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 Law

Another Bell CurveCourtesy of Our Good Buddies Yerkes-Dodsen

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

Specific Phobias

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

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)
70
60
50
40
30

Frequency

20
10
0

Black

Hispanic

Native
American

White

Employment
60
50
40
30

Frequency

20
10
0

Employed

Umemployed

Depression
35
30
25
20

Enter
Exit

15
10
5
0

Total Group

Severe PTSD

Moderate PTSD

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