Review the information in Chapter 5 of your textbook on anxiety and obsessive-compulsive disorders. Based on this reading, you are to write a 2-3 page paper that compares and contrasts at least two of these anxiety disorders. Specifically, you are to provide an overview of each disorder and associated symptoms. How are these disorders similar? How are they different?
The paper should be two-three pages in length (does not include the title page or reference page). Utilize at least two scholarly references that were published in the last five years that are preferably peer-reviewed*. Your paper and sources must use APA format. No more than 10% of your paper may contain direct quotes from other sources, such as websites or printed materials. Chapter is attached.
Basic Statistics for the Behavioral Sciences Chapter Five Anxiety Disorders and Obsessive-Compulsive Spectrum Disorders * Understanding Anxiety Disorders Anxiety: A feeling of uneasiness or apprehension; a fundamental human emotion Anxiety disorders: Fear or anxiety symptoms that interfere with an individual’s day-to-day functioning Anxiety is anticipatory: waiting for a dreaded event to occur Fear is a most intense emotion experienced in response to a threatening situation * Understanding Anxiety Disorders (cont’d.) Panic attacks: Intense fear accompanied by pounding heart, trembling, shortness of breath, fear of losing control, and fear of dying Panic attacks may be experienced without an anxiety disorder * Understanding Anxiety Disorders (cont’d.) Figure 5-1 Prevalence of Anxiety Disorders in the United States Anxiety disorders are the most common mental conditions in the United States. * Understanding Anxiety Disorders (cont’d.) Four anxiety disorders covered in this chapter: Phobias Panic disorder Agorophobia Generalized anxiety disorder (GAD) Obsessive-compulsive spectrum disorders also discussed due to similarities with anxiety disorders * Understanding Disorders from Multipath Perspective Figure 5-2 Multipath Model of Anxiety Disorders The dimensions interact with one another and combine in different ways to result in a specific anxiety disorder. The importance and influence of each dimension varies from individual to individual. * Biological Dimension Two main biological factors: Brain function Amygdala Hippocampus Prefrontal cortex Genetic influences Modest contribution to anxiety disorders Interact with other multipath factors * Biological Dimension (cont’d.) Figure 5-3 Neuroanatomical Basis for Panic and Other Anxiety Disorders The fear network in the brain is centered in the amygdala and interacts with the hippocampus and areas of the prefrontal cortex. Antianxiety medications appear to desensitize the fear network. Some psychotherapies also affect brain functioning related to anxiety. * Biological Dimension (cont’d.) Biological, psychological, and social factors interact with one another Interplay between genetic and environmental influences Environmental variables affect gene expression * Psychological Dimension Cognitive-behavioral theories focus on cognitive processes (negative, catastrophic, or irrational thoughts) Anxiety sensitivity (a personality variable) may be a risk factor Psychological variables such as one’s sense of control may also be involved * Social and Sociocultural Dimensions Daily environmental stress Traumatic events Social support network Gender Acculturation factors among minority groups Discrimination and prejudice * Phobias Phobia: Strong, persistent, unwarranted fear of a specific object or situation Extreme anxiety or panic is expressed when phobic stimulus is encountered Most common mental disorder in United States Comes from Greek word for fear * Phobias (cont’d.) Social phobia: Intense fear of being scrutinized or doing something embarrassing or humiliating in the presence of others “Threat cues” and “safety behaviors” Generalized type versus performance type Can be chronic and disabling * Phobias (cont’d.) Specific phobia: Extreme fear of a specific object or situation; exposure to stimulus nearly always produces intense anxiety or panic attack Five types (DSM-V): Animal Natural environmental Blood/injection or injury Situational Other * Phobias (cont’d.) Agorophobia: Intense fear of at least two of the following Being outside of the home alone Traveling in public transportation Being in open spaces Being in stores or theatres Standing in line or being in a crowd These situations are feared because escape or help may not be readily available * Etiology of Phobias Figure 5-5 Multipath Model of Phobias The dimensions interact with one another and combine in different ways to result in a phobia. * Etiology of Phobias (cont’d.) Biological dimension: Genetics or biological preparedness Psychological dimension: Classical conditioning Observational learning or modeling Negative information Cognitive-behavioral * Etiology of Phobias (cont’d.) Social dimension: Family interaction patterns Peer victimization Sociocultural dimension: Gender Child-rearing practices Discrimination and prejudice Culturally distinctive phobias * Treatment of Phobias Biochemical: Neurobiological abnormalities can be normalized with medication Norepinephrine, serotonin, and dopamine Antidepressants, benzodiazepines, and SSRIs Side effects of medications * Treatment of Phobias (cont’d.) Behavioral: Exposure therapy: Gradually introduce increasingly difficult encounters with feared situation Systematic desensitization: Uses muscle relaxation to reduce anxiety Cognitive restructuring: Unrealistic thoughts are altered Modeling: Patient observes a model coping with, or responding appropriately to, the feared situation * Panic Disorder Panic disorder: Recurrent unexpected panic attacks in combination with: Apprehension over having another attack or worrying about consequences of having an attack Changes in behavior or activities designed to avoid another panic attack * Panic Disorder (cont’d.) Three types of panic attacks: Situationally bound Situationally predisposed Unexpected or