Term
| Panic Disorder Statistics |
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Definition
8-10% of people who have panic attacks don't have panic disorder (disorder requires frequency and constantly worrying about future attacks, possibly avoiding places due to worry)
1.5-3.5% of the population have panic disorder. Onset is usually between adolecence and 3os |
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Term
| Panic Disorder COMMON SITUATIONS |
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Definition
People with panic disorder frequently avoid:
-crowded or busy places
-enclosed spaces
-wide open spaces
all fall into the category or agoraphobia
deal with embarassment and shame at the idea of people witnessing hteir attack or not being able to escape quickly if one comes on.
PD tend to become a chronic condition if it's not treated |
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Term
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Definition
| Safety signals are sometimes used in panic disorder as a coping stratefy. Sometime safe places or people are identified and can help mitigate a potential attack |
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Term
| Panic Disorder Coping Strategies |
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Definition
Maladaptive- drinking
Adaptive- safety signals |
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Term
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Definition
| Panic disorder patients are more likely to seek treatment for agoraphobia than they are initially for PD |
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Term
| Theories why Panic Disorder Develops (list) |
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Definition
1) Oversensitive nervous system
2) Hypersensistivity to CO2
3) Neurotransmitters
4) Genetics |
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Term
Theories why Panic Disorder Develops -
Oversensitive nervous system |
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Definition
Biological theory of Panic disorder
shaking, dizzyness, heart rate are all symptoms of sympathetic arousal
Theory is that people might have oversensitive sympathetic nervous systems
everyone has different SNS rxns. People with PD will have a lower threshhold for stress stimuli and a greater SNS response.
Mild simulated stress in a lab test can trigger a panic attack in someone with PD but not in someone without |
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Term
Theories why Panic Disorder Develops -
Hypersensitivity to CO2 |
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Definition
CO2 is a metabolic byproduct all bodies produce. Needs to be kept in balance. Heart rate and respiration increase to take in and circulate more O2 in response. Sympathetic nervous system activates this rxn when CO2 levels get too high in the brain.
People with PD might get SNS activation from even mild CO2 increases |
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Term
Theories why Panic Disorder Develops -
Neurotransmitters |
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Definition
Pharmacutical trials have shown that Panic Disorder can be improved with antidepressants. This suggests that neurotransmitters are involved.
Trycyclic Antidepressants
SSRIs
Benzodiazapines
all shown to help which suggests invovlement of seratonin, neurepinephrine,and GABA |
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Term
| Tricyclic Class of Antidepressants |
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Definition
block the reuptake of seratonin and neurepinephrine
effective in helping symptoms of panic disorder suggesting that neurotransmitters play a role in panic attacks |
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Term
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Definition
Selective seratonin reuptake inhibitors
effective in helping symptoms of
panic disorder suggesting that neurotransmitters play a role in panic attacks |
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Term
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Definition
Highly addictive, mild tranquilizers. Targets the GABA neurotransmitter which is an INHIBITORY neurotransmitter. If enough GABA docks on a neuron, it will keep it from firing/activating.
Benzos INCREASE RECEPTOR SENSITIVITY TO GABA- making less GABA necessary to inhibit neuron activation
effective in helping symptoms of
panic disorder suggesting that neurotransmitters play a role in panic attacks
Anxiety theory- not enough inhibiting GABA activity in the brain |
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Term
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Definition
Panic disorder often runs in families
Identical twin concordance rate= 24%
Non Identical concordance rate = 11%
Suggests both genetic and environmental
environmental- self report of childhood environment suggests overly protective parents cause overly sheltered kids who become more vulnerable to P.D.
-overly critical parents lead to low self esteem and confidences and increases feelings of anxiety- feelings of lack of ability to fcope.
Parenting style and parent modeling + genetics seems to play a role in P.D especially if the person has a biological predisposition |
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Term
| Psychology of Panic Disorder |
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Definition
Cognitions make P.D. worse or can contribute to its development
People with PD tend to be: -hyper vigilant to bodily experiences
-over interpret bodily symptoms by worrying in a cyclical manner
-neutral event causes
-bodily sensation which triggers
-negative thoughts (e.g. am I having a PA?)which cause
-SNS arousal which
-increases negative thinking which causes
-a panic attack
there is a focus on physical sx but also a focus on thoughts such as:
What am I going to do?
