The document titled "1.6 Normal or Abnormal_" is an extensive and detailed exploration of various psychological and psychiatric concepts, predominantly focusing on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the differences between fear and anxiety, phobias, and a comprehensi...
PBL 1.6 N. 1 - 15/03/2021
DSM-5
video: https://www.youtube.com/watch?v=G5MqOVB_JrM&t=1s
Diagnostic Statistical Manual of Mental Disorders (DSM-5) published by the
American Psychiatric Association. It is the current mental disorder
classification system.
The DSM provides information about each mental disorder including features,
symptoms and criteria used to diagnose that disorder.
Provides info about:
- each mental disorder ( e.g. features and criteria to diagnose)
- differential diagnosis ( disorders that present similar symptoms)
- prevalence
- NO INFO ABOUT TREATMENT
Not organized in alphabetical order but categorized according to the type of
disorder
The DSM is the most widely accepted and used diagnostic tool for mental health
scholars and professionals. However, it is also flawed → a theoretical attempt at
categorizing what is largely subjective (lacks clear boundaries) → met with much
criticism.
The DSM is periodically updated with new editions. The latest edition is the 5th
and it was published in 2013.
Fear VS Anxiety
Fear → it is an adaptive response (it allows us to escape), as it often prepares your
body for an immediate threat. It involves activation of the fight-or-flight response of
the autonomic nervous system. → instantaneous reaction to any imminent threat.
Fear is related to either a real or a perceived threat (exp. I’m afraid of snakes)
,Fear has three components:
➢ Cognitive/subjective components → I feel afraid/ terrified; I’m going to die
➢ Physiological components → increased heart rate and heavy breathing
➢ Behavioral component → strong urge to escape or flee
Anxiety → more difficult to identify as it is often the response to a vague sense of
threat, what the danger is cannot be clearly specified. Anxiety is the anticipation
of a future threat (exp. I’m anxious for my parents’ health) → it is irrational, no logical
reason to be afraid
The adaptive value of anxiety may be that it helps us plan and prepare for
possible threats.
In mild to moderate degrees, it can also actually enhance learning and
performance (anxiety on how you are going to do in your exam may be helpful)
However, anxiety is maladaptive when it becomes chronic and severe (anxiety
disorders)
Anxiety has three components:
➢ Cognitive/subjective components → negative mood, worry about possible
future threats or danger, self-preoccupation and a sense of being unable to predict
the future threat or control it
➢ Physiological components → state of tension and chronic overarousal. Anxiety
does prepare a person for the fight-or-flight response in case the threat occurs but
no activation as with fear.
➢ Behavioral component → strong tendency to avoid situations where danger
might be encountered, but there is no immediate urge to flee as there is with fear.
Many of the sources that produce fear and anxiety are learned (conditioning) →
neutral stimuli that are repeatedly paired with frightening events can acquire the
capacity to elicit fear or anxiety themselves.
Example → a girl named Angela sometimes saw and heard her father physically abuse her
mother in the evening. After this happened a few times, Angela started to become anxious
as soon as she heard her father’s car arrive in the driveway at the end of the day.
,Phobia → is a persistent and disproportionate fear of some specific object or
situation that presents little or no actual danger and yet leads to a great deal of
avoidance of these feared situations.
Epidemiology → is the study (scientific, systematic, and data-driven) of the
distribution (frequency, pattern) and determinants (causes, risk factors) of
health-related states and events in specified populations.
Aetiology → is the study of causation or origination
Comorbidity → the simultaneous presence of two or more diseases or medical
conditions in a patient
Anxiety Disorders
❖ Many people with one anxiety disorder will experience at least one more
anxiety disorder and/or depression either concurrently or at a different
point in their lives
PREVALENCE:
Around 30-40% of individuals will develop a problem that is anxiety related at
some point in their lives.
Lifetime prevalence rates for developing an anxiety disorder that was comorbid
with another psychological disorder was 44 per cent for women and 34 per cent
for men → more common in women than in men.
COMORBIDITY:
Many of the symptoms of anxiety are common to a number of different anxiety
disorders, and so it is relatively common for an individual to suffer from more
than one anxiety disorder
, Etiology for the Anxiety Disorders
Biological
BiologIcal - Genetical influences:
➢ Genetics have been known to contribute to the presentation of anxiety
symptoms.
Mutation of the serotonin transporter gene (5-HTTLPR) is related to a
reduction in serotonin activity and an increase in anxiety-related
personality traits.
➢ The interaction between genetics and stressful environmental
influences appears to account for more anxiety disorders than genetics
alone
Biological - Neurobiological structures:
Researchers have identified several brain structures (limbic system) and pathways
that are likely responsible for anxiety responses:
➢ The Amygdala → the area of the brain that is responsible for storing
memories related to emotional events.
When presented with a fearful situation, the amygdala initiates a reaction
to ready the body for a response. First, the amygdala triggers the
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