Test Bank for Abnormal Psychology 8th Edition Barlow Chapters 1,2,3, and 16 Latest Update (A+ GRADED)
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Theories Of Personality
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ANXIETY DISORDERS attacks if you don’t have a clue when or where the
next attack will occur.
Anxiety is a negative mood state characterized by
bodily symptoms of physical tension and by Biological contributions
apprehension about the future Increasing evidence shows that we inherit a
subjective sense of unease, a set of behaviors tendency to be tense, uptight, and anxious
(looking worried and anxious or fidgeting), or a depleted levels of gamma-aminobutyric acid
physiological response originating in the brain and (GABA), part of the GABA– benzodiazepine system,
reflected in elevated heart rate and muscle tension are associated with increased anxiety
Surprisingly, anxiety is good for us, at least in noradrenergic system has also been implicated in
moderate amounts. anxiety
perform better when we are a little anxious. In corticotropin-releasing factor (CRF) system as
short, social, physical, and intellectual performances central to the expression of anxiety (and
are driven and enhanced by anxiety. depression)
Howard Liddell (1949) first proposed this idea when The area of the brain most often associated with
he called anxiety the “shadow of intelligence. anxiety is the limbic system
Anxiety is a future-oriented state characterized behavioral inhibition system (BIS) is activated by
by negative affect in which a person focuses on signals from the brain stem of unexpected events,
the possibility of uncontrollable danger or such as major changes in body functioning that
misfortune; in contrast, fear is a present- might signal danger.
oriented state characterized by strong escapist fight/flight system (FFS). This circuit originates in
tendencies and a surge in the sympathetic the brain stem and travels through several midbrain
branch of the autonomic nervous system in structures
response to current danger.
A panic attack represents the alarm response of Psychological contributions
real fear, but there is no actual danger. general tendency to respond fearfully to anxiety
Panic attacks maybe (1) unexpected (without symptoms. This is known as anxiety sensitivity
warning), or (2) expected (always occurring in a Marked avoidance of situations and/or people
specific situation). associated with fear, anxiety, or panic attacks
Panic and anxiety combine to create different
anxiety and related disorders. Several disorders social contributions
are grouped under the heading Anxiety Social support reduces intensity of physical and
Disorders. emotional reactions to triggers or stress
What happens if you experience the alarm response
of fear when there is nothing to be afraid of—that Emotional and Cognitive Influences
is, if you have a false alarm? This sudden Heightened sensitivity to situations or people
overwhelming reaction came to be known as panic, perceived as threats
after the Greek god Pan who terrified travelers with Unconscious feeling that physical symptoms of
bloodcurdling screams. panic are catastrophic
panic attack is defined as an abrupt experience of
intense fear or acute discomfort, accompanied by GENERALIZED ANXIETY DISORDER
physical symptoms that usually include heart pal- Whereas panic is associated with autonomic
pitations, chest pain, shortness of breath, and, arousal, presumably as a result of a sympathetic
possibly, dizziness. nervous system surge (for instance, increased heart
Two basic types of panic attacks are described in rate, palpitations, perspiration, and trembling), GAD
DSM-5: expected and unexpected. is characterized by muscle tension, mental
If you know you are afraid of high places or of agitation, susceptibility to fatigue (probably the
driving over long bridges, you might have a panic result of chronic excessive muscle tension), some
attack in these situations but not anywhere else; irritability, and difficulty sleeping
this is an expected (cued) panic attack. By contrast, 6 months, difficulty controlling worry
you might experience unexpected (uncued) panic Statistics for GAD:
2/3 are female (more prominent)
, Most common in older adults (45 years old) o endure them with “intense dread”
Onset os early in adulthood as an immediate experience an unexpected panic attack and develop
response to a life stressor. substantial anxiety over the possibility of having
Causes another attack or about the implications of the
Generalized biological vulnerability attack or its consequences
Tends to run in families Most patients with panic disorder and agoraphobic
Physiological Responsivity of GAD patients showed avoidance also display interoceptive avoidance, or
less responsiveness on most physiological avoidance of internal physical sensations
measures such as heart rate and blood pressure. Statistics for PDA:
Hence, GAD patients are called autonomic fairly common; 2.7% in a year, 4.75% met criteria at
restrictors some point of their lives
2/3 were women
Treatment for GAD Occurs in early adult life—from mid-teens through
Benzodiazepines- often prescribes; short-term relief about 40 years of age most (75% or more) of those
(patients with family problems) Xanax, Klonopin who suffer from agoraphobia are women
used until crisis is over; for a week or two * It is more accepted for women to report fear and
Risks: to avoid numerous situations. Men, however, are
o (1) impair both cognitive and motor functioning expected to be stronger and braver—to “tough it
o (2) impair driving, and in older adults they seem out.” The higher the severity of agoraphobic
to be associated with falls avoidance, the greater the proportion of women.
