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Class%2010 - ANXIETY DISORDERS II ANXIETY DISORDERS II...

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Unformatted text preview: ANXIETY DISORDERS II ANXIETY DISORDERS II OVERVIEW OVERVIEW SOCIAL ANXIETY DISORDER OBSESSIVE­COMPULSIVE DISORDER POST­TRAUMATIC STRESS DISORDER Social Anxiety Disorder Social Anxiety Disorder Intense fear of one or more social situations due to fears of being embarrassed, humiliated, or rejected Situation(s) almost always cause fear Person recognizes fear as excessive/unrealistic Situations are avoided or endured with distress Social Anxiety Disorder Social Anxiety Disorder • Common feared situations: • • • • • • • Interacting with authority figures Parties Public speaking Assertiveness Small talk Talking on the telephone Using public restrooms Social Anxiety Disorder Social Anxiety Disorder Vicious cycle: Anticipatory anxiety leads to… Fearful cognition and anxiety symptoms lead to… Actual or perceived poor performance leads to… Embarrassment and increased anticipatory anxiety about feared situation…. Social Anxiety Disorder Social Anxiety Disorder Associated Features Hypersensitivity to criticism, negative evaluation, and rejection Difficulty being assertive Low self­esteem or feelings of inferiority Poor social skills Signs of anxiety (clammy hands) Underachievement due to anxiety Decreased social support networks May totally refrain from interacting with society Social Anxiety Disorder Social Anxiety Disorder Statistics Gender ratio – Females slightly higher Gender ratio at clinics equal Begins in adolescence (~ 15 yrs) – How does this compare to Panic D/O & Specific Phobia? Gradual onset generally More prevalent in young (18­29) Lifetime prevalence of 13.3% Point prevalence of 2­4% in adolescents Increasing in young More single people SOCIAL PHOBIA SOCIAL CAUSE BIOLOGICAL VULNERABLITY (infants that were just born can be predicted to have the disorder) FALSE ALARM (when you are in a social situation you might have the feeling of a panic attack) REAL SOCIAL TRAUMA= true alarm TREATMENT EXPOSURE IN FORM OF ROLE­PLAY COGNITIVE THERAPY ANTIDEPRESSANTS Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Person experiences either obsessions, compulsions, or both Obsession– recurrent irrational or unwanted thoughts, images or impulses Compulsion – repetitive behaviors or mental acts to reduce distress from obsession or are ritualistic Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Common themes: Wash/Clean Hoard Counting Repeating Rigidity Sexual Aggressive Ruminate Ordering Doubting/Checking Primary Obsessional/Mental Ritual Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Statistics Slightly higher prevalence in In children, boys more than girls Age of onset: early adolescence to mid 20’s Peak at 12 to 15 for boys Peak 20 to 24 for women Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Etiology Focus of anxiety is on future intrusive thoughts Compulsions can be thought of as avoidance behavior Early experience Some thoughts are unacceptable “ Thought­Action Fusion” – Thinking is same as doing Biological vulnerability to anxiety Self­blame – think that they are responsible for bad events Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Treatment Psychotherapy Exposure and Response prevention Cognitive therapies have mixed support Medication SSRI’s Relapse frequent with meds – even when paired with psychotherapy Posttraumatic Stress Disorder Posttraumatic Stress Disorder Witness or experience a traumatic or life Witness threatening event threatening B. Persistent Persistent re-experiencing re-experiencing A. C. Dreams Distress over trauma cues Avoidance of stimuli associated with the trauma D. Recollections Flashbacks Thoughts/feelings Inability to recall aspects Restricted emotions Persistent increased Persistent Activities/places Social withdrawal Foreshortened future arousal arousal symptoms Posttraumatic Stress Disorder Posttraumatic Stress Disorder • Common traumatic events • • • • • • Combat Sexual assault Crime victim, robbery, assault Motor vehicle accident Natural or man­made disasters Others Posttraumatic Stress Disorder Posttraumatic Stress Disorder Majority of adults experience at least one potentially traumatic event in lifetime Following stressor led to these rates of PTSD Rape – 32% Sexual Assault – 31% Physical Assault – 39% Homicide of family or friend – 22% Crime Victimization – 26% Non­crime related trauma (natural disaster) – 9% Posttraumatic Stress Disorder Posttraumatic Stress Disorder Statistics Prevalence estimated around 10% Higher rates in females High Comorbidity – around 50% with depression and alcohol abuse or dependence POST­TRAUMATIC STRESS POST­TRAUMATIC STRESS DISORDER CAUSE INTENSITY OF TRAUMA VULNERABILITIES EARLY EXPERIENCES SOCIAL AND CULTURAL FACTORS TREATMENT RE-EXPERIENCE TRAUMA IMAGINALLY RE-EXPERIENCE IMAGINALLY EXPOSURE TO TRAUMA TRIGGERS ...
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