Embarrasment
I might crash
all of these will contribute to an increase in SNS arousal and can lead to a panic attack |
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Term
| Classical conditioning and panic disorder |
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Definition
classical conditioning is an important factor in the development of agoraphobia. NO LEARNING REQUIRED TO CONNECT PANIC ATTACK WITH FEAR RESPONSE
panic attack at a movie theater = conditioned simulus
movie theater becomes associated with fear |
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Term
| Operant conditioning and panic disorders |
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Definition
Positive or negative reinforcers are more likely to increase a behavior
e.g. negative reinforcement:
avoid the movie theater and you will be rewarded by Not having a panic attack (removal of anxiety about panic attack reinforces avoidance of theater)
Positive reinforcer: wife will bring home movies instead - safety |
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Term
| Treatment of panic disorder |
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Definition
Exposure to phobias is the common treatment for panic disorder
-systematic desensitization
-flooding |
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Term
Treatment of panic disorder
-Systematic desensitization |
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Definition
systematic desensitization is IMAGINARY EXPOSURE.
The person come up with a personal list of ranked phobia and then beings talking about them and imaging interacting with the phobia (beginning with the least severe) |
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Term
Treatment of panic disorder
-Flooding |
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Definition
| Flooding goes beyond systematic desensitization by forcing direct interaction with the phobia. DIRECT EXPOSURE |
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Term
| Prior to exposure therapy - learn skills to prevent panic attacks |
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Definition
-Deep breathing
belly breathing takes in 8-10x more o2. The more o2 the heart has, the less hard it has to work to circulate blood- slowing sympathetic activity
-learn skills to reduce SNS arousal
-learn skills to counter negative emotions
-Practice by inducing a panic attack. Forced hyperventilation, breathing into a bag to limit O2 |
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Term
| Panic Disorder Video Clip |
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Definition
treatment includes:
taking away crutches - suffers need to feel personally in control
- meds are useful to get you to a place where you can function enough to begin to work on learning the skills to not need them
diet- caffine can trigger anxiety type symptoms. |
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Term
| Panic Disorder Treatment outcomes |
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Definition
Panic disorder is a very treatable condition but shame prevents a lot of people from getting help.
Bidirectional relationship between asthma and panic disorder |
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Term
| Generalized anxiety disorder |
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Definition
affects approximately 6% of the population.
Differs form Panic Disorder in that fear of having a panic attack is a primary component of Panic disorder
G.A.D. involves worry about a lot of different area-- excessive worrying.
The level of worry doesn't match the level of the threat.
The focus of the worry can shift.
The excessive worry interferes with the quality of life , sleep, fxn, muscle tension, exhaustion.
Awareness about the worrying through both internal and external observation.
Used to be called "Free floating anxiety" |
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Term
| Treatment for Generalized Anxiety Disorder |
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Definition
Cognitive behavioral therapy
Work to change cognitions and evaluate them to see if your assessments are reasonable
G.A.D. usually emerges in childhoood
Alcohol is a maladaptive coping method sometimes used.. |
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Term
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Definition
Used to be called "Social Phobia"
S.A.D. is the most common anxiety disorder affecting between 9-13% of people in the US.
-Fear of evaluation and embarrassment
-afraid they'll look stupid in an interaxn.
-often show the same symptoms of sympathetic nervous system arousal (sweating, blushing, shaky hands)
-people often think it's just a part of their personality
-disorder comes on in adolescence when perception of others becomes
important
-sometimes develops in childhood (children that were always "shy)
-most people have a generalized form which occur across an array of situations |
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Term
| Specific Social Anxiety Disorder |
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Definition
less common than generalized.
specific social anxiety disorder is limited to a single social situation (e.g. public speaking) but it's not just an normal aversion to it but rather causes EXTREME DISTRESS- leading people to avoid situations which might require it.
Extreme distress or complete avoidance |
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Term
| DMS criteria for social anxiety disorder |
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Definition
Criteria for diagnosis switched in the DSM III. Now avoidance of social situation is enough to be classified with SAD. Used to have to experience extreme distress.
This change led to an overnight increase in the rates of Social Anxiety Disorder being diagnosed |
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Term
| Possible causes of Social Anxiety Disorder |
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Definition
Genetics and environment
Genetics: moderatly heritable -people with a family history are more likely to have SAD. SSRIs are effective in treating it so it suggests that serotonin is most likely involved
Environment- learned social skills. Negative modeling of social skills such as over protectiveness, neglect, emotional abuse, teasing or bulling could contribute. |
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Term
| Possible cognitive behavioral treatments |
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Definition
People with SAD sometimes have trouble eating in front of people.
Feeling like people are watching and judging them. Perfectionist standards and hard on the self
Therapy can work on modifying those extremely high expectations to provide a more realistic and less self focused view of the world and itneractions |
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