Anxiety and Mood Disorders

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• Anxiety and Mood Disorders

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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

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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

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Model of Development of GAD

• GAD has some genetic component
• Related genetically to major depression
• Childhood trauma also related to GAD

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Phobias

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

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Phobias

• It is not phobic to simply be anxious about
  something

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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

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Some Unusual Phobias

• Ailurophobia - fear of cats
• Algobphobia - fear of pain
• Anthropophobia - fear of men
• Monophobia - fear of being alone
• Pyrophobia - fear of fire

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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

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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
• Seligmans preparedness theory

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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

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Panic Disorder

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

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Posttraumatic Stress Disorder (PTSD)

• Follows traumatic event or events such as war,
  rape, or assault
• Symptoms include
• nightmares
• flashbacks
• sleeplessness
• easily startled
• depression
• irritability

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Mood Disorders

• Depressive disorders
• depression of mood
• Bipolar disorders
• cycling between depression and mania (extreme
  euphoria)

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Depression

• Symptoms include
• sadness
• feelings of worthlessness
• changes in sleep
• changes in eating
• anhedonia
• suicidal behavior

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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

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Biological Bases for Depression

• Neurotransmitter theories
• dopamine
• norepinephrine
• serotonin
• Genetic component
• more closely related people show similar
  histories of depression

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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

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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

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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 didnt get the job because Im stupid
  and inept vs. I didnt get the job because the
  interview didnt go well

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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

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Bipolar Disorders

• 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

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Somatoform Disorders

• Bodily ailments in absence of any physical
  disease
• Examples are conversion disorder and somatization
  disorder

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• Psychological Influences on Physical Symptoms and
  Diseases

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Conversion Disorder

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

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Conversion Disorder

• Rare in western culture now
• relatively common 100 years ago
• prominent in Freuds 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

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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

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Somatization Disorder

• Kleinmans theory
• somatization and depression are different
  manifestations of the same problem
• cross-cultural research
• pattern of somatoform disorders affected by
  cultural beliefs

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Psychological factors and medical condition

• Traumatic Grief
• studied peoples health before and after death of
  spouse
• 25 months following death of a spouse
• surviving spouses had increased incidences of
  flu, heart disease, cancer

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Psychological factors and cardiovascular disease

• Friedman Rosenmans 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

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Friedman Rosenmans 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 theyre doing
  not at higher risk

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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

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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