Anxiety Disorders By Dr seddigh HUMS

Anxiety Disorders  Primary disturbance is  distressing رنج روانی,  persistent anxiety اضطراب مستمر or  maladaptive behaviors رفتار غیر انطباقی  that reduce anxiety  Anxiety - diffuse منتشر, vague feelings احساس مبهم of fear and apprehension –everyone experiences it –becomes a problem when it is irrational, uncontrollable, and disruptive غیر منطقی،غیر قابل کنترل ودر هم گسیخته

Generalized Anxiety Disorder (GAD) اختلال اضطراب منتشر  More or less constant worry about many issues نگرانی مداوم در اکثر موقعیتها  The worry seriously interferes with functioning اختلال عملکرد جدی  Physical symptoms علائم جسمی –Headaches سردرد –Stomachaches ناراحتی معده –muscle tension تنش عضلانی –Irritability تحریک پذیری

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

Phobias  Intense, irrational fear that may focus on: –category of objects اشیا –event or situation موقعیتها –social setting مسایل اجتماعی

Phobias  It is not phobic to simply be anxious about something Afraid of it Bothers slightlyNot at all afraid of it Being closed in, in a small place Being alone in a house at night Percentage of people surveyed SnakesBeing in high, exposed places MiceFlying on an airplane Spiders and insects Thunder and lightning DogsDriving a car Being in a crowd of people Cats Study of normal anxieties

Specific Phobias  Specific phobias - fear of specific object –animals (e.g., snakes) –substances (e.g., blood) –situations (e.g., heights) –more often in females than males

Some Unusual Phobias  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 خجالت زده in public –public speaking (stage fright) صحبت کردن –fear of crowds, strangers ترس از شلوغی –meeting new people ملاقات افراد جدید –eating in public خوردن و آشامیدن  Considered phobic if these fears interfere with normal behavior تداخل با رفتار طبیعی  Equally often in males and females ♂ = ♀

Development of Phobias  Classical conditioning model  مدل شرطی شدن کلاسیک –e.g., dog = CS, bite = UCS –problems: often no memory of a traumatic experience traumatic experience may not produce phobia

Obsessive-Compulsive Disorder (OCD)  Obsessions - irrational, disturbing thoughts that intrude into consciousness  Compulsions - repetitive actions performed to alleviate obsessions  Checking and washing most common compulsions  Heightened neural activity in caudate nucleus

Panic Disorder  Panic attacks - helpless terror, high physiological arousal  Very frightening - sufferers live in fear of having them  Agoraphobia often develops as a result

Posttraumatic Stress Disorder (PTSD)  Follows traumatic event or events such as war, rape, or assault  Symptoms include: –nightmares –flashbacks –sleeplessness –easily startled –depression –irritability

Somatoform Disorders  Bodily ailments in absence of any physical disease  Examples are conversion disorder and somatization disorder

Psychological Influences on Physical Symptoms and Diseases

Conversion Disorder  Person temporarily loses some bodily function –blindness, deafness, paralyzed portion of body –glove anesthesia  No physical damage to cause problems

Conversion Disorder  Rare in western culture now –relatively common 100 years ago –prominent in Freud’s work/clients  Often see examples in non-Western people exposed to traumatic event –e.g., high rate of psychological blindness in Cambodian women after Khmer Rouge reign of terror in 1970s

Somatization Disorder  Long history of dramatic complaints re: different medical conditions –complaints usually vague, undifferentiated –e.g., heart palpitations, dizziness, nausea  Often difficult to determine whether complaints are somatization or undetectable physical disease

Somatization Disorder  Kleinman’s theory –somatization and depression are different manifestations of the same problem –cross-cultural research pattern of somatoform disorders affected by cultural beliefs