anti-anxiety medications Valium Librium Xanax Klonopin Also used for sleeping pills & anti-seizure meds benzodiazepines

anti-anxiety medications “SSRIs” Prozac Paxil Zoloft Celexa selective serotonin reuptake inhibitors antidepressants

biological contributions polygenic trait of neuroticism** neurochemicals (GABA, NE, 5HT, CRH) **comorbidity

generalized anxiety disorder 6 mo+ of uncontrollable worry to many issues 3+ of: restlessness, fatigue, poor concentration, irritable, muscle tension, sleep probs distress or impairment CRITERIA

generalized anxiety disorder prevalence 3% 2:1 sex ratio onset yrs (but most “always been this way”) prognosis: chronic

panic attack inappropriate fear response CRITERIA 4+ of: heart palpitations, sweating, shaking, short of breath, choking, chest pain, nausea, dizzy, derealization/depersonalizaiton, fear of losing control, fear of dying, chills/heat, numbness/tingling

panic attack cued – conditioned to external cues uncued – conditioned to interoceptive cues situationally predisposed

panic disorder CRITERIA recurrent panic attacks 1+ for 1 mo+: - concern about future attacks or consequences - sig behavioral change (avoidance of external or internal cues)

panic disorder prevalence 3% 2:1 sex ratio relatives 8x more likely concordant COGNITIVE-BEHAVIORAL THERAPY cued: systematic desensitization uncued: induce interoceptive sensations + cognitive restructuring of perceived control

agoraphobia CRITERIA anxiety about situations where: - hard to access help - escape difficult/embarrassing

specific phobia CRITERIA 6+ mo persistent, excessive, irrational fear of an object of situation anxiety/fear on exposure avoided or endured w/ intense anxiety insight that phobia is irrational

specific phobia 9% prevalence 4:1 sex ratio prognosis: chronic ETIOLOGY -direct or vicarious trauma experience -conditioning from panic attack - information transmission TREATMENT systematic desensitization

social phobia CRITERIA fear of social/performance situations anxiety/fear upon exposure insight that fear is irrational avoidance behavior impairs functioning

social phobia 7% prevalence 1: 1.4 sex ratio CAUSE prepared learning or, neuroticism/inhibition, conditioned direct exp TREATMENT exposure & cognitive therapy

OCD CRITERIA recurrent & persistent thoughts/images associated behaviors compelled to perform insight to irrational “ distress, consumes 1+ hr/day, or impairs functioning

ocd obsessions repetitive, unwelcome thoughts compulsions repetitive, almost irresistible action germs something bad will happen symmetry religion #s washing counting checking touching rituals

OCD 1% prevalence sex ratio? onset: childhood-30’s prognosis: chronic TREATMENTS SSRIs, exposure + response prevention

ocd orbital frontal PFC basal ganglia cingulate abnormal activation decreases after psychotherapy or anxiolytics