Anxiety Screening Test http://psychcentral.com/quizzes/anxiety.htm

Anxiety Disorders a group of conditions where the primary symptoms are anxiety or defenses against anxiety. the patient fears something awful will happen to them. They are in a state of intense apprehension, uneasiness, uncertainty, or fear. http://www.youtube.com/watch?v=_Cr7IomSy8s (overview of anxiety disorders)

Anxiety disorders The DSM describes anxiety disorders as: Marked and persistent fear than is excessive and unreasonable Exposure to stimulus provokes immediate anxious response The person recognizes the fear as excessive The anxiety producing situation is avoided The anxiety disrupts a person normal life The phobia has lasted more than 6 months in people under the age of 18 years. No age specific timing for development of anxiety disorders as they are largely though to be learned or as a response to trauma and so can come on at any time.

Phobia http://www.youtube.com/watch?v=MkJazl9_YYw&feature=related

Phobias An intense, irrational fear of an object or situation that does not objectively justify such a reaction Usually realize fear is groundless, but anxiety persists Phobia List

PhobiasYouTube - Curing Arachnophobia (Fear of Spiders) The person with the phobia realizes that the fear is irrational with the response far outweighs any realistic consequence of the situation. However it is usually only when the fear really disrupts a person life that the disorder will be diagnosed as a mental illness (not going out of the house for fear of seeing a spider etc)

Classes of Phobias Specific phobias are unwarranted fears caused by the presence of a specific object or situation Blood, injuries, or injections - early childhood onset Situations (planes, elevators) – early 20s onset Animals – early childhood onset Natural environment (water, heights) – early childhood onset Other (contracting illnesses, choking) Social phobia (Social Anxiety Disorder) involves a persistent fear linked to the presence of other people (adolescence onset) Agoraphobia or “Fear of the Marketplace”, avoidance of “unsafe” places where panic attack may recur

Etiology of Anxiety Disorders Psychoanalytic theory: phobias result from anxiety produced by repressed id impulses Biological/Genetic theory: Heritability of panic disorder, and evolutionary basis of phobias Behavioral theories: focus on learning as the etiological basis of phobias Phobias are learned avoidance responses Phobias may be acquired through modeling We are biologically prepared to learn certain fears (e.g. taste with nausea) Cognitive theory: Thought processes result in high levels of anxiety

COMMON FEARS IN SOCIAL PHOBIA Public speaking or performing Making “small talk” Small group discussion Asking questions in groups Being introduced Meeting or talking with strangers Being assertive Being watched doing something (e.g., eating, writing) Attending social gatherings Using the telephone Using public restrooms Interacting with “important” people Indirect evaluation (e.g., test taking)

Treating Phobias Psychoanalytic therapy attempts to uncover repressed conflicts using free association Behavioral approaches use systematic desensitization and in vivo exposures to reduce anxiety responses to phobic stimuli and situations Flooding: exposure to a phobic stimulus at full intensity (now graded exposure is used more) Cognitive approaches focus on altering irrational beliefs (using socratic dialogue to disconfirm and reconstruct automatic thoughts, images)

Treating Phobias Biological approach uses drugs to eliminate anxiety symptoms Anxiolytic drugs such as the benzodiazepines (Valium) can reduce anxiety but are also addictive and give rise to withdrawal symptoms upon termination MAO inhibitors such as phenelzine reduce the degradation of norepinephrine and serotonin MAO inhibitors can have adverse side effects Selective serotonin reuptake inhibitors (SSRI’s) (fluoxetine) increase brain serotonin

What do you fear most? How long have you feared this thing or situation? How would you respond if you could not avoid this thing or situation? How much would you be willing to rearrange your life to avoid this feared thing or situation? After considering these questions, would you consider your fear to be a full-blown phobia?

Generalized Anxiety Disorder GAD Person is : Continuously tense and worried Feels inadequate Is oversensitive Can’t concentrate May suffer insomnia Is in a state of autonomic nervous system arousal (fight or flight).

Panic Disorder Minutes-long episode intense dread Terror Chest pain Choking Other frightening sensations. Strong association w/ agoraphobia 30% of pop. had panic attack w/in last year BUT only 2-3 % developed full-blown panic disorder

Post-traumatic Stress Disorder a.k.a. PTSD Flashbacks or nightmares following a person’s involvement in or observation of an extremely stressful event. Memories of the even cause anxiety. A Soldier’s Heart: http://www.pbs.org/wgbh/pages/frontline/shows/heart/view/

This Emotional Life Facing Our Fears (22:40) http://www.hulu.com/watch/227956/this-emotional-life-facing-our-fears

Obsessive-compulsive disorder Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action. Obsession about dirt and germs may lead to compulsive hand washing. http://www.vh1.com/video/the-ocd-project/full-episodes/arrival/1637103/playlist.jhtml (The OCD Project)

Obsessive-Compulsive Disorder (OCD): Causes and Associated Features Facts and Statistics Affects about 2.6% of the population at some point Most persons with OCD are female OCD tends to be chronic Onset is typically in early adolescence or adulthood Causes of OCD Parallel the other anxiety disorders Early life experiences and learning that some thoughts are dangerous/unacceptable Thought-action fusion – The thought is like the action

Obsessive-Compulsive Disorder (OCD): Treatment Medication Treatment of OCD Selective Serotonin Reuptake Inhibitors (SSRIs) – Benefit about 60% Tricyclic Antidepressants Psychosurgery – Used in extreme cases Relapse is common with medication discontinuation Psychological Treatment of OCD Cognitive-behavioral therapy – Most effective for OCD CBT involves exposure and response prevention Combined treatments – Not better than CBT alone