab raised monkeys became phobic of
39. DSM anxiety [1] specific phobia, [2] social phobia, [3] snakes by observing wild monkeys acting
disorder panic disorder with fearfully in response to snakes.
types agoraphobia, [4] panic disorder without
49. Positive life help insulate against development of
agoraphobia, [5] GAD, [6] OCD, [7] PTSD
experiences phobias. Many years of
40. 30, 19, women, Anxiety disorders are very common. Twelve good experiences with dogs may help
men month prevalence for women is prevent phobia from developing if one is
___ % and for men 1__ %. Anxiety disorders are bitten.
most frequently diagnosed disorders for
50. Immunizing Mineka and Cook showed that exposure
____ and the second most frequently
experiences to non-fearful
diagnosed group of disorders for ___.
monkeys immunized monkeys from
41. Anxiety and co-morbidity data indicates that most who becoming phobic of snakes when later
Mood have an anxiety exposed
disorders disorder diagnosis will also have a mood to monkeys who behaved fearfully with
disorder diagnosis (anxiety and depression snakes
correlate about .80 in the general
51. Inflation Effect One traumatic experience followed by
population). (not in book)
development of a phobia
42. Secondary may help maintain a phobia. For example, a (e.g., auto phobia following a mild
gains fear of people may keep accident) can increase the probability that
one (who dislikes his/her job) from having to a later
go to work. completely unrelated stressor (being
43. 16, 7 Specific phobias are common, lifetime robbed) will lead to development of a
prevalences are __% phobia
for women and __% for men. Most people
who have a simple phobia have at least one
more. They are generally more common in
women (but this depends on the type of
phobia).
44. Little Hans According to Freud's classic analysis, Hans'
fear and avoidance of horses
stems from a "repressed Oedipal complex."
52. Biological Martin Seligman et al., evolution has
Preparedness "prepared" us to learn
associations between aversive events
(getting bitten) and potentially dangerous
stimuli
(spiders). The fears are easily conditioned
and resistant to "extinction." Ohman et al.
found it easier to condition shock-related
fear to snakes and spiders than to flowers or
mushrooms. Also, monkeys acquire
conditioned fear responses to toy snakes but
not to
flowers or toy rabbits.
53. Behaviorally Individual differences help determine one's
Inhibited risk of developing
a phobia. Jerome Kagan found that "____ ____"
children were much more
likely to develop phobias than were children
who did not have this anxious
temperament, when exposed to unfamiliar
stimuli in infancy, they are highly reactive and
appeard distressed, as suggested by crying
and vigorous movement
54. Specific one or more specific situations are
social phobia problematic (e.g., public
speaking or eating in public).
55. Generalized almost all social situations are problematic
social phobia with this type of social phobia
56. Avoidant Most social phobics will also have this
Personality diagnosis. Many
Disorder argue that the two disorders are really the
same thing and both are not necessary. (not
in book), -fearful sensitivity to rejection (so
they avoid contact with people
57. social As with simple phobia, about 50% of ____
phobics recall a
specific traumatic social incident as
contributing to their social phobia (Ost
&Hugdahl).
58. Dominance Ohman et al. suggest that social phobia
hierarchies develops in predisposed
individuals as a by product of "pecking
order" establishment. This is why onset is
usually in adolescence or early adulthood.
Social phobics tend to endure anxiety rather
than avoid (as in specific phobia). This is
consistent with the behavior of submissive
(non-dominant) animals.
59. aggression - Ohman and colleagues demonstrated that
mild shocks
produced greater conditioned fear responses
when paired with angry faces than when
paired with smiling or neutral faces. We are
biologically prepared to acquire fears of
stimuli that signal dominance and ____ from
others.
60. Behavioral may be even more important as a risk factor
Inhibition for development of
social phobia than for specific phobia. Several
researchers including Kagan found
evidence of this.
61. Panic attack Defining symptom of a ___ ___ is fear that one is
either "dying," "losing control," or
"going crazy." Other classic symptoms include:
palpitations, shortness of
breath/choking, numbness or tingling,
sweating, dizziness, hyperventilating, and esp.
derealization and depersonalization. The "fight
or flight" response is being activated
when it shouldn't be.
62. agoraphobia Typical situations for _____ - large stores,
shopping malls, public transportation, sports
arenas,
driving on bridges/highways, venturing far
from home.
63. agoraphobia Two themes seem to underlie symptoms of
____- [1] being in places where escape would
be
difficult or embarrassing and [2] being in
places where help would be unavailable if
needed.
64. panic Agoraphobia without ___ disorder rarely found
in clinical settings but is found more
frequently in "epidemiological" studies. A
person with severe agoraphobia may not
be able to bring themselves to seek out
treatment.