o (3) produce both psychological and physical Males may end up with an even more severe
dependence, making it difficult for people to problem than PDA (addicted to alcohol to cope up).
stop taking them
Psychological treatments are probably more NOCTURNAL ATTACKS
effective in the long term panic attacks occur more often between 1:30 A.M.
designed treatments to help patients with GAD and 3:30 A.M. than any other time based on several
process the threatening information on an studies
emotional level, using images, so that they will feel through electroencephalogram, it was learned that
(rather than avoid feeling) anxious nocturnal panics occur during delta wave or slow
confront anxiety through the provoking images and wave sleep, which typically occurs several hours
thoughts head-on. The patient learns to use after we fall asleep and is the deepest stage of sleep
cognitive therapy and other coping techniques to people with panic disorder often begin to panic
counteract and control the worry process. when they start sinking into delta sleep, then they
awaken amid an attack
PANIC DISORDER WITH AGORAPHOBIA no obvious reason for them to be anxious or
panic disorder (PD), in which individuals experience panicky when they are sound asleep, most of these
severe, unexpected panic attacks; they may think individuals think they are dying
they’re dying or otherwise losing control. Possible Causes:
agoraphobia, which is fear and avoidance of change in stages of sleep to slow wave sleep
situations in which a person feels unsafe or unable produces physical sensations of “letting go” that are
to escape to get home or to a hospital in the event frightening to an individual with panic disorder
of a developing panic, panic-like symptoms, or other people are not dreaming when they have nocturnal
physical symptom panics (nightmares only happen during REM)
PDA matched with anxiety and panic are combined
with phobic avoidance Causes of PDA
almost all agoraphobic avoidance behavior is simply Strong evidence indicates that agoraphobia
a complication of severe, unexpected panic attacks develops after a person has unexpected panic
people with agoraphobia always plan for rapid attacks (or panic-like sensations).
escape According to the triple vulnerability model, we all
agoraphobic avoidance is simply one way of coping inherit vulnerability to stress, which is a tendency to
with unexpected panic attacks be generally neurobiologically overreactive to the
o coping with panic attacks include using (and events of daily life (generalized biological
eventually abusing) drugs and/or alcohol vulnerability).
, The influential cognitive theories of David Clark but approximately the same number of patients
(1986, 1996) explicate in more detail some cognitive responded to both treatments.
processes that may be ongoing in the development Combined treatment was no better than individual
of panic disorder. treatments.
Treatment:
Medication SPECIFIC PHOBIA
high-potency benzodiazepines A specific phobia is an irrational fear of a specific
newer serotonin-specific reuptake inhibitors object or situation that markedly interferes with an
(SSRIs) such as Prozac and Paxil individual’s ability to function.
Disadvantages: The very commonness of fears, even severe fears,
closely related serotonin-norepinephrine often causes people to trivialize the psychological
reuptake inhibitors (SNRIs) such as venlafaxine disorder known as a specific phobia.
Use SSRIs seem to make sexual dysfunction These phobias, in their severe form, can be
occur in 75% or more of people taking this. extremely disabling
Alprazolam (Xanax), work quickly but are hard 6 months
to stop because of psychological and physical
dependence and addiction. Blood-injury-injection phobia
Benzodiazepines remain the most widely used Blood-injury-injection phobia runs in families more
class of drugs in practice strongly than any phobic disorder we know.
however, all benzodiazepines adversely affect People with this phobia inherit a strong vasovagal
cognitive and motor functions to some degree. response to blood, injury, or the possibility of an
Psychological Intervention injection, all of which cause a drop in blood
The strategy of exposure-based treatments is to pressure and a tendency to faint.
arrange conditions in which the patient can The average age of onset for this phobia is
gradually face the feared situations and learn approximately 9 years.
there is nothing to fear.
Panic control treatment (PCT) concentrates on Situational phobia
exposing patients with panic disorder to the Phobia characterized by fear of public
cluster of interoceptive (physical) sensations transportation or enclosed places are called
that remind them of their panic attacks. situational phobias.
