Summary Course 1.6 Diagnostic psychology. Normal or Abnormal

1.6.C Normal or Abnormal

1.6.1 Just scared?


DSM: Diagnostic and statistical manual of mental disorder

 Classification system
 Symptoms
 Used universally, mainly in the US
 Psychologist, psychiatrists etc.

Anxiety:

general feeling of distress without any immediate danger or threat

great apprehension about possible future dangers

 Can’t specify what danger is/what they are afraid off
 response absent of visual danger → panic attack → like fear and subjective sense
doom, loose control, die, insane
 More common in women

cognitive subjective level: negative mood, worry possible future threat, self preoccupied,
unable to control

physiological level: tension and chronic overarousal→ risk deal dangereous situation →
prepare person for it

 Does not produce fight or flight response

Behavioral level: avoid situation of danger encountered but no immediate urge

→ mild/ moderate level adaptive and performance better

chronic and severe→ maladaptive and inhibit performance

most common source for fear is conditioning when an initial neutral stimulus is associated
with negative xeperience

Fear: basic emotion, escape from immediate danger

 Activates fight or flight response
 alarm reaction
 source of danger known

Similarities between anxiety and fear

 Behavioral component→ urge to flee because of Threat
 Cognitive/subjective components (“I feel afraid”)

,  Physiological components (e.g. increased heart rate)

Difference between anxiety and fear

 Anxiety - anticipation of future threat
 Fear - perceived threat
 Behavioral components
o Anxiety - avoid situation/feelings
o Fear - urge to escape

What are anxiety disorders?

 Irrational fears, unrealistic
 Disables daily function
 LT → chronic stress

What do they have in common

In what aspects do they differ

Specific Phobia

 Strong fear triggered by presence of specific object/situation
 faced phobia→ immediate fear and interfere with daily activity
 E.g. claustrophobia
 Go to great lengths to avoid phobia
 Drop in blood pressure and heart rate, display nausea and dizziness

5 categories

 Natural environment (storm, water)
 Animal (snakes, sharks, spiders)
 Blood-injection-injury
 Situational (public transportation, bridges)Other (vomiting, choking)




F. fear, anxiety causes clinically significant distress/ impairmeb´nt of social, occupational and
other improtant areas of functioning

G. the diaturbance is not better explained by another mental disorder

Prevalence/ age of onset / gender differences

 Childhood (blood-injection-injury, animals)
 Adolescence/early adulthood (claustrophobia, driving phobia)
 More common in women

Psychological causal factors ( why does it occur )

,  Conditioning
o Classical conditioning (experiencing)
o Vicarious conditioning (observing someone else)
o Operant conditioning (reward and punishment)
 Psychoanalytic view - defense against anxiety which stems from repressed impulses
from id
 Modeling (how parents react)

Evolution ( causes and influences )

 Prepared learning: evolutionary preparedness for certain phobias
o Snakes, water, heights

Biological factors ( causes and influences )

 Genes
o S allele: neurotic (more sensitive to fear and development of phobia)
 Twin study: monozygotic twins more likely to share phobia than dizygotic twins

Treatments

 Exposure therapy: controlled exposure to phobic stimuli→ break association fear
and object
o Participant modeling: observe clinician being exposed to object/sit.and model
appropriate behavior → show fear irrational
o Systematic desentization: practice breathing exercises & fear hierarchy after
teach → expose least fearful to most fearful
o use relaxation techniques to calm the patient
o fear and relaxation can not occur at the same time → learn replace fear with
relaxation
o vivo exposure: presence object in person **
o Imaginal exposure: imagining the object or situation → less intensive and less
effective
o Flooding: exposure to most feared object/situation - no fear hierarchy
o use vivo/ imaginal exposure
o more intensive and more likely client drop out of treatment
 Medication
o Does not seem to be effective
o Can enhance effects of exposure therapy

Social Phobia ( Social anxiety disorder )

 Fear individuals face in a social situation
 Feared of being negatively evaluated or criticised→ worry anxiety smptoms
apparent to others
 sign anticipatory fear days or weeks before social event occur
 Focused on themselves, internalized
 Try to avoid social situation or endure them
 Speaking in public, eating in front of others etc.

, 




Prevalence/ age of onset / gender differences

 More common in women
 Begins in adolescence
 Comorbidity: 50% suffering from social phobia also suffer from depression
 Persistent: 12 year study - 37% recovered

Psychological causal factors ( why does it occur )

 Learned behavior: direct of vicarious classical conditioning
 Cognitive biases
o Expect to be rejected and to become negatively evaluated (internalized danger
schemas)
o Amygdala shows greater activation to negative faces

Evolution ( causes and influences )

 Dominance hierarchy

Biological factors ( causes and influences )

 Genetics and interaction environment and temperaments
o High heritability (30%)
o Neurobiological structures:

3. Amygdala→ store memory related to emotional events

o fearful situation HPA axis triggered by amygdala prepare for immediate
action→ fight or flight

2. hippocampus and prefrontal cortex: pathway activated fear stimulus

send signal to hippocampus and PFC→ determine if threath is imagined or real

o Environment plays a more important role
o Behavioral inhibition: specific characteristics - introversion and neuroticism

Treatments

 Exposure therapy→ encoruage engage in social situations which cause anxiety
 clinicina start role lay various social situations in safe environment
 patient get used to it→ go outside and start talking to strangers in public places
(practice outside of therapy as well)
 Medication