Anxiety Disorders (Part 1)

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Both positive and negetive

Anxiety: diffuse, vague and very unpleasant feeling of fear and apprehension. They worry a lot, puticularly about unknown dangers.  Physical and psychological symptoms-

Physical- rapid heart rate, shortness of breath, diarrhea, loss of appetite, fainting, dizziness, sweating, sleeplessness, frequent urination, tremors.

Psychological- possible future events fear, catastrophic interpretations of past, feeling uncertainity and helpless, overly sensitive to threatening cues.

Earlier called neurosis.

Individual is abnormally anxious either generally or specific situation, but still has adequate contact with reality and rarely need institutionalization.

Major catagories:

Generalized Anxiety disorder

Prolonged, vague, unexplained, but intense fears that does not seem to be attached to any purticular object. Anxious for minor, or even when no stimuli present.

Symptoms-

1.      Worry and apprehensive feelings about feature.

2.      Hypervigilance- hyper aroused state

3.      Motor tension- not relaxed

4.      Autonomic Reactivity- symathetic and parasympathetic nervous system working overtime

Clinical Features:

1.      Excessive anxiety and worry occuring for atleast 6 months and affecting many areas of person’s life (no medication)

2.     Inability to control worry

3.      Three or more symptoms (DSM IV TR)

(a)    Restlessness, feeling on edge

(b)   Being easily fatigued

(c)    Difficulty in concentration

(d)   Irritablity

(e)    Muscle tension

(f)    Sleep disturbance

4.      Considerable distress or impairment in social, occupational, and other important areas of life.

3% have GAD. More in women. May long along 20 years(protracted). Starts at late teens and early 20s

Amyglada and neurotransmitters

Cognitively and psychodynamically Oriented psychotherapy.

Panic Disorder

Abrupt surge of intense anxiety rising to a peak, which is cued by either the presence of, thought of a purticular stimuli or that comes without obvious cues and is spontaneous and unpredictable.  Not persistant like phobia. Stressful life events like new job, marriage, can trigger. Also intense fear of having another attack.  Worry over the implications and consequences of having panic attacks

Symptoms:

 During normal fuctioning and comes unanticipated. It is recurring. Victims fear that they will die, go crazy, or do something uncontrolled, and report variety of psycho sensory symptoms.

Anticipatory Anxiety:  Have intense fear of having attacks again and hence avoid all area where they could possivly have an attack

Constant worry of health and more prone to suicidal tendencies.

Clinical features:

Recurrent, Unexpected panick attacks and atleast 1 month of persistant concern having them. Attacks charecterizes-

(a)    Shortness of breath

(b)   Dizziness, Unsteadyness, or faintness

(c)    Trembling, shaking, or sweating

(d)   Heart palpitation, or racing heart rate

(e)    Choking, nausea, or stomach pain

(f)    Numbness or tingling

(g)   Chest pain or discomfort

(h)   A sense of strangeness, or being detached from oneself or one’s surrounding

(i)     Fear of going crazy, losing control or dying

Length- few seconds to  days.

Comparison of panic disorder and GAD-

1.      

Panic disorder have early onset

2.      Role of heredity more in Panic Disoreder

3.      Ratio of women:men greater in PD.

4.      Alchaholism more in PD

5.      Unusually more depressed are PDs

 

Introduction to Abnormal Psychology

Abnormal psychology is one of the most scientific and interesting area in psychology. Lets unwind it step by step.

Included in:
1. Civil Services Mains Paper II, Chapter 2- Psychological Well being and Mental Disorders
2. Kerala University SEM V, Abnormal Psychology paper

Whats abnormality??

No definition has won universal acceptance. Still, most definitions have certain common features,often called the ‘four Ds’: deviance,distress, dysfunction and danger. That is,psychological disorders are deviant (different, extreme, unusual, even bizarre),distressing (unpleasant and upsetting tothe person and to others), dysfunctional(interfering with the person’s ability tocarry out daily activities in a constructive way), and possibly dangerous (to theperson or to others). No set standard for normal.

Various approaches have been used in distinguishing between normal and abnormal behaviours. From these approaches, there emerge two basic and conflicting views :

1.Social-Norm-The first approach views abnormal behaviour as a deviation from social norms. Abnormal behaviour, thoughts and emotions are those that differ

markedly from a society’s ideas of proper functioning. Each society has norms,

which are stated or unstated rules for proper conduct. Behaviours, thoughts and

emotions that break societal norms are called abnormal. A society’s norms grow

from its particular culture — its history, values, institutions, habits, skills,

technology, and arts.

-ve: A society’s values may change over time, causing its views of what is psychologically abnormal to change as well.

2. maladaptive- whether it fosters the well-being of the individual and eventually of the group to which s/he belongs. Well-being is not simply maintenance and survival but also includes growth and fulfilment.

Factors causing mental disorders-

1.Biological,

2. Genertical

3. Psychological-

These models maintain that psychological and interpersonal factors have a significant role to play in abnormal behaviour. These factors include maternal deprivation

(separation from the mother, or lack of warmth and stimulation during early years of life), faulty parent-child relationships (rejection, overprotection, overpermissiveness,

faulty discipline, etc.), maladaptive family structures (inadequate or disturbed family), and severe stress.

(a)   Psychodynamic theorists believe that behaviour, whether normal or abnormal, is determined by psychological forces within the person of which s/he is not consciously aware. These internal forces are considered dynamic, i.e. they interact with one another and their interaction gives shape to behaviour, thoughts and emotions. Abnormal symptoms are viewed as the result of conflicts between these forces.

(b)  Behavioural model. This model states that both normal and abnormal behaviours are learned and psychological disorders are the result of learning maladaptive ways of behaving. The model concentrates on behaviours that are learned through conditioning and proposes that what has been learned can be unlearned. Learning can take place by classical conditioning (temporal association in which two events repeatedly occur close together in time), operant conditioning (behaviour is followed by a reward), and social learning (learning by imitating

(c)  Cognitive model- This model states that abnormal functioning can result from cognitive problems. People may hold assumptions and attitudes about themselves that are irrational and inaccurate. People may also repeatedly think in illogical ways and make overgeneralisations, that is, they may draw broad, negative conclusions on the basis of a single insignificant event.

(d)  humanistic-existential model - focuses on broader aspects of human existence. Humanists believe that human beings are born with a natural tendency to be friendly, cooperative and constructive, and are driven to self actualise, i.e. to fulfil this potential for goodness and growth. Existentialists believe that from birth we have total freedom to give meaning to our existence or to avoid that responsibility. Those who shirk from this responsibility would live empty, inauthentic, and dysfunctional lives.

(e)   Sociocultural model- abnormal behaviour is best understood in light of the social and cultural forces that influence an individual. As behaviour is shaped by societal forces, factors such as family structure and communication, social networks, societal conditions, and societal labels and roles become more important.

(f)   Diathesis-stress model- This model states that psychological disorders develop when a diathesis (biological predisposition to the disorder) is set off by a stressful situation. This model has three components. The first is the diathesis or the presence of some biological aberration which may be inherited. The second component is that the diathesis may carry a vulnerability to develop a psychological disorder. This means that the person is ‘at risk’ or ‘predisposed’ to develop the disorder. The third component is the presence of pathogenic stressors, i.e. factors/stressors that may lead to psychopathology. If such “at risk” persons are exposed to these stressors, their predisposition may actually evolve into a disorder.