Panic Disorder Anxiety that turns the corner into terror Bouts of panic that come on suddenly, often...
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Transcript of Panic Disorder Anxiety that turns the corner into terror Bouts of panic that come on suddenly, often...
Panic Disorder
• Anxiety that turns the corner into terror• Bouts of panic that come on suddenly, often
with little or no warning• Include some of the following: heart
palpitations; tingling in hands, feet; shortness of breath, sweating, hot & cold flashes; trembling; chest pains; faintness; dizziness; feeling of unreality.
Panic Disorder
• Recurring bouts of panic dysfunctional changes in thinking & behavior
• Fears of “losing my mind”
• Avoidance of increasing # of places/things
• Panic Disorder can lead to agoraphobia
Panic Disorder
• What Causes Panic Disorder? – We don’t really know; many factors.
• But: Strong evidence that norepinephrine is involved.
• Norepinephrine: neurotransmitter especially active in Locus ceruleus part of the brain.
• Digression….
Models of Abnormality
Biological model
How the brain’s anatomy & physiology affect emotions, cognitions & behavior
Models of Abnormality
Biological model: Anatomy (structures)
Neo-Cortex
Corpus callosum
Amygdala
Locus ceruleus
Panic Disorder
• Anti-depressant drugs that regulate norepinephrine successful in treating panic
• When Locus ceruleus stimulated in monkeys panic like behavior
• Locus ceruleus rich in norepinephrine carrying neurons
• Hypothesis: Norepinephrine dysregulation may well be implicated in Panic Disorder
Panic Disorder
• Anti-depressant drugs
• Exposure-based treatment
• Support groups to venture out & gradually reduce avoidance behaviors
• Cognitive treatments to reduce focus on, and misinterpretation of bodily signals
Treatment
Obsessive-Compulsive Disorder
Obsession: Uncontrollable thoughts, ideas, impulses
Compulsion: Rigid, repetitive acts used to reduce anxiety
Example: “Germs are everywhere. I know they are. I better go wash my hands 53 times one more time.”
Obsessive-Compulsive Disorder
• We all harbor some O-C behaviors – can you think of any?
• O-C Disorder: When they become excessive and interfere with daily functioning.
• Equally common in men and women.
• Often associated with depression.
Obsessive-Compulsive Disorder
Obsessions: Can take the form of wishes, impulses, images, ideas, or doubts.
Common Obsessions: Dirt & germs; violence; inappropriate vocalizations; sexuality.
Obsessive-Compulsive Disorder
Compulsions: Usually recognized as unreasonable; yet cannot be ignored or avoided.
Suffer dreads horrible consequences if they abandon the compulsive behavior.
Common Compulsions: Hand washing; cleaning; “checking”; “ordering”; my friend & his backpack.
Obsessive-Compulsive Disorder
• Anxiety rooted in repressed ID impulses• Impulses = obsessive thoughts• Compulsions = ego defenses against them• E.g.: Lady Macbeth: Anxiety/guilt over
her part in a murder compulsive hand washing to get rid of the imagined blood.
• How would you treat Lady Macbeth?
Psychodynamic Perspective
Obsessive-Compulsive Disorder
• Focus on compulsions, not obsessions• Theory: association forms randomly between
fear/anxiety reduction and the compulsive behavior
• Compulsive behavior becomes reinforcing because it reduces anxiety
• Therefore compulsion increases in frequency
Behavioral Perspective
Obsessive-Compulsive Disorder
• Behavioral treatment: break the link between anxiety & compulsive behavior
• Induce anxiety, prevent the compulsive behavior
• Eventually, the link is broken• However, treatment does not address the
underlying obsessions
Behavioral Perspective
Obsessive-Compulsive Disorder
• Focus on OCD as a mental phenomenon
• Compulsive thoughts/acts are those that reduce “bad” thoughts & are therefore reinforced, becoming compulsions
• CBT researchers have demonstrated strong link between OCD & depression
Cognitive Perspective
Obsessive-Compulsive Disorder
• CBT Treatment: Habituation Training, a form of exposure
• Elicit anxiety-provoking thoughts repeatedly to diminish their power
• Then, use distraction to prevent use of compulsions to alleviate anxiety
Cognitive Perspective
Obsessive-Compulsive Disorder
• Drugs that increase Serotonin activity are somewhat effective in treating OCD
• Serotonin is also active in 2 brain areas that have been associated with OCD: the orbital region of the frontal cortex and caudate nucleus
Biological Perspective