Unit 12/13: Mental Illness and Therapies CHS AP Psychology Unit 12/13: Mental Illness and Therapies Essential Task 12/13.3:Discuss the major diagnostic category of anxiety disorders with specific attention to the diagnoses of panic disorder, agoraphobia, social phobia, specific phobias, OCD, GAD and PTSD, detail the defining symptoms of each and identify the best approach(es) for explaining the cause(es) of each. Logo Green is R=8 G=138 B=76 Blue is R= 0 G=110 B=184 Border Grey is R=74 G=69 B=64

Anxiety Disorders Panic Disorder Agoraphobia Social Phobia Specific Phobia Obsessive Compulsive Disorder Generalized Anxiety Disorder (PTSD & Acute Stress Disorder)

Panic Attack (not a diagnosis) A. Discrete period of intense fear or discomfort, in which 4 or more of the following develop abruptly and reach a peak within 10 minutes Palpitations Sweating Trembling/aching Sensations of shortness of breath or smothering Feeling of choking Chest pain/discomfort Nausea/abdominal distress Feeling dizzy/unsteady/lightheaded/faint Derealization/depersonalization Fear of losing control/going crazy Fear of dying Paresthesias (numbness or tingling sensation) Chills/hot flushes

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.

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

Agoraphobia (not a diagnosis) A. Anxiety about being in places or situations from which escape might be difficult or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms. B. The situations are avoided or are endured with marked distress C. Not better accounted for by another mental disorder

Social Phobia A. Marked, persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way that will be humiliating or embarrassing. B. Exposure to the feared social situation almost invariably provokes an anxiety response C. The person recognizes that the fear is excessive or unreasonable D. The phobic stimulus is avoided or endured with intense anxiety or distress E. There is significant distress or an impairment in functioning

Specific Phobia A. Marked, persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation B. Exposure to the phobic stimulus almost always provokes an immediate anxiety response C. The person recognizes that the fear is excessive or unreasonable D. The phobic stimulus is avoided or endured with intense anxiety or distress E. There is significant distress or an impairment in functioning due to the phobia F. The phobia is not better accounted for by another mental disorder

Subtypes of Specific Phobia Animal type Natural environment type Blood-Injection-Injury type Situational type Other type

Kinds of Phobias Acrophobia: Heights Aquaphobia: Water Gephyrophobia: Bridges Ophidiophobia: Snakes Aerophobia: Flying Arachnophobia: Spiders Herpetophobia: Reptiles Ornithophobia: Birds Agoraphobia: Open spaces Astraphobia: Lightning Mikrophobia: Germs Phonophobia: Speaking aloud Ailurophobia: Cats Brontophobia: Thunder Murophobia: Mice Pyrophobia: Fire Amaxophobia: Vehicles, driving Claustrophobia: Closed spaces Numerophobia: Numbers Thanatophobia: Death Anthophobia: Flowers Cynophobia: Dogs

Good Question… If phobias are learned behaviors, why don’t they extinguish on their own???

Answer to the Good Question… Avoidance works! Fear is never tested

Obsessive-Compulsive Disorder Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress. OBJECTIVE 8| Describe the symptoms of obsessive-compulsive disorder.

Obsessive-Compulsive Disorder Obsessions as defined by 1, 2, 3, and 4 Recurrent, persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress The thoughts, impulses, or images are not simply excessive worries about real-life problems The person attempts to ignore or suppress such thoughts, impulses, or images or tries to neutralize them with some other thought or action The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind

Typical Obsessions Doubts (e.g. Did I turn off the stove? Did I lock the door? Did I hurt someone?) Fears that someone else has been hurt or killed Fears that one has done something criminal Fears that one may accidentally injure someone Worry that one has become dirty or contaminated Blasphemous or obscene thoughts NOT just excessive worries about real-life problems

Obsessive-Compulsive Disorder Compulsions as defined by 1 and 2 Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly The compulsions are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

Typical Compulsions Checking Cleaning/washing Doing things a certain number of times in a row Doing and then undoing things Doing things in a certain order, with symmetry Mental acts such as praying, counting, etc.

Obsessive-Compulsive Disorder The person has recognized that the obsessions or compulsions are excessive or unreasonable There is significant distress or an impairment in functioning due to the obsessions or compulsions If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to the other Axis I disorder The disturbance is not due to a GMC or substance

OCD in Children Children have an average of 4 obsessions and 4 compulsions at any given time Often comorbid with Tourette’s syndrome and/or ADHD

Generalized Anxiety Disorder (GAD) Excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events The person finds it difficult to control the worry The anxiety and worry are associated with 3 or more of the following symptoms Restlessness or feeling keyed up or on edge Being easily fatigued Difficulty concentrating or mind going blank Irritability Muscle tension Sleep Disturbance

Generalized Anxiety Disorder (GAD) D. The focus of the anxiety and worry is not confined to features of another disorder and do not occur exclusively during PTSD E. There is clinically significant distress or impairment in functioning F. Not due to a GMC or substance

Post-Traumatic Stress Disorder A. The person has been exposed to a traumatic event and have experienced four or more weeks of one or more of the following symptoms: Haunting memories 2. Nightmares 3. Social withdrawal OBJECTIVE 9| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency. 4. Jumpy anxiety 5. Sleep problems

Anxiety Disorders - Overview Most common mental disorders in the U.S. At least 19% of the adult population suffer from at least one anxiety disorder in any given year All are more common in women, except for OCD Except for Panic Disorder, ages of onset are most likely going to be in childhood or adolescence (but do not have to be) Anxiety Disorders cost $42 billion each year in health care, lost wages, and lost productivity