Anxiety and Mood Disorders

1. Anxiety and Mood Disorders

2. Anxiety Disorders • Primary disturbance is distressing, persistent anxiety or maladaptive behaviors that reduce anxiety • Anxiety - diffuse, vague feelings of fear and apprehension • everyone experiences it • becomes a problem when it is irrational, uncontrollable, and disruptive

3. Generalized Anxiety Disorder (GAD) • More or less constant worry about many issues • The worry seriously interferes with functioning • Physical symptoms • headaches • stomachaches • muscle tension • irritability

4. Genetic predisposition or childhood trauma Hypervigilance GAD following life change or major event Model of Development of GAD • GAD has some genetic component • Related genetically to major depression • Childhood trauma also related to GAD

5. Phobias • Intense, irrational fear that may focus on: • category of objects • event or situation • social setting

6. Study of normal anxieties 100 90 80 70 60 50 40 30 20 10 0 Percentage of people surveyed Snakes Being in high, exposed places Mice Flying on an airplane Being closed in, in a small place Spiders and insects Thunder and lightning Being alone in a house at night Dogs Driving a car Being in a crowd of people Cats Afraid of it Bothers slightly Not at all afraid of it Phobias • It is not phobic to simply be anxious about something

7. Specific Phobias • Specific phobias - fear of specific object • animals (e.g., snakes) • substances (e.g., blood) • situations (e.g., heights) • more often in females than males

8. Some Unusual Phobias • Ailurophobia - fear of cats • Algobphobia - fear of pain • Anthropophobia - fear of men • Monophobia - fear of being alone • Pyrophobia - fear of fire

9. Social Phobias • Social phobias - fear of failing or being embarrassed in public • public speaking (stage fright) • fear of crowds, strangers • meeting new people • eating in public • Considered phobic if these fears interfere with normal behavior • Equally often in males and females

10. Development of Phobias • Classical conditioning model • e.g., dog = CS, bite = UCS • problems: • often no memory of a traumatic experience • traumatic experience may not produce phobia • Seligman’s preparedness theory

11. Obsessive-Compulsive Disorder (OCD) • Obsessions - irrational, disturbing thoughts that intrude into consciousness • Compulsions - repetitive actions performed to alleviate obsessions • Checking and washing most common compulsions • Heightened neural activity in caudate nucleus

12. Panic Disorder • Panic attacks - helpless terror, high physiological arousal • Very frightening - sufferers live in fear of having them • Agoraphobia often develops as a result

13. Follows traumatic event or events such as war, rape, or assault Symptoms include: nightmares flashbacks sleeplessness easily startled depression irritability Posttraumatic Stress Disorder (PTSD)

14. Mood Disorders • Depressive disorders • depression of mood • Bipolar disorders • cycling between depression and mania (extreme euphoria)

15. Depression • Symptoms include: • sadness • feelings of worthlessness • changes in sleep • changes in eating • anhedonia • suicidal behavior

16. Depression • Major Depression • prolonged, very severe depression • lasts without remission for at least 2 weeks • Dysthymia • less severe, but long-lasting depression • lasts for at least 2 years • Can have both at the same time • Women diagnosed far more often than men

17. Biological Bases for Depression • Neurotransmitter theories • dopamine • norepinephrine • serotonin • Genetic component • more closely related people show similar histories of depression

18. Situational Bases for Depression • Positive correlation between stressful life events and onset of depression • Is life stress causal of depression? • Most depressogenic life events are losses • spouse or companion • long-term job • health • income

19. Cognitive Bases for Depression • A.T. Beck: depressed people hold pessimistic views of • themselves • the world • the future • Depressed people distort their experiences in negative ways • exaggerate bad experiences • minimize good experiences

20. Cognitive Bases for Depression • Hopelessness theory • depression results from a pattern of thinking • person loses hope that life will get better • negative experiences are due to stable, global reasons • e.g., “I didn’t get the job because I’m stupid and inept” vs. “I didn’t get the job because the interview didn’t go well”

21. Seasonal Affective Disorder • Cyclic severe depression and elevated mood • Seasonal regularity • Unique cluster of symptoms • intense hunger • gain weight in winter • sleep more than usual • depressed more in evening than morning

22. Cyclic disorders Mood levels swing from severe depression to extreme euphoria (mania) No regular relationship to time of year (like SAD) Bipolar disorder is severe form Cyclothymia is less severe form Strong heritable component Bipolar disorder often treated with lithium Bipolar Disorders

23. Somatoform Disorders • Bodily ailments in absence of any physical disease • Examples are conversion disorder and somatization disorder

24. Psychological Influences on Physical Symptoms and Diseases

25. Conversion Disorder • Person temporarily loses some bodily function • blindness, deafness, paralyzed portion of body • glove anesthesia • No physical damage to cause problems

26. Conversion Disorder • Rare in western culture now • relatively common 100 years ago • prominent in Freud’s work/clients • Often see examples in non-Western people exposed to traumatic event • e.g., high rate of psychological blindness in Cambodian women after Khmer Rouge reign of terror in 1970s

27. Somatization Disorder • Long history of dramatic complaints re: different medical conditions • complaints usually vague, undifferentiated • e.g., heart palpitations, dizziness, nausea • Often difficult to determine whether complaints are somatization or undetectable physical disease

28. Somatization Disorder • Kleinman’s theory • somatization and depression are different manifestations of the same problem • cross-cultural research • pattern of somatoform disorders affected by cultural beliefs

29. Psychological factors and medical condition • Traumatic Grief • studied people’s health before and after death of spouse • 25 months following death of a spouse • surviving spouses had increased incidences of flu, heart disease, cancer

30. Psychological factors and cardiovascular disease • Friedman & Rosenman’s studies • type A personality • competitive, aggressive, easily irritated, impatient, workaholic • have shown increased risk for heart attack • biggest personality risks are the irritability and hostility, not the hurried life-style

31. Friedman & Rosenman’s studies • Type B personality • opposite of type A, more relaxed • Have shown low risk for heart attack • Anxiety and depression also predictive of heart disease • Conclusion • prolonged, frequent negative emotions increase risk of heart disease • hard working people who enjoy what they’re doing not at higher risk

32. Immune function & emotional distress • Emotional distress shuts down some bodily defenses against pathogens • makes person more vulnerable to infectious diseases • Some studies • temporary decrease in T-cells following frustrating cognitive task • only in people who also showed other signs of physiological distress to task

33. 50 45 40 35 30 25 Percentage who developed colds 5-6 7-8 9-10 11-12 3-4 Score on psychological distress scale Cohen, et al. (1991) • Exposed group of people to cold virus • Quarantined for 6 days • Distressed develop cold more easily • Not due to other risk factors like: • smoking • diet • sleep