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1、CHAPTER2ANXIETYDISORDERSAIMSANDOBJECTIVESDescribethenatureoffearandanxietydisordersDiscusstherangeofanxietydisordersProvideinformationaboutdiagnosis,epidemiology,andtreatmentforeachdisorderTHENATUREOFFEARANDANXIETYFlightorfightresponse(Cannon,1929)Bodyreactstod
2、angerbyreleasingadrenalinethroughbloodstreamRelatedbehavioursinclude:Freezing–toappraisedangerFlight–escapeFight–ifdangerisunavoidable“Truealarms”(directdanger)versus“falsealarms”(noimmediatethreat)FalsealarmsarethehallmarkofanxietydisordersTHENATUREOFFEARANDAN
3、XIETYTriplevulnerabilitymodel(Barlow,2002)THENATUREOFFEARANDANXIETYFearcanbeacquiredinseveralways:Conditioning–pairingofaconditionedstimuluswithanaversiveeventInformationalpathwayVicariousacquisitionTheseallcontributetotheexpectationthatanaversiveoutcomeisproba
4、bleTHENATUREOFFEARANDANXIETYUS(bittenbydog)UR(fear)CR(fear)CS(dog)pairwithConditioningSPECIFICPHOBIADSM-IV-TRDiagnosisincludes:MarkedfearthatisexcessiveorunreasonableCuedbypresenceoranticipationofphobicobject/situationCausesinterference/impairmentinlifeormarked
5、distressFoursubtypes:AnimalNaturalEnvironment(i.e.,storms,heights,water)Blood-Injection–Injury(i.e.,blood,operationscenes,injections,faintingcommon)Situational(i.e.,planes,elevators)EpidemiologyLifetimeprevalence4-8%,femaletomaleratio2:1SPECIFICPHOBIAAetiologyP
6、hobiasmaybeacquiredbyclassicalconditioningE.g.,AneutralCS(whiterat)ispairedwithaUS(loudnoise)thatproducesfearProblemswithclassicalconditioningaccountManypeoplewithspecificphobiasdonotrememberaninitialtraumaticevent(Menzies&Clark,1993)Preparedness:Somestimulusca
7、nbeconditionedmoreeasily(Seligman,1971)SPECIFICPHOBIATreatmentExposure-basedtreatmentsarethemosteffective(Choyetal.,2007)Invivoexposure–facingphobicstimulusinreallifeImaginalorvirtualexposureExposuresmayworkthroughextinctionFeardecreasesoverrepeatedpresentation
8、softheCSintheabsenceoftheUSTheymayalsoworkbychallengingexpectationsofdanger,increasingself-efficacy,andincreasingperceptionofcontrolPANICDISORDERANDAGORAPHOBIADSM-IV-TRDiagn
