Anxiety Disorders WEB

Anxiety as a Normal and an Abnormal Response Some amount of anxiety is “normal” and is associated with optimal levels of functioning. Only when anxiety begins to interfere with social or occupational functioning is it considered “abnormal.”

The Fear and Anxiety Response Patterns Fear Panic Anxiety Anxiety Disorder

The Bell Curve

An Important Law- The Yerkes Dodson LawThe Yerkes Dodson Law

Another Bell Curve- Courtesy of Our Good Buddies Yerkes-Dodsen

Phobic Disorders Phobias 1.Specific phobias 2.Social phobia 3.Agoraphobia

Specific Phobias

Psychosocial causal factors Genetic and temperamental causal factors Preparedness and the nonrandom distribution of fears and phobias Treating specific phobias

Social Phobia General characteristics Fear of being in social situations in which one will be embarrassed or humiliated

Social Phobia Interaction of psychosocial and biological causal factors –Social phobias as learned behavior –Social fears and phobias in an evolutionary context –Preparedness and social phobia

Social Phobia Interaction of psychosocial and biological causal factors –Genetic and temperamental factors –Perceptions of uncontrollability –Cognitive variables

Panic Disorder With and Without Agoraphobia Panic disorder Panic versus anxiety Agoraphobia Agoraphobia without panic

Panic Disorder Prevalence and age of onset Comorbidity with other disorders Biological causal factors The role of Norepinephrine and Serotonin

Panic and the Brain

Panic Disorder Genetic factors Cognitive and behavioral causal factors Interoceptive fears

Panic Disorder: The Cognitive Theory of Panic

Perceived control and safety Anxiety sensitivity as a vulnerability factor for panic Safety behaviors and the persistence of panic Cognitive biases and the maintenance of panic

Treating Panic Disorder and Agoraphobia Medications Behavioral and cognitive-behavioral treatments

Generalized Anxiety Disorder General characteristics Prevalence and age of onset Comorbidity with other disorders

Generalized Anxiety Disorder: Psychosocial Causal Factors The psychoanalytic viewpoint Classical conditioning to many stimuli The role of unpredictable and uncontrollable events A sense of mastery: immunizing against anxiety

Generalized Anxiety Disorder: Biological Causal Factors Genetic factors A functional deficiency of GABA Neurobiological differences between anxiety and panic

Obsessive-Compulsive Disorder Obsessions- repetitive unwanted ideas that the person recognizes are irrational Compulsions- repetitive, often ritualized behavior whose behavior serves to diminish anxiety caused by obsessions

Obsessive-Compulsive Disorder Prevalence and age of onset Characteristics of OCD Types of compulsions Comorbidity with other disorders

Obsessive-Compulsive Disorder: Psychosocial Causal Factors Psychoanalytic viewpoint Behavioral viewpoint The role of memory Attempting to suppress obsessive thoughts

Obsessive-Compulsive Disorder: Biological Causal Factors Genetic influences Abnormalities in brain function The role of serotonin

Post-Traumatic Stress Disorder Critical Component –Symptoms occurs AFTER a traumatic stressor

Symptoms Categories Intrusive –distressing recollections –dreams –flashbacks –psychological trigger reactions –physiological trigger reactions

Symptoms Categories Avoidance –avoid thoughts, feelings or discussions –avoid activities, places –memory blocks –anhedonia (without pleasure) –numb –alexithymia (emotions unknown) –feeling of doom

Symptom Categories Hyperarousal Symptoms –sleep disturbance –anger problems –concentration –startle response –“on guard” hypervigilence

Diagnoses Acute Stress Disorder –new to DSM-IV (1994) –symptoms 2 days to 4 weeks following traumatic event PTSD –new to DSM-III (1980) –symptoms beyond 4 weeks –delayed onset

Who Is Vulnerable? All ages Both genders Across Cultures and ethnic groups

Some Stats Andrews, Wahlberg, Montgomery (1993)

Employment

Depression

Types of Traumas Natural –earthquakes –floods –fires Human induces –war –crimes of violence

Co-Morbid Diagnoses Alcoholism –75% for Vietnam Veterans with PTSD Depression –77% of firefighters with PTSD also have depression Generalized Anxiety Panic Attacks