Anxiety Disorders

The Experience of Anxiety  Worry  Fear  Apprehension  Intrusive thoughts  Physical symptoms  Tension  Experience comes more from individual than situational factors  Sufferers often not clear as to origins of their anxiety Abnormal Psychology, 11/e by Sarason & Sarason © 2005

DSM-IV Anxiety Disorders  Generalized anxiety disorder  Panic disorder  Phobias  Obsessive-compulsive disorder  Posttraumatic stress disorder (PTSD) Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Prevalence of Anxiety Disorders Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Models and Treatment  Psychodynamic perspective  Therapy aimed at gaining insight into unconscious roots of threat, loss and abandonment  Behavioral perspective  Therapeutic interventions to change behavior include modeling, exposure therapy (imaginal, in vivo and interoceptive), management of safety behaviors, systematic desensitization, implosive therapy  Cognitive perspective  Therapy aimed at changing maladaptive thoughts include cognitive restructuring, thought stopping, and cognitive rehearsal  Biological perspective  Genetic and environmental factors  Anti-anxiety medications Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Generalized Anxiety Disorder (GAD)  Vague, intense concerns and fearfulness  Lasts at least six months  Symptoms  Motor tension  Autonomic reactivity  Apprehension about future  Hypervigilance  Duration  Protracted, often 20 years or more  Treatment  Cognitive, psychodynamic, and behavioral therapy  Anti-anxiety medication Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Panic Disorder  Recurrent unexpected panic attacks lasting from seconds to hours and days  Physiological arousal  Shortness of breath, chest pains  Trembling, sweating, dizziness  Feelings of helplessness; imminent death  Fear of recurrent attacks  Biological, psychological, and psychosocial factors play a role  Cognitive-behavioral therapy is effective; antidepressant medications are sometimes effective Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Symptoms of Panic Disorder and GAD Abnormal Psychology, 11/e by Sarason & Sarason © 2005

A Comparison of Panic Disorder and GAD  Clinical onset of panic disorder is later.  The role of heredity appears to be greater in panic disorder.  The ratio of women to men is greater in panic disorder.  Alcoholism is more common in people suffering from panic disorder.  Depression is more common in panic disorder. Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Phobic Disorders  Specific Phobias – Fears related to specific objects, people, or situations  Social Phobias – Intense, incapacitating fear and embarrassment when dealing with others  Agoraphobia – Fear of leaving home  With panic attacks  Without panic attacks  Treatment for Phobic Disorders  Exposure therapy is the treatment of choice in phobias  Agoraphobia with panic attacks sometimes treated with antidepressant medication Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Examples of Phobias Type of FearExamples of Fears Separation fears Crowds, traveling alone, being at home alone Social fears Eating with strangers, being watched while writing or working Animal fearsMice, rats, insects, Nature fearsMountains, water, heights Mutilation fearsOpen wounds, surgery, blood Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Cognitive Model of Social Phobia Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Obsessive-Compulsive Disorder  Preoccupation with specific ideas or thoughts (obsessive) and unable to resist repeated behaviors (compulsive)  Obsessions  Doubt, hesitation, fear of contamination, fear of one’s own aggression, impulses, images  Compulsions  Counting, ordering, checking, touching, and washing  Yielding and controlling  Begins before adulthood, more common in women  Exposure and response prevention therapies and serotonin-related drugs are helpful. Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Post-Traumatic Stress Disorder (PTSD)  Occurs after extreme, life threatening stress  Natural disaster, serious accident, war-related situations  Symptoms  Flashbacks, recurrent dreams, impaired concentration, emotional numbing lasting more than one month  Treatment  Insight psychotherapy  Behavior therapy  Medications Abnormal Psychology, 11/e by Sarason & Sarason © 2005