Anxiety Disorders “The Dark side of Fear”

Definitions Fear: A short-term emotional and physiological reaction to a threatening event Anxiety: A longer-term sense of apprehension

Anxiety Disorders Anxiety so intense and long-lasting that it disrupts the person’s daily functioning.

Table 12.3 Phobias Description: An intense, irrational fear of an object or situation.

Key to Phobias Irrational fear triggered by unconscious mind

DSM-IV Phobia Subtypes Specific Phobia: particular stimuli and situations Social Phobia: negatively evaluated by others or being embarrassing or humiliated Agoraphobia: fear of being separated from a safe place/person (fear of fear)

Generalized Anxiety Disorder Description “Free floating anxiety with no trigger” Symptoms –1. Excessive worry (health, money, family, work) –2. Insomnia, impatience –3. Sweating –4. Muscle Tension –5. Fatigue

Panic Disorder Description: experience of recurrent terrifying panic attacks shortness of breath and irregular heartbeat dizziness and feelings of unreality –can occur while sleeping –associated with agoraphobia (“comorbidity”) –concerns about “going crazy”

Obsessive-Compulsive Disorder Description: persistent, upsetting, and unwarranted thoughts (obsessions) that motivate repetitive behaviors (compulsions) –obsession causes anxiety, compulsion reduces it –equally common in men and women –often associated with depression

Obsessions –dirt, germs or toxins –something terrible is happening (fire, death or illness) –symmetry, order or exactness

Compulsions –Checking rituals: checking locks, car brakes, appliances, homework, etc. –Cleaning rituals: hand-washing, bathing, brushing teeth, etc. –Other: getting in/out of chair, opening/closing doors, etc.

OCD Spectrum Somatic Preoccupation –anorexia –bulimia –body dysmorphic Impluse –shopping –kleptomania –gambling –paraphilias

Germophobe “Howie Mandel” –doesn’t shake hands –but hugs and kisses “Live with Regis and Kelly” –antibacterial gel from audience member

Biology of Anxiety Disorders Biological Factors –locus coeruleus, norepinephrine, PANIC –orbital frontal/cingulate, OCD –neurotransmitter GABA in generalized anxiety

Locus Coeruleus

Anxiety Disorders and Learning Compulsive behavior are learned responses which removes temporarily remove distress (trigger could be a thought) Some phobias acquired through learning –biologically prepared to learn certain phobias –snake fears learned via observation

Other Causes Psychological Factors –Environmental stressors –Ways of thinking

Somatoform Disorders Can mental disorder cause blindness?

Somatoform Disorders body disorder even though there is no physical cause Conversion Disorder: –appear when person is under severe distress. –disorder enables person to avoid unpleasant situations. –organically impossible or improbable symptoms –little concern for this “serious” problem

Other Somatoform Disorders Hypochondriasis: strong, unjustified fear of serious physical problem Somatization Disorder: dramatic but vague, reports about a multitude of physical problems Pain Disorder: severe, often constant pain with no physical cause.

Anxiety Disorder Treatments Behavior Therapy –1. systematic desensitization/exposure therapysystematic desensitization/exposure therapy –2. response blocking/prevention (OCD)response blocking/prevention (OCD) –3. flooding/implosionflooding/implosion Drugs –yes to antidepressants, no to tranquillizers (valium) Cognitive –thinking, rumination, worry Exercise/Progressive Muscle Relaxation/Yoga Next

Exposure Therapy hierarchy of fearful stimuli learn relaxation methods gradual exposure to imagined stimuli in relaxed state substitute real stimuli Joseph Wolpe

Virtual Reality Exposure Therapy

Virtually Better Virtual HeightsVirtual Storm

Virtually Better Virtual AudienceVirtual Vietnam Back