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Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.22,0:00:01.80,Default,,0000,0000,0000,,- [Instructor] Now let's take a look
Dialogue: 0,0:00:01.80,0:00:05.05,Default,,0000,0000,0000,,at Generalized Anxiety Disorder or GAD.
Dialogue: 0,0:00:06.02,0:00:08.16,Default,,0000,0000,0000,,And this disorder is characterized
Dialogue: 0,0:00:08.16,0:00:12.44,Default,,0000,0000,0000,,by excessive anxiety\Nunder most circumstances
Dialogue: 0,0:00:12.44,0:00:15.52,Default,,0000,0000,0000,,and worry about practically anything.
Dialogue: 0,0:00:16.45,0:00:19.44,Default,,0000,0000,0000,,GADs sometimes is what is also referred to
Dialogue: 0,0:00:19.44,0:00:21.53,Default,,0000,0000,0000,,as free-floating anxiety.
Dialogue: 0,0:00:24.32,0:00:28.32,Default,,0000,0000,0000,,It usually first appears\Nin childhood or adolescence
Dialogue: 0,0:00:28.32,0:00:32.95,Default,,0000,0000,0000,,and in fact it is quite\Ncommon in the Western society.
Dialogue: 0,0:00:32.95,0:00:35.74,Default,,0000,0000,0000,,Women tend to be diagnosed more than men
Dialogue: 0,0:00:35.74,0:00:38.41,Default,,0000,0000,0000,,by about a ratio of two to one.
Dialogue: 0,0:00:38.41,0:00:42.58,Default,,0000,0000,0000,,And about 1/4 of people\Nwho are diagnosed with this
Dialogue: 0,0:00:43.54,0:00:46.38,Default,,0000,0000,0000,,are currently in treatment.
Dialogue: 0,0:00:46.38,0:00:47.80,Default,,0000,0000,0000,,And there you see
Dialogue: 0,0:00:48.84,0:00:52.42,Default,,0000,0000,0000,,the characteristics\Nfor GAD from the DSM-5.
Dialogue: 0,0:00:53.68,0:00:56.14,Default,,0000,0000,0000,,For six months and more,\Nthe person experiences
Dialogue: 0,0:00:56.14,0:00:59.18,Default,,0000,0000,0000,,disproportionate, uncontrollable,
Dialogue: 0,0:00:59.18,0:01:03.94,Default,,0000,0000,0000,,and ongoing anxiety and\Nworry about multiple matters.
Dialogue: 0,0:01:03.94,0:01:07.23,Default,,0000,0000,0000,,The symptoms include at\Nleast three of the following.
Dialogue: 0,0:01:07.23,0:01:11.40,Default,,0000,0000,0000,,Edginess, fatigue, poor\Nconcentration, irritability,
Dialogue: 0,0:01:12.46,0:01:15.24,Default,,0000,0000,0000,,muscle tension, and sleep problems.
Dialogue: 0,0:01:15.24,0:01:18.24,Default,,0000,0000,0000,,And there's significant\Ndistress or impairment
Dialogue: 0,0:01:18.24,0:01:20.18,Default,,0000,0000,0000,,with the disorder.
Dialogue: 0,0:01:20.18,0:01:21.68,Default,,0000,0000,0000,,And we know that there are a variety
Dialogue: 0,0:01:21.68,0:01:25.84,Default,,0000,0000,0000,,of theoretical explanations to\Nexplain Generalized Anxiety,
Dialogue: 0,0:01:27.29,0:01:31.18,Default,,0000,0000,0000,,so let's take a look at those\Ntheoretical explanations.
Dialogue: 0,0:01:31.18,0:01:34.97,Default,,0000,0000,0000,,The first is the\Nsocio-cultural perspective,
Dialogue: 0,0:01:34.97,0:01:36.08,Default,,0000,0000,0000,,which basically focuses
Dialogue: 0,0:01:36.08,0:01:39.24,Default,,0000,0000,0000,,on societal and multicultural factors.
