CHAPTER 7 ANXIETY DISORDERS

THE EXPERIECE OF ANXIETY Worry Fear Apprehension Intrusive thoughts Physical symptoms Tension Experience comes more from individual than situational factors Sufferers often not clear as to origins of their anxiety

ANXIETY DISORDERS Generalized anxiety disorder Panic disorder Phobias Obsessive-compulsive disorder Posttraumatic stress disorder (PTSD)

ANXIETY DISORDERS IN THE U.S.

GENERALIZED ANXIETY DISORDER Vague, intense concerns and fearfulness Lasts at least six months Symptoms Motor tension Autonomic reactivity Apprehension about future Hypervigilance Duration Protracted, often 20 years or more Treatment Cognitive, psychodynamic, and behavioral therapy Anti-anxiety medication

PANIC DISORDER Recurrent unexpected panic attacks lasting from seconds to hours and days Physiological arousal Shortness of breath, chest pains Trembling, sweating, dizziness Feelings of helplessness Fear of recurrent attacks Biological, psychological, and psychosocial factors play a role Cognitive-behavioral therapy and antidepressant medication are sometimes effective

PHOBIC DISORDERS Specific Phobias – Fears related to specific objects, people, or situations Social Phobias – Intense, incapacitating fear and embarrassment when dealing with others Agoraphobia – Fear of leaving home With panic attacks Without panic attacks Treatment for Phobic Disorders Exposure therapy helpful in treatment of phobias Agoraphobia with panic attacks sometimes treated with antidepressant medication

FIVE CATEGORIES OF PHOBIAS Type of Fear Examples of Fears Separation fears Crowds, traveling alone, being at home alone Social fears Eating with strangers, being watched while writing or working Animal fears Mice, rats, and insects Nature fears Mountains, the ocean, heights Mutilation fears Open wounds, surgery, blood

COGNITIVE INTERPRETATION OF SOCIAL PHOBIA

SYMPTOMS ASSOCIATED WITH PANIC DISORDER AND GENERALIZED ANXIETY DISORDER

PANIC DISORDER COMPARED WITH GENERALIZED ANXIETY DISORDER COMPARED Clinical onset of panic disorder is later. The role of heredity appears to be greater in panic disorder. The ratio of women to men is greater in panic disorder. Alcoholism is more common in people suffering from panic disorder. Depression is more common in panic disorder.

OBSESSIVE-COMPULSIVE DISORDER Preoccupation with specific ideas or thoughts (obsessive) and unable to resist repeated behaviors (compulsive) Obsessions Doubt, hesitation, fear of contamination, fear of one’s own aggression Compulsions Counting, ordering, checking, touching, and washing Begins before adulthood, more common in women Exposure and response prevention therapies and serotonin-related drugs are helpful.

POSTTRAUMATIC STRESS DISORDER (PTSD) Occurs after extreme stress Natural disaster, serious accident, war-related situations Symptoms Flashbacks, recurrent dreams, impaired concentration, emotional numbing lasting more than one month Treatment Insight psychotherapy Behavior therapy

INTERPRETING AND TREATING ANXIETY DISORDERS Psychodynamic perspective Therapy aimed at gaining insight into unconscious roots of loss and abandonment Behavioral perspective Therapeutic interventions to change behavior include exposure therapy, systematic desensitization, implosive therapy, in vivo exposure, flooding, and modeling Cognitive perspective Therapy aimed at changing maladaptive thoughts include cognitive restructuring, thought stopping, and cognitive rehearsal Biological perspective Genetic and environmental factors Anti-anxiety medications