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Panic Disorder

Panic Disorder. Anxiety that turns the corner into terror Bouts of panic that come on suddenly, often with little or no warning

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Panic Disorder

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  1. 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.

  2. 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

  3. 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….

  4. Models of Abnormality Biological model How the brain’s anatomy & physiology affect emotions, cognitions & behavior

  5. Models of Abnormality Biological model: Anatomy (structures) Neo-Cortex Corpus callosum Amygdala Locus ceruleus

  6. Models of Abnormality Biological model: Physiology (processes) Nerve impulse

  7. 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

  8. Panic Disorder Treatment • 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

  9. 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.”

  10. 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.

  11. Obsessive-Compulsive Disorder Obsessions: Can take the form of wishes, impulses, images, ideas, or doubts. Common Obsessions: Dirt & germs; violence; inappropriate vocalizations; sexuality.

  12. 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.

  13. Obsessive-Compulsive Disorder Psychodynamic Perspective • 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?

  14. Obsessive-Compulsive Disorder Behavioral Perspective • 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

  15. Obsessive-Compulsive Disorder Behavioral Perspective • 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

  16. Obsessive-Compulsive Disorder Cognitive Perspective • 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

  17. Obsessive-Compulsive Disorder Cognitive Perspective • 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

  18. Obsessive-Compulsive Disorder Biological Perspective • 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

  19. Caudate nucleus Orbital frontal cortex

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