Class Notes

Lillian Hsu
Abnormal Psychology
Unit 2

02.13.12
Feared Outcome→Safety Behavior
-Heart attack→check pulse, breathe deeply
-Negative evaluation from others→no eye contact, not talking
-Being assaulted→avoiding going out in public
-Burning down the house→re-checking stove, iron
-Child abducted→picking up in frnt of school-
-Going insane→suppressing thoughts
-suffocation→water bottle,loose clothing
-freezing up during conversation→drink alcohol, rehearse lines

Safety Behaviors
-do these safety behaviors actually prevent catastrophes from occurring?
-when is the last time you’ve heard of a social phobic die of embarrassment, a patient experience a heart attack during a panic attack, a claustrophobic patient suffocate in an elevator, or an OCD patient get deathly ill fromtouching a doorknob?

The Neurotic Paradox
-if these feared catastrophes consistently fail to occur, why do anxious individuals not reazlie this and abandon their fears
-what’s preventing them from learning form their own experience?

Maintenance of Anxiety Disorders
-the non-occurrence of feared catastrophes is attributed to safety behaviors rather than to the fact that catastrophe wouldprobably not have occurred anyways
-in this manner, safety behaviors maintain anxiety disorders by preventing the disconfirmation of erroneous beliefs
-in other words, they prevent irrational fears from naturally self-correcting over time

Panic Attacks
-40% of the population will experience a panic attack within a given year
-time window→10 minutes with persisting symptoms
-common inall anxiety disorders
-can occur in response to an obvious trigger or for no apparent reason
-what do you conclude is happening, or what would you do to feel safe if you experience a panic attack for no reason?
-around 33% of ER visits can be accounted for by panic attacks

Diagnosing Panic Disorder
-DSM-IV diagnostic criteria:
-recurrent, unexpected panic attacks
-at least 1 month ofpersistent concern about additional attacks, worry about implications of attacks, change in behavior related to the attacks

Statistics
-lifetime prevalence; 3.5%
-twice as common in women
-1/3 also have Agoraphobia (75% of whom are women)
-typical age onset: mid-teens through 40

Treatment
-medications
-psychotherapy: cognitive-behavioral therapy (CBT)
-combined treatment (CBT and drugs)Panic Disorder Medications
-antidepressants and benzodiazepines
-most common treatemnts
-short-term effectiveness
-problems with side effects, drop outs, relapse
-DRUGS ARE EFFECTIVE

CBT for Panic Disorder
-cognitive-behavioral therapy components
-education about the anxiety/panic response
-disputing/modifying erroneous beliefs
-exposure to feared body sensations
-exposure tofeared activities and places
-elimination of safety behaviors

Obsessive-Compulsive Disorder
-obsessions: unwanted, distressing, intrusive thoughts, images, or urges
-cause anxiety
-contamination, aggressive, symmetry/order, religious/morality, somatic, hoarding/saving
(NOT considered OCD)
-NOT an obsession
-any thought that is not distressing or inconsistent with yourbeliefs/values
-being “obsessed” with sex, grades, high performance, matters of morality, etc.
-compulsions: thoughts or actions used to neutralize obsessions and reduce anxiety
-reduce anxiety and/or prevent feared catastrophes
-checking, cleaning, washing, ordering, arranging, mental rituals (mental compulsion), repeating, counting, hoarding

02.15.12
OCD
-pervasive need to re-check things-NOT compulsions
-actions that do not reduce anxiety caused by an obsession
-“compulsive” shopping, eating, drinking, masturbation, etc.
-compulsive cleanliness, orderliness; perfectionistic studying
-DSM-IV criteria
-either obsessions or compulsions
-recurrent obsessions
-obsessions are not just excessive worries
-attempts to ignore, suppress, or neutralize obsessions
-recognizes...