PSYX 340 Psychological Disorders · Unit 1: Foundations, anxiety and trauma · on Exam 1
1.4 Anxiety, obsessive-compulsive and related disorders
Study notes for Anxiety, obsessive-compulsive and related disorders in PSYX 340 Psychological Disorders at Montana State University: the big ideas, a worked example, common mistakes and an exam tip. The same topic has endless practice questions and flashcards in Mathub.
Big ideas
- Generalized anxiety disorder (GAD): excessive, hard-to-control worry about many things, more days than not for at least 6 months, with at least 3 of 6 symptoms in adults (restlessness, fatigue, poor concentration, irritability, muscle tension, sleep trouble). Explanations include the sociocultural view (dangerous environments), cognitive views (metacognitive theory, intolerance of uncertainty, avoidance theory) and biology (GABA, benzodiazepines).
- Phobias: specific phobia (a particular object or situation) and agoraphobia (fear of places where escape could be hard, in at least 2 of 5 situation types), both lasting 6 months or more. Behaviorists explain phobias through classical conditioning and modeling, kept alive by avoidance; the treatment is exposure (systematic desensitization, flooding, modeling).
- Social anxiety disorder: intense fear of social or performance situations where one could be judged, lasting 6 months or more. Treated with exposure, social skills training, CBT and antidepressants.
- Panic disorder: recurrent, unexpected panic attacks (a surge of intense fear peaking within minutes, with at least 4 of 13 symptoms) followed by at least a month of worry about more attacks or changed behavior. Explained by the locus coeruleus and norepinephrine, plus the cognitive idea of misinterpreting body sensations; treated with antidepressants and CBT with interoceptive exposure.
- Obsessive-compulsive disorder (OCD): obsessions (intrusive, unwanted thoughts, urges or images) and/or compulsions (repetitive acts done to reduce distress) that take time (often over an hour a day) or cause distress. First-line treatments: exposure and response prevention (ERP) and SSRIs; serotonin and orbitofrontal-caudate circuits are implicated. Related disorders include body dysmorphic disorder, hoarding, trichotillomania and excoriation.
Worked example
Jordan has had three sudden attacks of pounding heart, dizziness and fear of dying in the past two months, each out of the blue. For the last six weeks he has avoided the gym in case exercise “sets one off”. Diagnosis?
Show the solution
Panic disorder. The attacks are unexpected and recurrent, and for more than a month he has worried about them and changed his behavior (avoiding exercise). A panic attack by itself is not a diagnosis; the persistent concern or behavior change is what makes it a disorder. If he began avoiding many places where escape is hard, agoraphobia would be considered too.
Common mistakes
- Calling a single panic attack “panic disorder”. You need recurrent unexpected attacks plus at least a month of concern or avoidance.
- Placing OCD among the anxiety disorders in DSM-5-TR: it now has its own chapter (obsessive-compulsive and related disorders).
- Treating compulsions as enjoyable. They are done to reduce anxiety, not for pleasure.
- Forgetting the 6-month duration for GAD, specific phobia, social anxiety disorder and agoraphobia.
Exam tipMake a grid of each disorder, its core fear, its duration and its best treatment. Exposure-based treatment appears again and again: exposure for phobias, interoceptive exposure for panic, ERP for OCD.
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