I.

Specific Phobia
A. B. C. Traumatic experience and conditioning Heritability and neuroticism Phobic conditioning Morers two-factor model
1. Classical conditioning neutral stimuli (CS) with an unconditioned stimuli (UCS) 2. Operant conditioning

D.

Modelling, direct exposure, verbal instruction

II.

Social Phobia
A. Two-factor model
1. 2. Classical conditioning Operant conditioning

B.

Negative social experience: modelling or verbal instruction

C. Cognitive factor: focus on negative self-evaluation (do not believe in themselves; unrealistic negative consequences in response to their behaviour)

III.

Treatment for Phobia

A. Exposure to feared object or situation
1. Systematic desensitization a) b) 2. Relaxation training Dealing with the hierarchy of fears

Cognitive therapy not as effective as #1 a) Challenging phobic beliefs

3.

Medications

a)

Benzodiazepenes and antidepressants

b) Beta blockers (block adrenaline effects that increase the heart rate)

IV.

Panic Disorder
A. Neurobiological factors
1. Locus ceruleus major source of neurotransmitter norepinephrine in the brain which triggers the sympathetic nervous system activity 2. Misfire of the fear circuit system

B.

Classical conditioning
1. Interoceptive conditioning arousal of internal bodily sensations

C.

Cognitive factors
1. 2. 3. Perceived control no control over somatic changes Fear of the bodily sensations Agoraphobia (etiology) a) Fear-of-fear hypothesis driven by negative thoughts about the consequences of having a panic attack in public

V.

Treatment of Panic Attack and Agoraphobia

A. Cognitive Behavioural Approach or Panic Control Therapy (PCT)
1. Use of exposure technique

2. Stop from seeing sensations as loss of control and see them as harmless sensations that can be controlled

B.

Medication
1. SSRI antidepressants (selective serotonin reuptake inhibitor)

VI.

Generalized Anxiety Disorder

A. Worry is reinforcing because it distracts people from more powerful negative emotions and images B. Decreased physiological signs of arousal

VII. Treatment of GAD

A. Behavioural and cognitive approaches
1. Relaxation training (promote calmness)

2. Training in detecting cues to anxiety and strategies to counter negative thoughts 3. 4. Worry only at certain times and keep a diary of the outcomes of worry Focus thoughts on the present moment

B.

Medications
1. 2. 3. 4. Benzodiazepenes Tricyclic antidepressants Buspirone SSRI

VIII. Obsessive-Compulsive Disorder (OCD)

A. Neurobiological factor
1. 2. 3. Orbitofrontal cortex Candate nucleus Anterior cingulated

B.

Behavioural factors in compulsions

1. Compulsions a) b) Operant conditioning Reinforced by reducing anxiety

C.

Cognitive factors in obsessions

1. 2.

Attempt to suppress thoughts about these obsessions Over-occupation with suppressing their obsessive thoughts

IX.

Treatment of OCD
A. B. Behavioural approach ERP (Exposure and Ritual Prevention) Medication

X.

Posttraumatic Stress Disorder (PTSD)

A. B. Nature of trauma: severity Neurobiological factors
1. Hippocampus role in memories, smaller in people with PTSD

2. Hormones increase sensitivity of receptors to stress hormone cortisol, leading to high levels of norepinephrine 3. People with PTSD have high levels of norepinephrine

C. D.

Behavioural factors two-factor model of Morer Psychological factors

1. 2. 3. Cognition and coping Symptoms of dissociation - lack of perceived control Suppression of memory

E.

Critical Incident Stress Debriefing (CISD)

1. Immediate treatment of trauma victims within 72 hours of traumatic event: one lone session 2. Done so victims of traumatic events can vent out and express their feelings about the event 3. Sometimes people cope better when they are helped by people they know such as family and friends: sometimes therapists are coercive in their methods

XI.

Treatment and factors to help cope with PTSD

A. Coping
1. 2. Strong social support High intelligence

B.

Treatment
1. More exposure to fear-provoking stimuli to confront the trauma and gain mastery and anguish anxiety 2. 3. Intervention for acute cases Psychoactive drugs a) 4. Benzodiazepenes and antidepressants

Eye Movement Desensitization and Reprocessing (EMDR) a) Person imagines an object or situation related to the traumatic event b) Eye is made to move across the image back and forth, following the therapists finger c) The person is made to imagine a positive object or situation while following the therapists finger