Chapter 7 Anxiety Disorders © 2016 Academic Media Solutions

Anxiety Disorders Specific Phobia Social Anxiety Disorder (Social Phobia) Panic Disorder Agoraphobia Generalized Anxiety Disorder Anxiety Disorders have consistently been among the most prevalent of all mental disorders in the U.S. © 2016 Academic Media Solutions

Fear and Anxiety Fear: A set of emotional, behavioral, and physical responses to danger. Panic: Fear when no actual danger is present. Anxiety: A diffuse or vague sense of apprehension accompanied by fearful behavior and physiological arousal. © 2016 Academic Media Solutions

Specific Phobia Intense, persistent fear of specific objects or situations that pose little or no actual threat. Specifiers describe the type of phobic stimulus: Animal (includes insects) Natural Environment (e.g., storms, heights) Blood-Injection-Injury Situational (e.g., elevators, buses, airplanes) © 2016 Academic Media Solutions

Social Anxiety Disorder (Social Phobia) Intense fear or anxiety of social situations in which the individual may be scrutinized by others. Common situations that evoke social anxiety disorder: Speaking or performing in public Meeting strangers (especially authorities and members of the opposite sex) Using public restrooms or dressing rooms Eating or writing in public © 2016 Academic Media Solutions

Figure 7.2 A Diathesis-Stress Model of Phobias (p. 258) © 2016 Academic Media Solutions

Treatment of Specific Phobia and Social Anxiety Disorder Phobias are the most treatable of the anxiety disorders (and perhaps of all mental disorders). Treatments using learning-based procedures have proved the most consistently successful. Systematic desensitization Exposure techniques Modeling Cognitive-Behavioral Treatments © 2016 Academic Media Solutions

Panic Disorder Periodic and unexpected attacks of intense, terrifying fear (called panic attacks), coupled with persistent anxiety that another attack will occur. p. 262 © 2016 Academic Media Solutions

Agoraphobia A fear of open spaces or of being separated from a safe place. Individuals typically fear leaving home alone, being in public, and traveling. For many, the basic concern is having a panic attack while being away from a place they consider safe. Often comorbid with Panic Disorder Secret Lives of Women: Agoraphobia Case © 2016 Academic Media Solutions

Causes of Panic Disorder and Agoraphobia Potential Causes Include: A biological predisposition to overreact physically to stressors (i.e. genetics, hypersensitivity of the locus coeruleus in the brain stem) A tendency to misinterpret bodily sensations as signs of danger Low perceived control over negative events and emotional experiences © 2016 Academic Media Solutions

Treatment of Panic Disorder and Agoraphobia -Cognitive-Behavioral Treatments (CBT) in 3 steps: 1. breathing retraining 2. cognitive restructuring 3. interoceptive exposure to somatic cues -Medications are often prescribed, but their efficacy is unclear Benzodiazepines Valium, Ativan, Xanax Antidepressants SSRIs Tricyclics © 2016 Academic Media Solutions

Generalized Anxiety Disorder (GAD) Anxiety is experienced as “free floating” (not connected to any specific stimulus) and is pervasive enough to interfere with daily functioning p. 270 © 2016 Academic Media Solutions

Causes of GAD Potential Causes Include: Biological vulnerability, including abnormal amygdala and prefrontal cortex activation (also found in other anxiety disorders) as well as frontal lobe circuits Cognitive Avoidance Theory Worry is an attempt to avoid the emotional or physical feelings of anxiety Verbal thought predominates during worry and may serve to distract from more emotional topics © 2016 Academic Media Solutions

Treatment of GAD CBT is the treatment of choice for GAD Cognitive restructuring Relaxation training Medications are also prescribed Benzodiazepines Robust efficacy in the short-term management of GAD, but not shown to be effective in producing long-term improvement Antidepressants (more commonly prescribed in recent years) © 2016 Academic Media Solutions