65. females, panic disorder "with" agoraphobia is more
males common in ____ while
"without" agoraphobia is more common in ____.
It may be that (traditionally) it was
more difficult for a male to explain not
working, never leaving the house, etc.
66. panic Comorbidity in __ Disorder - is high for other
anxiety disorders, depression, and alcohol
abuse (esp. in males)
67. imipramine, Donald Klein found that ____ reduced
valium panic but not generalized anxiety. The
reverse was true for ____ and other
benzodiazepines. Thus, "panic" differs
qualitatively, not quantitatively, from
"anxiety." The two have their basis in
different brain
areas and neurotransmitters.
68. panic, The neurotransmitters norepinephrine
generalized and
anxiety serotonin are implicated in ____ disorder.
The neurotransmitter GABA is implicated
in
___ ___ disorder.
69. general Panic patients respond differently than
sensitivity non-panickers in a number of
"provocation"
studies using sodium lactate, CO2,
caffeine, etc. There are so many that a ____
____ and not a specific mechanism must be
at work. All produce symptoms that
"mimic" a panic attack and panickers are
more "tuned in" to these sensations.
70. brain areas the locus coeruleus has long been
(involved in panic suspected of playing a role in panic
attack) responses. More recently, attention has
focused on the amygdala. The limbic
system is
also implicated in the development of
"anticipatory" anxiety.
71. Cognitive theory (e.g., Beck & Emory, Clark, Barlow)
of Panic suggests that panic patients
tend to misinterpret bodily sensations
("Interoceptive stimuli") such as increased
heart
rate in catastrophic terms. Most people
ignore these sensations. This leads to
even
more bodily arousal and the "Panic
Circle." However, this does NOT explain
WHY
panic patients are so in tune to these
sensations. Also, their bodily sensations
may
actually be more intense.
72. Anxiety is a personality trait that some believe
Sensitivity predisposes one to panic
disorder. It may, in reality, be just one part
of a more general "anxious
temperament."
73. Generalized (GAD) hallmark symptom is chronic
anxiety excessive worry more
disorder days than not for at least 6 months. Other
symptoms include: restlessness, easily
fatigued, difficulty concentrating, irritability,
muscle tension, sleep disturbance, difficulty
making decisions, intolerance for
uncertainty, etc
74. Worries most commonly center on family, work,
finances, and illness.
75. Unpredictable GAD patients may have had many such
and events
uncontrollable in their histories.
76. uncontrollable, It is thought that a history of
mastery _____ aversive events predisposes one to
GAD while a history of mastery and
control "immunizes" one against its
development. Mineka et al. raised two
groups of
monkeys. "Master" monkeys could get
reinforcers by pressing bars etc. "Yoked"
monkeys received the same reinforcers but
had no control. Master monkeys later
adapted better to a fear-provoking toy,
were bolder and coped better in general.
77. GABA GAD is somewhat heritable and a
deficiency in activity of the
neurotransmitter ____ (gamma amino buutyric
acid) is apparent. Valium, Xanax, and
similar benzodiazepine tranquilizers
enhance GABA activity.
78. OCD ___ is less common than the other anxiety
disorders. There is no gender difference, it
is equally common in males and females.
79. depression, Comorbidity - is high, esp. for ____, also with
OCD other anxiety disorders and
avoidant/dependent personality disorders.
Body dysmorphic disorder (BDD), which has
recently received much attention, is thought
to be closely linked to ___.
80. nesting, When research animals are put in stressful
grooming circumstances, they will engage in
inappropriate ___ and ____ behaviors
(maybe as distraction from the stressor).
Washing and checking in humans are similar
behaviors.
81. OCD there is strong evidence of heritability of
this disorder (54 of 80 MZ twin pairs and 9
of 29 DZ twin pairs concordant).
82. Tourette's syndrome also supporting a biological basis of OCD is a connection with this
disorder, characterized by severe and chronic motor and vocal tics and the
uncontrollable blurting out of obscenities.
83. OCD serotonin is especially implicated. Anafranil (clomipramine) is a
tricyclic antidepressant that has particularly strong effects on serotonin. Patients
with
____ respond more to Anafranil than to other tricyclics
84. Edna Foa Probably the most well known figure in OCD takes a strictly "behavioral"
approach (i.e., exposure therpay).
85. Exposure (OCD response prevention a popular behavioral approach. Example, a
treatment) "contamination" patient must carry around garbage or dirt, or not shower, until
anxiety
subsides. The rationale is provided by Mowrer's two-process (factor) theory.