Dialogue: 0,0:01:41.24,0:01:45.05,Default,,0000,0000,0000,,For this perspective, GAD\Nis most likely to develop
Dialogue: 0,0:01:45.05,0:01:47.99,Default,,0000,0000,0000,,in people faced with social conditions
Dialogue: 0,0:01:47.99,0:01:50.07,Default,,0000,0000,0000,,that are truly dangerous.
Dialogue: 0,0:01:51.22,0:01:54.05,Default,,0000,0000,0000,,Research supports this theory.
Dialogue: 0,0:01:54.05,0:01:57.10,Default,,0000,0000,0000,,For example, when you take\Na look at situations like
Dialogue: 0,0:01:57.10,0:02:01.67,Default,,0000,0000,0000,,nuclear disaster, the\NThree Mile Island in 1979,
Dialogue: 0,0:02:01.67,0:02:05.83,Default,,0000,0000,0000,,Hurricane Katrina in 2005,\Nthe Haiti Earthquake in 2010,
Dialogue: 0,0:02:08.42,0:02:13.04,Default,,0000,0000,0000,,we've found significantly\Nhigher rates of GAD.
Dialogue: 0,0:02:13.04,0:02:16.64,Default,,0000,0000,0000,,A lot of the most powerful\Nforms of societal stress
Dialogue: 0,0:02:16.64,0:02:20.51,Default,,0000,0000,0000,,is poverty, and we find\Nthat those individuals
Dialogue: 0,0:02:20.51,0:02:25.15,Default,,0000,0000,0000,,who face less equality, less\Npower, greater vulnerability,
Dialogue: 0,0:02:25.15,0:02:28.56,Default,,0000,0000,0000,,rundown communities, higher crime rates,
Dialogue: 0,0:02:28.56,0:02:31.67,Default,,0000,0000,0000,,fewer educational and job opportunities,
Dialogue: 0,0:02:31.67,0:02:35.84,Default,,0000,0000,0000,,are definitely at a greater\Nrisk for health problems.
Dialogue: 0,0:02:36.81,0:02:39.67,Default,,0000,0000,0000,,And as would be predicted\Nby this model then,
Dialogue: 0,0:02:39.67,0:02:42.27,Default,,0000,0000,0000,,rates of GAD are generally higher
Dialogue: 0,0:02:42.27,0:02:45.74,Default,,0000,0000,0000,,in lower socio-academic status groups.
Dialogue: 0,0:02:45.74,0:02:48.80,Default,,0000,0000,0000,,However, while the poverty\Nand other social pressures
Dialogue: 0,0:02:48.80,0:02:51.37,Default,,0000,0000,0000,,may create a climate for GAD,
Dialogue: 0,0:02:51.37,0:02:54.83,Default,,0000,0000,0000,,other factors are clearly at work.
Dialogue: 0,0:02:54.83,0:02:56.29,Default,,0000,0000,0000,,And we find that quite honestly,
Dialogue: 0,0:02:56.29,0:02:59.18,Default,,0000,0000,0000,,most people who're living\Nin dangerous environments
Dialogue: 0,0:02:59.18,0:03:01.96,Default,,0000,0000,0000,,don't actually develop GAD,
Dialogue: 0,0:03:01.96,0:03:04.31,Default,,0000,0000,0000,,and other models will\Nattempt to explain then
Dialogue: 0,0:03:04.31,0:03:08.47,Default,,0000,0000,0000,,why some people develop the\Ndisorder and others do not,
Dialogue: 0,0:03:09.92,0:03:14.09,Default,,0000,0000,0000,,such as this perspective, the\Npsychodynamic perspective.
Dialogue: 0,0:03:15.04,0:03:16.90,Default,,0000,0000,0000,,The psychodynamic perspective believe
Dialogue: 0,0:03:16.90,0:03:19.90,Default,,0000,0000,0000,,that all children experience anxiety
Dialogue: 0,0:03:19.90,0:03:24.09,Default,,0000,0000,0000,,and use defense mechanisms\Nto help control it.
