Anxiety
Apprehension about a future threat
List of Anxiety Disorders
Specific and social phobias, Panic disorder and agoraphobia, Generalized anxiety disorder, Obsessive compulsive disorder, Posttraumatic stress disorder
Phobia
Disruptive fear of a particular object or situation. Fear out of proportion to actual threat. Awareness that fear is excessive. Must be severe enough to cause distress or interfere with job or social life
Specific Phobia
Unwarranted, excessive fear of specific object or situation (Snakes, blood, flying, spiders, etc.). Trigger or feared object is avoided or endured with intense anxiety. High comorbidity of specific phobias.
Social Phobia
Persistent, intense fear of social situations. Fear of negative evaluation or scrutiny. More intense and extensive than shyness. Exposure to trigger leads to anxiety about being humiliated or embarrassed socially. Onset often adolescence.
Panic Disorder
Frequent panic attacks unrelated to specific situations
Panic Attack
Sudden, intense episode of apprehension, terror, feelings of impending doom. Symptoms reach peak intensity within 10 minutes.
Accompanied by at least 4 other symptoms: Sweating, nausea, labored breathing, dizziness, heart palpitations, upset stomach, ligh
Uncued Attacks
Occur unexpectedly without warning. Panic disorder diagnosis requires recurrent uncued attacks.
Cued Attacks
Triggered by specific situations (e.g., tunnel). More likely a phobia
Generalized Anxiety Disorder
Involves chronic, excessive, uncontrollable worry. Lasts at least 6 months. Interferes with daily life
Symptoms of GAD
Restlessness, poor concentration, irritability, muscle tension, tires easily, sleep disturbance
OCD-Obsessions
Intrusive, persistent, and uncontrollable thoughts or urges. Experienced as irrational (eg. Contamination, sexual & aggressive impulses, body problems)
OCD-Compulsions
Impulse to repeat certain behaviors or mental acts to avoid distress (e.g., cleaning, checking, hoarding, repeating a word, counting). Extremely difficult to resist the impulse. May involve elaborate behavioral rituals
PTSD
Extreme response to severe stressor. Anxiety, avoidance of stimuli associated with trauma, emotional numbing. Exposure to a traumatic event that involves actual or threatened death or injury (e.g., war, rape, natural disaster)
PTSD-Categories of Symptoms
1.Re-experiencing the traumatic event (Nightmares, intrusive thoughts, or images)
2.Avoidance of stimuli (e.g., Refuse to walk on street where rape occurred) Numbing (Decreased interest in others. Distant or estranged from others, Unable to experience pos
Acute Stress Disorder
Symptoms similar to PTSD, Duration varies (Short term reaction, Symptoms occur between 2 days and 1 month after trauma)
Comorbidity
� of those with anxiety disorder meet criteria for another disorder. 60% meet criteria for major depression.
Other Disorders Associated with Anxiety
Substance abuse, Personality disorders, Avoidant, Dependent, Histrionic
Gender and Sociocultural Factors of Anxiety
Women are 2x as likely as men to have anxiety disorder except for OCD (Why? Women may be more likely to report symptoms. Women are more likely to experience childhood sexual abuse. Women show more biological stress reactivity)
Risk Factors of Anxiety
Genetic: Twin studies suggest heritability
?About 20-40% for phobias, GAD, and PTSD
?About 50% for panic disorder
? Relative w/phobia increases risk for other anxiety disorders in addition to phobia).
Neurobiological:
Fear circuit overactivity
? Amygdala
Behavioral Inhibition
Tendency to be agitated, distressed, and cry in unfamilar or novel settings (Observed in infants as young as 4 months, may be inherited, predicts anxiety in childhood and social anxiety in adolescence). Risk factor.
Neuroticism
React with negative affect. Linked to anxiety and depression.
Common Aspects of Psychological Assessment
Face the situation or object that triggers anxiety. Should include as many features of the trigger as possible. Should be conducted in as many settings as possible. More effective than systematic desensitization
Systematic Desensitization
Relaxation plus imaginal exposure. Exposure is more effective.
Cognitive Approaches
Enhances treatment for social but not specific phobias. Clark's (2003) cognitive therapy more effective than medication or exposure.
Social Phobia Treatment
Exposure (Role playing or small group interaction.) Social skills training (Reduce use of safety behaviors)
Panic Control Treatment
Exposure to somatic sensations associated with panic attack in a safe setting. (Increased heart rate, rapid breathing, dizziness.) Use of coping strategies to control symptoms. (Relaxation, Deep breathing)
Panic and Agoraphobia Treatment
Cognitive Behavioral Therapy (CBT). Increase patient's awareness of thoughts that make physical sensations threatening. Patient learns to challenge and change maladaptive beliefs
Treatment of GAD
Relaxation training. Cognitive Behavioral methods
Treatment of OCD
Exposure plus ritual prevention (Most widely used treatment). Cognitive Therapy (Challenge beliefs about anticipated consequences of not engaging in compulsions. Usually also involves exposure)
Treatment of PTSD
Exposure to memories and reminders of the original trauma (Either direct (in vivo) or imaginal ? more effective than medication). Cognitive therapy
Anxiolytics
Drugs that reduce anxiety
Medications to Treat Anxiety
Benzodiazepenes (Valium, Xanax). Antidepressants (Tricyclics, Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin Reuptake Inhibitors (SRIs))