1.6 Normal or Abnormal, Clinical Psychology
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Problem 1 – abnormal psy by Hooley and Butcher 17th Ed. + abnormal psy by Nolen and Hoeksema 6th Ed.
Anxiety vs fear: anxiety involves a general feeling of apprehension about possible future danger, whereas
fear is an alarm reaction that occurs in response to immediate danger.
‘Anxiety disorders’ share symptoms of clinically significant anxiety or fear. Anxiety disorders are the most
common category of disorders for women and second most common for men. Anxiety disorders have the
earliest age of onset of all mental illnesses.
Historically anxiety disorders were considered to be classic neurotic disorders. People with neurotic
disorders show maladaptive and self-defeating behaviors but they are not incoherent, dangerous or out of
touch with reality. Freud says neurotic disorders developed when intrapsychic conflict produced significant
anxiety.
FEAR
Fear is a basic emotion that involves activation of
the fight or flight response of the autonomic
nervous system. This is an instantaneous reaction
to an immediate threat, it’s a primitive response
that allows us to escape. When the fear occurs in
the absence of any obvious external danger we
say the person is having a panic attack. In
contrast to fear and panic, the anxiety response pattern is a complex blend of unpleasant emotions and
cognitions that is more oriented towards future. They all have 3 components.
Anxiety disorders are characterized by unrealistic, irrational fear or anxieties that cause significant distress
and/or impairments in functioning. Disorders recognized among these in the DSM-5 are:
Specific phobia
Social anxiety disorder (social phobia)
Panic disorder
Agoraphobia
Generalized anxiety disorder
People with these disorders differ from one another in terms of the amount of fear/panic or anxiety they
experience.
Phobia: is a persistent and disproportionate fear of some specific object or situation that represents little
to no actual danger and yet leads to a great deal of avoidance of these feared situations. 3 main categories
of phobias are: specific, social and agoraphobia. The diagnosis of phobia is only warranted when people
reorganize their lives to avoid the feared situation or have severe anxiety attacks when confronted with
them.
SPECIFIC PHOBIAS
- It’s present if a person shows strong and persistent fear that is triggered by the presence of a
specific object or situation and leads to a significant distress and/or impairment in a person’s ability
to function.
- When people encounter a phobic stimulus, they often show an immediate fear response that
resembles a panic attack except for the existence of a clear external trigger. They also experience
anxiety if they anticipate the phobic object/situation and go to great lengths to avoid them.
- The avoidance is a key characteristic of phobia, it occurs both because the phobic response is
unpleasant and because of the person’s irrational appraisal of something terrible will happen.
, Phobic behavior tends to be reinforced because every time the person with a phobia avoids a feared
situation, his anxiety decreases. Increased attention, sympathy and some control over the behavior of
others can also reinforce phobia.
Blood-injection-injury phobia: people typically experience as much disgust as fear. Most people show
increase in heart rate and blood pressure when they encounter their phobic object but these people show
an initial acceleration and a dramatic drop in heart rate and BP which is accompanied by nausea, dizziness
or fainting. From an evolutionary perspective, this unique response pattern may have evolved to inhibit
further attacks when the person faints and the low BP minimizes blood loss. This type of phobia appears to
be highly heritable.
Specific phobias are common and occur in about 12% of people at some point in their life. Phobias are
more common in women (90-95% of animal phobias are women). Blood-injection-injury, dental or animal
phobias begin in childhood, others as claustrophobia and driving phobia tend to begin in adolescence or
adulthood.
Psychological causal factors:
Psychoanalytic view: phobias represent a defense against anxiety that stems from repressed impulses
from the id. It’s too dangerous to know the repressed id impulse, so the anxiety is displaced onto some
external object/situation that has some symbolic relationship to the real object of anxiety. Criticism: far too
speculative
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