Dialogue: 0,0:03:24.09,0:03:28.62,Default,,0000,0000,0000,,Realistic anxiety results\Nfrom actual danger.
Dialogue: 0,0:03:28.62,0:03:31.29,Default,,0000,0000,0000,,Neurotic anxiety, though,\Nresults when children
Dialogue: 0,0:03:31.29,0:03:35.29,Default,,0000,0000,0000,,are prevented from\Nexpressing their id impulses.
Dialogue: 0,0:03:36.92,0:03:40.47,Default,,0000,0000,0000,,So Freud believes then, that\Nexcessive childhood neurotic
Dialogue: 0,0:03:40.47,0:03:43.72,Default,,0000,0000,0000,,or moral anxiety set the stage for GAD.
Dialogue: 0,0:03:44.96,0:03:48.14,Default,,0000,0000,0000,,Contemporary theorists,\Nhowever, often disagree
Dialogue: 0,0:03:48.14,0:03:51.77,Default,,0000,0000,0000,,with very specific aspects\Nof Freud's explanation,
Dialogue: 0,0:03:51.77,0:03:54.34,Default,,0000,0000,0000,,though most continue to\Nbelieve that the disorder
Dialogue: 0,0:03:54.34,0:03:58.50,Default,,0000,0000,0000,,can be traced to an adequate\Nparent-child relationships.
Dialogue: 0,0:04:00.68,0:04:03.18,Default,,0000,0000,0000,,So when we take a look at the techniques
Dialogue: 0,0:04:03.18,0:04:06.31,Default,,0000,0000,0000,,that are used or the therapies,
Dialogue: 0,0:04:06.31,0:04:09.02,Default,,0000,0000,0000,,in general they use the\Nsame general techniques
Dialogue: 0,0:04:09.02,0:04:11.50,Default,,0000,0000,0000,,for treating all dysfunctions.
Dialogue: 0,0:04:11.50,0:04:15.67,Default,,0000,0000,0000,,So example free association,\Ntherapist's interpretation,
Dialogue: 0,0:04:17.52,0:04:20.95,Default,,0000,0000,0000,,transference, resistance, dream analysis.
Dialogue: 0,0:04:20.95,0:04:23.30,Default,,0000,0000,0000,,So those items that we\Nhad mentioned earlier
Dialogue: 0,0:04:23.30,0:04:24.45,Default,,0000,0000,0000,,when we were taking a look
Dialogue: 0,0:04:24.45,0:04:26.98,Default,,0000,0000,0000,,at some of the different approaches.
Dialogue: 0,0:04:26.98,0:04:30.36,Default,,0000,0000,0000,,Specific treatment for GAD,\Nthe Freudians focus less
Dialogue: 0,0:04:30.36,0:04:34.86,Default,,0000,0000,0000,,on the fear and more on\Nthe control of the id.
Dialogue: 0,0:04:34.86,0:04:38.35,Default,,0000,0000,0000,,Object-Relations therapists\Nattempt to help patients
Dialogue: 0,0:04:38.35,0:04:42.35,Default,,0000,0000,0000,,identify and settle\Nearly-relationship problems.
Dialogue: 0,0:04:43.35,0:04:45.83,Default,,0000,0000,0000,,Overall though, the research has shown
Dialogue: 0,0:04:45.83,0:04:48.28,Default,,0000,0000,0000,,that the psychodynamic approaches
Dialogue: 0,0:04:48.28,0:04:52.45,Default,,0000,0000,0000,,to be of only modest help\Nin treating cases of GAD.
Dialogue: 0,0:04:54.33,0:04:58.49,Default,,0000,0000,0000,,So now let's take a look at\Nthe humanistic perspective.
