361 - 10
Popular in Abnormal Psychology
Popular in Psychology (PSYC)
This 3 page Class Notes was uploaded by Tricia Mae Fortuna on Thursday October 6, 2016. The Class Notes belongs to 361 at Towson University taught by DR. ERIN GIRIO-HERRERA in Fall 2016. Since its upload, it has received 3 views. For similar materials see Abnormal Psychology in Psychology (PSYC) at Towson University.
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Date Created: 10/06/16
10/06/2016 The Phenomenology of Panic Attacks o Chest tightening o Breathing Fast o Dread o Feeling that they’re going to die o Faster heart rate o Panic Attacks will stop and it won’t last forever – body cannot stay catabolic that long o Common at 1-3am while sleeping Can occur in number of disorders Panic Disorder: o Recurrent unexpected panic attacks o Worry about having additional attacks OR Behaviors to avoid having panic attacks (safety behavior) Worrying about unexpected attacks Fleeing when having panic attacks Panic Attacks: DSM-V o Recurrent unexpected panic attacks are present o At least one of the attacks had been followed by 1 month or more of one or both of the following: (a) Persistent concern or worry about additional panic attacks or their consequences or (b) A significant maladaptive change in behavior related to the attacks o The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition and is not better explained by another mental disorder From American Psychiatric Association (2013). Diagnostic and Statistical manual th of mental disorders (5 Ed.) Washington, DC. Medical Referral o Rule out medical conditions that could be causing panic o Hypoglycemia o Hyperthyroidism o Asthma o Heart Condition o Seizure disorder Panic Disorder o Statistics: 2.7% of general population per year, 4.7% lifetime Onset: acute, mean onset between 20-24 years old o 8-12% of population has had an occasional, unexpected panic attack in the last year – most do not develop anxiety. Why? Not perceiving it as a dangerous event – not turn a disorder Panic Disorder Cause: o Biological Neurobiological overactive (general biological vulnerability) Sensations (internal) and situations (external) become associated with an emergency alarm reaction o Psychological Thoughts: Perceive bodily sensations are dangerous (specific psychological vulnerability) associated with belief in negative outcome Emotions: emotional reaction to stress o Social/Cultural Women? – higher than men African Americans? – higher than other ethnicities Panic Disorder and Agoraphobia o Agoraphobia: fear of being in places in which it would be difficult to escape in the event of unpleasant physical symptoms (e.g., panic attack, dizziness, vomiting, incontinence – bladder accident) o Panic and agoraphobia often occur together o Coupled together in previous editions of the DSM, e.g., “Panic disorder with agoraphobia,” “Agoraphobia without a history of panic disorder” o If both occur, both diagnosed (dx) ; can be dx independently DSM-V – Agoraphobia: o Marked fear or anxiety about two or more of the following: public transportation, open spaces, enclosed places, standing in line or being in a crowd, being outside the home alone o The individual fears or avoids these situations due to thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms o The agoraphobic situations almost always provoke fear or anxiety o The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety o The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations, and to the sociocultural context o The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more o The fear, anxiety, or avoidance causes clinically significant distress or impairment in important areas of functioning o If another medical condition is present, the fear, anxiety or avoidance is clearly excessive o The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder From American Psychiatric Association (2013). Diagnostic and Statistical manual th of mental disorders (5 Ed.) Washington, DC. Panic Disorder: Associated Features and Treatments (Tx) o Associated Features (Not in DSM criteria) Nocturnal Panic Attacks during non-REM sleep Interoceptive avoidance o Medical Treatment SSRIs (e.g., Prozac and Paxil) or benzodiazepines (e.g., Ativan) Relapse rates are high following medication discontinuation Did not change thought processes – relapse happens when they didn’t take their medication o Cognitive-behavioral therapy is highly effective Will include exposures – expose them with what they find dangerous supply tools to help change the thoughts and behaviors Anxiety, Trauma, Stressor, Obsessive-Compulsive Disorders Panic Disorder: Treatment Panic Control Treatment (PCT) o CBT – cognitive behavioral therapy o PLUS purposefully triggering panic sensations Psychological and combined Treatments o Cognitive-behavioral therapies are highly effective o No evidence that combined treatment (CBT & Medication) produces better outcome o Best long-term outcome is CBT Order of Treatment? o What do we know?
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