15.4-15.6

• Anxiety


  Apprehension, avoidance, and cautiousness regarding a potential threat, danger, or other negative event
• Fear


  Instantaneous reaction to an imminent threat
• Anxiety disorders are much more common in women than in men
• Specific phobia


  Excessive, distressing, and persistent fear or anxiety about a specific object or situation
• Agoraphobia


  Intense fear, anxiety, and avoidance of situations in which it might be difficult to escape or receive help if one experiences symptoms of a panic attack
• Social anxiety disorder


  Extreme and persistent fear or anxiety and avoidance of social situations in which the person could potentially be evaluated negatively by others
• Panic attacks


  Periods of extreme fear or discomfort that develop abruptly and reach a peak within 10 minutes. Symptoms include accelerated heart rate, sweating, trembling, choking sensations, hot flashes or chills, dizziness or lightheadedness, fears of losing control or going crazy, and fears of dying
• Panic disorder


  Recurrent (more than one) and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attacks, or self-defeating changes in behavior related to the attacks
• Panic attacks are not mental disorders. Around 23% of Americans experience isolated panic attacks in their lives without meeting the criteria for panic disorder
• Causes of panic disorder

  • Genetic factors (heritability around 43%)
  • Abnormal norepinephrine activity in the locus coeruleus
  • Classical conditioning of panic responses to subtle bodily sensations
  • Catastrophic interpretations of ordinary bodily sensations
• Generalized anxiety disorder


  A relatively continuous state of excessive, uncontrollable, and pointless worry and apprehension
• Obsessive-compulsive and related disorders


  A group of overlapping disorders that generally involve intrusive, unpleasant thoughts and repetitive behaviors
• Obsessive-compulsive disorder (OCD)


  • Experiencing thoughts and urges that are intrusive and unwanted (obsessions)
  • Engaging in repetitive behaviors or mental acts (compulsions)
• Approximately 2.3% of the U.S. population will experience OCD in their lifetime
• Body dysmorphic disorder


  Preoccupation with a perceived flaw in physical appearance that is either nonexistent or barely noticeable to other people
• An estimated 2.4% of adults in the United States meet the criteria for body dysmorphic disorder
• Hoarding disorder


  An inability to part with possessions, regardless of their actual value
• Posttraumatic Stress Disorder (PTSD)


  Psychological disorder that can develop after experiencing an extremely stressful or traumatic event
• PTSD was previously called "shell shock" and "combat neurosis" as its symptoms were observed in soldiers who had engaged in wartime combat
• Criterion for PTSD diagnosis

  The person must be exposed to, witness, or experience the details of a traumatic experience involving actual or threatened death, serious injury, or sexual violence
• Hoarding disorder


  People with this disorder cannot bear to part with personal possessions, regardless of how valueless or useless these possessions are
• For PTSD to be diagnosed, the symptoms must occur for at least one month
• Hoarding disorder is made only if the hoarding is not caused by another medical condition and if the hoarding is not a symptom of another disorder
• Roughly 7% of adults in the United States, including 9.7% of women and 3.6% of men, experience PTSD in their lifetime
• Studies have implicated about two dozen potential genes that may be involved in OCD; these genes regulate the function of three neurotransmitters: serotonin, dopamine, and glutamate
• 12.6% of Manhattan residents were observed as having PTSD 2–3 years after the 9/11 terrorist attacks
• Orbitofrontal cortex


  A brain region that is believed to play a critical role in OCD, involved in learning and decision-making
• In people with OCD, the orbitofrontal cortex becomes especially hyperactive when they are provoked with tasks
• The orbitofrontal cortex is part of a series of brain regions that, collectively, is called the OCD circuit; this circuit consists of several interconnected regions that influence the perceived emotional value of stimuli and the selection of both behavioral and cognitive responses
• Adolescent boys are more likely to experience accident, physical assault, and witness death/injury; adolescent girls are more likely to experience rape/sexual assault, intimate partner violence, or unexpected death or injury of a loved one
• The symptoms of OCD have been theorized to be learned responses, acquired and sustained as the result of a combination of classical conditioning and operant conditioning
• Acquisition of OCD through classical conditioning

  1. Neutral stimulus becomes associated with an unconditioned stimulus that provokes anxiety or distress

  2. Subsequent encounters with the neutral stimulus trigger anxiety, including obsessive thoughts
• Sustaining of OCD through operant conditioning

  1. Anxiety and obsessive thoughts (conditioned response) may persist until the individual identifies some strategy to relieve it

  2. Relief may take the form of a ritualistic behavior or mental activity that, when enacted repeatedly, reduces the anxiety (negative reinforcement)
• Personality characteristics such as neuroticism and somatization (the tendency to experience physical symptoms when one encounters stress) have been shown to elevate the risk of PTSD
• Social support


  The comfort, advice, and assistance received from relatives, friends, and neighbors