Unit 2

• Fear anxiety response


  Involves a variety of physiological changes
• Why we need fear/anxiety

  For survival, can assist in getting things done
• When fear/anxiety becomes problematic

  When it is not a useful response, or it goes on too long
• Phobia


  A persistent and unreasonable fear of a particular object, activity, or situation
• Most effective treatment for phobia

  1. Systematic Desensitization

  2. Relaxation training

  3. Fear hierarchy

  4. Convert to in vivo gradual progression

  5. Real contact with feared stimulus in a relaxed state
• Panic attack


  A sudden onset of physical psychological symptoms that reach a peak within minutes, and then gradually passes
• Panic disorder


  1 month of attacks and either: -persistent concern about having additional attacks -Significant dysfunctional change in behavior
• Panic attacks vs. anxiety

  Panic attacks are more intense and sudden, anxiety is more prolonged
• Obsession


  Recurrent, internal (thoughts, urges, images) experiences that are distressing
• Compulsion


  Behavior (internal or external) that is done to relive the distress from the obsessions
• Relationship between obsession and compulsion

  Negative reinforcement
• Most effective treatment for OCD

  1. Exposure & Response Prevention

  2. Education/challenging unhelpful beliefs

  3. Exposed to obsessions without engaging in compulsion
• Main categories of symptoms in PTSD

  • Re-experiencing
  • Avoidance
  • Changes in Cognition/Mood
  • Changes in Arousal/Reactivity
• Examples of symptoms in each PTSD category

  • Re-experiencing: flashback, memories, nightmares
  • Avoidance: Avoiding internal or external trauma reminders & thoughts, memories, emotions
  • Changes in Cognition/Mood: Isolation, negative beliefs, increased unpleasant feeling, decreased pleasant affect, anhedonia, fragmented memory
  • Changes in Arousal/Reactivity: sleep problems, trouble concentrating, risk taking, easily startled, excessively alert
• Risk factors for developing PTSD

  • Biological factors
  • Childhood experiences
  • Social support
• Similarities between anxiety disorders and PTSD


  Unhelpful avoidance, over activation of the stress response, FFF (flight, fight, freeze)
• Key difference between PTSD and other anxiety disorders

  PTSD: symptoms all relate to precipitating traumatic event, Anxiety: does not require symptoms be related to past experience
• Controversies about Dissociative Identity Disorder

  • Role of the media/sensationalism
  • False memories/loading in therapy
• Symptoms of depression


  • Sleep problems
  • Appetite changes
  • Psychomotor change
  • Loss of energy
  • Anhedonia: Loss of interest
  • Concentration difficulty
  • Suicidal ideation
• Crisis or therapy resources

  • The National Lifeline (call and text)
  • Veterans crisis line (press 1 on National Lifeline)
  • National Alliance on Mental Illness call line (M-F 10am-10pm)
  • The Trevor Project (call and text line)