Comorbidity: existence of two disorders at a given time

Prevalence: extent of occurrence of disorder

Incidence: probability of occurrence

Neurosis vs. Psychosis

- Misconception: both are entirely different from one another

- Fact: both are related and are on the same scale
- Neurosis Normal Psychosis

- Neurotics “escape” reality but are able to return/rebound (builds sand castle but does not live there)
- Psychotics escape reality and live in their distortion (builds sand castle and lives there)

Anxiety vs. Worrying vs. Fear

- Worrying is a normal reaction to a situation (adaptive response)

- Anxiety is exaggerated worrying and fear (oftentimes maladaptive) of something yet to happen
(may/may not actually occur)
- Fear is directed to a present and real obstacle

ANXIETY

- Formerly called as “NEUROSIS” (being prone to anxiety, fear, and guilt feelings)
- 2 basic features:
o Concept of reality is relatively unimpaired
o “Ambulatory” disorders – most people are still able to go on with their daily fxns (they are
still able to cope but poorly)
- Psychodynamic perspective on anxiety disorders (phobia): repressed impulses from the id

ANXIETY DISORDERS

GENERALIZED ANXIETY DISORDER (GAD)

- Etiology: strict parental demands for perfectionism/strong parental control (baby boomers)
(psychodynamic)
- No/insufficient consensual validation – results to affirmation as love language
- May develop compulsion; guilt prone
- EF: Apprehension, exaggerated worrying; difficulty in controlling; interference with psychosocial
functioning
o Chronic panic attacks – constantly and continuously occurring (free-floating anxiety:
person constantly believes that something bad is about to happen)
 o Secondary manifestation: Health
 Some people become prone to medical illnesses (e.g. diarrhea, ulcers, etc.)
- Manifestation of secondary anxiety (anxiety about their anxiety) – people don’t want to be worrying
but as a result, they develop an anxiety towards that
- L. Lapuz – panic attacks as “atake ng nerbiyos”

SPECIFIC PHOBIA (2nd most common)

- Etiology: learning
o Shaping
o Reinforcement
 Genie? – raised in narcissistic manner, sexually abusive father
o Learned behaviour incapacitated her functioning
o Hygiene and moral capacity; language/communication skills
- Prevalence: 10%
- Common: animal, acrophobia, claustrophobia, agoraphobia

PANIC DISORDER

- Duration Criteria: 1 month

- Not due to drug abuse/addiction or other medical condition
- Prior to panic attacks, worrying is experienced
- Recurrent panic attacks (sweats, dizziness, trembling, shivering, gasping for breath)
- Experiences episodes of total collapse
- Feelings of losing one’s mind/having mental breakdown

AGORAPHOBIA

- Fear of public places

- Essential Feature: fear is coming from the idea of being mixed with huge crowds

SELECTIVE MUTISM

- EF: fear/failure of speaking in specific social situation where there is an expectation of

speaking/talking to others
- Not attributable to lack of knowledge/speech disorders

SEPARATION ANXIETY

- Excessive fear/anxiety of being separated from home/attachment figures

- Applicable to transitional objects as attachment figures
 DSM IV-TR DSM 5
Anxiety Disorders Anxiety Disorders Obsessive-Compulsive Trauma and Stress
and related Disorders related Disorders
Specific Phobia Specific Phobia
Social Phobia Social Anxiety Disorder
Panic Disorder
Panic Disorder
Agoraphobia
Generalized Anxiety GAD
Disorder (GAD)
Obsessive-Compulsive OCD
Disorder (OCD)
Acute Stress disorder Acute Stress Disorder
Posttraumatic Stress PTSD
Disorder (PTSD)
Separation Anxiety Body Dysmorphic
Disorder Disorder
Selective Mutism Hoarding
Unspecified Anxiety Trichotillomania (hair-
Disorder pulling disorder)
Excoriation (skin-picking
disorder)

OBSSESSIVE-COMPULSIVE AND RELATED DISORDERS

OCD

- Obsessions: repetitive and persistent thoughts, images, urges (preoccupation with an idea)
- Compulsions: repetitive (recurrent) behaviours/acts that the person feels driven to perform in
response to obsessions (ritualistic/habitual)
- Obsessions are unwanted/unpleasant – anchored on negative thoughts; may be
morbid/sexual/aggressive
- Person tries to remove obsessions thru compulsive behaviour
- Obsessions are more common
- Obsessive-Compulsive Cycle

Relief Obsession

Compulsion Anxiety
 - Prevalence: 3%
o 14-22% in twins
- No gender-difference
- Onset: generally late adolescence, early adulthood
- Comorbidity: with mood disorders/anxiety disorders
- Etiological Factors:
o OCD as learned behaviour
o Effects of attempting to suppress obsessive thoughts
o Appraisals of responsibility for intrusive thoughts
o Cognitive biases and distortions
o Genetic factors
o OCD and the brain – basal ganglia (midbrain)
o Neurotransmitter abnormalities – high serotonin; in some cases, GABA (not indicated
whether high/low)
o Psychodynamic – regression to anal phase (2-4 yrs); rigid/fixed/tight

BODY DYSMORPHIC DISORDER

- EF: perceived body defect/flaws in physical appearance not observable/appear slight to others
o Unacceptance of body flaws (based on persons’ perception of himself)

HOARDING

TRICHOTILLOMANIA (Hair-Pulling Disorder)

EXCORIATION (Skin-Picking) Disorder