Mood Disorders Flashcards
(41 cards)
Anxiety Disorders
Wittchen et al., 2011
14% of people across Europe are estimated to have anxiety disorders - the most common of all mental illnesses
Gender differences in anxiety disorders
Anxiety disorders occur more commonly in females than males
Narrow, Rae, Robbins, and Regier, 2002
– In 70% cases anxiety disorders care considered clinically significant e.g., they interfere significantly with life functions causing the person to seek medical or psychological treatment
Biological factors in Anxiety disorders - twin study
Identical MZ twins have a concordance rate of 21.5% compared to 13.5% in DZ twins (Andrews et al., 1990)
Barlow, 2002
Genetic vulnerability may be down to the ANS overreacting to a perceived threat creating high levels of physical arousal
Smoller, 2016
Two genes modulating homeostasis may play a role
Mineka et al., 1998
– Hereditary factors may cause over reactivity of NT systems (such as GABA – which is also known to be involved in PD) involved in emotional responses
Support from Bremner, 2000
– Low levels of GABA may cause people to have highly reactive nervous systems that quickly produce anxiety responses to stressors
Goddard et al., 2001
– People with a history of panic attacks have 22% lower concentration of GABA in the occipital cortex than age matched controls without PD
Craske, 2003 - sex-linked condition
Sex differences in anxiety emerge as early as 7. Suggests a sex linked biological predisposition for anxiety disorders however social conditions that give women less power and personal control may also contribute
Psychological factors - Freud
neurotic activity occurs when unacceptable impulses threaten to overwhelm the ego’s defenses and explode into the consciousness
Evidence from Little Hans study
In phobic disorders neurotic anxiety is displaced onto an external stimulus e.g., little Hans’ fear of horses
Psychoanalysts
Psychoanalysts believe that obsessions and compulsions are ways of handling anxiety e.g., in OCD when there is a compulsion of hand washing is a way of dealing with one’s ‘dirty’ sexual impulses
Why does general anxiety disorder (GAD) and Personality disorder (PD) occur according to psychanalysts?
GAD and PD are thought to occur when one’s defenses are not strong enough to control or contain neurotic anxiety
Cognitive factors in Anxiety disorder
Role of maladaptive thought patters and beliefs in anxiety disorders
People with anxiety catastrophise about demands and magnify them into threats
They anticipate that the worst will happen and feel powerless to cope effectively (Clark, 1988)
Intrusive thoughts about the previous traumatic event are a central feature of PTSD and the presence of such thoughts after the trauma predicts later development of PTSD (Falsetti et al., 2005)
PD results from catastrophic misinterpretation (Clark, 1986, 1988)
Anxiety responses lead to increased anxiety responses
The person becomes hypervigilant where their sensitivity to physical changes is increased
Person uses avoidance to avoid the sensations
However, some people report that they do not engage in catastrophic misrepresentation
Treated with CBT which can included exposure therapy, desensitization, and flooding with the goal of retraining the person to see their physical sensations as being relatively normal
How does classical conditioning contribute to the development of anxiety disorder?
Some fears are acquired as a result of traumatic experiences that produce as classically conditioned fear response (Rachman, 1998)
However, some people with anxiety have never had a traumatic experience with the phobic object or situation they now fear (Bruce and Sanderson, 1998)
How does operant conditioning contribute to anxiety disorder?
Behaviours that are successful in reducing anxiety such as compulsions or phobic avoidance responses become stronger through negative reinforcement
This prolongs the problem as it prevents the learned anxiety response from being extinguished
How does observational learning contribute to anxiety disorder?
May be mediated by cognitive and biological factors whether someone develops a phobia from observing or hearing about a traumatic event
Once anxiety is learned it may be triggered by cues from internal (thoughts or images; Pitman et al., 2000) or external cues
Phobic reactions tend to result from external cues and panic reactions tend to result from internal ones (Clark, 1986)
Socio-cultural factors in anxiety disorder
Culture bound disorders e.g., social phobia in Japan called Taijin Kyofushu (Begum and McKenna, 2010) in which people are pathologically fearful of offending others by emitting offensive odours, blushing, staring inappropriately or having a blemish or improper facial expression
This has been attributed to the Japanese value of extreme interpersonal sensitivity and to cultural prohibitions against expressing negative emotions or causing discomfort in others (Kleinknecht et al., 1997)
Eating disorders such as anorexia nervosa is found almost exclusively in developing countries which being thin has become a cultural obsession (Becker et al., 1999)
Phobic disorders
What are they?
Where are they most common?
When do they arise?
Strong and irrational fears of certain objects or situations.
Most common in the West: agoraphobia, social phobias, specific phobias e.g., of dogs, snakes, water, injections
Animal phobias are most common among women and fear of heights are most common among men (Curtis et al., 1998)
Many arise during childhood, adolescence, and early adulthood
Once they develop, they rarely go away on their own and may get worse over time (Beck, Emery and Greenberg, 2005)
Generalised anxiety disorder (GAD)
Chronic ongoing state of anxiety that is not attached to specific situations or objects
May last for months with signs almost continually present
Interfere significantly with daily functioning
Difficulty concentrating, making decisions, and remembering commitments
Tends to occur in childhood and adolescence (Wittchen et al., 1994
Panic Disorder
Panic attacks appear suddenly in the absence of any identifiable stimulus (Clark and Beck, 2010)
60% of people with daytime panic attacks also experience panic attacks during sleep
7.9 million Europeans are predicted to suffer from PD
CBT is regarded as long term and effective treatment but medical treatments such as anti-depressants have also been shown to be effective
Can lead to people developing agoraphobia as they fear they will have a panic attack in public
Danger that these will be seen as two separate things when they are very interlinked (Pompoli et al., 2018)
Some have been known to remain housebound for years at a time (Davey, 2008)
OCD
Usually consists of obsessions (repetitive and unwelcome thoughts, images or impulses that invade consciousness and are difficult to dismiss or control) and compulsions (repetitive behavioural responses such as rituals or repetitive checking of light switches or door locks that are difficult to resist)
These can occur separately
Compulsions are often responses that function to reduce the anxiety associated with the intrusive thoughts (Clark and O’Connor, 2005)
Compulsions are strengthened through negative reinforcement because they allow the person to avoid anxiety
Where the thoughts (obsessions) combine with actions (compulsions) there is a situation of Thought Action Fusion (TAF). The thought is equated with the action e.g., ‘if I don’t do this, I will get ill’
1.1 % of the population (Torres et al., 2006) but DeSilva estimates it at 3%
Significant co morbidity with depressive episodes, panic disorders and phobias
OCD was significantly higher in people with other neuroses – 10% (Torres et al., 2006)
PTSD
What are the 4 major symptoms? (Falsetti et al., 2009)
Severe anxiety disorder that can occur in people who have been exposed to a traumatic life event
Four major symptoms (Falsetti et al., 2009)
Severe symptoms of anxiety, arousal and distress that were not present before the trauma
Relives trauma recurrently in flashbacks, dreams or fantasies
Becomes numb to the world and avoids stimuli that serves as a reminder to trauma
Intense survivor guilt in instances where others were killed, and individual was spared