Dialogue: 0,0:04:58.49,0:05:01.09,Default,,0000,0000,0000,,According to the humanistic perspective,
Dialogue: 0,0:05:01.09,0:05:05.18,Default,,0000,0000,0000,,GAD arises when people\Nstop looking at themselves
Dialogue: 0,0:05:08.26,0:05:10.89,Default,,0000,0000,0000,,honestly and acceptingly.
Dialogue: 0,0:05:10.89,0:05:13.63,Default,,0000,0000,0000,,And we have to look to\NCarl Rogers who again,
Dialogue: 0,0:05:13.63,0:05:17.80,Default,,0000,0000,0000,,we first met when we talked\Nabout the humanistic approach,
Dialogue: 0,0:05:18.81,0:05:20.96,Default,,0000,0000,0000,,but according to Carl Rogers,
Dialogue: 0,0:05:20.96,0:05:25.20,Default,,0000,0000,0000,,the lack of unconditional\Npositive regard in childhood
Dialogue: 0,0:05:25.20,0:05:29.37,Default,,0000,0000,0000,,leads to harsh self-standards,\Nknown as conditions of worth.
Dialogue: 0,0:05:30.31,0:05:32.74,Default,,0000,0000,0000,,These threatening\Nself-judgments break through
Dialogue: 0,0:05:32.74,0:05:36.91,Default,,0000,0000,0000,,and cause anxiety, setting\Nthe stage for GAD to develop.
Dialogue: 0,0:05:38.61,0:05:43.41,Default,,0000,0000,0000,,Carl Rogers proposed\Nclient-centered therapy then
Dialogue: 0,0:05:43.41,0:05:47.77,Default,,0000,0000,0000,,in which unconditional\Npositive regard is given
Dialogue: 0,0:05:47.77,0:05:51.19,Default,,0000,0000,0000,,to help the individual deal with anxiety.
Dialogue: 0,0:05:53.99,0:05:56.98,Default,,0000,0000,0000,,The cognitive perspective believes
Dialogue: 0,0:05:56.98,0:05:59.19,Default,,0000,0000,0000,,that psychological problems are caused
Dialogue: 0,0:05:59.19,0:06:01.92,Default,,0000,0000,0000,,by dysfunctional ways of thinking,
Dialogue: 0,0:06:01.92,0:06:04.50,Default,,0000,0000,0000,,in particular, excessive worry.
Dialogue: 0,0:06:05.64,0:06:08.85,Default,,0000,0000,0000,,And very often, cognitive\Ntherapists will say
Dialogue: 0,0:06:08.85,0:06:11.24,Default,,0000,0000,0000,,that someone who is dealing with GAD
Dialogue: 0,0:06:11.24,0:06:15.40,Default,,0000,0000,0000,,is dealing with this because\Nit's caused primarily
Dialogue: 0,0:06:16.34,0:06:19.10,Default,,0000,0000,0000,,by maladaptive assumptions.
Dialogue: 0,0:06:19.10,0:06:20.79,Default,,0000,0000,0000,,The person that we want associating
Dialogue: 0,0:06:20.79,0:06:23.22,Default,,0000,0000,0000,,with this approach is Albert Ellis.
Dialogue: 0,0:06:23.22,0:06:25.30,Default,,0000,0000,0000,,And he proposed that the presence
Dialogue: 0,0:06:25.30,0:06:28.08,Default,,0000,0000,0000,,of these basic irrational assumptions
Dialogue: 0,0:06:28.08,0:06:31.50,Default,,0000,0000,0000,,lead people to act in inappropriate ways
Dialogue: 0,0:06:31.50,0:06:36.13,Default,,0000,0000,0000,,when these assumptions are\Nrelied on in everyday life.
Dialogue: 0,0:06:36.13,0:06:38.97,Default,,0000,0000,0000,,Another theorist, Aaron Beck, argued
Dialogue: 0,0:06:38.97,0:06:42.36,Default,,0000,0000,0000,,that those with Generalized\NAnxiety Disorder hold
Dialogue: 0,0:06:42.36,0:06:46.53,Default,,0000,0000,0000,,unrealistic silent assumptions\Nimplying imminent danger.
