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361 - 10

by: Tricia Mae Fortuna

361 - 10 361

Tricia Mae Fortuna
GPA 3.49

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Panic Attacks and Panic Disorders with or without Agoraphobia
Abnormal Psychology
Class Notes
phenomenology, panic, attacks, disorders, agoraphobia, DSM-5, unexpected, Expected, PCT, control, treatment, SSRI, CBT, Cognitive-Behavioral, Therapy
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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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