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

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

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

Caudate nucleus Orbital frontal cortex