Dialogue: 0,0:06:48.41,0:06:51.65,Default,,0000,0000,0000,,And research does suggest\Nor support the notion
Dialogue: 0,0:06:51.65,0:06:55.82,Default,,0000,0000,0000,,that people with GAD do hold\Nthese maladaptive assumptions,
Dialogue: 0,0:06:58.00,0:07:00.42,Default,,0000,0000,0000,,especially when they're facing situations
Dialogue: 0,0:07:00.42,0:07:03.09,Default,,0000,0000,0000,,that are particularly dangerous.
Dialogue: 0,0:07:05.10,0:07:08.71,Default,,0000,0000,0000,,Biological perspective then, believes
Dialogue: 0,0:07:08.71,0:07:13.05,Default,,0000,0000,0000,,that GAD is caused primarily\Nby biological factors.
Dialogue: 0,0:07:13.05,0:07:15.33,Default,,0000,0000,0000,,And in particular, what\Nwe're gonna focus on
Dialogue: 0,0:07:15.33,0:07:17.45,Default,,0000,0000,0000,,are the pedigree studies.
Dialogue: 0,0:07:17.45,0:07:21.20,Default,,0000,0000,0000,,And in fact, the pedigree studies find
Dialogue: 0,0:07:21.20,0:07:24.82,Default,,0000,0000,0000,,significant support for\Nthe biological approach.
Dialogue: 0,0:07:24.82,0:07:29.21,Default,,0000,0000,0000,,Biological relatives are\Nmore likely to develop GAD,
Dialogue: 0,0:07:29.21,0:07:33.76,Default,,0000,0000,0000,,about 15%, compared to\Nthe general population,
Dialogue: 0,0:07:33.76,0:07:36.81,Default,,0000,0000,0000,,which is only approximately 6%.
Dialogue: 0,0:07:36.81,0:07:40.16,Default,,0000,0000,0000,,And what we find is that\Nthe closer relative,
Dialogue: 0,0:07:40.16,0:07:42.42,Default,,0000,0000,0000,,the greater the likelihood.
Dialogue: 0,0:07:42.42,0:07:46.68,Default,,0000,0000,0000,,However, there is also some\Nevidence or some indication
Dialogue: 0,0:07:46.68,0:07:50.85,Default,,0000,0000,0000,,that shared-upbringing can\Ncontribute to having GAD.
Dialogue: 0,0:07:56.72,0:08:00.88,Default,,0000,0000,0000,,Alright, when we take a look\Nat the neurotransmitter GABA,
Dialogue: 0,0:08:01.74,0:08:06.62,Default,,0000,0000,0000,,we find that GABA inactivity\Ndoes contribute to it,
Dialogue: 0,0:08:06.62,0:08:10.78,Default,,0000,0000,0000,,and may play a role in an\Nindividual developing GAD.
Dialogue: 0,0:08:13.44,0:08:17.12,Default,,0000,0000,0000,,So when we take a look at\Nthe biology of anxiety,
Dialogue: 0,0:08:17.12,0:08:18.95,Default,,0000,0000,0000,,we find that the circuit in the brain
Dialogue: 0,0:08:18.95,0:08:21.98,Default,,0000,0000,0000,,that helps produce anxiety reactions,
Dialogue: 0,0:08:21.98,0:08:25.28,Default,,0000,0000,0000,,includes areas such as the amygdala,
Dialogue: 0,0:08:25.28,0:08:30.26,Default,,0000,0000,0000,,the prefrontal cortex, and\Nthe anterior cingulate cortex.
Dialogue: 0,0:08:30.26,0:08:32.40,Default,,0000,0000,0000,,So in other words, what we are finding
Dialogue: 0,0:08:32.40,0:08:35.84,Default,,0000,0000,0000,,is that there are definitely\Ncertain parts of the brain
Dialogue: 0,0:08:35.84,0:08:38.59,Default,,0000,0000,0000,,that are impacting one's anxiety.
