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Anxiety Disorders

Anxiety Disorders

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Anxiety Disorders

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  1. Anxiety Disorders Chapter 3

  2. Outline • The Complexity of Anxiety Disorders • Generalized anxiety disorder • Panic disorder with and without Agoraphobia • Specific Phobia • Social Phobia • Posttraumatic Stress Disorder • Obsessive-Compulsive Disorder

  3. The complexity of Anxiety Disorders • Anxiety • Negative mood state characterized by bodily symptoms of physical tension, and apprehension about the future • Fear • Immediate alarm reaction to present danger activating a massive response from the autonomic nervous system (flight or fight) • Panic attack • Abrupt experience of intense fear or discomfort in the absence of danger accompanied by physical symptoms (dizziness, heart palpitations, chest, pain, shortness of breath)

  4. Anxiety and its causes • Causes of Anxiety • Biological contributions • Inherited tendency to be tense, behavioral inhibition system (anxiety), flight or fright system (panic) • Psychological contributions • Early childhood (overprotective and overintrusive parents, psychological vulnerability • Social contributions • Social pressures (family, job, school) • Comorbidity of anxiety disorders • Co-occurrence of two or more disorders in a single individual (high (50%) in anxiety disorders)

  5. Generalized anxiety disorder • Intense, uncontrollable, unfocused, chronic, and continuous worry and mental agitation that is distressing and unproductive accompanied by physical symptoms of tenseness, irritability and restlessness (generalized to everyday life) • 4% of population (two thirds are women), onset in early adulthood • Psychological treatments (CBT, meditation) have approx. the same benefit as drugs (benzodiazepines) but are better in the long term • Cognitive-Behavioral Therapy (CBT) • systematic exposure to anxiety-provoking situations or thoughts • learning to substitute positive behaviors and thoughts for negative ones • learning new coping skills; relaxation, meditation, breathing exercises

  6. Generalized anxiety disorder

  7. Panic disorder with and without agoraphobia • Individuals experience severe unexpected panic attacks, they may think they’re dying Y • Agoraphobia is fear and avoidance of situations in which they would feel unsafe in the event of a panic attack (e.g. public places, “fear of market place”) • 3.5% of population (two thirds are women), onset in early adulthood • Treatment usually involves medication (antidepressants) but it has high levels of relapse (20-50%), psychological treatments involve gradual exposure combined with coping exercises (panic control treatment)

  8. Specific phobia • Irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function Y-Snake Phobia • There are four major subtypes of specific phobia • Animal type • Natural environment type (heights, storms, water) • Blood-injection-injury phobia (runs in families) • Situational phobia (planes, elevators, claustrophobia) • Other (e.g. choking, contracting an illness) • 11% of population with different onsets • Treatment consists of exposure-based therapy

  9. Social phobia • Extreme, enduring, irrational fear and avoidance of social or performance situations Y-Virtual Reality • Social phobia generalized type vs. performance anxiety • 13.3.% of population at some point in their lives (favors females only somewhat); onset 15 years of age • The most effective treatment is cognitive behavioral group therapy; medication in severe cases (antidepressants)

  10. Social phobia

  11. Posttraumatic stress disorder • Enduring, distressing emotional disorder that follows exposure to a severe helplessness or fear-inducing threat Y - PTSD • It is characterized by reexperiencing the trauma, avoiding stimuli associated with it, increased vigilance and arousal, sometimes suicidal thoughts and attempts, and sometimes memory impairments • Acute PTSD (1-3 months after event) or chronic PTSD (more than 3 months) • Combat and sexual assault are the most common traumas • Treatments – catharsis, gradual imaginal exposure, possibly antidepressants

  12. Obsessive-compulsive disorder • Anxiety disorder involving unwanted, persistent, intrusive thoughts and impulses as well as repetitive actions intended to suppress them • Most frequent obsessions (contamination, sexual content, aggressive impulses, need for symmetry) and compulsions (checking, ordering, arranging, washing, cleaning) • 2.6% of population (majority female) • Exposure and ritual prevention and CBT treatments • Y-OCD patient