topic 7

• Panic Disorder


  consists of a series of recurrent,

  unexpected panic attacks coupled with the fear of future panic attacks.
• Panic Attack


  It is defined as a sudden or abrupt surge of fear or impending doom along with at least four physical or cognitive symptoms.
• Unexpected-meaning there is nothing that triggers them.

  Recurrent-meaning they occur multiple times
• Generalized Anxiety Disorder


  It is characterized by

  an underlying excessive anxiety and worry related

  to a wide range of events or activities and lasting for

  more days than not for at least six months.

  Symptoms are restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and

  problems sleeping.
• Specific Phobia


  It is distinguished by fear or anxiety

  specific to an object or a situation.
• Agoraphobia


  It is defined as intense fear or anxiety

  triggered by two or more of the following: using

  public transportation such as planes, trains, ships,

  buses; being in large, open spaces such as parking

  lots or on bridges; being in enclosed spaces like

  stores or movie theaters; being in a crowd or standing in line; or being outside of the home alone.
• Social Anxiety Disorder


  the anxiety or fear relates

  to social situations, particularly those in which an individual can be evaluated by others.
• Obsessive-Compulsive Disorder


  more commonly

  known as OCD, requires the presence of obsessions,

  compulsions, or both
• Obsessions


  defined as repetitive and persistent

  thoughts, urges, or images.
• Compulsions


  time-consuming, repetitive

  behaviors or mental acts that an individual performs

  in response to an obsession.
• Neurotransmitters


  particularly serotonin, have

  been identified as a contributing factor to obsessive

  and compulsive behaviors.
• Amygdala


  the area of the brain that is responsible for storing memories related to emotional events.
• Locus Coeruleus


  the brain structure that serves as an "on-off" switch for norepinephrine

  neurotransmitters.
• Corticostriatal-thalamocortical Circuit


  also known as the fear-specific circuit, is theorized as a major contributor to panic symptoms
• Psychological - Cognitive


  The cognitive

  perspective on the development of anxiety related disorders centers around dysfunctional thought

  patterns.
• Maladaptive Assumptions


  routinely observed

  in individuals with anxiety-related disorders, as they

  often engage in interpreting events as dangerous or

  overreacting to potentially stressful events, which contributes to an overall heightened anxiety level.
• Negative Appraisals


  in combination with a

  biological predisposition to anxiety, likely contribute to the development of anxiety symptoms
• Respondent Conditioning


  When two events that

  occur close together become strongly associated with one another, despite their lack of causal relationship.
• Psychological - Modeling


  It is another behavioral

  explanation of the development of specific and

  social phobias.An individual acquires a fear though observation and imitation
• Stimulus Generalization


  the tendency for the

  conditioned stimulus to evoke similar responses to

  other stimuli, a fear of one stimulus (such as the dog) may become generalized to other items (such as all animals).
• Psychopharmacology


  Benzodiazepines, a class of

  sedative-hypnotic drugs that will be discussed in

  more detail in the substance abuse module,

  originally replaced barbiturates as the leading

  anti-anxiety medication due to their less addictive nature, yet equally effective ability to calm individuals at low dosages.
• Emotion-Focused Coping


  More common in women, less effective in reducing distress.
• Rational-Emotive Therapy


  developed

  by Albert Ellis in the mid-1950s as one of

  the first forms of cognitive-behavioral therapy. The

  goal is to identify

  irrational, self-defeating assumptions, challenge the

  rationality of those assumptions, and to replace them with new, more productive thoughts and feelings.
• Cognitive Behavioral Therapy (CBT)


  discussed in detail in the Mood Disorder Module;

  however, it is also among the most effective

  treatment options for a variety of anxiety disorders, including generalized anxiety disorder.
• Biofeedback


  provides a visual representation of a patient's physiological arousal.
• EMG measures the amount of muscle activity currently experienced by the individual.

  
  

  electroencephalography (EEG), which measures

  the neurofeedback or brain activity

  
  

  heart rate variability (HRV), which measures autonomic activity such as heart rate or blood pressure

  
  

  galvanic skin response (GSR) which measures sweat.
• Exposure Treatments


  Most effective behavioral techniques for specific phobias.
• Exposure Treatment


  the individual is

  exposed to their feared stimuli. This can be done in

  several different approaches: systematic

  desensitization, flooding, and modeling.
• Systematic Desensitization


  It is an exposure

  technique that utilizes relaxation strategies to help

  calm the individual as they are presented with the

  fearful object.
• Flooding


  It is another exposure technique in which

  the clinician does not utilize a fear hierarchy, but

  rather repeatedly exposes the individual to their

  most feared object or situation.
• Modelling


  is another common technique used to

  treat phobias. In this technique, the clinician

  approaches the feared object/subject while the

  patient observes. As the name implies, the clinician

  models appropriate behaviors when exposed to the

  feared stimulus, showing that the phobia is irrational.
• Exposure


  A hallmark treatment approach for all

  anxiety disorders. Specific to social anxiety disorder, the individual is encouraged to engage in social situations where they are likely to experience increased anxiety.
• Social Skills Training


  This treatment is specific to

  social anxiety disorder as it focuses on the patient's

  skill deficits or inadequate social interactions that contribute to their negative social experiences andnanxiety.
• Cognitive Behavioral Therapy (CBT).


  It is the

  most effective treatment option for individuals with

  panic disorder as the focus is on correcting misinterpretations of bodily sensations
• Self-Monitoring


  the act of self-observation, is

  essential to the CBT treatment process for panic

  disorder. In this part of treatment, the individual is

  taught to identify the physiological cues immediately leading up to and during a panic attack.
• Relaxation Training


  Similar to that in

  exposure-based treatment for phobias, prior to

  engaging in exposure training, the individual must learn relaxation techniques to apply during onset of panic attacks.
• Progressive Muscle Relaxation


  To replace the

  breathing retraining suggest this techniques. the patient learns to tense and relax various large muscle groups throughout the body.
• Cognitive restructuring


  The ability to recognize

  cognitive errors and replace them with alternate,

  more appropriate thoughts, is likely the most powerful part of CBT treatment for panic disorder, aside from the exposure part.
• Interoceptive Exposure


  Involves inducing

  panic-specific symptoms to the individual

  repeatedly for a prolonged period, so that

  maladaptive thoughts about the sensations can be

  disconfirmed and conditional anxiety responses are

  extinguished