Dialogue: 0,0:08:41.67,0:08:45.15,Default,,0000,0000,0000,,So when we take a look at treatment,
Dialogue: 0,0:08:45.15,0:08:47.90,Default,,0000,0000,0000,,the anti-anxiety medications,
Dialogue: 0,0:08:47.90,0:08:52.07,Default,,0000,0000,0000,,the pre-1950s treatments\Nwere primarily barbiturates.
Dialogue: 0,0:08:53.46,0:08:57.25,Default,,0000,0000,0000,,Post-1950 treatments were Benzodiazepines,
Dialogue: 0,0:08:57.25,0:09:00.46,Default,,0000,0000,0000,,and they provide temporary modest relief,
Dialogue: 0,0:09:00.46,0:09:04.14,Default,,0000,0000,0000,,but they can cause\Nrebound-anxiety with withdrawal
Dialogue: 0,0:09:04.14,0:09:07.64,Default,,0000,0000,0000,,when you stop using them,\Nand physical dependence,
Dialogue: 0,0:09:07.64,0:09:10.66,Default,,0000,0000,0000,,we know, is definitely very possible.
Dialogue: 0,0:09:10.66,0:09:13.29,Default,,0000,0000,0000,,In addition, Benzodiazepines
Dialogue: 0,0:09:13.29,0:09:17.45,Default,,0000,0000,0000,,also have undesirable\Neffects, such as drowsiness.
Dialogue: 0,0:09:20.39,0:09:23.99,Default,,0000,0000,0000,,More recently, other medications\Nhave become available,
Dialogue: 0,0:09:23.99,0:09:28.16,Default,,0000,0000,0000,,such as antidepressants and\Nantipsychotic medications.
Dialogue: 0,0:09:29.15,0:09:32.46,Default,,0000,0000,0000,,In addition, there is relaxation training,
Dialogue: 0,0:09:32.46,0:09:36.91,Default,,0000,0000,0000,,in which someone learns\Nto physically relax,
Dialogue: 0,0:09:36.91,0:09:40.57,Default,,0000,0000,0000,,which will lead to\Npsychological relaxation,
Dialogue: 0,0:09:40.57,0:09:45.13,Default,,0000,0000,0000,,and in particular, on\Nthe use of biofeedback.
Dialogue: 0,0:09:45.13,0:09:46.71,Default,,0000,0000,0000,,So with biofeedback,
Dialogue: 0,0:09:46.71,0:09:50.90,Default,,0000,0000,0000,,there're electrical signals from the body
Dialogue: 0,0:09:50.90,0:09:52.33,Default,,0000,0000,0000,,that are used to train people
Dialogue: 0,0:09:52.33,0:09:55.74,Default,,0000,0000,0000,,to control their physiological responses.
Dialogue: 0,0:09:55.74,0:09:58.67,Default,,0000,0000,0000,,The most widely used biofeedback tool
Dialogue: 0,0:09:58.67,0:10:01.83,Default,,0000,0000,0000,,is this electromyograph or EMG,
Dialogue: 0,0:10:01.83,0:10:05.43,Default,,0000,0000,0000,,which provides feedback\Nabout muscle tension.
Dialogue: 0,0:10:05.43,0:10:09.10,Default,,0000,0000,0000,,The greatest impact is\Nfound when it is used
Dialogue: 0,0:10:10.57,0:10:14.32,Default,,0000,0000,0000,,in combination with\Nother medical treatments.
Dialogue: 0,0:10:16.18,0:10:18.18,Default,,0000,0000,0000,,Alright, this mini lecture took a look
Dialogue: 0,0:10:18.18,0:10:21.46,Default,,0000,0000,0000,,at Generalized Anxiety, the symptoms,
Dialogue: 0,0:10:21.46,0:10:22.97,Default,,0000,0000,0000,,and the different theories,
Dialogue: 0,0:10:22.97,0:10:26.14,Default,,0000,0000,0000,,as to what causes Generalized Anxiety.