1. Anxiety Screening Test

2. Anxiety Disorders
a group of conditions where the primary symptoms are anxiety or defenses against anxiety.
the patient fears something awful will happen to them.
They are in a state of intense apprehension, uneasiness, uncertainty, or fear.
(overview of anxiety disorders)

3. Anxiety disorders The DSM describes anxiety disorders as:
Marked and persistent fear than is excessive and unreasonable
Exposure to stimulus provokes immediate anxious response
The person recognizes the fear as excessive
The anxiety producing situation is avoided
The anxiety disrupts a person normal life
The phobia has lasted more than 6 months in people under the age of 18 years.
No age specific timing for development of anxiety disorders as they are largely though to be learned or as a response to trauma and so can come on at any time.

4. Phobia

5. Phobias
An intense, irrational fear of an object or situation that does not objectively justify such a reaction
Usually realize fear is groundless, but anxiety persists
Phobia List

6. PhobiasYouTube - Curing Arachnophobia (Fear of Spiders)
The person with the phobia realizes that the fear is irrational with the response far outweighs any realistic consequence of the situation.
However it is usually only when the fear really disrupts a person life that the disorder will be diagnosed as a mental illness (not going out of the house for fear of seeing a spider etc)

7. Classes of Phobias
Specific phobias are unwarranted fears caused by the presence of a specific object or situation
Blood, injuries, or injections - early childhood onset
Situations (planes, elevators) – early 20s onset
Animals – early childhood onset
Natural environment (water, heights) – early childhood onset
Other (contracting illnesses, choking)
Social phobia (Social Anxiety Disorder) involves a persistent fear linked to the presence of other people (adolescence onset)
Agoraphobia or “Fear of the Marketplace”, avoidance of “unsafe” places where panic attack may recur

8. Etiology of Anxiety Disorders
Psychoanalytic theory: phobias result from anxiety produced by repressed id impulses
Biological/Genetic theory: Heritability of panic disorder, and evolutionary basis of phobias
Behavioral theories: focus on learning as the etiological basis of phobias
Phobias are learned avoidance responses
Phobias may be acquired through modeling
We are biologically prepared to learn certain fears (e.g. taste with nausea)
Cognitive theory: Thought processes result in high levels of anxiety

9. COMMON FEARS IN SOCIAL PHOBIA
Public speaking or performing
Making “small talk”
Small group discussion
Asking questions in groups
Being introduced
Meeting or talking with strangers
Being assertive
Being watched doing something (e.g., eating, writing)
Attending social gatherings
Using the telephone
Using public restrooms
Interacting with “important” people
Indirect evaluation (e.g., test taking)

10. Treating Phobias
Psychoanalytic therapy attempts to uncover repressed conflicts using free association
Behavioral approaches use systematic desensitization and in vivo exposures to reduce anxiety responses to phobic stimuli and situations
Flooding: exposure to a phobic stimulus at full intensity (now graded exposure is used more)
Cognitive approaches focus on altering irrational beliefs (using socratic dialogue to disconfirm and reconstruct automatic thoughts, images)

11. Treating Phobias
Biological approach uses drugs to eliminate anxiety symptoms
Anxiolytic drugs such as the benzodiazepines (Valium) can reduce anxiety but are also addictive and give rise to withdrawal symptoms upon termination
MAO inhibitors such as phenelzine reduce the degradation of norepinephrine and serotonin
MAO inhibitors can have adverse side effects
Selective serotonin reuptake inhibitors (SSRI’s) (fluoxetine) increase brain serotonin

12. What do you fear most?
How long have you feared this thing or situation?
How would you respond if you could not avoid this thing or situation?
How much would you be willing to rearrange your life to avoid this feared thing or situation?
After considering these questions, would you consider your fear to be a full-blown phobia?

13. Generalized Anxiety Disorder GAD
Person is :
Continuously tense and worried
Feels inadequate
Is oversensitive
Can’t concentrate
May suffer insomnia
Is in a state of autonomic nervous system arousal (fight or flight).

14. Panic Disorder Minutes-long episode intense dread Terror Chest pain
Choking
Other frightening sensations.
Strong association w/ agoraphobia
30% of pop. had panic attack w/in last year BUT only 2-3 % developed full-blown panic disorder

15. Post-traumatic Stress Disorder a.k.a. PTSD
Flashbacks or nightmares following a person’s involvement in or observation of an extremely stressful event.
Memories of the even cause anxiety.
A Soldier’s Heart:

16. This Emotional Life
Facing Our Fears (22:40)

17. Obsessive-compulsive disorder
Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action.
Obsession about dirt and germs may lead to compulsive hand washing.
(The OCD Project)

18. Obsessive-Compulsive Disorder (OCD): Causes and Associated Features
Facts and Statistics
Affects about 2.6% of the population at some point
Most persons with OCD are female
OCD tends to be chronic
Onset is typically in early adolescence or adulthood
Causes of OCD
Parallel the other anxiety disorders
Early life experiences and learning that some thoughts are dangerous/unacceptable
Thought-action fusion – The thought is like the action

19. Obsessive-Compulsive Disorder (OCD): Treatment
Medication Treatment of OCD
Selective Serotonin Reuptake Inhibitors (SSRIs) – Benefit about 60%
Tricyclic Antidepressants
Psychosurgery – Used in extreme cases
Relapse is common with medication discontinuation
Psychological Treatment of OCD
Cognitive-behavioral therapy – Most effective for OCD
CBT involves exposure and response prevention
Combined treatments – Not better than CBT alone