OUTLINE FOR LECTURE NOTES IN PSYC 405

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Chapter 4

Chapter 4: Anxiety Disorders, Trauma and Stress Related Disorder, Obsessive-Compulsive and Related Disorders

I. Introduction

....A. Basic Terms

..........1. Fear

..........2. Anxiety

..........3. Panic attack and the DSM concept of "Episode"

....B. Causes of Anxiety: Triple Vulnerability Model

..........1. General Biological vulnerability factors

..............a. Genetic vulnerability

..............b. Neurobiological factors

..........2. General psychological vulnerability factors

..............a. Sense of "uncontrollability"

..............b. Cognitive/Behavioral conditioning

..........3. Specific psychological vulnerability

..............a. Stress (personal and social)

....C. The Anxiety Disorders

..........1. Essential characteristics = excessive anxiety, obviously apparent

..........2. Types

..............a. Generalized Anxiety Disorder (GAD).

...................1. Symptoms

...................2. Characteristics: Autonomic Restrictor

...................3. Causes

...................4. Treatment

........................a. Biological

........................b. Psychosocial (Choice)

..............b. Panic Disorder (And Agoraphobia)

..................1. Symptoms

.......................a. Panic Attack (Usually unexpected)

..................2. Characteristics

..................3. Causes

.......................a. Biological factors: BIS (Behavioral Inhibitory System)

.......................b. Psychosocial factors: Real and False Alarms = Learned Alarm

..................4. Treatment: CBT

..............c. Specific Phobia

..................1. Symptoms (Usually expected)

..................2. Characteristics: Expected panic

..................3. Causes

..................4. Treatment: Exposure

..............d. Social Anxiety Disorder

..................1. Symptoms

..................2. Characteristics

..................3. Causes

..................4. Treatment: Meds, CBT

....C. Trauma and Stress Related

.........1. Symptoms

..............a. Exposure to actual or threatened death, serious injury, or sexual violation

..............b. Types (Onset time is factor)

...................1. Acute Stress Disorder = onset < 1 month

...................2. Posttraumatic Stress Disorders > 1 month

...................3. Delayed onset PTSD > 6 months

.........2. Characteristics

.........3. Causal factors (Triple Vulnerability Model again)

.........4. Treatment

..............a. Psychological Imaginative exposure (Choice)

..............b. Biological

....D. Adjustment Disorder (Most common DX)

.........1. Symptoms

............a. Distress in response to identifiable event in last 3 months

............b. Severity, social-occupational impairment

.........2. Characteristics & Causes = life

.........3. Treatment = ventilation, support

....E Obsessive-Compulsive and Related Disorders

.........1. OCD

..............a. Symptoms

..............b. Characteristics

..............c. Causes

...................1. Biological (Cingulate area)

...................2. Psychological (Thought-action fusion)

..............d. Treatment

...................1. Biological

...................2. Psychological = CBT (Choice)

...................3. Concept of SPECIFIER (Degree of insight or severity)

.........2. Body Dysmorphic (Some delusionality)

.........3. Others: Tics, Tourette's, Hoarding

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