Anxiety Disorders

Anxiety Anxiety is an unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension, and worry Puts us on physical alert, preparing us to defensively “fight” or “flee” potential dangers, Also puts us on mental alert, making us focus our attention squarely on the threatening situation

Anxiety Disorders In the anxiety disorders, the anxiety is maladaptive, disrupting everyday activities, moods, and thought processes Three features distinguish normal anxiety from pathological anxiety. Pathological anxiety is: Irrational—it is provoked by perceived threats that are exaggerated or nonexistent, and the anxiety response is out of proportion to the actual importance of the situation. Uncontrollable—the alarm reaction cannot be shut off even when the person knows it’s unrealistic. Disruptive—it interferes with relationships, job or academic performance, or everyday activities

Generalized Anxiety Disorder and Panic Disorder

Generalized Anxiety Disorder An anxiety disorder characterized by disruptive levels of persistent, unexplained feelings of apprehension and tenseness

Generalized Anxiety Disorder (GAD) More or less constant worry about many issues The worry seriously interferes with functioning Physical symptoms headaches stomach aches muscle tension irritability

Symptoms of Generalized Anxiety Must have at least three of the following: Restlessness Feeling on edge Difficulty concentrating/mind going blank Irritability Muscle Tension Sleep Disturbance

Model of Development of GAD GAD has some genetic component Related genetically to major depression Childhood trauma also related to GAD Genetic predisposition or childhood trauma GAD following life change or major event Hypervigilance Discovering Psych Slides (Shulman)

Are Your Worries Excessive? Add up your TOTAL Score 0-11 points = You are not the fretful type. Worry, which no doubt makes you uncomfortable, goads you to take necessary action in your life. 12-20 points = You’re a potentially unhealthy worrier. 21-30 points = Danger zone! Agonizing constantly about small matters isn’t good for you physically or emotionally.

Panic Disorder An anxiety disorder characterized by sudden bouts of intense, unexplained panic Panic attacks may happen several times a day

Panic Disorder Panic attacks—sudden episode of helpless terror with high physiological arousal Very frightening—sufferers live in fear of having them Agoraphobia often develops as a result

Cognitive-behavioral Theory of Panic Disorder Sufferers tend to misinterpret the physical signs of arousal as catastrophic and dangerous This interpretation leads to further physical arousal, tending toward a vicious cycle After their first panic attack, they become even more attuned to physical changes, increasing the likelihood of future panic attacks

Phobia

Phobia An anxiety disorder characterized by disruptive, irrational fears of specific objects or situations The fear must be both irrational and disruptive. About 10 percent of the general population will experience a specific phobia at some point in their lives.

Phobias Generally, the objects or situations that produce specific phobias tend to fall into four categories Natural environment—heights, water, lightening Situation—flying, tunnels, crowds, social gathering Injury—needles, blood, dentist, doctor Animals or insects—insects, snakes, bats, dogs

Phobias It is not phobic to simply be anxious about something Afraid of it Bothers slightly Not at all afraid of it Being closed in, in a small place alone in a house at night Percentage of people surveyed 100 90 80 70 60 50 40 30 20 10 Snakes in high, exposed places Mice Flying on an airplane Spiders and insects Thunder lightning Dogs Driving a car a crowd Cats Study of normal anxieties

Phobias

Some Unusual Phobias Watch this video of a girl with a phobia for pickles. Ailurophobia—fear of cats Algobphobia—fear of pain Anthropophobia—fear of men Monophobia—fear of being alone Pyrophobia—fear of fire

Social Phobias Social phobias—fear of failing or being embarrassed in public public speaking (stage fright) fear of crowds, strangers meeting new people eating in public Considered phobic if these fears interfere with normal behavior Equally found in males and females

Agoraphobia Fear of situations the person views as difficult to escape from Fear of leaving one’s home or room in the house

Phobia Play “Three Anxiety Disorders” (4:08) Segment #37 from Psychology: The Human Experience. The segment includes a discussion on Generalized Anxiety Disorder.

