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locus ceruleus is the key to panic disorder. Others believe that related neurotransmitters
and structures in the panic brain circuit also play key roles. Biological therapists use certain
antidepressant drugs or powerful benzodiazepines to treat people with this disorder.
Cognitive theorists suggest that panic-prone people are very sensitive to their
bodily sensations and misinterpret them as signs of medical catastrophe. Such persons have a high degree of anxiety sensitivity and also experience greater anxiety
during biological challenge tests. Cognitive therapists teach patients to interpret their
physical sensations more accurately and to cope better with anxiety. jObsessive-Compulsive Disorder
Obsessions are persistent thoughts, ideas, impulses, or images that seem to invade a
person’s consciousness. Compulsions are repetitive and rigid behaviors or mental acts
that people feel they must perform in order to prevent or reduce anxiety. As Figure 4-6
on the next page indicates, minor obsessions and compulsions are familiar to almost
everyone. You may find yourself filled with thoughts about an upcoming performance
or exam or keep wondering whether you forgot to turn off the stove or lock the door.
You may feel better when you avoid stepping on cracks, turn away from black cats, or
arrange your closet in a particular manner.
Minor obsessions and compulsions can play a helpful role in life. Little rituals often
calm us during times of stress. A person who repeatedly hums a tune or taps his or her
fingers during a test may be releasing tension and thus improving performance. Many
people find it comforting to repeat religious or cultural rituals, such as touching a
mezuzah, sprinkling holy water, or fingering rosary beads.
According to DSM-IV-TR, a diagnosis of obsessive-compulsive disorder is
called for when obsessions or compulsions feel excessive or unreasonable, cause great
distress, take up much time, or interfere with daily functions (see Table 4-9). The disorder is classified as an anxiety disorder because the obsessions cause intense anxiety, while
the compulsions are aimed at preventing or reducing anxiety. In addition, anxiety rises
if individuals try to resist their obsessions or compulsions.
A woman with this disorder observed:“I can’t get to sleep unless I am sure everything
in the house is in its proper place so that when I get up in the morning, the house is
organized. I work like mad to set everything straight before I go to bed, but, when I get
up in the morning, I can think of a thousand things that I ought to do. . . . I can’t stand
to know something needs doing and I haven’t done it” (McNeil, 1967, pp. 26–28). ComFun6e_Ch04_C!.indd 121 The show can’t go on
On September 12, 2007, the eclectic
garage-rock duo The White Stripes had
to announce to its many fans that it was
canceling the remainder of its U.S. tour,
saying that drummer Meg White was
“suffering from acute anxiety and . . .
unable to travel at this time.” table: 4-9
DSM Checklist OBSESSIVE–...
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