uncued All three types may be present in individuals with panic disorder * Etiology of Panic Disorder Figure 5-6 Multipath Model for Panic Disorder The dimensions interact with one another and combine in different ways to result in a panic disorder. * Etiology of Panic Disorder (cont’d.) Biological dimension: Modest heritability rate of 32% Brain structures (e.g., amygdala) and neurotransmitters (e.g.. serotonin) involved Psychological dimension: Interoceptive sensitivity Cognitive behavioral: stresses individual’s interpretation of unpleasant bodily sensations as indicators of impending disaster * Etiology of Panic Disorder (cont’d.) Social and sociocultural dimensions: Disturbed childhood Separation anxiety Family conflicts School problems Loss of loved one Major life changes occurring prior to attacks Culture plays a role * Treatment of Panic Disorder Both medication and cognitive therapies have been effective Biochemical: Benzodiazepines, antidepressants, and SSRIs Cognitive-behavioral: 80% reported to achieve and maintain panic-free status Improve quality of life Extinction of fear * Generalized Anxiety Disorder (GAD) Persistent high levels of anxiety and excessive worry over many life circumstances; symptoms must be present for at least three months Develops gradually, beginning in childhood and adolescence Somatic symptoms: Muscle tension, restlessness, sleep difficulties, poor concentration, and avoidance of situations associated with worry * Generalized Anxiety Disorder (GAD) (cont’d.) Two-thirds have comorbid disorders Most frequently diagnosed anxiety disorder worldwide Twice as common in women as in men Must consider cultural context * Etiology of GAD Figure 5-8 Multipath Model for GAD The dimensions interact with one another and combine in different ways to result in generalized anxiety disorder (GAD). * Etiology of GAD (cont’d.) Biological dimension: Small but significant heritability factor May disrupt prefrontal cortex modulation of amygdala Psychological dimension: Cognitive theories: dysfunctional thinking and beliefs * Etiology of GAD (cont’d.) Social and sociocultural dimensions: Poverty Poor housing Prejudice Discrimination Traumatic events * Treatment of Generalized Anxiety Disorder Biochemical treatment: Benzodiazepines, but problems of dependence Tricyclic and SSRI antidepressants are medications of choice due to less risk or dependence Newer antianxiety medication: buspirone Cognitive-behavioral therapy: Only consistently validated psychological treatment * Obsessive-Compulsive (OC) Spectrum Disorders Have much in common with anxiety disorders Include: Obsessive-compulsive disorder Body dysmorphic disorder Hair-pulling disorder Skin-picking disorder * Obsessive-Compulsive Disorder Characterized by: Obsessions: Intrusive, repetitive thoughts or images that produce anxiety (e.g., contamination, orderliness, uncertainty) Compulsions: The need to perform acts or dwell on thoughts to reduce anxiety (e.g., repetitive behaviors, mental acts) * Obsessive-Compulsive Disorder (cont’d.) Associated thoughts and actions that are out of character and not under voluntary control Recognition that thoughts and impulses are senseless, but no control In a given year, about 1% of U.S. adult population suffers from OCD May be underdiagnosed * Obsessive-Compulsive Disorder (cont’d.) Four identified types: Harm-related, sexual, aggressive, and/or religious obsession with checking compulsions Symmetry obsessions with compulsions to arrange things or repeat behaviors Contamination obsessions with cleaning compulsions Hoarding and saving compulsions * Obsessive-Compulsive Disorder (cont’d.) INSERT Video Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder Children talking about their experienced with obsessive-compulsive disorder. * Body Dysmorphic Disorder (BDD) Involves preoccupation with a perceived physical defect in a normal-appearing person or excessive concern over a slight physical defect Comes from Greek word for abnormal shape Produces marked clinical distress Chronic and difficult to treat Underdiagnosed * Body Dysmorphic Disorder (BDD) (cont’d.) Compulsive behaviors: Frequent mirror checking Excessive grooming Seeking constant reassurance Common concerns: Bodily features (e.g., lack of hair, size of nose) Muscle dysphoria: believing that one’s body is too small or insufficiently muscular * Hair-Pulling and Skin-Picking Disorders Hair-pulling disorder (trichotillomania): Involves hair-pulling that causes significant distress and results in hair loss 4% of population may be affected Four times higher prevalence in women Skin-picking disorder: Recurrent picking of the skin and resultant skin lesions Three quarters are females * Etiology of OC Spectrum Disorders Figure 5-11 Multipath Model for OCD The dimensions interact with one another and combine in different ways to result in obsessive-compulsive disorder * Etiology of OC Spectrum Disorders (cont’d.) Biological dimension: Brain structure: Orbital frontal cortex Genetic factors: May account for half of variance in hoarding Biochemical abnormalities: Serotonin deficiency * Etiology of OC Spectrum Disorders (cont’d.) Figure 5-12 Orbital Frontal Cortex Untreated patients with obsessive-compulsive disorder show a high metabolism rate in this area of the brain. Certain medications reduce metabolic rates to “normal” levels and also reduce obsessive-compulsive symptoms. What would it mean if similar results are found with psychotherapy? * Etiology of OC Spectrum Disorders (cont’d.) Psychological dimension: Behavioral perspective: Obsessive-compulsive behaviors develop because they reduce anxiety Cognitive characteristics: Threat estimation Control Intolerance of uncertainty Probability bias Morality bias * Etiology of OC Spectrum Disorders (cont’d.) Social and sociocultural dimensions: Family variables Controlling, overly critical parenting styles Low parental warmth Discouragement of autonomy Culture may affect how symptoms are expressed Minorities are underrepresented in clinical studies *