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Anxiety and Mood Disorders
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Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Apr 01, 2015

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Sonia Presswood
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Page 1: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Anxiety and Mood Disorders

Page 2: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Anxiety Disorders

Primary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Anxiety - diffuse, vague feelings of fear and apprehension everyone experiences it becomes a problem when it is irrational,

uncontrollable, and disruptive

Page 3: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Generalized Anxiety Disorder (GAD)

More or less constant worry about many issues

The worry seriously interferes with functioning

Physical symptoms headaches stomachaches muscle tension irritability

Page 4: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Model of Development of GAD

GAD has some genetic componentRelated genetically to major depressionChildhood trauma also related to GAD

Genetic predispositionor childhood trauma

GAD following life change or major event

Hypervigilance

Page 5: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Phobias

Intense, irrational fear that may focus on: category of objects event or situation social setting

Page 6: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Phobias It is not phobic to simply be anxious about something

Afraid of it Bothers slightly Not at all afraid of it

Beingclosed in,

in a smallplace

Being alone

ina houseat night

Percentageof peoplesurveyed

100

90

80

70

60

50

40

30

20

10

0Snakes Being

in high,exposedplaces

Mice Flyingon an

airplane

Spidersand

insects

Thunderand

lightning

Dogs Drivinga car

Being in

a crowdof people

Cats

Study of normal anxieties

Page 7: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Specific Phobias

Specific phobias - fear of specific object animals (e.g., snakes) substances (e.g., blood) situations (e.g., heights) more often in females than males

Page 8: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Some Unusual Phobias

Ailurophobia - fear of catsAlgobphobia - fear of painAnthropophobia - fear of menMonophobia - fear of being alonePyrophobia - fear of fire

Page 9: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Social Phobias

Social phobias - fear of failing or being embarrassed in public public speaking (stage fright) fear of crowds, strangers meeting new people eating in public

Considered phobic if these fears interfere with normal behavior

Equally often in males and females

Page 10: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Development of Phobias

Classical conditioning model e.g., dog = CS, bite = UCS problems:

often no memory of a traumatic experiencetraumatic experience may not produce

phobia

Seligman’s preparedness theory

Page 11: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Obsessive-Compulsive Disorder (OCD)

Obsessions - irrational, disturbing thoughts that intrude into consciousness

Compulsions - repetitive actions performed to alleviate obsessions

Checking and washing most common compulsions

Heightened neural activity in caudate nucleus

Page 12: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Panic Disorder

Panic attacks - helpless terror, high physiological arousal

Very frightening - sufferers live in fear of having them

Agoraphobia often develops as a result

Page 13: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Posttraumatic Stress Disorder (PTSD)

Follows traumatic event or events such as war, rape, or assault

Symptoms include: nightmares flashbacks sleeplessness easily startled depression irritability

Page 14: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Mood Disorders

Depressive disorders depression of mood

Bipolar disorders cycling between depression and

mania (extreme euphoria)

Page 15: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Depression

Symptoms include: sadness feelings of worthlessness changes in sleep changes in eating anhedonia suicidal behavior

Page 16: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

DepressionMajor Depression

prolonged, very severe depression lasts without remission for at least 2 weeks

Dysthymia less severe, but long-lasting depression lasts for at least 2 years

Can have both at the same timeWomen diagnosed far more often than men

Page 17: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Biological Bases for Depression

Neurotransmitter theories dopamine norepinephrine serotonin

Genetic component more closely related people show

similar histories of depression

Page 18: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Situational Bases for Depression

Positive correlation between stressful life events and onset of depression Is life stress causal of depression?

Most depressogenic life events are losses spouse or companion long-term job health income

Page 19: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Cognitive Bases for Depression

A.T. Beck: depressed people hold pessimistic views of themselves the world the future

Depressed people distort their experiences in negative ways exaggerate bad experiences minimize good experiences

Page 20: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Cognitive Bases for Depression

Hopelessness theory depression results from a pattern of thinking person loses hope that life will get better negative experiences are due to stable,

global reasonse.g., “I didn’t get the job because I’m stupid and

inept” vs. “I didn’t get the job because the interview didn’t go well”

Page 21: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Seasonal Affective Disorder

Cyclic severe depression and elevated mood

Seasonal regularityUnique cluster of symptoms

intense hunger gain weight in winter sleep more than usual depressed more in evening than morning

Page 22: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Bipolar Disorders

Cyclic disorders Mood levels swing from severe depression to

extreme euphoria (mania) No regular relationship to time of year (like SAD) Bipolar disorder is severe form Cyclothymia is less severe form Strong heritable component Bipolar disorder often treated with lithium

Page 23: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Somatoform Disorders

Bodily ailments in absence of any physical disease

Examples are conversion disorder and somatization disorder

Page 24: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Psychological Influences on Physical Symptoms

and Diseases

Page 25: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Conversion Disorder

Person temporarily loses some bodily function blindness, deafness,

paralyzed portion of body

glove anesthesia

No physical damage to cause problems

Page 26: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Conversion Disorder

Rare in western culture now relatively common 100 years ago prominent in Freud’s work/clients

Often see examples in non-Western people exposed to traumatic event e.g., high rate of psychological blindness in

Cambodian women after Khmer Rouge reign of terror in 1970s

Page 27: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Somatization Disorder

Long history of dramatic complaints re: different medical conditions complaints usually vague, undifferentiated e.g., heart palpitations, dizziness, nausea

Often difficult to determine whether complaints are somatization or undetectable physical disease

Page 28: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Somatization Disorder

Kleinman’s theory somatization and depression are

different manifestations of the same problem

cross-cultural research

pattern of somatoform disorders affected by cultural beliefs

Page 29: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Psychological factors and medical condition

Traumatic Grief studied people’s health before and

after death of spouse 25 months following death of a

spousesurviving spouses had increased

incidences of flu, heart disease, cancer

Page 30: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Psychological factors and cardiovascular disease

Friedman & Rosenman’s studies type A personality

competitive, aggressive, easily irritated, impatient, workaholic

have shown increased risk for heart attackbiggest personality risks are the irritability

and hostility, not the hurried life-style

Page 31: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Friedman & Rosenman’s studiesType B personality

opposite of type A, more relaxed Have shown low risk for heart attack

Anxiety and depression also predictive of heart disease

Conclusion prolonged, frequent negative emotions increase

risk of heart disease hard working people who enjoy what they’re

doing not at higher risk

Page 32: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Immune function & emotional distress

Emotional distress shuts down some bodily defenses against pathogens makes person more vulnerable to infectious

diseases

Some studies temporary decrease in T-cells following

frustrating cognitive task only in people who also showed other signs of

physiological distress to task

Page 33: Anxiety and Mood Disorders. Anxiety Disorders zPrimary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety zAnxiety.

Exposed group of people to cold virus

Quarantined for 6 days

Distressed develop cold more easily

Not due to other risk factors like: smoking diet sleep

Cohen, et al. (1991)

11-12

Score on psychological distress scale

3-4 5-6 7-8 9-10

50

45

40

35

30

25P

erce

nta

ge

wh

o d

evel

op

ed c

old

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