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PSY 436 Instructor: Emily Bullock Yowell, Ph.D.

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Presentation on theme: "PSY 436 Instructor: Emily Bullock Yowell, Ph.D."— Presentation transcript:

1 PSY 436 Instructor: Emily Bullock Yowell, Ph.D.
Anxiety Disorders PSY 436 Instructor: Emily Bullock Yowell, Ph.D.

2 ANXIETY Anxiety: An emotional state characterized by physiological arousal, unpleasant feelings of tension, and a sense of apprehension or foreboding. (text p.169) Typically a normal response but becomes abnormal when its level is out of proportion to a threat or associated with no specific trigger Anxiety Disorder: A class of psychological disorders characterized by excessive or maladaptive anxiety reactions

3 DSM-IV-TR Anxiety Disorders
Panic Disorder without Agoraphobia Panic Disorder with Agoraphobia Agoraphobia without History of Panic Disorder Specific Phobia Social Phobia Obsessive-Compulsive Disorder Posttraumatic Stress Disorder Acute Stress Disorder Generalized Anxiety Disorder Anxiety Disorder due to general medical condition Substance-Induced Anxiety Disorder Anxiety Disorder NOS

4 Anxiety Disorders to be Covered in this Class
Panic Attacks Panic Disorder with and without Agoraphobia Phobias Specific Social Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Generalized Anxiety Disorder (GAD)

5 Anxiety-Panic Panic Attack: discrete period of intense fear or discomfort in the absence of real danger that is accompanied by somatic or cognitive symptoms Panic Disorder: presence of recurrent, unexpected panic attacks followed by at least 1 month of persistent concern related to having another panic attack or significant behavioral change related to the attack Agoraphobia: anxiety about being in places or situations from which escape might be difficult or in which help may not be available in the event of having a panic attack

6 Anxiety-Panic Panic Disorder without Agoraphobia
Panic Disorder with Agoraphobia Agoraphobia without History of Panic Disorder

7 Prevalence of Panic Disorder by Gender

8 Panic Disorder Treatments
Drug Therapy-Antidepressants Cognitive-Behavioral Therapies/Treatments Self Monitoring Exposure Development of coping responses Relaxation Exercises See 6-second Quieting Exercise on pg. 230

9 Anxiety-Phobias Phobia: excessive, irrational fear
Do you have a phobia? Is it a problem for you?

10 Anxiety-Specific Phobia Criteria
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation Exposure to the phobic stimulus provokes an immediate anxiety response Person recognizes that the fear is excessive or unreasonable Phobic situation is avoided or endured with intense anxiety Phobia interferes significantly with the person’s normal routine Duration is 6 months

11 Anxiety-Social Phobia Criteria
A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. Individual fears that they will act in a way that will be humiliating or embarrassing Exposure to the phobic stimulus provokes an immediate anxiety response Person recognizes that the fear is excessive or unreasonable Feared social or performance situation is avoided or endured with intense anxiety

12 Anxiety-Social Phobia Criteria(cont.)
Phobia interferes significantly with the person’s normal routine Duration is 6 months Not due to physiological effects of a substance of general medical condition

13 Phobic Disorders Treatment Approaches Learning-Based
Systematic desensitization Fear-stimulus hierarchy Gradual exposure Flooding

14 Anxiety—Obsessive-Compulsive Disorder (OCD) Criteria
Obsessions Recurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate and cause marked anxiety or distress Obsessions are not simply excessive worries about real-life problems Attempts to ignore and suppress obsessions or neutralize them with some other thought or action Recognizes the obsessions are a product of their own mind (not thought insertion)

15 Anxiety— OCD Criteria Compulsion
Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly Behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation

16 Anxiety— OCD Other Criteria
Person recognizes Obsessions or compulsions are excessive or unreasonable Cause marked distress, time consuming (more than 1 hour a day) or significantly interfere with routine Content of obsession or compulsion is not restricted to another Axis I Diagnosis (e.g., eating disorder) Not due to physiological effects of a substance or general medical condition

17 OCD Treatments Exposure with response prevention Drug Therapy-SSRIs
Combination of drug and Cognitive Behavioral Therapy show best results for most anxiety disorders

18 Anxiety--Posttraumatic Stress Disorder (PTSD) Criteria
Exposure to a traumatic event Traumatic event is persistently reexperienced Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness Persistent symptoms of increased arousal (not present before trauma) Duration of disturbance more than 1 month Disturbance causes clinically significant distress or impairment

19 PTSD Treatments Drug Therapy-antidepressants for associated symptoms of depression and anxiety PTSD-specific cognitive-behavioral treatment protocols (often in group therapy formats) EMDR

20 Anxiety- Generalized Anxiety Disorder
Generalized Anxiety Disorder: persistent feelings of anxiety that are not triggered by any specific object, situation, or activity

21 Anxiety-Generalized Anxiety Disorder Criteria
Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities Person finds it difficult to control the worry Associated Symptoms Anxiety and worry not confined to another Axis I diagnosis (e.g., Social phobia) Cause clinically significant distress or impairment Not due to the direct physiological effect of a substance or general medical condition

22 Generalized Anxiety Disorder Treatments
Cognitive Behavioral Therapy Relaxation skills Drug Therapy-Paxil

23 Ethnic Differences in Anxiety Disorders
Evidence from a nationally representative sample of U.S. adults showed that rates of anxiety disorders were generally comparable across racial and ethnic groups.

24 Review Panic Attacks Phobias Obsessive-Compulsive Disorder (OCD)
Panic Disorder with and without Agoraphobia Phobias Specific Social Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Generalized Anxiety Disorder (GAD) -

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