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Panic disorder (Cognitive model
--> says elaborative reappraisal needs…
Panic disorder
Cognitive model
--> says elaborative reappraisal needs to be separate from automatic responses for panic attack to happen lol :P
--> cause if reappraisal of threat possible there would be no panic attack :D !!
--> CBT AIMS TO REESTABLISH LINK BETWEEN REAPPRAISAL STRATEGIES AND ALL TEH AUTOMATIC PROCESSES :D!!
1. Stimulus
--> physical sensation
--> change in mental state (mind goes blank :D!!)
--> external stimuli will become associated with these and then can serve as triggers cause mind needs to give us reason as to why we do things we do :D!!!
2. Orienting mode
--> biased to detect and identify immediate danger to survival (as specified person to person lol)
--> automatic + unconscious --> hypersensitivity to body sensations
3. Primale mode activation
--> schemata's :D!!
--> believe body physiological changes = danger
-----> e.g. breathlessness = suffocation , pain = heart attack
--> depends on prior learning and context of first panic attack
--> symptoms / sensations need to reach threshold to trigger the schemas
4. Catastrophic Misinterpretation
--> sensations interpreted as immediate physically or mental disaster :p!! like omggg immadiehaha
--> if not imminent threat then only anxious :P !!
--> autonomic / automatic response :3!!
Intensifies autonomic arousal
---> cause makes people focus more on that particular body sensation :D!! which intensifies the feeling itself which makes them more worried which makes them pay more attention an ahhh omg haha vicious circle haha :D!!
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5. Loss of reappraisal strategies :D!!
--> cause if reappraisal of threat possible there would be no panic attack :D !!
--> they instead are being replaced by maladaptive coping strategies and worry :D !! see next points on the right :3!!
worry about panic attacks + future attacks
--> exclusively focused on panic attacks and not being able to withstand stress
avoidant coping + safety seeking
- --> avoiding situations that became triggers (agoraphobia = no longer going outside)
- --> safety signals (anxiety medicine, going with partner or friend)
---> BOTH BAD cause they become negative reinforcers based on Mower's 2 factor model cause through them the panic/anxiety avoided thus negative reinforcement after operant conditioning paradigm!!)
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Exposure therapy
---> not really based on conditioning see the 2016 awesome article I've downloaded which takes critical review of mowers 2 factor model with examples of why it doesn't really work :3 !!
mechanism
Extinction
Types of extinction
discrimination of reinforcement rate
--> more accumulated reinforcement in extinction condition leads animal to ignore actually fear cs-US association which has less accumulated reinforcement ( amount of time CS was reinforced = determines how strongly / often it activates so if extinction = more reinforced than actually cs-US then extinction works)
generalisation decrement
--> animal learned previous CS predicts nothing LOL
-----> KNEW THAT SHIT WHATS WITH THIS SHITTY NAMEE OMGG !!!!!!!!
inhibition of the response
--> extinction not equal to inhibiting the first conditioned response!
--> high responding to extinction doesn't mean more efficient extinction learning
Expectation violation á la rescorla wagner is what causes extinction :D!!
--> support form neurological studies :3!! #
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issues:
--> renewal effect = conditioning occurs in different context than extinction!
--> reinstatement= if presenting first US after extinction CS- US association might be reinstated
--> spontaneous recovery = after some time the extinction can spontaneously wear off :p and then pop back lol
--> rapid requisition = after extinction pair same CS- US stimulus and they learn it quicker than before (not so relevant :P! ocd maybe)
--> can be overcome by: (list of other reader :D!!)
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How to:
- get rid of safety behaviors (edition etc etc)
- stay in situation until anxiety decreases
- ask patient level of anxiety
- use hirachy
- habituation rational
- we don't need to know the cognition of patient
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AUTOMATIC / UNCONSCIOUS # # # # # #
Deliberate conscious reappraisal # #
LOOK AT ALL THSI LOL
all a bunch of bs titles :P !!
--> only good ones happens based on expectation violation (insight) and then learns CS = predicts nothing !! FINITE :D !! # #