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Social Factors. Stressful life events Childhood adversity Attachment relationships and separation anxiety. Psychological Factors. Learning Classical conditioning Preparedness model Observational learning Cognitive factors Perception of lack of control Catastrophic misinterpretation
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Social Factors • Stressful life events • Childhood adversity • Attachment relationships and separation anxiety
Psychological Factors • Learning • Classical conditioning • Preparedness model • Observational learning • Cognitive factors • Perception of lack of control • Catastrophic misinterpretation • Attention to threat and shifts in attention • Thought suppression
Biological Factors • Genetic Contributions • Panic disorder and GAD seem to run in families • Generalized form of social phobia is linked to genetics, but not non-generalized form • OCD not specifically linked to genetics, but to anxiety disorders in general
Biological Factors • Neuroanatomy: • Phobias and Panic Disorder: two pathways • Without Cortex: thalamus amygdala • With Cortex: thalamus frontal lobe amygdala • Panic Disorder • Locus ceruleus (brain stem) – norepinephrine • OCD • Basal ganglia (caudate nucleus and putamen) • Orbital prefrontal cortex • Anterior cingulate cortex
Biological Factors • Neurochemistry • Pharmacological challenge • Lactic acid • 50-90% with panic, 0-25% without • Caffeine • Carbon dioxide
Treatment • Psychological interventions • Systematic desensitization • Flooding • Exposure • Situational exposure • Interoceptive exposure (panic disorder) • Prolonged exposure, plus response prevention (OCD)
Psychological Interventions • Relaxation training (GAD) • Breathing retraining (Panic Disorder) • Cognitive therapy • Recognize faulty logic • Decatastrophizing
Biological Interventions • Benzodiazepines • For example: Valium; Buspar • Selective Serotonin Reuptake Inhibitors (SSRIs) • For example: Paxil • Tricyclic Antidepressants • Imipramine: agoraphobia with panic attacks • Clomipramine: OCD