It is relatively new and not yet available to many Claustrophobia, a fear of small enclosed places,
individuals who suffer from panic disorder isituational, as is a phobia of flying.
because administering them requires therapists Both situational phobia and PDA tend to emerge
to have advanced training. from midteens to mid-20s and have been shown to
Combined Psychological and Drug Treatments run in families.
NIMH looked at the separate and combined The main difference between situational phobia and
effects of psychological and drug treatments. PDA is that people with situational phobia never
Patients were randomly assigned into five experience panic attacks outside the context of
treatment conditions: psychological treatment their phobic object or situation.
alone (CBT); drug treatment alone (imipramine-
IMI-a tricyclic antidepressant); a combined Natural environment phobia
treatment condition (IMI = CBT); and two Sometimes very young people develop fears of
“control” conditions, using one placebo alone situations or events occurring in nature, these fears
(PBO), and one using PBO + CBT (to determine are called natural environment phobias.
the extent to which any advantage for Major examples are heights, storms, and water.
combined treatment was caused by placebo These phobias have a peak age of onset of about 7
contribution). years.
Results indicated that all treatment groups were
significantly better than all placebo, with some Animal phobia
evidence that, among those who responded to Fear of animals and insects are called animal
treatment, people taking the drug alone did a phobias.
little better than those receiving the CBT alone, The fear experienced by people with animal phobias
is different from an ordinary
, Many of these situations have some danger Require structured and consistent exposure-based
associated with them and, therefore, mild to exercises
moderate fear can be adaptive. Specific examples:
The age onset for these phobias’ peaks around 7 Treatment for Separation Anxiety
years. Structured exercises (with the help of the
parents)
SEPARATION ANXIETY DISORDER Ex. 1-week program (girls age 8-11): sleepover
Separation anxiety disorder is characterized by at a clinic = highly successful
children’s unrealistic and persistent worry that Treatment for blood-injection-injury phobia
something will happen to their parents or other Graduated exposure-based exercises (carried
important people in their life or that something will out in specific ways) Examples:
happen to them that will separate them from their During exposure exercises, patients should
parents. tense various and specific muscle groups so that
These fears can result in refusing to sleep alone and blood pressure will maintain sufficiently high to
maybe characterized by nightmares involving complete the practice.
possible separation and by physical symptoms, Goal of the treatment: To hopefully make phobia
distress and anxiety. disappear altogether as well as to lessen the
4 weeks in children and adolescents, 6 months vasovagal response (fainting) associated at the sight
adults of blood.
These treatments essentially "rewire" the brain
STATISTICS: according to brain-imaging scans.
During a given 1-year period, the prevalence is
8.7%. SOCIAL PHOBIA (SOCIAL ANXIETY
Approximately 12.5% of the population, their fears DISORDER)
become severe enough to earn the label “phobia”. Extreme, enduring, irrational fear and avoidance of
4.1% of children have separation anxiety at a severe social or performance situations.
enough level to meet criteria for a disorder. Experienced marked and persistent anxiety focused
As with common fears, the sex ratio for specific on one or more social or performance situations.
phobias is at 4:1, overwhelmingly female. Marked and persistent fear of one or more social or
performance situations in which the person is
CAUSES OF PHOBIA: exposed to unfamiliar people or to possible scrutiny
Phobias acquired by direct experience, where real by others, with the fear that one will be
danger or pain results in an alarm response (a true embarrassed or humiliated
alarm) Exposure to the feared social situation almost
There are at least three others; experiencing a false invariably provokes anxiety, sometimes as a panic
alarm (panic attack) in a specific situation; attack
observing someone else experience severe fear Recognition that the fear is excessive or
(vicarious experience); or, under the right unreasonable
conditions, being told about danger. The feared social or performance situation is
In summary, several things have to occur for a avoided or are endured with intense anxiety or
person to develop a phobia: distress
First, a traumatic conditioning experience often The avoidance, anxious anticipation, or distress in
plays a role. the feared social or performance situation(s)
Second, fear is more likely to develop if we are interferes significantly with the person’s life and
“prepared” -- that is, we seem to carry an inherited healthy functioning
tendency to fear situations that have always been 6 months
dangerous to the human race Types
Third, we also have to be susceptible to developing
anxiety about the possibility that the event will Performance Anxiety
happen again. Individuals with performance anxiety usually have
no difficulty with social interaction, but when they
TREATMENTS for Phobia must do something specific in front of people,
Fairly straightforward
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