Development of Phobias Classical conditioning may be involved in the development of a specific phobia that can be traced back to some sort of traumatic event. People with phobias may have developed a conditioned response of fear to a conditioned stimulus Problems with this theory: often no memory of a traumatic experience traumatic experience may not produce phobia

Other Learning Factors Observational learning--watching another experiencing fearfulness--may result in developing fear. Operant Conditioning - Fear of an object may be negatively reinforced when by avoiding the feared objects.

Development of Phobias Preparedness theory—phobia serves to enhance survival. Humans seem biologically prepared to acquire fears of certain animals and situations that were survival threats in human evolutionary history

Cognitive Therapy for Phobias In this video, the therapist tries to get the person to rethink their phobia. (7 min)

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder An anxiety disorder characterized by reliving a severely upsetting event in unwanted recurring memories (flashbacks) and dreams

Posttraumatic Stress Disorder (PTSD) Follows events that produce intense horror or helplessness (traumatic episodes) Core symptoms include: Frequent recollection of traumatic event, often intrusive and interfering with normal thoughts Avoidance of situations that trigger recall of the event Increased physical arousal associated with stress There is a high correlation of suicide and drug abuse in PTSD – See news report on Military Suicides in Soldiers fighting in Iraq – 2 min.

Potential Causes of PTSD - Post Traumatic Stress Syndrome – Studies of the Hippocampus in PTSD patients find that on average, their hippocampus is 25% smaller. - Some think this is a warning sign that someone is susceptible to PTSD. - Others say it is due to excessive stress hormones during trauma or an excessive sensitivity to these hormones after trauma. - Coping strategies to avoid PTSD in traumatic situations – Holocaust Case Study – Read the 7 strategies described on pg. 11 of Myers Guide.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder An anxiety disorder characterized by unwanted, repetitive thoughts and actions Obsessions – repetitive thoughts Compulsions – repetitive actions The obsessions/compulsions begin to take control of the person’s life.

Obsessive-Compulsive Disorder (OCD) Obsessions—irrational, disturbing thoughts that intrude into consciousness Compulsions—repetitive actions performed to alleviate obsessions Overt physical behaviors, such as repeatedly checking or washing your hands Covert mental behaviors, such as counting or reciting certain phrases to yourself Potential Biological Causes: Heightened neural activity in caudate nucleus A deficiency in the neurotransmitter serotonin The caudate nucleus is located in the basal ganglia and is associated with initiation of learned, habitual motor activities Using drugs that increase Serotonin reduces the activity of the caudate nucleus and leads to a reduction in the obsessions and compulsions - people who recover from OCD using behavioral and cognitive therapies also show a reduction in activity in the caudate nucleus

Trichotillomannia: The Disease of Hair Pulling What it’s like to live with it – video Trich – An explanation – video Other Obsessions… Obsessive Texting - video

Finding Your OCD Score Circle the following item numbers if you marked TRUE for them: 1, 2, 4, 6, 7, 8, 16, 17, 21 Circle the following item numbers if you marked FALSE for them: 5, 9, 10, 11, 12, 13, 14, 19, 20, 22 Now add up your total score. Highest score possible is a 20 (items 3 & 15 are validity checks) The mean (average) score is 11.15 for males and 11.24 for females. Remember, even if you scored high on this scale it doesn’t mean you have OCD. Always ask yourself, “Do these tendencies I have disrupt my daily life and relationships?” If the answer is NO you don’t have a problem.

Obsessive Compulsive Disorder Play “Obsessive-Compulsive Disorder” (2:57) Segment #36 from Psychology: The Human Experience.

Causes of Anxiety Disorders

Biological Factors Hereditary factors may result in a predisposition for developing anxiety disorders Brain functions appear to be different in an anxiety disorder patient Evolutionary factors may lead to anxiety disorders.